This month’s EMS Dashboard Confessional comes from a supervisor in a third-service EMS department.

I was the on-duty supervisor for our EMS agency with the headache of crew assignments and assuring the system was functioning. I was also given the “blessing” of sorts of having the dedicated supervisors vehicle at my disposal.

The shift was nothing special but what happened next will always stay with me – the Director came downstairs to the supervisors office and asked me for a ride to one of our local hospitals for a pre-planned meeting. As we pulled out of the building, he looked down, cursed and then said “ok, turn on the lights and sirens, I am running late.” I said no, knowing full well that this would anger him but also knowing that of anything occurred on the way to the meeting, he would rapidly disavow knowledge of asking me to turn on the emergency warning devices. He looked at me and said “fine, I will remember this”

This experience taught me a few things – not the least of which was that we, as leaders, need to assure our behavior is above reproach and always in line with our policies and procedures. How would if have looked to any of our crews had they seen this? Any time a leader takes a “do as I say, not as I do” attitude, it does not bode well for them.

This month’s EMS Dashboard Confessional comes from a lead paramedic in an EMS-only system.

I was a lead paramedic in an organization but not actually a supervisor with supervisory authority. We were the eyes and ears of management, and could troubleshoot issues on-shift, but we could not “write someone up” when they did something wrong. Our job, when something reached that level, was to document the issue in our shift report.

I had someone on my shift who was constantly late for work. At one point, he was late several times in a row, so I confronted him and told him that I was going to “write him up” for his conduct. What I meant was that I was going to include this in my shift report, but he interpreted it as a threat to discipline on him.

He went to my boss and said that I had exceeded my authority, which I didn’t since I wasn’t giving him a written warning, but after talking to my boss I understood how I sent the wrong message. The thing was that I wanted to change his behavior, and at the time, the only thing I could think to do was threaten him with discipline. What I learned from this is that instead of going immediately to threats to change behavior, I should have looked at what might have been causing him to come in late and how we could find a good solution to the problem. This is especially important considering I didn’t have the actual authority to follow through on my threat!

As moderator of this blog, I think it’s important that we remember we have numerous tools in our leadership toolbox. Coercive power, or threatening, has a time and a place but probably should not be the first thing you reach for. Rather than using fear, we can start with problem-solving, shared vision, and inspiration.

However, it’s just as important to remember that even if you do have to resort to coercive power, consider if this is a hill you want to die on. If you were exceeding your authority for a life-safety issue, or some other mission-critical concern, then risking exceeding your authority has good justification. But it’s hard to go to your boss and explain that you simply HAD to do this because someone kept coming into work late.

This month’s EMS Dashboard Confessional comes from a hospital-based manager, and speaks to the human dynamic of leadership.

While in an operations leadership role in a hospital system that attempted to merge EMS services from several individual hospitals, I found myself faced with a dilemma when the system decided to stop the initiative of integration.

This decision left employees scrambling for positions because they were floating and working for hospitals where they were technically not employed. Many employees were upset about returning to their home hospital since they had found working in different geographical locations, and with different partners, made their job more enjoyable. Emotions were running high from both the staff and for the leadership.

The Director and I were called to the President of the hospital and were shown a letter from a local public safety leader that was submitted to encourage our hospital to find a way to keep a list of specific employees that were not employed by our hospital. The letter blindsided the Director and myself. as we had just completed a staff meeting directing all employees to return to their home hospital site and then we would sort out switches/swaps for requesting changes.

When we returned to our office, we immediately picked up the phone and called the staff members who we felt had orchestrated the letter. When the employees answer their cell phones, we immediately launched into our narrative about being blindsided. This caused even more emotional instability, as well as potential safety issues because we never asked if people were in a place to hear the news, or what they were doing, before we started talking about OUR point of you. Some employees were actively driving, and one was in the process of medical treatment with a loved one. Our emotions got the best of us and we led in a way that was not proactive.

The experience taught me the act of mindfulness and importance of checking in with whomever you are approaching to discuss a conflict. This could be a student, employee, subordinate or a boss. Having the wherewithal to take a deep breath, check in with the other person to see how they’re feeling before beginning my own narrative has changed my leadership style and definitely improved the respect I receive from people who work for me, with me, or beside me. Similar to holistic medicine, this is an example of holistic leadership, which promotes treating the employee from a physical, mental, and spiritual approach and thus allows for enhanced communication.

“This is a great example of progressive EMS leadership,” says Anthony W. Minge, Ed.D, Partner at Fitch and Associates. “This leader identified a starting point that was not centered around the staff, but rather was directed inward at his or her feelings. Recognizing that it may not be ‘about you’ and that other dynamics may be at play is critical for an effective servant leader.” Anthony leads the Ambulance Service Manager and Communications Center Manager programs for Fitch, and is co-chair of the Pinnacle EMS Leadership Forum.

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This month’s EMS Dashboard Confessional comes from an experienced executive working in a hospital-based agency. I am a big fan of getting stakeholder input before making critical decisions, but sometimes there is a downside:

“Some years back, we needed to replace our cardiac monitors and had secured capital to purchase about 50 of them – not a small purchase. Wanting to be inclusive, I stood up a committee to review products and asked the group of about 10 opinionated paramedics to make a recommendation.The group met multiple times and had spirited and thoughtful debate about what they thought would be the monitor best for our agency. After a time they made a unanimous recommendation that we should buy brand X. 

When I was ready to move forward with the purchase, I went to hospital management and ask them to place the order. To my dismay, I was told that our parent organization had an exclusive contract with the maker of brand Y, and I was not allowed to purchase outside that contract. With great regret I had to go back to the committee with my tail between my legs and explain that I never actually had the authority to authorize what I had asked the committee to do. It was painful, and it took me months (if not longer) to regain their trust. Moral of the story – understand your level of authority, and if you can’t accept someone’s opinion and/or recommendation, don’t ask for it.”