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The lost art of interacting with the public: Simple guidelines for EMS

With skills, preparation and clear expectations, EMTs and paramedics can facilitate productive conversations with bystanders at an incident

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Paramedics and EMTs are two of the occupations that command the highest level of trust among the public. And EMS depend on this trust to be able to do their jobs.

AP Photo/Julio Cortez

This has not been a good year for human interaction. People are fearful of strangers. Communication is hindered by masks and the need to social distance. Ordinary gatherings among friends or colleagues have been impossible.

This change in how people interact has taken its toll on firefighters, too. In the past year, EMS has not been able to engage in the kind of formal and casual relationships with the public that were normal before the pandemic. Additionally, incidents of civil unrest have put EMTs and paramedics in the position of being viewed as an authority figure and potentially an adversary to some. And some in public safety have made this worse through their own behavior.

It’s time for all of that to change.

Paramedics and EMTs are two occupations that command the highest level of trust among the public. And EMS depends on this trust to be able to do their jobs. Every provider is responsible for building trust with the service community.

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To some degree, that relationship of trust has been damaged in the past year, if only through neglect. But it is never too late to turn things around.

Improving communication with bystanders

How can communication between EMS personnel and the service community be improved? The first important step is empowerment.

When I was a new firefighter, we were told not to speak to the public on an emergency scene unless our officers directed us to do so. If a bystander asked a question, we were to always refer it to the incident commander or officer at the scene.

This makes sense, to a point. You don’t want EMS providers freelancing at a scene, either in their tactical actions or in what information they disseminate to the public. But in a more global way, it leads to dysfunction. Say a paramedic is standing at an incident and a bystander asks a reasonable question like, “What happened here?” If the paramedic responds by saying, “I’m not allowed to talk to you” or simply walks away, damage will be done by that interaction.

All department members should recognize that they have both the ability and responsibility to interact with the public within their scope of knowledge and authority. If someone asks what happened, responding by saying that there was fire in the building is obvious. If a bystander asks, “Was anyone hurt?” the paramedic can respond in an honest, if limited, way, such as by saying, “The paramedics have been treating people who came out of the building” or “I’m aware of at least one person being transported to the hospital.” Having civil and professional interactions with people at the scene is part of everyone’s job.

However, empowerment alone is not enough. People need to be prepared for the roles they play, and training is part of this. You don’t necessarily want people being spontaneous, especially under stressful conditions. Training in communications and de-escalation techniques can go a long way to mitigating harm and building trust even under difficult conditions. Scenario-based training can let EMS providers prepare responses to anticipated questions and troubleshoot potentially difficult interactions before they occur.

If every provider has skills and is prepared for the role, every provider can potentially act as an information liaison at a scene. You won’t have to wait for the city PIO to show up before you have positive interactions with the public. With skills, preparation and clear expectations, paramedics and EMTs can facilitate productive conversations with bystanders and others at an incident, and never feel ambushed or blindsided.

Departments should encourage and promote related skills in this area as well. If you live in an area where multiple languages are spoken, having someone with even rudimentary language skills can go a long way toward increasing trust and making people feel more comfortable.

But it is important to remember that you cannot create relationships in the heat of the moment. That is work that must be done over time, every day for the long haul.

COVID-19 restrictions are still in place in many areas, but summer is coming, and the science is clear that outdoor transmission of the virus through casual contact is extremely rare. So start planning events where the public can meet you in an outdoor setting. Be creative. For example, stop-drop-and-roll training can happen as easily, and perhaps even more enjoyably, in a public park as it can in the fire station meeting room. Pull the rigs out on the front ramp and have an open house for families in the neighborhood. Of course, you can require that masks be worn, but you don’t have to eliminate these kinds of events entirely, especially given the amount of good they do in building relationships of trust with the community.

Reinforce your relationships

It’s been a tough year in so many ways, and people are both exhausted and full of pent-up energy. Now is the time to recognize the critical importance of establishing and reinforcing relationships of trust with the public. Empowering and preparing every provider to meet this need will serve individuals and the organization at every level.

Editor’s note: Does your agency have a policy for front-line personnel interacting with the public. Share in the comments below.

Linda Willing is a retired career fire officer and currently works with emergency services agencies and other organizations on issues of leadership development, decision making, and diversity management through her company, RealWorld Training and Consulting. She is also an adjunct instructor and curriculum advisor with the National Fire Academy. Linda is the author of On the Line: Women Firefighters Tell Their Stories. She has a bachelor’s degree in American studies, a master’s degree in organization development and is a certified mediator. Linda is a member of the FireRescue1/Fire Chief Editorial Advisory Board. To contact Linda, e-mail Linda.Willing@FireRescue1.com.
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