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How to deal with angry EMS employees

When you truly listen to a group of angry EMS providers, there is always a bounce from negative complaints to positive affirmations

I was feeling pretty good about the morning meeting based on how things had gone the night before with an EMS system that was a mess. The organization was weeks away from declaring bankruptcy. Only half of their ALS rigs had a working heart monitor, their ambulances broke down so often that they had acquired a second tow truck and their entire senior management team had been ousted.

I was brought in to help resuscitate this nearly dead organization.

We hired a whole new leadership team and group of field supervisors, most from inside the organization. The previous evening we talked with them about high-quality clinical care, fiscal responsibility, fleet/equipment maintenance systems, team building and customer service.

The leadership team was fired up and fully committed to turning things around. The two hours that we scheduled for the evening meeting had stretched to five hours with questions, brainstorming solutions and “we can do this” spirit.

The next morning, pumped full of energy and optimism, I fired up my EMS customer service presentation for the hundred-plus EMTs and paramedics crowded into a windowless, too-small training room. It was pretty dark so I could not see their faces.

Eight or nine slides into my presentation, I noticed that there was no laughter in response to my funny pictures. In fact, there was no response at all. It took me longer than it should have to realize that something was definitely off track.

I paused, now that my eyes had adjusted to the low light, and I looked at the front row of crossed arms and “you can mandate my butt to be in the seat, but you can’t mandate me to like you” faces.

I said, “This isn’t really working is it?”

The biggest EMT said, “Well ain’t you the smartest mother*&$#$ to ever fall off a turnip truck?”

That line got the first chuckle of the morning. I turned up the lights, turned off the slides and asked, “What’s going on?”

Listen to every word

They erupted - all talking at once with words to the effect of, “You buy crap ambulances, supervisors are abusive jerks, we don’t know if our paychecks are going to bounce,” and more. This was in the late 1980s and I was a brand new consultant facing my first group of angry employees.

I had no idea what to do, but I felt like it could turn violent if I didn’t come up with something quick. I asked them to give me 60 seconds. Sprinting down the hall, I interrupted the brand new operations manager Todd Stout, who is now my boss, and said, “Grab your legal pad, two pens, and follow me. We need to listen. That means that you can’t say anything, just take notes on everything.”

Re-entering the blood-filled shark tank feeling like chum I said, “It’s clear that you’ve got a lot to say and we are committed to listening to every word. For this to work, the only thing we need is for you to go one at a time. You can say anything you want to, any way that you want, using every cuss word you can think of if you need. Just go one at a time and let the person in front of you finish before you jump in.”

They agreed and it started rolling out.

I wrote the key points on the whiteboard. The operations manager aggressively wrote everything down. We did not question, push back, educate, clarify, correct or reframe. We just listened deeply, empathically and fully. They went on for two and a half hours without much repetition.

The bounce always happens

After a pause in the storm, one of them said, “Hey now folks, not everything around here is terrible. We’ve got a lot of proud, hard-working folks trying their darndest to care for patients even with all the rest of this crap.”

Then, as if the group had been mass injected with happy juice, they started talking about all of the good things and the good people with the same passion that they had when creating the list of complaints. They rode this positive train for another 40 minutes.

We were able to end the meeting with plans to address as many of the complaints as we could, a commitment to turn up the volume on the good stuff and a batch of frontline employees who were willing to help make things better.

Essential ingredients to bounce from negative to positive

Since this experience nearly 30 years ago, I’ve had the opportunity to be with several groups of unhappy EMS professionals. Yes, in case you’re wondering, I caused some of the unhappiness. I don’t know if it’s a law of human behavior or not, but every single group complaint session has turned from negative to positive without me steering, guiding or nudging.

Here are the essential ingredients to make the transition from negative to positive work:

  1. When you notice that there is an emotional charge in the group, it’s time to listen.
  2. Listen deeply without interruption.
  3. Avoid the overwhelming temptation to defend, to provide more information, to correct misperceptions, to educate, to re-frame or to talk about how bad things are for you. Just listen. Don’t talk.
  4. Write things down on something the group can see or read, a whiteboard, a flipchart or an LCD projector works great.
  5. When you write things down, use their language. If someone says, “My supervisor is an insensitive jerk,” write it down just like that. Don’t edit it to say, “Supervisor problems.”
  6. When someone repeats something that someone else has said, you can make a tick mark next to what was said earlier as a subtle signal that it’s a repeat and it’s been heard again. Repeats are valuable information too.
  7. When they start to run out of ideas, encourage them to reach for more. You want them to get it all out, to feel as fully drained of negative thoughts as possible.
  8. Ask them not to save anything for the meeting after the meeting. Get it all out now.
  9. When the bounce from positive to negative happens, it’s OK for you to enjoy it as long as you don’t suggest that things are not as bad as they said previously. They can say that, but as the leader you can’t.
  10. Make sure that you take quick action, in the next 24 hours, on at least some of the easy things on the list. Encourage people to get involved in implementing the improvements identified.

Participation does not always happen, but in this case the angry guy that called me out at the beginning of this employee meeting stepped up to help make improvements. He became a key part of the leadership team and we have been good friends for the last three decades.

Mike Taigman uses more than four decades of experience to help EMS leaders and field personnel improve the care/service they provide to patients and their communities. Mike is the Improvement Guide for FirstWatch, a company which provides near-real time monitoring and analysis of data along with performance improvement coaching for EMS agencies.

He teaches Improvement Science in the Master’s in Healthcare Administration and Interprofessional Leadership at the University of California San Francisco and the Emergency Health Services Management Graduate Program at the University of Maryland Baltimore County. He’s the author of “Super-Charge Your Stress Management in the Age of COVID-19.” Contact him at

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