Editor’s note: The most recent What Paramedics Want Report from EMS1 and Fitch & Associates tells us the top concerns our people are experiencing. The next question is not simply, “How do we fix burnout, high turnover and low morale, etc.? Folks in EMS have been asking this question for years and yet the issues have persisted and only gotten worse. Why? Because the question itself comes from a misunderstanding.
Burnout, high turnover and low morale are not the problem. They are the result of the problem — the underlying system — in the same way that car exhaust is the result of the design of a carbon engine. If you focus on stopping exhaust, the engine will not function properly. If you want to stop exhaust, you must go upstream and redesign the engine.
Consider burnout, high turnover and low morale naturally occurring results of the design of the current EMS system.
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Quality control expert W. Edwards Deming noted, “Every system is perfectly designed to get the result that it does.”
The question then to ask is, “What system could we create that would lead to the results paramedics really want? The goal is not merely less burnout, less turnover or less disengagement. The goal is for paramedics and EMTS to thrive, to be the best they can be, to do good work and to be cared for while doing it.
What system can we design that would produce that outcome?
In this three-part series, we will provide a practical framework for building the system for your organization for the results paramedics truly want:
- Part 1: The impact of your communication system
- Part 2: Your system to keep and attract the best talent
- Part 3: Your system for creating a thriving, magnetic organization
Once you accept the premise that burnout, low morale and high turnover are results it opens up whole new possibilities. In the first installment of this series, “The Impact of Your Communication System,” we made the case that the first step was to identify and transform the foundation of your leadership — your system for communication.
In these next two installments, we will explore the source of the recruitment and retention problem, and provide practical strategies to potentially eradicate the issue for good. Before we go on, it is essential that you first check the filter you are reading these words through. As we discussed in Part I of this series, your filter is the opinions, judgments, i.e., stories that are mistaken for truth that you see life through.
If your filter is anything other than curious, then we invite you to slow down and see if you can give up your point of view. Confirmation bias is real. You don’t have to believe anything we are about to tell you, however, to get the most value out of this series, it’s helpful to read it with a learner’s mindset, curious and open to seeing something new.
In this article, we will focus on creating your leadership system to produce the results paramedics really want — to thrive, to be the best they can be, to do good work and to be cared for while doing it.
Part 2: Your system to keep and attract the best talent
Leadership may not be thought about as a system, however, it is and it is the number one driver of culture in an organization. Gallup research has found one in two employees have left a job to get away from a manager and that managers account for at least 70% of the variance in employee engagement scores across teams. Altering your leadership system will have a significant effect on burnout, turnover and engagement.
Over the last 15 years, we have asked participants in our leadership training to create an image that fills in the blank, “Being an EMS leader is like being a .” The images drawn are almost always bleak and have ranged from herding cats, to being a babysitter with multiple arms, walking a tightrope juggling knives with broken glass below, to being a circus ringleader with the tents on fire. These images point to the leadership system that is producing the experience of paramedics in EMS.
This system operating in the background is not innocuous. It is driving behavior throughout the day … every interaction, decision, task. You name it; it’s influenced by those perceptions.
The point of the exercise is to bring awareness to a blind spot — an inherited conversation about EMS leadership — not to be critical, but to give people the opportunity to choose something else, to reinvent themselves as a leader. You cannot create something new on top of something old, especially if you can’t see it.
Inventor Buckminster Fuller once said, “You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete.”
The next exercise in our leadership training is to have the participants fill in the blank in this sentence, “I wish being an EMS leader was like .” Pictures of a conductor leading an orchestra, a row of jugglers working together with no balls on the ground, being the captain of a ship with everyone rowing together on smooth seas are just a few examples of the images from participants. The images provided are filled with hope. We spend the rest of the training helping participants discover how to lead from a new system to create an experience consistent with what’s expressed in their images.
It’s not fantasy. Once the blind spot is realized and a new possibility is created, the potential for behavior change is increased dramatically and new outcomes naturally follow. Said another way, a change in beliefs changes actions and leads to new results. A perfect example of this is the change in resuscitation science and how CPR is performed. Once we understood that stopping compressions to provide mouth-to-mouth breathing was counterproductive — a redefined focus on hands-only CPR and reducing interruptions in compressions helped improve outcomes.
The point isn’t to fix yourself or to become a “better” version of the leader you have always been. It is to examine the system you’re operating from and intentionally create a different one — one that produces the results you want.
7 ways to be a leader people want to follow
The following leadership practices are central to being the kind of leader people want to follow. Together, they create a new system of leadership and a new culture that brings out the best in people and enables them to thrive.
- Adopt a learner’s mindset. Approach situations with curiosity and a willingness to learn. Be vigilant about letting go of your preconceived notions and being open to new ideas. Be responsive to what’s happening in the present moment and trust that you can discover what’s needed to handle whatever circumstances come your way.
- Make developing people your number one priority. Know that your number one responsibility is to grow and develop the people around you. See yourself as a coach, always looking for ways to bring out the best in your people. See your people as assets and trust them to co-create solutions.
- Give people ownership. Articulate the desired outcome rather than the “how to.” Empower people to take risks and use their creativity to accomplish the goal. Be supportive and provide a safe environment for learning to occur. Understand that failure is an essential part of the learning process.
- Take 100% responsibility for outcomes and results. See the results around you, both good and bad, wanted and unwanted, as measures of your own effectiveness as a leader. Do not blame yourself or others. Treat failure as neutral and recognize that it merely shines a light on where you are on the learning curve — which is good news when learning is the number one priority.
- Acknowledge and appreciate your people. Make it your business to acknowledge and appreciate others in ways that are meaningful to them. Be on the lookout for opportunities to show your people how valued they are and express your gratitude.
- Know what your people value. Be genuinely interested in getting to know your people, including what’s important to them and where they see themselves in the future. Be committed to your people’s success and the fulfillment of their goals. When you know how to grow a great employee, you are not afraid of losing one.
- Focus on what’s working. Understand that you have a choice about what to focus on and choose to focus most of your attention on what’s working and how to do more of it. Recognize that within the organization there are far more things working than not working, and you get more of what you focus on. By emphasizing what’s working, you strengthen the organization and the people in it, enabling them to handle problems with more creativity, ease and grace.
These seven leadership practices are not simply a list of things great leaders do. They are the building blocks of a new system of leadership. When leaders begin to think, communicate and lead differently, people experience the difference. And when enough leaders within an organization begin operating from a different system, the culture begins to change.
That is where the real opportunity lies.
In Part 3, we will take this one step further and explore what happens when these practices become embedded throughout the organization — when the structures, systems and culture are intentionally designed to support people in thriving. The result is a magnetic, flourishing organization that attracts great people, brings out their best, and gives them compelling reasons to stay.
About the EMS Leadership Academy
Co-founded by Robbie MacCue and Lisa Giruzzi, the EMS Leadership Academy focuses on helping leaders navigate organizational change, culture transformation and leadership development within the emergency medical services industry. Having trained thousands of leaders, published essential resources for emerging leaders and hosted the annual EMS Leadership Summit featuring global experts, the Academy empowers agencies to build high-trust, learning organizations and eliminate operational burnout. Evaluate your leadership skills and pinpoint critical gaps in your agency by taking our free Leadership Self-Assessment. If you are ready to drive deeper systemic change, sign up for our Keeping The Best training program designed to support leaders in coaching and mentoring the next generation of leaders within an organization.
