Recruitment and Retention: More of the Same

I was thinking about some of the recruitment issues that EMS is facing. Lots of large, well known departments are having challenges filling paramedic vacancies. Over the last decade, many of them have gone away from double medic staffing because of the shortage of paramedics.

Yet, we all know of EMS services, most of which are smaller and/or lesser well known, that are approaching full staffing. Funny thing is that many of these services aren’t even the best paid in their area or state.

I think we need to look at them and see what they’re doing. My guess is that it has a lot to do with culture and working environment. Those things tend to keep people around a lot more than a department appearing in the EMS media and/or having a “celebrity” EMS chief or medical director. The truth is, having supportive management, a station to return back to, and equipment that consistently works is going to make more of a difference in your EMS career than “working under Celebrity Medical Director” who’s regularly published and presents at all of the EMS conferences. And here’s where I’ll issue my semi regular reminder that the “Gathering of Eagles” (which some rightfully refer to as the Gathering of Egos) represents the medical directors of the fifty largest EMS systems in the country, NOT the fifty best EMS systems in the country.

And while we’re talking about that, more than a few of those EMS “celebrities” remind me of Paris Hilton – famous for being famous. An EMS organization that’s social media savvy or has an extensive PR program can have an outsized influence or reputation that may not match their actual reality, either operationally or clinically.

In that spirit, I share the following link from EMS1. The article should be titled “Water is Wet” as the statements are obvious and it’s basically the usual EMS commentary. People trying to solve the problems they created in the first place.

If there is one thing that EMS excels at, it is our uncanny ability to believe that the people who created much of the current EMS mess, whether it’s education, operations, or clinical standards, can and should be trusted to sit on the next “blue ribbon panel” or “stakeholder group” to solve the problems they created in the first place. It’s little wonder that we still see EMS employers offering sign-on bonuses for so-called “high performance” EMS jobs which mean little more than a punishing call volume while you bounce around a city from parking lot to parking lot.

So long as EMS promotes the same celebrities who caused the problems they’re trying to solve, EMS will remain where it’s at. The solution? Look for the jobs at the departments that aren’t continuously hiring. Ask around. People who’ve been around for a few minutes in EMS know which jobs those are. Hiring bonuses, pizza parties, and self-promotion will only help a dysfunctional organization limp along so long. And until political leaders understand EMS and actually support EMS — with funding — these “celebrities” combined with the usual cabal of professional EMS committee members and stakeholders will continue to hold EMS back. And that extends absolutely to the current staffing crises we’re dealing with.

If you’re an EMS chief/director or a medical director and you’re wondering if this post is about you, it is well worth asking why people are leaving (or not applying). And actually addressing the problem rather than just boosting pay or giving incentives. People know the salary coming into a job. What they never know is what they have to put up with for the salary. Way too many EMS organizations ask people to put up with way too much for way too little salary. And that truth applies to volunteers too.

For Love of the Job

I have a few friends I consider extended family. One of them in particular feels like a brother from another mother. We have a similar taste for good food and sarcasm mixed with snark. And like me, he doesn’t do EMS full-time. He’s not paid either. He’s a pretty wicked smart (I think that’s the New England term) MBA who is in the financial sector full time and volunteers as a “paramedic light” and firefighter. He’s also acquired a taste for Texas BBQ. (You’re welcome for that trip to Cooper’s.)

He and I are in a group chat with several other like minded individuals. And yes, we’re probably talking about you.

But here’s what caught my eye this morning.

My friend mentioned the trust that the public places in us. The other night, he gets called for a six week old child with respiratory distress. In his own words, he says “it’s 99% likely panicking parent and 1% potential for ‘oh sh-t.'” Fortunately, the kid turns out to be ok. And I’ll quote his words on the next part, which is the key part. “Here’s the trust part: the other twin was crying so mom says ‘I have to get her’ and just hands me the little one. Has NO idea who these three guys standing in her living room are, never met or seen us before, we’re in a mix of regular clothes and ‘uniform,’ etc. Hands me the kiddo and goes upstairs like it’s nothing.” Exactly, my friend. Exactly.

He did a thorough assessment of the kiddo, then calmed the kiddo — and Mom and Dad. And whatever he was thinking about being woken up for what turned out to be a low acuity call, he made the patient and family feel as if they were all that mattered. (On that note, I’d note that there are more than a few paid EMS providers out there whose attitude is much less “professional” than my fellow volunteer in a small New England state.)

Years ago, a San Marcos cop told me that regardless of how silly it seems, to the person who called 911, it’s the most important thing that’s happened to them that day. It’s a lesson I try to remember when I’m responding and it’s the lesson I try to impart to those who I train and work with.

For those of us in emergency services and emergency medicine, we’re offered a ringside seat to humanity. Those who call us trust us implicitly. Let’s keep earning that trust. Train like it counts. Care for people like they’re your family. And never stop learning.

Earlier this week on Facebook, I said “Do the work. Be nice. Look like a professional. Polish your duty boots.” My friend from New England shared his experience that reminded me exactly why those things count — for both us and the public we’re trusted to care for. I hope I never violate that trust and that you don’t either.

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