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The Art of EMS
by Steve Whitehead

5 things great EMS supervisors do differently

Regardless of sizes, genders and personality types, great EMS leaders tend to master these five traits

By Steve Whitehead

Updated on 5/22/14

If you’ve been in EMS for more than a few years, you’ve possibly been considered for a supervisory position. In some EMS organizations the opportunities for promotion can come surprisingly fast, especially if you are good at being an EMT or paramedic.

For some reason we believe that being good at the job is a strong predictor of success at the supervisory level. It isn’t true, but the belief is persistent.

If you are a standout or strong performer in the back of the ambulance, you’ve probably already been approached with the suggestion, “Have you ever thought of promoting to supervisor?”

EMS supervision is a tough job. The years I spent as an EMS supervisor were not my favorite years in EMS. They were often lonely and filled with conflict.

I didn’t like being the bearer of bad tidings, or being a sounding board for a seemingly endless stream of gripes and complaints about the operation. I wasn’t used to people questioning my credibility and worst of all, I missed transporting patients to the hospital.

What my years in the supervisor vehicle did give me was a profound respect for people who are good at leadership in general, and EMS leadership in particular. Supervisors are tasked with the continuous monitoring of the system, deployment and resource utilization, while also looking after their employees’ welfare and well-being.

It’s a tough job.

Some do it very well and some … not so well. Since I left my supervisor vehicle for new horizons, I’ve made some observations about what good EMS leaders do consistently well. There is no single model of leadership that always works.

Great leaders come in all sizes, genders and personality types. Regardless of who they are, great EMS leaders tend to master these five traits.

1. Build up the weakest members of the team

On every EMS supervisor’s team, there will be several poor performers. Some individuals will be low performers because they are burned-out or disengaged.

Some will have knowledge deficits and some will need skills improvement. Some will lack experience. Some will have too many bad habits.

For many leaders, these individuals will be identified as the “problem children,” the proverbial thorns in the supervisor’s side. Many leaders will decide that the best course of action is to somehow weed these individuals out.

Great EMS leaders will labor to discover the proper way to build these people up. They will ask themselves, what kind of support does this individual need from me to become better at what he does?

Great EMS leaders make their charges better at what they do. They build people up.

2. Listen intently with a desire to understand

Just about any leadership book will mention the importance of listening. Stephen Covey called it seeking first to understand before being understood, and John Maxwell called it the law of connection.

It’s nearly impossible to find a well-known leadership tome that doesn’t espouse the importance of listening. But good leaders don’t just listen, they listen differently and people sense the difference.

When you are frustrated about something or attempting to convey an idea, have you noticed that you can tell the difference between a person who is listening with the intention of understanding and someone who listens long enough to begin formulation a response? When you are listened to by someone who genuinely is seeking to understand you, it feels different.

That’s the way good leaders listen. When they interrupt, it’s usually to check their understanding of your words. When they respond, it’s often with clarifying questions or a rephrasing of your ideas and feelings. Good leaders listen completely.

3. Keep private feedback private

Great supervisors have a way of saving their feedback for the appropriate time. They treat performance feedback as sacred ground. You’ll never hear a really good supervisor bad-mouth another individual in a public forum, or in a private conversation when the individual in question isn’t around.

When folks are recognizing and criticizing another member of the team, it’s tempting for someone in a leadership position to want to affirm that feedback. The temptation is a desire to let people know that you also recognize poor performers or disengaged members of the team. The desire is to send the message, “I know about this. I’m on top of things.”

Participating in negative observations only serves to undermine team trust in their leader. Once a leader has crossed the line and participated in employee bashing (constructive or not) they have sent the message that negative performance feedback is not sacred. Team members want to know that, if their turn comes to be the subject of the rumor mill, their supervisor isn’t going to participate in airing the dirty laundry.

4. Communicate challenging expectations

Subordinates don’t want to feel that making the right choices is a guessing game. They want leaders who are clear about their expectations. Most folks will work hard to meet even the most challenging of expectations. But they need to have those expectations communicated clearly.

Poor supervisors wait for people to fail to meet expectations and then they point out the failure — or they point it out to others. Great leaders communicate their expectations clearly and then motivate others to perform to a high standard. They do so daily, using the most powerful tool available.

5. Lead by example

Leadership by example is the most difficult aspect of leadership. It is difficult because it challenges those in leadership positions to maintain their own high standards every hour of every day. Once a leader falls short of the standard just once, it gives everyone permission to disregard the standard.

If a leader expects others to look professional, her uniform needs to be impeccable every day. If she expects subordinates to show up to work early, she needs to be even earlier.

If he demands a rig checkout be completed every shift, the supervisor unit needs to be perfectly stocked. If he expects fast turn out times, he needs to run when the tones go off.

Leadership by example touches every aspect of an EMS leader’s job. Great leaders embody the high standards that they demand. And for that reason, they are respected.

In all areas of human endeavor, there are those who lead well and those who lead poorly. EMS is no exception. We have our share of great leaders and poor leaders.

If you are aspiring to a leadership position or if you are currently in a leadership role in your organization, good leadership can be learned. It’s never too early to begin growing your influence and practicing your leadership skills.

What things do you feel are essential in an EMS leader? Leave us a comment and let us know.

About the author

Steve Whitehead, NREMT-P, is a firefighter/paramedic with the South Metro Fire Rescue Authority in Colo. and the creator of blog The EMT Spot. He is a primary instructor for South Metro's EMT program and a lifelong student of emergency medicine. Reach him through his blog at or at
The comments below are member-generated and do not necessarily reflect the opinions of or its staff. If you cannot see comments, try disabling privacy and ad blocking plugins in your browser. All comments must comply with our Member Commenting Policy.
Chris Winkelmann Chris Winkelmann Tuesday, March 11, 2014 3:19:34 PM Great read
Michael Deering Michael Deering Tuesday, March 11, 2014 5:39:37 PM I agree Chris, this was really a great read. I also think that to be a great leader you must also be a great follower. Also, don't ask or make your crew do anything that you would not do. Be there for you crew, take care of them, listen to then when they are having problems. Get to know them, by doing this, it may be easier to help and lead them. Find out their strengths and see if they are willing to help you in helping the poor performance people. Try to do things to help the moral of your crew and don't just sit behind a desk barking orders.
Joseph Skydawg Clem Joseph Skydawg Clem Wednesday, March 12, 2014 9:43:14 AM Excellent advice!! ...Been there, done that!
Rodger Kirtner Rodger Kirtner Sunday, March 16, 2014 12:15:04 PM Excellent article !
David Newton David Newton Sunday, March 16, 2014 1:20:35 PM Good Job!
Skip Kirkwood Skip Kirkwood Sunday, March 16, 2014 5:34:10 PM Everybody says "Being a great medic doesn't mean that you will make a good supervisor." That is a true statement - but it leads to some wrong conclusions. Being a bad medic will not make you a good supervisor - in fact, it will keep you from ever being a credible supervisor with the good medics. If you haven't met their standard, they won't "follow" you as a leader - at best they will tolerate you. To be accepted as a leader, you MUST be seen as competent in the core competencies of a paramedicine first. That competence will not make you a leader, but lack of it will prevent you from becoming a leader. Strive to be a good medic - then learn the leadership stuff! It's not that hard - be honest, take care of your people before you take care of yourself, and don't ask people to meet standards that you can't, or haven't, met yourself. If your whole focus is helping your people be successful, you'll be half way there!
Alana Cameron Brown Alana Cameron Brown Sunday, March 16, 2014 5:49:24 PM Excellent points. Thanks for putting this out there. So many people never figure out why they are not promoted...
Rick Trask Rick Trask Sunday, March 16, 2014 7:29:05 PM There is an old saying. hose who can, do. Those who can't , teach. Those who can't teach, manage.
Rick Callebs Rick Callebs Monday, March 17, 2014 5:11:12 AM Really?
Bruce A Mills Bruce A Mills Monday, March 17, 2014 1:56:15 PM WOW you hit that out of the park
Michael Aguilar Michael Aguilar Monday, March 17, 2014 3:45:04 PM Great article! What can also help up and coming supervisors is for the service to invest in them by sending them to conferences, seminars, or have them even take college courses in leadership, time management, human resources topics, etc. By the service showing an investment into the new manager/supervisor it is sending a message that the service believes in this individual and also earned their promotion by doing the required work. Should this not be the case then I feel the individual then needs to take matters in their own hands and become educated in their new field of work. To be 'picked' for promotion is not enough. There is a responsibility when you assume this new role and it means going out of your way in obtaining the knowledge necessary in order to be able to perform in the new acquired position.
Scott Brown Scott Brown Tuesday, March 18, 2014 8:51:44 AM The reason people say that is because clinical competence has been used for so long as the SOLE criteria for management. Every single awful leader I've encountered in this field has been a good paramedic. The leadership stuff is, in fact, that hard...especially given the fact that so many people are so incredibly bad at it. We train them in medicine, don't train them in management, then watch them drive the industry where it is...and navel gaze, wondering why that is. Being a great medic NEVER means you'll be a good leader...the 2 skills are different. Good medic, bad leader is the what point is that going to become unacceptable and the focus change to requiring some management training or professional development as a requirement for promotion to leadership? are a box demon...can you lead, inspire and manage? Sadly, that answer is mostly no...
Randy Fischer Randy Fischer Friday, March 21, 2014 10:11:39 AM You have to have the skills of a medic and be credible first, then maybe, you might become a good supervisor. Most leadership needs to focus on serving the good of the company (meaning both the company economics and the employees needs). Then, determining the best course of action in a given situations that maximizes "survival" and even more important...GROWTH (both the company and employees). Helping the company succeed is accomplished by helping the employees succeed, and visa versa. Serving both of these "masters" will be the challenge, the mission, and an important decision that good supervisors make regarding when and how to serve both effectively and thoughtfully when their is conflict between them. Problem with most leaders is that they forget they are first, servants.
Bob Darnell Bob Darnell Thursday, May 22, 2014 6:19:01 PM Excellent article, for all of us, not just ones who have accepted promotion.
Steve Johnson Steve Johnson Thursday, May 22, 2014 6:29:58 PM Brings a great many things to light. In this era, I believe that experience in the field is a must. But in light of this article I can agree that a good medic or even a great medic does not mean they will be a good supervisor. If you want to be a good supervisor show the skills that it takes to execute the job fluently and with professional ethics. Also, you must have some kind of business sense, you must know HOW to run the crew AND interact with the people around you... If you go into your office, close the door and try to run the business without your people, your people will run the business and not you. Also what holds that business together will eventually crumble the same business when your employees are burned out.
Mathieu Chartier Mathieu Chartier Thursday, May 22, 2014 8:28:55 PM Good article. Great points for someone to follow in a leadership position, But like all things written they aren't followed. EMS leadership is based on paramedic skill not management skill. A lieutenant in a generally speaking Career fire service had taken multiple leadership and officer classes. A supervisor in EMS yea he's been here 20 years, he's an old school medic so he knows what he's doing. Oh he's worked in a bigger service before he came here. The list goes on. Need i mention the good ole boy system. EMS will never progress to the levels of respectability until the leadership status quo changes.
Robert Hutson Robert Hutson Friday, May 23, 2014 12:42:42 PM I agree with many of the well thought out statements on this subject. I would take it one step further in stating that be a leader doesn't mean you should be a supervisor. for myself I tend to have a dominate personality but will help any of the my fellow Medics or EMT's. I provide leadership to the newer people and help bring along and develop our personnel. I do not have any desire to be a Supervisor or Manager. I feel being a good Medic is enough and my example helps others develop their skills. That is enough for me!!
Michael Green Michael Green Friday, May 23, 2014 3:00:48 PM Very good response Skip! Also very true.
Andrew Bosma Andrew Bosma Friday, October 24, 2014 7:16:10 PM Wish my supervisors were like this.
Derek Chambers Derek Chambers Friday, October 24, 2014 8:23:19 PM I disagree with the statement you just be competent in the core competencies to be accepted as a leader. I believe one must have an understanding of paramedicine to be accepted as a leader. It's not your medic skills that will make you a good leader.. It's your actions in a leadership role that will define you.
Daniel Gerard Daniel Gerard Saturday, October 25, 2014 10:12:58 AM Solid article Steve. Good work.
Jason Combes Jason Combes Saturday, October 25, 2014 2:54:44 PM #5 is the biggest problem

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