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Why commitment is the foundation of volunteer EMS

A volunteer EMT without commitment or compassion is a short-term fix that usually becomes a long-term problem


Volunteer EMS organizations often find keeping their EMTs confident, competent and response-ready challenging due to the part-time nature of volunteerism and the low-call volume typically found in rural areas. Compounding the problem is the fact that rural EMS calls tend to have longer transport times, higher-acuity medical and trauma patients and inconsistent or delayed access to ALS response. For many state officials, medical directors and service chiefs this issue is second only to concerns regarding response failures.

The future of volunteer EMS is dependent on a commitment to resolving these critical issues. Volunteerism in EMS began with neighbors helping neighbors. Professionals, local business owners, blue collar workers and housewives shared a common passion: working together to provide emergency medical care for their community. Seeking out the people best suited to continuing that tradition will be the key to success. Leadership alone is not enough.

4 attributes of volunteer EMTs

For a volunteer EMS organization to flourish, its personnel need to exemplify four attributes. (Photo/Nancy Magee)
For a volunteer EMS organization to flourish, its personnel need to exemplify four attributes. (Photo/Nancy Magee)

For a volunteer EMS organization to flourish, its personnel need to exemplify four attributes. Here are the four C's of EMS volunteers.

1. Commitment

EMS is a complex and constantly evolving profession. The amount of time and effort necessary to be successful as a volunteer EMT must be understood by new recruits, and clearly demonstrated by current members. Schedule "ghosts" and regular absenteeism from training are commitment problems that threaten the foundation of the organization and must be addressed.

2. Compassion

EMS providers are caregivers. It is important to recognize the soft skills needed to do this job well. Empathy is the ability to understand another person’s experience from their perspective and compassion can be visualized when you think of the people who you would want treating a loved one who is sick or frightened. They go the extra mile to provide comfort, reassurance and advocacy regardless of the nature of the call. They see every patient as a person in need, not a disease process or in any way unworthy of their time.

Do not invest further in a volunteer EMT if this quality of empathy is lacking. It is easy to recognize compassion, but it may be impossible to teach. 

3. Competence

Committed, compassionate EMTs have the inherent desire to provide the best possible care to their patients. They stay informed and seek out opportunities for practice and continuing education. QA rarely identifies clinical issues in EMTs who are committed, compassionate and competent. Ensure volunteers have the tools and support to remain sharp.

4. Confidence

Confidence comes from practice, experience and positive feedback. A confident provider can quickly and calmly recognize what needs to be done. They will represent a confident organization which welcomes progress, and easily adapts to new practices and ideas.

"Great organizations demand a high level of commitment by the people involved." - Bill Gates

A solid foundation

For volunteer agencies, survival depends on building a solid foundation for the future. Success will require EMTs who fit the 4C model and are willing to work together and support these organizational commitments. Here is a further exploration of what commitment means for a successful volunteer EMT.

Commitment to excellence

Many long- term volunteers have responded to fewer 911 calls in their entire EMS experience than an urban career provider responds to in six months. It will take creativity, organization, patience and most of all an unwavering commitment to providing excellent care to the community to overcome these challenges. Achieving excellence can only happen with the combined effort of all individuals.

Commitment to accountability

Every EMT must accept ownership of his role and impact in the organization. Volunteer leaders must cultivate an environment dedicated to helping every individual member achieve his full potential.

One of the first steps agency leaders can take is to honestly evaluate every EMT’s clinical competence and confidence. This can be difficult with volunteers who may only run a few calls a month, sometimes even less. The tendency to avoid this important piece of quality assurance because of fear of conflict or offending a member who might then leave the service will need to be overcome.  

Commitment to creating buy-in

New providers are not the only EMTs with confidence and competence issues. The most recent changes in EMS practice are radically different than the care older members have been providing since before many newly graduated EMTs were born. The foundation of their knowledge has come into question. Concern that even with the best intentions, they may not have been providing the best possible care can lead to either push back against change or even an unwillingness to continue participating as a caregiver.

Dedicated and long-serving EMTs deserve to have their medical director and leadership commit to spending as much time as necessary to provide extra training, to answer questions and dispel any uncertainty voiced about changes in practice and protocol. Achieving buy-in is critical to keeping these volunteers' skill competent and knowledge current.

Commitment to retention

Retention is affected in many organizations due to older EMTs wariness of technology and discomfort with rapid changes that are often poorly presented or in their minds, even unjustified.

The knowledge capital of organization history and operational processes held by long-term EMTs is an asset whose value must be recognized. It may seem easier to allow these members to just fade away, but this can lead to a fractured organizational culture and a brain drain that may never be overcome.

Being confident that they are prepared to provide the best care for their patients can have a big impact on a volunteer’s willingness to respond, commit time to scheduled shifts, or remain active in the organization. A commitment to creating a culture that not only attracts new members, but inspires long-term members to remain involved is critical to the continuing success of a volunteer EMS agency.

Commitment to continuing education and training

Constantly evolving initial educational requirements and the expectation of increased continuing education hours should be presented as positive measures in place to assure the best possible care is provided to our patients. Too often, educational requirements are scapegoated, with little supporting evidence, as an excuse for the decline in volunteerism.

Education is a valuable commodity which should be promoted as a benefit provided to prospective and existing members. A commitment to ensuring that access to educational opportunities is both accommodating and affordable will be a key component in achieving this goal. 

Commitment to the future

Too often, the 4C pyramid is inverted. EMTs with credentials and a cocky attitude seem to be the quick answer to putting meat in the seat. These providers are usually quick to criticize and slow to contribute to the greater good.

Remember, an EMT with a solid foundation based on commitment, compassion and a sincere desire to serve is a better investment than the know-it-all who believes the agency needs him more than he needs them. The inverted pyramid EMT may be a short-term fix, but is usually a long-term problem.

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