The most recent What Paramedics Want Report from EMS1 and Fitch & Associates tells us the top concerns our people are experiencing. The next question is not simply, “How do we fix burnout, high turnover and low morale, etc.? Folks in EMS have been asking this question for years and yet the issues have persisted and only gotten worse. Why? Because the question itself comes from a misunderstanding.
Burnout, high turnover and low morale are not the problem. They are the result of the problem — the underlying system — in the same way that car exhaust is the result of the design of a carbon engine. If you focus on stopping exhaust, the engine will not function properly. If you want to stop exhaust, you must go upstream and redesign the engine.
Consider burnout, high turnover and low morale naturally occurring results of the design of the current EMS system.
| DOWNLOAD: What Paramedics Want in 2026
Quality control expert W. Edwards Deming noted, “Every system is perfectly designed to get the result that it does.”
The question then to ask is, “What system could we create that would lead to the results paramedics really want? The goal is not merely less burnout, less turnover or less disengagement. The goal is for paramedics and EMTS to thrive, to be the best they can be, to do good work and to be cared for while doing it.
What system can we design that would produce that outcome?
In this three-part series, we will provide a practical framework for building the system for your organization for the results paramedics truly want”
- Part 1: The impact of your communication system
- Part 2: Your system to keep and attract the best talent
- Part 3: Your system for creating a thriving, magnetic organization
Part 1: The impact of your communication system
Once you accept the premise that burnout, low morale and high turnover are results, this understanding opens up new possibilities. The first step is to identify the foundation of your leadership — your current system for communication. While most people think they are good at communicating, there is a fundamental misunderstanding that leads to the vast majority of challenges and frustrations. Once you see it, your conversations will improve immediately.
There is much more to communication than what you say, what you hear or even how you communicate. First and foremost, it’s crucial to discover the filters you are communicating through. Filters are the opinions, interpretations, judgments, assessments (i.e., stories) that are mistaken for truth. When filters are confused with facts, communication is ineffective, leading to misunderstandings and the experience of not being heard, valued or respected.
However, when you get clear about the facts (i.e., what is happening or happened, devoid of your filters, conversations and strategies become simpler and more effective. Filters (stories, opinions, etc.) significantly limit what you can see, hear and how important or meaningful variables are to you. This is known as confirmation bias.
For example, if you have an employee or member named Sue who has been late to her shift five times in the past two weeks, angering the other members who have had to cover for her, you might decide that Sue is inconsiderate, not a team player or passive aggressive.
Once you have your filter, let’s say inconsiderate, you then start noticing other instances that resemble inconsiderate to you, such as failing to wash out the coffee pot when taking the last cup, changing the thermostat without asking others. The evidence starts piling up.
When you speak with Sue, you are likely not talking about her behaviors. You are talking about your conclusion about her behaviors. You unconsciously added each fact up and made it equal inconsiderate and this became your filter
“Sue is inconsiderate” is not just your opinion; it becomes your reality and you live like it is a fact.Your conversation with her is focused on helping her be more considerate. You are acting as if you have all the facts without noticing that your mind (in its very mischievous way) has filtered out a huge amount of data.Perhaps you didn’t notice that she got out late every shift this week, when she brought food in for the whole crew or when she picked up an extra shift despite working 7 consecutive days.
Communicating through your filter likely will make Sue defensive, argumentative and feel misunderstood, unappreciated, etc. Her response might even be interpreted as “burned out.” A far more effective way to handle this type of situation is to assume there are facts you do not know or cannot see given your filter.
Here are examples of things you could say that are fact-based:
- Sue, I noticed (or heard) that you were late to your shift five times over the last two weeks. Can you tell me what happened?
- You were on time five times in the last two weeks, what worked on those days?
By dealing only with the facts, there is less chance of disempowering your employees or members and a greater likelihood that you will learn something to help you help them.
Whenever you are unsure what is fact and what is assessment (it gets blurry sometimes), get a piece of blank paper, draw a line down the middle to make two columns. (See Figure 1). Differentiate between the facts and your filters (opinions). This will help you to get clear about what there is to focus on and the best way to approach the conversation.
Another important distinction is how your filter unconsciously impacts how you listen or perceive others. For example, imagine you have an employee named Joe, and your opinion of Joe is that he’s lazy. Now imagine you are meeting with your staff, including Joe, to assign work that is critical to your organization’s success. How does your assessment of Joe affect how you’ll listen to Joe? How does it influence your expectations of Joe? What if Joe mentions a potential roadblock to the fulfillment of the goal? How likely are you to take Joe’s comment seriously, rather than dismiss it as an attempt by Lazy Joe to get out of work?
Now imagine instead of lazy, you believe that Joe is a back stabber. Now how will you hear his suggestion?
Finally, imagine that you think Joe is a hardworking, team player. How does that impact how you’ll respond to his suggestion?
Can you see how limiting and impactful filters are? Can you see why a new system for communicating is necessary to alter the culture of EMS?
A more effective communication system is being aware of your inner dialogue and instead of blindly believing it, recognize that you are always missing essential information. Then, focus on being present to the other person and listen with curiosity to see what you can discover together.
In teaching EMS leaders this approach, they frequently cited how effective this communication method was when practiced. They were most surprised with how one change led to fostering a more collaborative environment that empowered team members and encouraged open dialogue.
Do not underestimate the power of this communication system. Removing your filters, focusing on the facts and starting with curiosity rather than conclusions is a revolutionary approach. Your people want to be seen and heard. When you listen like you already know everything and speak from there, it diminishes them. Over time, that leads to burnout, high turnover and low morale.
| MORE: 7 effective communication steps for EMS leaders
About the EMS Leadership Academy
Co-founded by Robbie MacCue and Lisa Giruzzi, the EMS Leadership Academy focuses on helping leaders navigate organizational change, culture transformation and leadership development within the emergency medical services industry. Having trained thousands of leaders, published essential resources for emerging leaders and hosted the annual EMS Leadership Summit featuring global experts, the Academy empowers agencies to build high-trust, learning organizations and eliminate operational burnout. Evaluate your leadership skills and pinpoint critical gaps in your agency by taking our free Leadership Self-Assessment. If you are ready to drive deeper systemic change, sign up for our Essential Communication Course to enhance communication effectiveness and begin to solve organizational issues at a systems level.
