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The characteristics of a thriving middle manager

Providing our middle managers the mentorship, resources and tools to lead well is paramount to the future of EMS


“Sharing our wisdom and providing leadership training and education to our middle managers is essential to growing healthy, well equipped EMS leaders of the future,” writes Abbas.

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This article was originally posted in the Wisconsin EMS Association EMS Professionals Magazine and is reprinted here with permission.

Emergency Medical Services middle managers are the heart of any thriving EMS organization. When supervisors are poorly equipped as middle managers, however, organizations can struggle.

Sharing our wisdom and providing leadership training and education to our middle managers is essential to growing healthy, well equipped EMS leaders of the future.

There are specific important characteristics found in building our best, thriving middle managers. They are as follows:

  1. Being trustworthy

    There is nothing that deteriorates trust faster than a supervisor who gossips and talks poorly of others when they’re not in the room. Employees want to know you are trustworthy and that what they share with you will stay with you. If you’ve convinced yourself that supervisor gossip doesn’t travel, you are sadly mistaken. When we violate trust in relationships the people we manage become distant and engagement suffers. Not everyone has integrity, but our leaders must have integrity and trustworthiness if we expect our organizations to thrive.

  2. Practicing accountability & coaching

    As much as we believe employees despise discipline, they also have little respect for a manager with no backbone or a company that allows for poor clinical care. Practicing accountability breeds a healthy culture, and when done well it creates a platform for mutual respect while providing the opportunity to learn and grow. Supervisors must hold their team members to a standard and be willing to coach and mentor staff.

  3. Being fair and fact checking

    A manager who is aware of their own biases and strives for fairness is valuable to any organization. Operating from a place of non-judgement with a willingness to fact find before making decisions that effect the team builds trust and provides a safe work environment.

  4. Offering an ear to listen

    One of the most rewarding aspects of being in a middle manager role is the opportunity to positively impact the daily lives of everyone you work with. A supervisor that listens, keeps confidentiality when possible, and holds you accountable while not passing judgement is modeling a strong character and will influence a healthy culture.

  5. Being consistent and keeping your word

    No one respects a middle manager who fails to get things done. It’s important that employees know they can come to us for what’s needed. If you find yourself unable to deliver on those needs, following up and connecting them to the right person or place is valuable. Unanswered emails and a lack of follow through on deliverables will rob you of opportunities and give your team the impression you’re unreliable, or even worse, incompetent.

  6. Providing hope and inspiration

    Bringing hope and inspiration, especially during difficult times, builds team morale. A middle manager who loses hope and becomes uninspired can negatively impact organizational culture and fail to positively influence others. It doesn’t mean you won’t need to vent, or that you won’t ever have negative feelings… of course you will, because you’re human. Channel those feelings to a mentor outside of the organization.

  7. Being authentic & real

    As a middle manager, no matter who you are, you will not be liked by everyone. Often middle managers shy away from their authentic selves in attempt to be liked or to be invisible. Inauthentic behavior breeds superficial, low trust relationships. If you hide behind a façade, unfortunately your relationships with team members will suffer. Own who you are, be authentic and bring your whole self to the table.

  8. Practicing what you preach

    Doing the work and doing it well sets the example. If you came up trough the ranks not washing your truck, cutting corners with patient care, failing to clean your station and treating your co-workers with anything less than respect…. well, you have a lot of work to do. Respect begins with setting the example. “Do as I say and not as I do” doesn’t fly in EMS.

  9. Being okay with being in the middle

    “It’s normal for any person to want recognition, and leaders are the same. The fact that leaders in the middle of the pack are often hidden- and as a result they don’t get credit or recognition they desire and often deserve-can be a real ego buster.” - John C Maxwell, The 360 Degree Leader.

Leading from the middle offers a variety of challenges. Middle managers describe feeling like they have little actual power while holding much of the responsibility for what happens above and below them. You aren’t running the show but may be held responsible for much of the show. The tension middle managers feel and lead while in their positions offers a wealth of growth and learning opportunities, and if executed well, can lead to exponential prosperity. Providing our middle managers the mentorship, resources and tools to lead well is paramount to the future of EMS.

Andrea is the owner and author of The EMS Professional. With over 20 years of EMS industry experience in various leadership roles, including field training officer, supervisor, quality assurance and compliance manager, EMS director and programs management, Andrea is skilled in system management, training, education, administration and project management. She has work experience in frontier, rural, suburban, and urban EMS systems.

In addition to her leadership experience, she brings years of experience working in the ambulance and emergency department. Andrea holds her National Registry Paramedic license, Community Paramedic certification and Instructor Coordinator license in addition to her formal education and degrees. Her unique consulting approach is detailed, honest and highly personalized. Andrea offers a variety of EMS leadership and wellness courses to EMS agencies and departments. She’s an avid blogger, national speaker, podcaster and consultant. You can contact her at: