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Enhancing wellbeing, engagement and patient care in EMS with weak ties

Approaching casual relationships intentionally in EMS has lasting implications for improving engagement and optimism in the EMS workforce

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Our brains are hard-wired to seek connection with other people. It’s in all of our best interests to cultivate the fine art of making small talk with people we don’t know very well.

Photo/Russ Myers

This article originally appeared in the Paramedic Chief Leadership Briefing, Garlic festival MCI response | Weak ties | 9/11 Victim Compensation Fund. Read the full briefing and add the Paramedic Chief eNewsletter to your subscriptions.

Think about an EMS provider’s typical work day, apart from the clinical aspects. Our medic gets to the base, where he sees a coworker, and asks about their weekend. Crews are coming and going; they chat for a few minutes and wish each other well. Our medic has a brief exchange with a supervisor, manager or administrative support person. Heading out, he makes his regular stop for coffee and a snack at the convenience store, and shoots the breeze with the clerk. He then responds to a call, where he exchanges greetings with the police officers, and the fire and rescue team on scene. He may not know any of these people well, but their paths cross occasionally, and they engage in some light conversation.

It appears that these “weak ties” have a greater impact on our wellbeing than we realize. A 2014 study found that “daily interactions with casual acquaintances ... can contribute to day-to-day well-being.”

Tracking interactions with family and friends (strong ties) and with acquaintances (weak ties), participants in the research reported a greater sense of belonging and happiness on the days when they had more weak tie conversations. “Evidence suggests that weak ties such as these – relationships involving less frequent contact, low emotional intensity and limited intimacy – confer some important benefits,” the authors noted.

Social relationships, with weak ties or strong ties, are an essential part of being human. Our brains are hard-wired to seek connection with other people. It’s in all of our best interests to cultivate the fine art of making small talk with people we don’t know very well.

Patient care implications

For our EMS providers, this has implications for both their inter-personal relationships and in the patient care they deliver. First, weak ties with those providers encounter throughout the day benefits their own sense of well-being. Having casual contact with peers, public safety colleagues, hospital staff and others deepens their sense of connectedness. Another study reports that “feeling socially connected increases happiness and health, whereas feeling disconnected is depressing and unhealthy.” Small talk aids in our ability to see others as fellow human beings, beyond the uniform.

Volpe observes that “Instead of considering these minor brushes of socialization throwaway interactions, cultivating low-stakes relationships can pay dividends.” Our intentional efforts to nurture weak ties with those around us also extends to our patients. Making small talk with patients and their loved ones invites providers to look beyond the illness, beyond the circumstances that bring EMS to their aid, and see them as fellow human beings. The same benefits of social connection that we enjoy – an increase in our happiness and health – also benefit the patient.

Encouraging empathy and engagement

The practice of cultivating weak ties has potential leadership, business and institutional implications as well. Wallace notes, “Chitchat is also an important social lubricant, helping to build empathy and a sense of community. It is much harder to snap at a [coworker] ... if you have just exchanged pleasantries.”

I believe that managers who have an intentional, weak-tie relationship with their direct reports are more likely to have employees who are more engaged, resulting in lower rates of employee turnover. Those employees are also more likely to be more empathetic toward their patients, which leads to increased patient satisfaction. Weak ties can be nurtured by the occasional social event, manager-provided food, and EMS Week activities. Work relationships have some natural boundaries, but that doesn’t preclude being friendly and showing an interest in your employees.

It’s clear that making small talk has surprising benefits. The challenge, and the opportunity, for EMS clinicians and leaders is to approach those interactions deliberately. It’s a win-win.

Russ Myers is a chaplain with Allina Health EMS, St. Paul, Minnesota, and author of “Because We Care: A Handbook for Chaplaincy in Emergency Medical Services.” He can be contacted at