This week on EMS One-Stop, I sit down with Liz Harney, almost a year after I first walked into a classroom at EMS World Expo looking for another session to report on and found what I later described as “the keynote I didn’t know I needed.”
Liz’s presentation was built around a part of EMS education we routinely acknowledge but rarely give equal billing: the affective domain — empathy, communication, professionalism, self-awareness and the ability to connect with another human being in what may be the worst moment of their life.
But the real power came from Liz herself. Before she was a paramedic, educator and EMS leader, she was the patient. At the lowest point of a decade-long struggle with addiction, one paramedic looked beyond the overdose, the circumstances and the judgement, and treated her as a person who still mattered.
Liz credits that interaction not simply with helping save her clinically, but with changing the trajectory of her life. She recovered, entered EMS and ultimately became the kind of paramedic she had encountered that day.
It is a remarkable journey from patient to paramedic, and in this conversation, Liz explains why that experience now sits at the heart of everything she teaches about the human side of EMS.
| MORE: Liz Harney — the affective domain is the heart of EMS, so why aren’t we teaching it?
Our discussion also catches up with where Liz’s thinking has evolved since. In her recent EMS1 article, “Shiny Happy People,” she takes that same belief in people and applies it to EMS leadership, challenging professionals that is exceptionally good at identifying everything that might go wrong not to let that instinct extinguish every new idea before it gets moving.
Together, we connect those themes: the provider who changed one patient’s life, the importance of deliberately teaching the affective domain, turning cynics into champions, recognizing burnout through QA and QI, and creating leadership teams with enough optimism and emotional intelligence (EI) to make change happen.
At a time when EMS is increasingly consumed by another form of intelligence (AI), the conversation comes back to a proposition I think matters more and more: if we are going to get good at AI, we first need to get much better at EI.
Additional resources:
- Liz Harney: Shiny happy people. The leadership power of optimism
- Rob Lawrence: The affective domain is the heart of EMS — so why aren’t we teaching it?
- Inside EMS: Tactical empathy: The leadership tool you’re not using enough
- Colby Davis: Can emotional intelligence be taught?
- Shannon L. Gollnick: The paradox of progress — emotional intelligence as the differentiator in an AI-augmented workforce
Key quotes
- “It truly was a paramedic that not only saved me in a clinical sense, but she saved me in a human sense.” — Liz Harney
- “Everybody has a story and they’re all a little the same, but they’re all very different at the same time.” — Liz Harney
- “It’s our role as educators and program directors to be able to ensure that we are instilling, improving the affective domain, just as we are the cognitive and the psychomotor.” — Liz Harney
- “You created from the cynic, turned them into the champion, and then the champion then took that back to their own service.” — Rob Lawrence
- “I am the dreamer, probably because I have forged myself out of the depths of hell.” — Liz Harney
- “Look at me, anything is possible. Like there is never a ‘no’ in my language.” — Liz Harney
- “In order to build, in order to make change, in order to move the needle, you have to have folks that are strong in EI to make that happen.” — Liz Harney
- “There’s always room for improvement.” — Liz Harney
- “I may not be able to teach everyone to care, but I absolutely think you can teach people what caring looks like in practice.” — Liz Harney
- “No one’s ever complained about the gauge of needle that we used, but they’ve certainly complained that the medic was mean.” — Rob Lawrence
- “People underestimate the power of storytelling, but I’m here to tell you that is what creates the change into someone, that changes their perspective.” — Liz Harney
Episode timeline
- 00:00 — Harney on surviving addiction, being written off and the potential EMS providers have to influence another person’s future
- 01:02 — Rob welcomes listeners to EMS One-Stop and introduces Liz Harney
- 02:14 — How Rob first encountered Harney at EMS World Expo and why he describes her presentation as “the keynote I didn’t know I needed”
- 02:40 — Liz Harney 101: critical care paramedicine, organizational leadership, Baptist Health, Kentucky EMS workforce initiatives and Paramedic Pathways
- 04:10 — Harney reflects on the rapid growth of her speaking platform and why sharing her story remains difficult but necessary
- 05:32 — The human side of EMS: affect, emotional intelligence and why clinical competence alone is not enough
- 08:10 — AI versus EI: why Lawrence argues that increasingly intelligent technology makes human emotional intelligence even more important
- 09:00 — From patient to paramedic: Harney recounts the interaction with the paramedic who changed the direction of her life
- 18:33 — Revealing her past to colleagues and students, and how that story changes attitudes toward people experiencing addiction
- 22:08 — Why simply telling EMS students to care does not work — and how Harney began using clinical rotations and direct patient interaction to build the affective domain
- 23:18 — “Everybody has a story:” students hear directly from people in addiction recovery
- 25:23 — The cynic-to-champion story: a student’s dismissive attitude toward patients with addiction is transformed through one clinical rotation
- 31:00 — Educating not simply for cognitive and psychomotor competence, but for the clinician the student is becoming
- 32:15 — Harney moves from education into leadership and begins seeing the same issues around decision-making tables
- 33:19 — The case for optimism: Harney describes herself as a dreamer and explains how persistent negativity can kill innovation
- 34:04 — Lawrence’s rule: “If we do what we always did, we’ll get what we always got”
- 36:27 — Why potential barriers matter — but introducing every possible objection too early can destroy an idea before it develops
- 38:02 — “Shiny, happy people:” the discussion turns to Harney’s article on optimism, innovation and assembling teams capable of making change
- 39:02 — Harney describes Kentucky’s EMS workforce committee and what happened when a group of optimistic problem-solvers started building ideas without immediately saying “no”
- 41:00 — Choosing the right people for decision-making groups: why names, titles and tenure should not outweigh emotional intelligence
- 41:59 — Harney defines EI: self-awareness, self-regulation, communication and empathy
- 45:00 — “You can teach people what caring looks like in practice.”
- 45:15 — Lawrence asks whether EMS can genuinely change the affect and attitudes of a generation of clinicians
- 46:39 — Protecting the workforce: recognizing behavioral changes, cumulative exposure and the early warning signs of burnout
- 47:41 — QA/QI as more than clinical oversight: documentation can expose frustration and changes in provider behavior
- 48:07 — The leadership question: “What can I do for you?”
- 49:27 — The power of storytelling to challenge judgment and change perspectives
- 49:49 — Harney returns to her own experience: addiction, being cast off and ultimately demonstrating that recovery and transformation are possible
- 51:10 — Harney’s closing message: “You don’t have to understand someone’s life to understand your responsibility to them.”
- 52:41 — Turning QA/QI from a fault-finding function into a mechanism for recognizing providers, celebrating success and checking on people carrying heavy cognitive and emotional loads
- 54:10 — Lawrence recommends seeing Harney speak: “You will come away emotional but enlightened.”
