Wandering the various EMS forums and groups out in cyberspace, I have an opportunity to hear a lot of rants and gripes about EMS life in general. Some folks ask for advice with challenging interactions, and others just want to blow off some steam.
Some of the situations are run-of-the-mill conflicts that are pretty predictable when human beings work together in stressful situations:
- My Q.A. manager wants to know why I didn’t give nitro to an inferior wall M.I. with hypotension. Should I really have to explain this?
- The local firefighter / paramedic gave me a patient that was clearly an ALS transport.
- The off-going crew always leaves us a dirty rig.
- Some of our volunteers never show up to our company trainings.
Other individuals describe behavior that is so deplorable that it’s hard to imagine how these folks continue to work among us:
- I hung up a “supplies needed” dry-erase board and the supervisor broke it in two and threw it in the trash.
- Our officer consistently shows up drunk on calls. He often drives the apparatus even though the local police have warned him about it.
- I am repeatedly grabbed inappropriately by multiple coworkers.
I tried something new in 2013. Instead of offering advice, encouragement or understanding to these folks. I began asking a simple question: What did you do? I didn’t ask accusingly. I just requested the rest of the story. After this thing that you described happened, what did you do next? What did you say?
I’ve noticed that when the stories of wrongdoing and misadventure are offered, the storyteller’s response is often left out of the story. More often than not, this is because the storyteller didn’t respond or address the issue when it occurred. They walked away and stewed about it for a few hours or days before going online and expressing their frustrations to everyone except the individuals involved.
When I ask people, “What did you do?” the answer is typically, “I didn’t do anything.” Or “I just sat there and smiled.” Or “I ignored them and walked away.” Time and again, when confronted with both minor and major offenses in social etiquette, failures in knowledge or performance and behaviors that are immature, mean, offensive and sometimes even illegal, we choose the option of non-confrontation.
Sometimes individuals offer up some explanation for why they failed to respond. “It won’t make any difference.” “You can’t get through to those guys.” Or, my personal favorite, “I’ve got kids to feed. I can’t afford to get on people’s bad sides.”
It amazes me. We will go inside burning buildings looking for strangers. We will stand on the side of an icy freeway while cars drive past us inches away. We will treat violent and aggressive patients (often with far too little regard for our own personal safety). In an industry where courage and bravery seem plentiful, we shrink from even the slightest appearance of social conflict.
So why do we avoid uncomfortable personal confrontations so much? The simple answer is fear, but fear takes on many forms. When I ask individuals why they didn’t confront some misbehavior in their coworkers or managers, they tend to offer the same three excuses. I’d like to address each one of them individually.
The ineffectiveness excuse
With the ineffectiveness excuse, we rationalize that our protest will be a useless gesture for a variety of reasons. It’s comfortable to believe that because of our lack of authority or the persistence of the problem or the stubbornness of the offender, any direct communication with the individual is worthless.
Those who fear ineffectiveness say things like, “You can’t get through to these guys.” Or “Why bother, it won’t make any difference.” Or “It’s been this way for as long as anyone can remember. It isn’t going to change any time soon.”
What we need to remember when we offer the ineffectiveness excuse is that we can diplomatically and respectfully stand up for what we feel is right regardless of the final outcome. Whether or not we feel we will ultimately be successful shouldn’t change our willingness to do the right thing. The final outcome doesn’t need to be the complete resolution of the problem. Our influence doesn’t need to be definitive, it only needs to be positive.
Often, we use the ineffectiveness excuse as a way of avoiding the social pressure of doing the right thing even though we are actually very poor predictors of our ability to influence. Rosa Parks wasn’t trying to be a civil rights leader, she just wanted to rest her feet. When Henry David Thoreau wrote “Civil Disobedience,” he simply wanted to give people the courage to stand up for themselves. Instead, he managed to bend the course of human history in ways he never could have predicted.
With the right words and a polite refusal to simply ignore the problem, you might be amazed by what you accomplish.
The forbidden fruit excuse
The forbidden fruit excuse is the rationalization that there are some unspoken rules that prohibit us from addressing the conflict. Perhaps you work for the local private ambulance service, and the other half of the conflict works for the local fire service. Or perhaps the individual at the root of your issue is a promoted officer, a supervisor, a hospital employee or in some position of authority.
Once we perceive that the other individual in the conflict has some sort of protected status, we can dismiss any notion of confronting them because ... well, we just don’t do that sort of thing around here. When we would prefer to avoid having an uncomfortable conversation, we will create all sorts of rules and reasons why that would be prohibited.
While there are often social and organizational rules and traditions that need to be honored, they rarely prohibit us from speaking up when faced with a conflict. Unacceptable behavior is still unacceptable, regardless of what is normative in your organization. You may need to begin with the chain of command. You may need to begin with a trusted mentor. Even better, you may want to just bring the individual you are confronting a cup of coffee and politely request to have a private conversation.
No method is always appropriate, but some method is appropriate in every situation. There is a diplomatic way to say whatever it is that needs to be said. What’s missing isn’t the permission to say what needs to be said, it’s the courage to say it. Choose your method, but don’t choose silence.
The fear of retribution excuse
This is perhaps the most common excuse for ducking an important conversation. It’s the idea that if we make waves and cause others discomfort, they will somehow punish us in the future. We worry that punishment will be direct, like termination, or indirect, like a denied promotion or reduced job responsibilities.
We evoke the fear of retribution with phrases like, “I have a family at home.” Or, “I can’t afford to lose a good job over stuff like this.” The implication is that there are greater priorities than speaking the truth or holding individuals accountable.
In over two decades of work in emergency services — from public agencies to biotech firms and universities; from large multi-national ambulance providers to small mom-and-pop ambulance companies — I have never even once seen anyone fired or disciplined for honestly and respectfully speaking their mind. Yet this fear is rampant in our culture. Folks seem to be convinced that they are required to toe the line and say yes on cue or face some negative consequence.
On the contrary, I have found that just the opposite is often true. It is often the individuals with the courage to speak honestly and openly about their observations that gain the trust to be considered for promotions and additional responsibilities. Individuals who are confronted in a respectful manner often develop greater trust and confidence in the individuals who are willing to speak up when they see the need.
When new opportunities arise, we often want to pass them to employees who are engaged in the process of improving our organization. Those are often the individuals who are willing to challenge the social norms and work toward a better future.
Perhaps our greatest point of confusion about interpersonal conflict occurs when we automatically link conflict and disagreement to disrespect, judgment and anger. Having the courage to confront inappropriate behavior and poor performance is not a license to disregard people’s feeling or disrespect others.
We need to be able to approach individuals with respect for their individuality and dignity. We need to begin from a place of caring about them as individuals, caring about our shared responsibilities, and caring about making a better future.
Social courage means being brave enough to care about working together better. We don’t confront others to tear them down. We confront them to build them up. And if we are courageous enough to try, we will often find that we better ourselves as well. Let go of your fear and you may find that you can bend the course of history.
