District Chief Justin Sypolt shares insights in retaining EMS employees by using simple tips to create a more welcoming environment.
EMS staffing is in a state of crisis. It has been and it will be. That is, unless the mentality of leaders within the field changes to better understand the next generation of EMS professionals and why it is that these folks are abandoning agencies and a field they once loved.
If your own employee roster doesn’t convince you, a quick search on the internet will populate dozens of articles and news stories reporting on EMS staffing woes. Staffing issues are not unique to EMS. There is a widespread issue which some are calling the “Great Resignation.” Interestingly, the phenomenon also been deemed the “Great Renegotiation” as employees are considering their own value and values while leaving current positions to search for jobs that create more personal fulfillment, promote a work-life balance, and recognize employee contributions to the workplace.1
The proposed solution thus far has been a major focus on recruitment efforts in many fields. Some systems offer wages for nurses and paramedics that have never been seen before. Conversely, some agencies are having trouble competing with unskilled, or low-skilled jobs that are offering higher wages for positions that also offer little or no mandated overtime, less responsibility, controlled work environments, decreased risk of exposure to diseases such as COVID-19 and a lower chance of developing post-traumatic stress disorder. Considering all of that, how can we find a way to reduce the hemorrhaging of providers from our ranks?
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Simply put, do what we do? Search for the reversible causes, or as ACLS would have us remember, review the Hs and Ts.2
To develop a solution to the problem of employee engagement and retention, we must first evaluate what is causing employees to leave their positions and or fields of work in general. People have now realized their longing for purpose is greater than the desire for a paycheck. A validating article by the Harvard Business Review (HBR) provides that workers have now begun to question the value of their work and the sense of meaning it provides them.3 HBR references recent research by McKinsey and Co., citing the top two reasons that employees have left or are considering leaving their jobs is because they didn’t feel their work was valued by their organization or they lacked a sense of belonging at work.4
Money or happiness: which is more valuable? John Wright, the manager of Quality and Standards at Sussex County EMS in Delaware gave me his perspective in an interview by proclaiming: “I don’t care how much you pay people, if you treat them poorly, they are going to leave.”5
Wright touches on what so many other EMS officers overlook, the value that individuals place on their treatment and their satisfaction in the workplace which cannot generally be quantified or monetized. Wright also suggests that developing an organizational culture of engaging employees at all levels to participate in the core functions of the department which breeds job satisfaction and permits higher level executives an opportunity to communicate openly with all levels of personnel about what is good and what is bad within the agency. It also allows for open discussion about the strategic goals of the agency in general and gives ownership of those goals to all personnel, not just the ones at the top.
Another human resources leader, Cathy Guthrie, put it bluntly: “If you’re happy, you’re not even looking at other jobs.”6 A simple and straightforward thought, but how do we gauge the overall happiness of our workforce? Happiness is to the individual what morale is to the organization. So, while it may not be possible for leaders of larger organizations to know the intimate details of every employee’s life, leaders must engage their front-line supervisors and labor leaders to gauge the levels of morale in the department.
It is up to us, the incoming generation of EMS leaders, to solve the problem. We’re in the second half of the resuscitation, we have tried what we thought worked, we have assessed the situation, acquired some background information, and recognized that current treatments are not working, what do we do now? You guessed it, let’s review the Hs and Ts, but this time, of EMS leadership.
Honor Your People
An article titled Millennials Work For Purpose, Not Paycheck tells us millennials want fulfillment at work and are “constantly seeking purpose in what they do.”7 People search for honor in their work. Professionals today want to know that what they are doing matters. In EMS, I doubt that many would argue that the work is not honorable. What could be more honorable than saving a life, or bringing a new one into the world?
So, why are we so bad at honoring the people who do it? How do you honor them? Did you just mutter “with a paycheck” under your breath? Do you pop out of the office during EMS Week to hand out a few awards only to see your shadow and retreat for another year like Punxsutawney Phil? Let your team know that what they do really matters.
Hold People Accountable
Honor good employees by holding the bad ones accountable. Demand excellence. That means you too. As a leader, you are accountable to your people even though they may not have voted you into Chiefdom. You owe it to them to be the best that you can be. Hold your officers accountable for their part. Are they holding their subordinates accountable for their actions or are they playing “good cop?” People generally want to be part of something great and good people are ruined quickly when under performance is permitted or even promoted. Holding people accountable, at all levels, lets your team know that the success of the agency is everyone’s mission.
Humility
John Wright described an environment where chief officers engage employees of all levels to participate in core functions of the department. The action recognizes the equal importance of all personnel within an organization. Leaders must recognize that all personnel have a vested interest in the success of the organization and should be able to participate in core functions, such as strategic planning for the future and defining the mission of the agency. To lead is to serve. Leaders must realize that no part is greater than the sum and maintain a fervent desire for the success of the team. Becoming a chief officer is not the finish line, it’s the starting point of what should be your life’s greatest work.
Human
Just today, I had to mandate an EMT to cover an overtime shift; one that he did not want to work. My partner explained, “Hey, it’s extra money.” The EMT replied: “I have enough money. I want to be with my family.” As leaders, it must be recognized that you hired people to do God’s work. These people have families, hopes, desires and dreams that don’t necessarily involve the back of an ambulance. Once you get that nice cushy office job, you can’t forget that some people still work weekends, nights, and holidays.
At your dinner table, think of the other house that has an empty seat where mom or dad should be if they weren’t riding the bench. If right now you are thinking “I paid my dues,” or “get some time on the job,” you are the problem. When people are thought of as a number instead of a person, they will rapidly lose interest in giving you what you are so ready to take, their time.
Honesty/Truth
Does your team know what the mission and values of the agency are? Have you shared the strategic plan? Is there one? Be open and honest with your team about the mission of the agency and the direction it is heading. Let them know what you expect of them and what they can expect of you. Create an environment where you and they have no question about the agency’s vision or values and ensure they are adhered to.
Trust
I don’t mean trusting that the few bucks you left on the table when the tones dropped will be there when you get back. I mean, do you and your team mutually trust that you have each other’s best interests in mind? Do you have an open door policy, but nobody comes in? As a leader you must create an environment where your team can trust you enough to come to you with problems, even if you are the problem.
Teams must be able to openly discuss and even debate agency problems without the fear of reprisal. Does your team trust you to support them on all fronts and to work to achieve the mission of the agency? Do they trust you to hold them accountable for their actions? Do you trust them? Try assigning responsibilities to personnel in lower ranks. Just because they don’t have a gold badge, doesn’t mean they’re incapable. What you achieve together can surprise you.
Team
Many, if not all, leaders will say when asked that their employees are their most valued asset, but their actions tell another story. A friend and colleague explained the problem to me in this way; “We are the players, we’re out here doin’ it,” he said, “and you all are the coaches. We are supposed to be a team.” As a coach, it is your job to make sure your team has what they need to succeed. Whether that is training, equipment, or a moment to decompress. Build the team mindset, we are stronger together. My soon to be seven-year-old son reminds me regularly, “teamwork makes the dream work.” If he can figure it out, you can too.
Them
Sorry chief, it isn’t about you. It’s about them – your team, your community, your patients and their families. Show them that you truly care about them and their wellbeing. Make the effort to show your people that you care, send them a birthday card, recognize their years of service and their personal achievements. Show the community you care about them by working with community leaders on public health initiatives. Show patients you care by maintaining a professional and empathetic workforce, be willing to hear their concerns and share the ways you plan to address them. The first step to solving your agency’s problem is admitting that you have one. Be honest with yourself and your team. Admit that you can do better. It’s not meant to be easy, nothing worth doing is. Stay humble, it isn’t about you, it’s about them. Honor your people when they do good and hold them accountable when they do not. Provide them with what they need to succeed. Have trust in your people and strive to earn theirs, they will thank you with their loyalty and willingness to go above and beyond for the team.
References
- Rosalsky, G., “The Great Resignation? More like The Great Renegotiation”, NPR, 25 Jan 2022., www.npr.org/sections/money/2022/01/25/1075115539/the-great-resignation-more-like-the-great-renegotiation, Accessed 10 Feb 2022.
- “What Are The H’s and T’s of ACLS,” American Medical Resource Institute, www.aclsonline.us/hs-and-ts/, Accessed 24 April 2022
- Cook, I., “Who Is Driving the Great Resignation,” Harvard Business Review, 15 Sep 2021., hbr.org/2021/09/who-is-driving-the-great-resignation, Accessed 8 Feb 2022.
- De Smet, A.,Dowling, B., Mugayar-Baldocchi, M., Schaninger, B., “Great Attrition or Great Attraction? The choice is yours,” McKinsey Quarterly, 8 Sep 2021., www.mckinsey.com/business-functions/people-and-organizational-performance/our-insights/great-attrition-or-great-attraction-the-choice-is-yours?cid=soc-web, Accessed 9 Feb 2022.
- Wright, III, John., Interview by phone. By Justin Sypolt. 4 Feb 2022.
- “This is Why People Leave Your Company”, First Round Review, review.firstround.com/This-is-Why-People-Leave-Your-Company, Accessed 11 Feb 2022.
- Moore, K., “Millennials Work For Purpose, Not Paycheck,” Forbes Magazine, 2 Oct 2014., www.forbes.com/sites/karlmoore/2014/10/02/millennials-work-for-purpose-not-paycheck/?sh=3ce2f89b6a51, Accessed 11 Feb 2022.
