May 23, 2019 | View as webpage


National EMS Week is a designated time to advocate for the profession, as well as the EMTs and paramedics who are on the front lines, improving the health, safety and well-being of the citizens in their communities. This May, EMS1 celebrates the dedication of EMS providers and their public safety allies by providing resources for improving mental and physical health, and workplace conditions, with the goal of helping providers stay resilient and well while caring for others.

In this newsletter, Kelly Grayson offers the provider perspective on what this year's EMS Week theme, "Beyond the Call" means for front-line staff, and how you as the paramedic chief can support personnel. Also, Rebecca Szeles, communications supervisor at the Richmond Ambulance Authority, details how RAA leveraged a CISM program and resiliency training to form a Peer Support Program to augment mental health efforts for providers.

Make every week EMS Week in your efforts to provide a culture of resiliency in your EMS organization.


Greg Friese, MS, NRP
Editor-in-Chief, EMS1

P.S. Please forward this leadership brief to at an EMS leader at a neighboring agency and let that leader know to sign up here for the Paramedic Chief Leadership Briefing.

In this issue:

By Kelly Grayson

This year's EMS Week theme is "Beyond the Call."

Finally, an EMS Week slogan that doesn't make me roll my eyes so far I can see my own occipital lobe!

Beyond the Call is an excellent opportunity for us to educate and inform the public and lawmakers about what happens in EMS, well ... beyond the call. Let this be our rallying cry to speak to the issues that are important to us.

  • Tell policymakers about what happens beyond the call you ran for a child struck by a car, when you went home after your shift and couldn't shake the feeling that the child looked so much like your kid that you could barely stay clinically detached. And how, for the last week, you've woken up in the middle of the night with fear gripping your heart in an icy fist, and had to go check on him while he slept, just to reassure yourself that he's OK.

  • Tell the taxpayers in your district that beyond the call at your primary EMS job, means you have to run more calls at your secondary EMS job, just so you can afford to feed your family, and even with both jobs, you likely don't make as much money as the guy that rides the garbage truck in their neighborhood. And to remember that when it comes time to renew or increase a tax millage.

  • Remind them when they gripe about the cost of an ambulance bill, that the biggest expense in EMS isn't the cost of service, it's the cost of readiness, and readiness bears financial burdens well beyond the call.

  • Remind your supervisors that the physical toll on you extends well beyond the call. The station duties, radio traffic, street corner posting and the necessity to take a second job because the first doesn't pay a living wage all disrupt your sleep cycle and worsen your health. Point out to them that a fatigue mitigation policy and sleep rooms demonstrate concern for an agency's most valuable resource far better than a grilled hamburger on a designated day in May.

  • Advocate to your employers that better mental health benefits are a tangible way to help providers with all the psychic turmoil that lingers beyond the call. Help them understand that you'd be a much happier and productive employee if you didn't go home after every shift so physically and emotionally drained that you can't even devote time to your family – the same family that recharges your career satisfaction batteries and keeps you motivated.

  • Assure your coworkers that you have their backs beyond the call. You’re going to be there for them, even after the ePCR is transmitted and the rig is cleaned and restocked. And if they can’t mentally get beyond the call, you’re not going to judge. You’re going to help, whatever that takes.

  • Make the commitment to your profession that you’re going to focus more on advocacy and education. I know when you’re struggling to master your craft and pay the bills and advocate for your patients that it’s hard to see beyond the call, but EMS is bigger than you or your agency. Act as a steward of your profession.

  • Hug your spouse, play with your kids, and show them every day that the most precious things to you are beyond the call. Getting away from EMS and living your life is important, too.

  • Mentor that millennial or Generation Z medic that needs to learn that responsibility, work ethic and initiative extend beyond the call. And don’t be blind to the fact that they have lessons to teach you as well. Quality of living, leisure time and a social life have value far beyond the call, Mr. Workaholic Generation X Medic.

In short, culture change in EMS isn’t something we’re going to accomplish in a week in May. It’s a constant effort, and we can start by focusing more every day on what we do beyond the call.

Advocate for your providers all year long with these resources:

Always Going Beyond the Call

The Red Cross thanks first responders every day, and particularly during EMS Week.

Stay #EMSstrong with our new BLS, ALS, & PALS Resuscitation Suite™ programs.

A better solution at a better price.

Visit or call 1-888-926-6405.

By Rebecca Szeles

In December 2018, the Richmond Ambulance Authority (RAA) launched a Peer Support Program to support the mental health and well-being of its employees, designed to help paramedics, EMTs and communications staff deal with the day-to-day stresses of the job.

Richmond Ambulance Authority has had a Critical Incident Stress Management (CISM) team in place for years to help employees who experienced a traumatic event (e.g., a mass casualty incident, a line of duty death or a pediatric death). While CISM has been an important program and helped some of RAA's staff, there was a realization that a greater need among employees wasn't being met.

During my 12 years with the RAA, I have served in our Logistics Department, cleaning and restocking trucks, as a medic on the streets, and am now a communications supervisor. I have seen the toll these jobs have taken on my coworkers, organization-wide. I joined the Wellness Committee in 2010, and advocated for focusing on mental health in addition to physical health. While we created some initiatives to address mental health, they weren't enough.

Organizing Peer Support from CISM

In 2017, we invited Jim Marshall from the 911-Training Institute to speak to our Communications Center about resiliency. It was a success! Our communications officers that took the class still use techniques today to deal with the stress of daily work.

It still wasn’t enough. I had only helped 18 employees. I knew many of the over 200 other employees at RAA needed more. I attended a three-day CISM course along with four other employees, doubling our program by June 2018. We were helping more employees, but it still wasn’t enough.

In CISM debriefings, I heard the same comments over and over from employees. “It’s hard to talk to supervisors. We don’t want to appear weak.”

Clarity was like a bucket of cold water over my head. We needed peer-to-peer interactions with peers trained to help each other through the tough days. We needed peer support!

Selecting and training Peer Support team members

We called in Jim Hyde, an expert from Peer Support Central. He provided a two-day train-the-trainer course for myself and four others that I hand-picked based on my interactions with them and their previous teaching experience. This became our steering committee. We developed a two-day course that would train our peer support providers in:

We developed a 5-question survey and distributed it on two different occasions to all Operations employees. Any employee that was interested in the Peer Support Program (PSP) would fill out the survey and return it for review by the steering committee. The strongest candidates were selected and trained.

We’re in the midst of changing our process for selecting peers as awareness for the PSP has grown. Our next round will consist of nominations from the employees themselves. Who do they trust and confide in?

How RAA overcame Peer Support hurdles

When building the program, we focused on peer privacy. We developed an Ethics Code and Program Scope, similar to our CISM program. We have a peer on call 24/7, but instead of using company phones, we have a single Google voice number that is not tracked by RAA (we do the same for the CISM on call numbers).

Our peers fill out a Google document survey after each contact, but do not report any identifying information. The only information that is reported is the number of contacts and type of contact (e.g., CISM follow up, work-related issue, family, daily stress). This process gives our peers a limited amount of autonomy to get the job done, and has increased the providers’ trust in the system exponentially.

Our Peer Support Program has been active since December of 2018, and 10% of our providers have already benefited from its use. One of our biggest hurdles has been awareness. Most of our providers did not know what a PSP was. We have spread awareness of our Peer Support Program by:

  1. Holding peer-hosted meet-and-greet breakfasts for both day and night shifts (with other activities planned for the future)
  2. Developing a video and posters to increase internal and external awareness
  3. Supplying the peers with business cards

We’re not done yet! We still have a cultural stigma about asking for help. Continuing education is the key. We are developing an eight-hour, mandatory resiliency course for our providers. This course will teach providers about mental health, what we are up against and how we can overcome the challenges. It will be taught by the Peer Support peers. By empowering our employees and giving them tools to succeed, we can improve their overall health and effectiveness as EMS employees.

About the author

Rebecca Szeles is a nationally registered paramedic and communications supervisor at the Richmond Ambulance Authority. She is also a member of RAA’s Critical Incident Stress Management Team and Peer Support Program.

Additional resources for supporting personnel mental health:

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3. Structuring a tactical EMS team. In these episodes of the MCHD Podcast, Dr. Dan O'Donnell and Dr. Kevin Schultz discuss scaling TEMS to availability and training.

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1. A dose of reality about recruitment and retention. Watch the curve to understand how connectivity impacts how future generations learn and engage.

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