Professional Development: Part 1 - Becoming an EMS Leader

 EMS needs good leaders and managers. What can you do to become one? Over the coming months, EMS Magazine will present its Professional Development series, a comprehensive curriculum for forward-thinking EMS providers wishing to improve their leadership and management skills, increase their authority and responsibility within their organizations, and change their field for the better. We welcome your comments on this series and invite you to submit ideas for future content. E-mail editor@emsworld.com.

     One of the hardest things about being promoted into a leadership position is the transition from being one of "us" to one of "them." I was first promoted in the mid 1980s when I worked for a hospital-based emergency ambulance service. One of the shift supervisors quit, and I was the one tagged "You're it!" Though I really wanted the promotion, it was hard. I loved being a street medic, and I liked the folks I worked with, but mostly it was because I knew next to nothing about leadership, management or supervision.

     The position required me to not only staff one of our ambulances, but also supervise the platoon. I had one foot in the trenches and one on the surface. It was an awkward position. I muddled through on a tightrope between learning on the job and crashing and burning. I wouldn't wish that kind of transition on anyone. Unfortunately, I have experienced that same kind of fear and disorientation more than once over the past 20 years. Fortunately, I've had mentors along the way to keep me from slamming into the ground and bursting into flames.

     Over the next several months, we'll look at skills an EMS leader/manager should develop: strategic planning, effective performance evaluation, changing behavior, delegation and professional development planning. A friend and mentor once told me that successful administrators have to be both leaders and managers. In this first article we'll examine what makes such people effective and respected.

Learning to Lead

     The first step to take as an aspiring leader/manager is to learn the rules and regulations of your organization. Second, you must be well versed in current EMS policy and practice at the local, state and national levels. Third, you must be honest with yourself about your strengths and weaknesses. You must be motivated to work hard, dedicated to personal growth and development, and have a vision for your future. You must also look out for the folks you supervise and facilitate solutions for their problems.

     These rules apply to both formal and informal leadership roles. Formal leaders are given organizational authority based upon a promotional process. Informal leaders gain authority through knowledge and experience. They become the people who can provide reliable information and answers - they have expert power. Effective leaders embrace both the formal and informal aspects of leadership. In high-functioning leaders and organizations, the formal and informal coincide - the more they overlap, the more functional the individual or organization.

     In general, leaders look outward to where they and their organization are going and articulate a vision for the future. Once you have a vision in mind, you have to share it. There are no leaders without followers. Others have to believe in and embrace your vision to follow you. They have to see the value of following; you have to be able to tell them what's in it for them.

Managing to Manage

     Just as you must master leadership, you must also master the acts of management. Managers look inward; they provide the tools, supplies and support followers need to make leadership's vision a reality. Managers must evaluate performance to recognize and reward success and strengthen weakness. Your job as a manager is to facilitate solutions to your followers' problems so they can spend their time getting their job done. Leaders inspire commitment; managers ensure compliance.

     You have to communicate effectively. This means articulating your vision, and it means listening. Authentic dialogue is a two-way process. There is a sender, a message, a medium and a receiver. To complete the communication process, the receiver must confirm understanding—the receiver becomes the sender, and vice versa. It can be hard. I have to remember to shut off my inner voice that's preparing a response or a defense, already moving ahead of the person I'm listening to. It takes practice. Be aware of that inner voice and stop it so you can concentrate 100% on what the other person is saying.

     Treat people fairly. Assess your own biases, examine yourself for prejudices and learn to overcome them. It's hard to look yourself in the eye and admit you have prejudices. It's hard to see yourself as others see you. Have you ever listened to a recording of your voice? The voice you hear on playback usually sounds different than the one you hear inside your head when you speak. You are hearing yourself as others hear you. When you see yourself on video, you see an image 180 degrees from what you see in the mirror - it's how others see you. Until you see the video, your self image and the image others have of you are not the same.

Where to Start?

     This is a lot to learn and do. It will be hard work, whether you're striving for a formal or informal leadership role, preparing for promotion or have already been promoted. The rewards are a function of effort.

     Where do you start? Become an expert in the rules and regulations. Know the protocols inside out and be a reference with good answers. Know the material, but also admit when you don't, then follow through, find the answer and get back to who asked. This goes miles toward developing credibility.

     This first installment of our Professional Development series barely scratches the surface. I hope it makes you think. I challenge you to dig deeper and to learn more. There are many books out there that address leadership and management, as well as classes to attend. The National Fire Academy, for instance, offers EMS leadership programs; its two-week Management of EMS residence program was recently updated. I recommend applying. You'll receive some formal education (ACE accredited for 3 credits) and have the rare opportunity to spend time with folks from around the country and world who are struggling with the same issues you are. The networking opportunities are invaluable. EMS conferences also offer great opportunities to network, learn from your peers and continue your professional development.

     Next time - In the next installment of this series, we'll discuss strategic planning, a process that can be applied from the highest administrative levels of an organization down to the personal, individual level.

     Michael Touchstone, BS, EMT-P, is chief of EMS training for the Philadelphia Fire Department. He has been involved in EMS since 1980 as an EMT, paramedic and instructor. He has participated in EMS leadership, management and educational development initiatives at the local, state and national levels.

Sidebar:

Shifting Out of Provider Mode

     To succeed as a leader, you must look at your job from a broad perspective. If you're a supervisor, one of the "them," you have to begin to step away from the provider's focused assessment/diagnosis/treatment frame of mind. It sounds simple to say, but a supervisor supervises. A leader leads. If you're doing the assessment and providing patient care, you're not supervising. If you're in the crowd, you're not leading. Of course you need to keep up your skills and not forget where you came from, and it's important to remember the provider's perspective, but you don't need to step on your crews' toes. Let them do their job. If you're down in the trenches doing the digging, you'll likely miss any signs the trench is about to collapse. You have new roles and responsibilities, and in "provider mode," you'll not be able to meet them.

Look Up, Down and All Around

     What new roles and responsibilities should an aspiring leader/manager seek to embrace? Start with your organizational rules and regulations, your SOPs/SOGs—there are likely job descriptions to reference. Ask your boss what he or she expects of you. Ask your peers what they think. Finally, ask the people you supervise what they need and want. This is essentially a 360-degree survey, which can be valuable in understanding what to do to succeed. It will also help you demonstrate and earn respect.

A Selection of EMS Management and Leadership Resources Organizations, Associations

• National EMS Management Association (NEMSMA), www.nemsma.org

Classes, Courses, Certificate/Degree Programs

• National Fire Academy EMS management and leadership courses, www.usfa.dhs.gov/nfa/
• AAA/Fitch & Associates Ambulance Service Manager program, www.fitchassoc.com/ASM_Ambulance_Service_Manager.html
• Association of Air Medical Services Medical Transport Leadership Institute, www.aams.org
• Colorado State University EMS Management course, www.learn.colostate.edu
• Cowley College (KS) EMS Leadership degree program, www.cowleycollege.com
• Eastern New Mexico Univ. EMS Management program, https://business.enmu.edu
• George Washington University EMS Management degree program, www.gwumc.edu
• Johns Hopkins University Fire/EMS Executive Leadership program, https://psl.jhu.edu/programs/felp/
• Maryland Fire-Rescue Institute EMS Officer I course, www.mfri.org
• Springfield College (MA) EMS Management program, https://www.spfldcol.edu
• Texas Engineering Extension Service (TEEX) Emergency Services Training Institute (ESTI) EMS Leadership Academy, www.teex.com/ems
• University of Florida Executive EMS Officer certificate, www.distancelearning.ufl.edu
• University of Maryland-Baltimore County Dept. of Emergency Health Services EMS Leadership/Management courses, https://ehs.umbc.edu
• UNC-Charlotte Management Institute for EMS, www.continuinged.uncc.edu/ems

Conferences

• EMS EXPO, publicsafetyevents.com
• Pinnacle EMS Leadership Conference, www.pinnacleems.com
• South Carolina EMS Leadership Conference, www.scemsleadership.com

Books, Publications

• Brophy JR. Leadership Essentials for Emergency Medical Services. American Academy of Orthopaedic Surgeons, pub. Mar 2009.
• Emergency Medical Services Management and Leadership Development in America: An Agenda for the Future. National EMS Management Association, 2008. www.nemsma.org.

Related:

• Professional Development: Professional Development: Part 2 - Strategic Planning