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5 ways to tell EMS managers they were wrong

Follow these tips for explaining a mistake your manager made, responding to accusations of wrongdoing or suggesting an idea to improve your service


By Franklin Banfer

As prehospital professionals, it’s our duty to make split-second decisions every day. But, let's face it, not every decision is a good one. Sometimes our decisions are right. Sometimes they are wrong. And when our decisions are wrong, it’s critical we receive feedback to correct our actions. No matter your role, an incorrect decision can be detrimental to yourself, your organization and most importantly your patient. This holds true for the rookie EMT, the veteran paramedic, the ride-along resident physician, and, yes, even management.

But as a field provider, how do you tell management they got something wrong? Here are five ways to defend your actions from accusations of wrongdoing, make a suggestion to improve a process or to give feedback about a new policy.      

1. Gather facts, not fantasy. 

Example: You were called into the supervisor’s office and placed on suspension because Tom said that Jane said that Tony said you backed the ambulance into the building without a spotter and violated the safe driving policy. 

There are three sides to every story – your perception of the event, someone else's perception of the event and what truly occurred. It’s incredibly important to collect factual, objective and accurate information about the story. Information should be from firsthand knowledge, for example, from someone that was present during that event. 

Here, you bring to the supervisor’s attention your ambulance service’s security camera footage from the day of the incident and that, should they download the footage, would see your partner exiting the ambulance to act as a spotter while you backed into the building. This footage is factual, objective and accurate and clarifies the misinformation from Tony, Jane and Tom as reported to the supervisor.       

2. Follow the chain of command.

Example: Your co-worker attempted to start an IV on a patient four times, each time being unsuccessful. When they ask you to sign off on the ePCR, your co-worker documented only one attempt and that the IV attempt was successful. You ask your co-worker about the false documentation and they respond "What do you know? You’re only an EMT. Just sign the thing."     

First, follow your service's policy for filing complaints and grievances. 

If your service doesn’t have such a policy in place, go to your immediate supervisor. If it was your immediate supervisor that made a wrongful decision, then proceed up the chain of command to their superior.

Don’t confuse reporting wrongful conduct as "tattle telling" or "ratting someone out." Egregious events must be addressed and corrected to avoid any further wrongful conduct. There may even be a legal course of action you can take to right the wrong, but any legal action is highly fact specific and should be discussed with an attorney licensed to practice law in your state. 

3. Be respectful. 

Example: Management has set forth a new policy that personal vehicles are not to be washed while on duty. You take the station's binder of policies outside, put it in a bucket, cover it with car wash soap and fill the bucket up with water. All of this is occurring with your partner live streaming it to social media. 

In any discussion – to anyone - be respectful. This may be difficult, especially if management is younger than you, less educated or less experienced. But you are an employee and management is a voice for your employer.

It’s possible to respect someone and disagree with them, but it’s all about how you present yourself. Remember that when speaking to management, you are speaking to an extension of those that own the ambulance service and those signing your paychecks. 

Ultimately, respecting someone, though disagreeing with them, is a hallmark of professionalism.

4. Watch how and what you say.

Example: You get called into the supervisor’s office. As you walk in, the supervisor is behind the desk with her arms crossed. Someone from the billing office is also in the supervisor’s office, with his arms crossed. Right off the bat, the mood is set as aggressive. 

We’ve all seen those patients with crossed arms and legs. This is called the defensive posture. Crossed extremities connote a stand-offish appearance or one that is closed. As you are speaking, re-examine your posture and stance. Keep your arms uncrossed. Remember, this is a conversation, not a cage match or a schoolyard brawl.    

Next, watch how you phrase things. Don’t assign blame and don’t belittle the management decision. Use clear and accurate wording to describe your perception of the decision and how the decision is negatively affecting you.

Don’t assume the decision was made to target you personally and assume no one specific is to blame. Be careful with how loud you voice your opinion. There is a difference between being passionate about your point and yelling at someone. 

5. Actions speak louder than words. 

Example: You approach your supervisor with an idea to cut costs while increasing patient care. Your supervisor says it’s a good idea and encourages you to attend a board meeting to present your idea. So, you attend a board meeting and describe your idea.

Two months later, you are still waiting to hear from management regarding your proposal. At the three month mark, you go on social media and blast your management, service and co-workers as the most "lazy" and "incompetent" people you have ever met. 

Manage your expectations of an encounter with management, especially high-ranking corporate executives. Most often, change doesn’t occur overnight. Sometimes a proposal must go through multiple channels and people not even in attendance at the meeting. A proposal may have to go through multiple legal terms to ensure it is lawful. It may then have to go through financial teams to assess its merits. It may then have to go to a local government board, like a township or commissioner, for further permission.

Change takes time. But that doesn’t justify defaming, slandering and posting negative comments about your experience, service and supervisor on social media. It’s perfectly normal to feel frustrated. But when frustrated, it’s best to act like a prehospital health care professional.

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