We just returned to our station and I’m unable to sleep. There is a feeling of grief that’s come over me.

Hours earlier you left the house with your sister and cousin to enjoy brunch with your family. You never made it.

As you drop to your knees and begin to weep, a feeling of emptiness washes over me. A black hole opens, and I hear waves from the ocean crashing. For a few moments I stand in silence as I watch you experience the worst day of your life.

Quality is a big word. It’s commonly used to signify excellence. Simply placing the connotation of quality in front of a product or service is easy. Anyone can make the statement, “we deliver quality patient care to the communities we serve.” It’s a word often taken for granted. We like to toss quality into our marketing flyers and communications to bolster our EMS programs. It’s a crowd pleaser and a feel-good statement. It’s what we all want….. but are we delivering quality?

It’s 3 months into Bob’s career as a paramedic and he’s struggling to meet the job requirements. He is a new graduate, and this is his first job as a paramedic. While openly discussing concerns with Bob about his work performance he bravely shares his experience with our field training program. He explains that he was not placed with a field training officer during his field training third rides and expresses that he feels he missed valuable mentorship within our organization.

My partner and I smirk as we sip our newly acquired Starbucks coffee. Ah, we relish in the joy of caffeine during our 24 hour shifts. It’s mid winter in Michigan and our ambulance has been dispatched to a residence for a well being check. Sarah, my partner, inquires, “Where are we headed?” My head is buried in our routing system as I read the additional call information, “17 year old male home alone for one week.”

There is meaning and purpose in each call we respond to. Our presence can be to act as a messenger or simply to show kindness and compassion to someone that needs it. Often, our patients teach us about ourselves and can act as catalysts for our own lives.

“The devil is in the detail” is a common idiom that addresses a mysterious element hidden in the details, meaning something may seem simple at first glance but will take more time and effort to accomplish than expected. This idiom is derived from the earlier phrase “God is in the detail” expressing the idea that whatever one does should be done thoroughly.

You asked me to move stations...

You asked me to take one more call...

You asked me to holdover...

There is no shortage of discussion about toxic workplace cultures and “bad bosses”, but what happens when the culture is healthy or making a change to healthy, and you identify toxic employees on your team?  When does the failure to engage, inspire, or motivate the employee stop being identified as a leadership failure, but a reflection of someone’s character?

Tending to and witnessing the grief of others is part of the role we play as first responders. If we’re lucky in our career we’ll have the opportunity to learn from great mentors that teach compassion and empathy while providing exceptional care. After losing my mom this year, I’ve been giving thought to what happens to us when we experience profound loss and grief in our own lives?

“If you don’t get culture right, nothing else matters.”

Few have gotten a handle on retention and many struggle to captivate their workforce long term.  Research has demonstrated that EMS providers do not choose this field of work expecting a six-figure income.

The more time we immerse ourselves in an environment the more that environment influences us.

Ever hear the saying that people start to look like their dogs?

Overutilizing EMS supervisors as clinical providers hinders the effectiveness of middle management and negatively impacts an organization’s operational quality and oversight.

EMS supervisor positions are often rewarding yet demanding.

Chaos puts me at ease like a warm blanket.

I can stand still in madness. Levitate.

I get a rush as my world slows and I cope using the extreme as talent.

I didn’t go to the gym again today….

I didn’t apply for the promotion I was excited about….

I was late for work again today….

I didn’t allow myself the sleep & rest I needed…

To create the life we dream of we must not betray ourselves. Failing to honor our best selves can destroy our confidence and get us stuck in a cycle of joyless comfort.

Middle managers are the heart of any thriving EMS organization. When supervisors are poorly equipped as middle managers organizational culture struggles.