Traditions & Ceremonies in EMS

Traditions can be very powerful. Some, like Thanksgiving, are embraced by an entire society. Others shape images and public perceptions, like those of military institutions and our colleagues in fire protection and law enforcement.

EMS, by definition, is very young. Modern EMS began in the 1960s, so the early organizations are at most 40-some years old. Because most EMS agencies in the United States today have a short history, they lack tradition and ceremony. It is time for the EMS community to acknowledge the importance of tradition, both within the service and as part of what it presents to the community at large.

Traditions are beliefs, customs and practices taught by one generation to the next. A ceremony is an activity infused with ritual significance and performed on a special occasion.¹ Many EMS agencies struggling to survive think they are too young to have traditions and don't have time for ceremonies or organizational special occasions. That just means no one has taken time to attend to these concepts.

For the past decade, EMS agencies have struggled to recruit and retain members, both paid and volunteer. One issue that comes up repeatedly when talking about careers in EMS, particularly with those individuals who are contemplating leaving EMS for the fire or police services, is the lack of an "organizational culture" or sense of brotherhood. They see EMS agencies as not committed to their people, thus not inspiring loyalty in return. EMS becomes a "McJob" that fills space and time until something more meaningful comes along. This tells me EMS leaders haven't recognized the importance of making their personnel feel special, and they've overlooked the need to celebrate the organization's successes and special occasions. Making members feel as though they are a part of something special adds to a sense of belonging that may contribute to improvement in organizational stability and member longevity.

Developing and, more important, maintaining ceremonies and traditions takes effort, but beyond the time involved, the little it costs is well worth paying to produce benefits both inside and outside the organization.

SWEARING-IN

Many organizations and professions like the military, law enforcement and the fire service use swearing-in ceremonies to mark the induction of new members. While your EMS agency might not be required by law to administer an oath, there is generally no bar to doing so. Even private organizations can ask new members to pledge to support the mission, vision, values, goals and rules of the new employer. This activity carried out in the presence of VIPs, friends and family forms a lasting impression on both new and old members who participate. It conveys a sense of personal and organizational commitment, pride and professionalism.

PROMOTIONS

Promotions are similar cause for celebration. Organizations celebrate the appointment of new leadership, and the individual promoted celebrates his or her professional achievement. Morale and esprit de corps are enhanced by publicly recognizing the event. Since most agencies provide some sort of regalia (badge, insignia, different color helmet) upon promotion, presenting them forms a logical basis for a simple ceremony. In community-based organizations, election of new leadership is often associated with a banquet or other ceremony. From the newest member to a new officer or chief, having a loved one or a respected colleague "pin on" the badge or insignia of a new position is a moment of pride and appreciation for the person being recognized.

RETIREMENT

The retirement of a serving member is a special occasion that presents a number of opportunities for the organization to recognize the member's service, both formally and informally. The agency can present the retiring member with mementos of service (shadow boxes with badges, patches, and awards), plaques and certificates of appreciation. Social events provide an informal opportunity to gather, eat and perhaps "roast" the retiring member.

ACHIEVEMENTS

EMS providers commit acts worthy of recognition every day. Unfortunately, most of us (line medics and leadership alike) don't pay as much attention as we should to recognizing the achievements of our agencies and our people. Celebrating our successes, like saving lives and other meritorious acts, is an activity worthy of investing our energy.

At Wake County EMS, one highlight each year is the Cardiac Arrest Save Celebration. Members of the EMS system (9-1-1 telecommunicators, first responders and EMS medics) gather with government leaders and family members of people who have been successfully resuscitated for an evening of celebration and recognition that people who would otherwise have died walked out of the hospital to spend additional time with their loved ones. It's a full evening, with music provided by the Wake&District Public Safety Pipes and Drums, presentation of colors by a joint fire-EMS honor guard, guest speakers (including a survivor), and presentation of the coveted red and white commendation bar that indicates participation in a successful resuscitation.

REMEMBRANCES

Whether or not an organization has lost a member in the line of duty, it is appropriate to remember those who have given their lives in service to others. A remembrance can be as simple as a moment of silence announced by radio or a gathering at a memorial site. An agency may wish to conduct its remembrance on a date and place of special significance, or concurrently with the National EMS Memorial Service events.³

At its annual awards banquet (itself a celebration of achievement), the National Association of EMTs takes time just before dinner for a moving "Table of Honor" ceremony to remember those who died in the line of duty.

Funerals and memorial services are special forms of remembrance conducted immediately following the death of a member in the line of duty, for which every EMS agency should be prepared. EMS funerals often include "last call" ceremonies to say farewell to a fallen member. While the first concern of the agency should be the care and support of the family of the deceased, the agency's personnel must be afforded an opportunity to say good-bye and mourn the loss of their comrade. In areas served by numerous small agencies, preparation for a line of duty death might be a good project for the regional chiefs' association or regional EMS council.

CELEBRATIONS

Every organization has a birthday or day the service was initiated. Why not take time to celebrate the organization on that day? The Marines celebrate the founding of the Corps at Tun Tavern on November 10, 1775 (yes, the Marine Corps was founded in a bar).² The first celebration, not held until 1925, has grown into an anniversary event celebrated by Marines no matter where they are in the world.

Most EMS agencies don't have to dig very far to find out when they were first chartered, when they ran their first call, or some other significant event.

HONOR AND COLOR GUARDS

Participation in community celebrations and ceremonial occasions of other organizations is another opportunity for an EMS agency to present a positive professional face in the community.

The "colors" or flags of organizations are a symbol of an organization's unique identity and its loyalty to and alliance with other organizations. Uniformed organizations "on parade" typically are led by a color guard carrying the flags of the nation and state to which they belong, along with the organization's flag. This practice is similar to the opening ceremonies of the Olympics, where each team parades into the stadium, led by an honored and distinguished athlete carrying the nation's flag.

A number of EMS agencies have formed color guards as part of their department's "honor guard"--an organization with a broader focus than a color guard. The color guard, sometimes accompanied by a marching contingent of the organization's members or a group of vehicles on display, makes a very positive and lasting impression at community parades held to celebrate national holidays or other special occasions. In one short interval last year, the Wake County EMS color guard was called on to "present colors" for the swearing-in ceremony of the newly elected Board of County Commissioners. As a result of that appearance, they were requested by the local federal judiciary to present the colors at a naturalization ceremony where the oath of citizenship was administered to some 40 new Americans.

The "honor guard" is a group of individuals specially trained to perform the duties of the color guard, plus other ceremonial functions. Perhaps the most important duty of an honor guard is to provide support to the funeral of an organization member who has died in the line of duty. Other roles include flag ceremonies, escorting dignitaries and families at formal functions and assisting other organizations in times of tragedy or celebration.

Some honor guards have developed distinctive uniforms to facilitate their unique functions. This is not essential, however. Well-known and highly respected honor guard units like those of the U. S. Marine Corps make their presence known through flawless presentation of their organization's basic uniform.

Developing an honor guard is not a difficult process, but it will require leadership. Perhaps the most challenging aspect for the agency leadership is identifying a member to head up the effort. Fortunately, most EMS organizations have in their ranks individuals with some relevant (perhaps military) experience or willingness to learn. Most communities have law enforcement, fire or military members with experience and expertise who are willing to assist in developing a fledgling honor guard.

Organizational support is required. If the organization does not currently have a dress uniform that can be used as the basis for the honor guard uniform, they can start with a modified class A uniform, adding a long-sleeved shirt, necktie and cover (hat) to the standard uniform. Other accoutrements, including flags, poles, carriers and white gloves are easily obtained. The most challenging aspect of organizational support is flexibility. The need for honor guard services is often unscheduled. The death of an agency or allied agency member will require the agency to free honor guard members from their regular duties to fulfill honor guard functions.

SUMMARY

Traditions and ceremonies don't just happen on their own--they require vision and effort. When honor guard services are required, it is too late to think about getting one organized. Advance preparation and training are necessary if a ceremonial unit is to accomplish its mission in a manner that brings credit to the organization. A wise EMS leader will scan the environment and seek out opportunities to develop the capabilities, nurture traditions and arrange ceremonies that will contribute to organizational morale and support the achievement of the organization's mission.

SIDEBAR: "Just Because" Celebrations

It can be as informal as an annual "pig pickin'" in a park (that's a North Carolina term for a picnic organized around a delicious barbequed porker prepared over a grill, with cole slaw, green beans, potatoes and other food and drink), or as formal (and just as much fun) as the miltary's traditional "mess night" or "dining in," where members gather in formal attire for an evening of food and fellowship adhering to the customs and traditions handed down through generations of military personnel. For an amusing look at "dining in," see www.usmc1.us/usmc_mess_night.html, https://www.military.com/features/0,15240,89349,00.html, and https://afmentor.com/ceremony/diningin-out.htm.

The Special Operations Medical Association (www.trueresearch.org/soma/) has a formal Mess Night at its annual conference, at which the wearing of formal attire is prohibited. Law enforcement agencies and their associations have a long history of holding dinner dances to recognize police officers and raise funds for worthy causes (www.austinpolice.com/ball.htm).

SIDEBAR: Widely Recognized EMS Honor Guards

City of Boston EMS Honor Guard*

City of Pittsburgh EMS Honor Guard*

City of Cleveland EMS Honor Guard*

Detroit Fire Department EMS Honor Guard

Forsyth County (NC) EMS Honor Guard

Louisville Metro EMS Honor Guard*

Manatee County EMS Honor Guard

North Shore-LIJ Health System Honor Guard*

Maine

Minnesota Ambulance Association Honor Guard

Sedgwick County (KS) EMS Honor Guard

Sussex County (DE) EMS Honor Guard*

St. Charles County (MO) Ambulance District Honor Guard

Wake County EMS Division Honor Guard*

*National EMS Memorial Service Honor Guard participants

REFERENCES

1. https://en.wikipedia.org/wiki/Ceremony.

2. www.usmcpress.com/heritage/usmc_heritage.htm.

3. https://nemsms.org/silence.htm.

Skip Kirkwood, MS, JD, EMT-P, EFO, CMO, is chief of Wake County EMS in North Carolina and is a member of EMS Magazine's editorial advisory board.