EMS From a Distance: The whole package

Why compromise on capabilities when recruiting EMS providers?

I recently came across an industry blog in which the author made the case that, though we should look presentable in EMS, he would prefer a sloppily dressed medic who makes patients feel important and cared for to a well-dressed medic who’s a jerk.  

That statement made me wonder about accepting coworkers’ weaknesses in return for their strengths. In a service business with as little room for aberrancy as EMS, is it too much to expect exceptional performance and good grooming? Must we settle for any major flaws in the people we hire?

Before you answer that last question, let me frame it in another context, many years before I started in EMS.

What's the perfect combination of traits for EMS personnel?
What's the perfect combination of traits for EMS personnel? (Photo/Wikimedia Commons)

My first full-time job after graduating engineering school in 1974 was at a consumer-products factory. Those of us new to supervisory roles were introduced to a then-popular evaluation system known as the Managerial Grid. The self-proclaimed “style leadership model” from theorists Robert Blake and Jane Mouton used dual nine-point scales to grade managers on their perceived concerns for productivity versus people.

A wannabe hero of the working class like me, who yearned for the camaraderie and group-think of a college dorm with little regard for the efficiency of a workforce, might have scored 1,9 – beloved by subordinates but a disaster at getting things done. A dictatorial taskmaster who consistently exceeded measurable objectives could have been a 9,1. The ideal, and the way most of us saw ourselves, was 9,9 – a composite of Henry Ford and Mother Teresa. Almost all of us were somewhere in the middle of both scales.

Weighing faults and traits when hiring EMS professionals

If grid screening were a prerequisite for employment instead of an after-the-fact exercise, very few 9,1s or 1,9s would have been hired. The managerial labor pool was robust enough so there was no need to settle for either Genghis Khan or Dale Carnegie. There were plenty of productive, personable candidates without major faults.

That’s how I see the EMS market – stocked with lots of multi-talented people – yet we still weigh workers’ traits as if bad must accompany good. For example:

  • Book-learning versus experience. I see book-learning mentioned a lot on social media to characterize formal schooling. The vibe is old-fashioned, like something Charles Ingalls might tell his kids to do right after their chores on “Little House on the Prairie.” This may sound harsh, but I think many paraprofessionals intend to trivialize or even demean higher education when they speak of book-learning, as if practical experience and scholarship antagonize each other. I think the opposite is true: Education enriches experience.
  • Smarts versus common sense. Similar to the above, intelligence and common sense are often treated as mutually exclusive (e.g., “She knows the name of every bone in the body but can’t figure out how the coffee machine works”). Most bright folks I’ve met used common sense to help understand stuff and became even smarter.
  • Personality versus competence. When I hear about a new medic who’s very nice but couldn’t cannulate an 18-gauge in a garden hose, should I wonder if there’s a connection? Uh, no. I haven’t seen any studies showing good humor interferes with fine-motor skills. Linking the two merely reflects a peculiar assumption within EMS that those who enjoy patient care must be doing it wrong.
  • Enthusiasm versus realism. I like to think I was fairly enthusiastic about doing 911 for 20 years. I looked forward to most shifts and felt good about little victories, like stabilizing a not-yet-critical patient or simply convincing an even sicker, scared one to take a ride with us. I was also realistic about how rarely we made a measurable difference in anyone’s life. It takes more than a few months for most of us to achieve that balance. And yet, I’ve watched the combined resources of our industry beat the last bit of eagerness out of some newcomers – not because their enthusiasm alone was an impediment, but because some of my colleagues seemed to believe pragmatism couldn’t coexist with idealism. I’ve found lots of gray area between those extremes.

I’m not sure why we’d want to minimize one desirable trait to bolster another. There’s plenty of room in the talent continuum for some of this and some of that. Any qualities that give caregivers an edge should be nurtured, not dismissed.

If I were hiring EMTs or paramedics, I’d want the whole package: smart, knowledgeable, friendly, mature, capable, dependable, sensible and unselfish; and yes, a great listener in a proper uniform who makes patients feel important.

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