From the Officer’s Desk: Trust

One fundamental value that must be woven into any organization’s DNA is trust. Without trust a positive organizational culture is difficult to achieve, strategic execution is nearly impossible, and patients may develop doubts about your ability to deliver quality emergency medical services.

Organizational trust is the confidence employees place in their organization and each other. Why is it important? In the January 2017 Harvard Business Review, Claremont professor Paul Zak wrote: 

“Compared with people at low-trust companies, people at high-trust companies report 74% less stress, 106% more energy at work, 50% higher productivity, 13% fewer sick days, 76% more engagement, 29% more satisfaction with their lives, and 40% less burnout.”

Maintaining Trust Between Employees and Leadership  

Trust begins to take shape as a positive relationship between two parties grows. Therefore, trust and positive working relationships go hand in hand. It is difficult to have one without the other, but neither can happen immediately. The EMS officer must understand that trust will come with time as they build history and rapport with their direct reports.

If establishing trust proves a challenge, it may be the result of several things. For example, an employee may not have had enough time to get to know their officer; the officer may demonstrate poor professional decisions and/or behavior; or they may not show they support their team members in the work they do.

For officers working to establish relationships with the goal of building trust must begin with demonstrating good moral and ethical character. In addition, the EMS officer must demonstrate empathy and that they care about each of their team members. They must be able to clearly articulate their expectations to ensure their direct reports know what is expected of them on a consistent basis.

Psychologist Bruce Tuckman defined 5 general stages of group development: forming, storming, norming, performing, and adjourning. To get to the performing stage, a group must first go through the norming stage—creating ways for members to function together. This is where relationships and trust are developed. These build over time when both parties see each other staying true to their actions and commitments and are reinforced with each positive exchange.

Maintaining Customer Trust

Customer trust is essential for any organization and certainly for the emergency medical services. While it’s built much the same way as departmental trust, the trust of customers is lost when the service delivered is not what is promised. This can occur in many ways—for example, with delays in responses to calls for help or when a condition is misdiagnosed or the wrong treatment given, resulting in a bad outcome. And trust can be lost when organizations don’t seek or appear to not care about customers’ input.

If that trust is damaged, you can rebuild it with an approach similar to the one used internally. Foster relationships between the customers, community members, and the organization. Deliver what you promise. Be transparent—own up when things go wrong. Trust can be fractured if customers believe an organization is hiding something. Ask for feedback after interactions.

As filmmaker and entrepreneur Dhar Mann said, “Trust takes years to build, seconds to break, and forever to repair.” The EMS officer must not only be prepared to establish, foster, and sustain trust but also to work at keeping it, especially when things aren’t going well. 

When Times Are Tough

EMS officers will face many challenges throughout their careers. Tough times also challenge relationships. There are several things EMS officers can do to help navigate such periods.

• Realize that you will make mistakes. How you recover from them will shape your relationships with direct reports.
• When you make a mistake, own up to it and apologize.
• Seek feedback and listen closely to the concerns of those affected.
• Be honest and transparent. Explains decisions and steps to correct problems, how they will work, and then follow through.
• Always lead by example.
• Be patient—establishing, maintaining, and regaining trust takes time.

Neither employees nor customers will buy into your organization’s mission if they don’t trust you. Foster the ongoing relationships needed to develop and sustain that trust.

Orlando J. Dominguez, Jr., MBA, RPM, is assistant chief of EMS for Brevard County Fire Rescue in Rockledge, Florida. He has more than 30 years of EMS experience and has served as a firefighter-paramedic, flight paramedic, field training officer, EMS educator, and division chief. He hosts the EMS Officer Exchange podcast; has authored 2 books, including EMS Supervisor: Principles and Practice; and is a certified Lean Six Sigma Black Belt. Follow him at @ems_officer.