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Finding the joy: Beyond job satisfaction in EMS

Identify what you can change in your agency to create a shared action plan where increased professional passion heralds better patient care


A strange thing happened during our first of four Regional Meetings for the EMS Agenda 2050 project. The setup is that everyone who participates is involved in a series of dialogues with members of the Technical Expert Panel.

Each of these dialogues is focused around a question designed to provoke creativity and inspire visionary thinking. The topics include person-centered system design, inherent safety, full integration and the like.

When we asked the question, “What could we do from the provider perspective to increase health, safety and joy?” people pushed back hard. They said things like:

The concept of joy in work is not new, even though it seemed new to the folks in our meeting. (Courtesy photo)
The concept of joy in work is not new, even though it seemed new to the folks in our meeting. (Courtesy photo)
  • “It’s a job, we should not expect it to be joyful.”
  • Satisfaction sure. A living wage absolutely. Joy is not something people should expect from work.”
  • “Are all of you people from California?”
  • “This topic is a waste of time, we should focus on issues that are meaningful.” 

I was surprised by the response. It caused me to pause and examine my professional life. I’ve been fortunate to work in a lot of places and with a lot of people that bring me joy. My job has me working with a gaggle of the smartest and most passionate leaders in EMS, fire, law enforcement and healthcare, all working to make this world a little better.

My co-workers are wickedly smart, deeply committed to serving customers, and incredibly kind. The reality is that I’ve had a blast throughout better than 90 percent of my career in EMS. I was feeling joyful, even while people were pushing back on the concept of joy in work. The 10 percent of my work life that was not joyous wasn’t terrible. It was just satisfying.  

I don’t know about you, but for the 50-60 hours a week that I spend working (my wife says this is an underestimate), just being satisfied is too low a bar. My bias and the perspective of many world-class leaders in healthcare and quality improvement is that work can be joyous more often than not. And more, that joy is essential for people to be effective at what they’re doing over time.

An essential component in the enterprise of healing

The concept of joy in work is not new, even though it seemed new to the folks in our meeting. Dr. W. Edwards Deming, the father of the science of quality improvement, said, “Management’s overall aim should be to create a system in which everybody may take joy in his work.”  Dr. Deming was not talking about party hats and kegorators in the workplace, but rather intrinsic reinforcement from the job itself, the sense of accomplishment that comes from the ability to control and improve your own work.

Rosabeth Moss Kanter, former editor of “The Harvard Business Review,” described joy in what she called “Rubik’s Cube moments, when everything clicks into place for an uplifting accomplishment.” In our world, that might be after the successful management of a complex multi-casualty incident that taxed all of your resources. Or it might be having all of your paramedic students pass the National Registry on their first try.

Maureen Bisognano, former CEO of the Institute for Healthcare Improvement, says, “You cannot give whet you do not have. The gifts of hope, confidence and safety that health care should offer patients and families can only come from a workforce that feels hopeful, confident and safe. Joy in work is an essential resource for the enterprise of healing.” 

EMS burnout lowers patient experience and care

The Institute for Healthcare Improvement white paper, “IHI Framework for Improving Joy in Work,” describes the opposite of joy as burnout: “Burnout affects all aspects of the pursuit of better health and health care. It leads to lower levels of staff engagement, which correlate with lower customer (patient) experience, lower productivity, and increased risk of workplace accidents. These all significantly affect the financial vitality of an organization. The impact on patient care is even more worrying. Lower levels of staff engagement are linked with lower-quality patient care, including safety, and burnout limits providers’ empathy, a crucial component of effective and person-centered care.”

The white paper recommends four steps for leaders:

  1. Ask staff, “What matters to you?”
  2. Identify unique impediments to joy in work in the local context.
  3. Commit to a systems approach to making joy in work a shared responsibility at all levels of the organization.
  4. Use improvement science to test approaches to improving joy in work in your organization.

Asking your teammates what matters to them and what gets in the way of their experiencing joy in the workplace can be a scary endeavor. There are a few keys to making this conversation successful. The first goal is to listen, listen deeply, listen to seek understanding. Listening does not mean you agree or that you promise to fix everything they bring up.

Once their bucket is empty, then you can go through the list of what’s been said with them and discuss what’s easy to do, what’s possible to do and what’s unlikely to change. Based on that triage, you can create a shared action plan where everyone is involved is making things better, more joyful.

My wish for everyone in our helping professions is that you experience joy every day in your personal and professional life. It matters.

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