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September 1, 2010 / jeffmedic

Separation

I intended this blog to be about EMS education and for the most part it will be. In addition to being trained as a paramedic, I also have a B.S. in Human Resource Management. Since I was a paramedic first, I was able to apply the things I learned in school to EMS. As a result, I have a keen interest in EMS workforce issues. Hopefully one day I will get to spend part of my time researching employment in EMS.

In that vein, occasionally I pick up a book or read an article about HR stuff and think about how it could apply to EMS in general and in EMS Education specifically. I want to make sure my program is fair and continues to produce field ready paramedics that can function as a part of an EMS organization.

With every class that graduates, I worry about the world they are going out into. I hope that they will find a good agency to work with and that the passion that got them through school will stay with them. Inevitably some will leave, or separate from, their employers. The reasons will vary. Some separations will be voluntary, some won’t. This is one of the things I hope to research one day.

I recently picked up a book that shed a lot of light on the subject of separation. It is The 7 Hidden Reasons Employees Leave by Leigh Branham. This book is the result of thousands of exit interviews conducted by the Saratoga Institute. Mr. Branham has distilled the results of these interviews down to 7 reason people leave an organization.

Reason #1- The job or workplace was not as expected.

This has been discussed on several of the EMS related social networking sites. EMS education programs are often accused of painting an unrealistic picture of what life will be like on an ambulance. The curriculum is partly to blame. We spend most of our time teaching things that will make up a small portion of the EMS call volume. There are a whole lot more routine transports than there are death defying saves. On the other hand, the consequences of not being able to handle a high acuity, infrequent call badly are a lot worse than making a mistake on a low acuity, more frequent type call. Those of us that teach in EMS programs need to figure out a way to balance these factors out to give the students a more reasonable picture of what life in EMS is like.

Reason #2- The mismatch between the job and the person.

I am not completely sold on requiring paramedics to be EMT’s first but this does provide an advantage when it comes to filtering out mismatches. Hopefully if someone has gone through an EMT course and worked a bit, they will have an idea about whether EMS is for them or not. Then again, I suppose it does take a few months, if not more, to get a feel for what EMS is really like.

The mismatch may be at the agency level as opposed to the industry level. Finding the right home within EMS is just as important as finding out if EMS as a career is right for you.

Reason #3- Too little coaching and feedback.

It would be easy to start bashing EMS managers when it comes to employee relations but that really isn’t fair. Most EMS leaders that I have worked around genuinely want their employees to be happy, they just don’t always have the tools required to lead other people. Leading and teaching are two sides of the same coin. Both require a person to consistently coach and give feedback, no matter how uncomfortable it might be. This is a vital skill if students and employees are to feel secure and grow.

I really have a hard time with this, especially where professionalism and behavior is concerned. It is hard to look into another adult’s eyes and tell him that his behavior is not acceptable. Not doing so when your position calls for it is cowardly and does a disservice to everyone involved. I am trying hard not to be a coward.

Reason #4- Too few growth and advancement opportunities.

This one has been beaten to death on the EMS internet sites. No further comment required.

Reason #5- Feeling devalued and unrecognized.

I think everyone feels this way at one time or another. The job of an EMS program director or supervisor is to make an effort on the organization’s behalf to minimize the opportunity to feel this way. It is important to give positive feedback as well as constructive criticism.

Reason #6- Stress from overwork and work-life imbalance.

This is a tough issue for a lot of EMS people. Ron Davis and Kelly Grayson spoke about this recently on their excellent podcast “Confessions of an EMS Newbie.” It is very easy to let your entire world revolve around work. EMS can be emotionally taxing and having people around you that understand this can really help. The problem comes when things are bad at work and you don’t have anything else to anchor to.

I counsel my students to develop and maintain a life outside of EMS. This can be difficult at times given the schedules we work but it is worth it.

Reason #7- Loss of trust and confidence in senior leaders.

As a paramedic program director, I get a lot of trust from my students initially. Whether or not I keep that trust is another matter. I don’t have to do anything big to lose that trust, just not do what I say I am going to. Every time I don’t deliver when I say I will, every deadline that gets changed, every lesson that wasn’t adequately prepared for erodes that trust and confidence. It is also vital that I make every effort to give my students the most accurate information available. Teaching error or falsehood breeds falsehood. I know it is going to happen but I need to make every effort to keep it to a minimum and not let it happen due to lack of effort.

I really enjoyed this book. It has given me a lot to think about.

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