Safety Farmer

Question: What do you do? You're an experienced leader, but currently you're the newest person in your agency. You are surrounded by good folks, but, although you get a sense they worry about getting hurt, some of them drive too fast. Others ignore rules about wearing safety gear, checking their equipment and using backers. You know that has to change, and you'd like to make it happen today.

Answer: It takes about three years to change an organization's culture. You can do it faster than that, but not without scaring people. Scare them, and you prompt them to defend themselves—usually as a group. Against you.

Leading any EMS organization is like walking up an escalator that's going down. You need to keep climbing just a little faster than the escalator. The most important changes you make will be the ones that impact people's safety. But safety doesn't happen because you make (or change) a lot of rules. It happens when you grow a culture that subconsciously embraces it, makes it part of people's lives and induces them to insist on it in their own daily practices.

In my experience, you need to get inside their heads and plant a few seeds, then be patient. You need to teach them a whole new way to talk. You can start doing that right away without alienating anybody. Try this: Every time you leave a group of them, instead of just saying good-bye, faithfully remind them to be safe. Tell them you hope they have a safe shift, drive safely or something like that. When they respond to a call, urge them to "come back safe to us." Make those your standard parting comments.

Find ways of your own to bring up safety in meetings and in your casual conversations with them. Tell them, even in the smallest ways, over and over, that they're valuable, they can't be replaced and their well-being matters. Eventually, there needs to be no doubt in their minds that you honestly care about it and about them.

Of course, safety's a lot bigger than what you say. It's about the personal commitment of every individual who makes up an organization. Be patient, and never give up. They'll get it. When they do, you'll hear them speaking the language themselves. Eventually, they won't even remember who planted the seeds. And that won't matter.

Thom Dick has been a passionate advocate of sick people and the safety of their field caregivers since 1970. He has written hundreds of articles and three books on those subjects, including the People Care books ( You can reach Thom via Facebook, or at

Thom is the author of People Care: Perspectives & Practices for Professional Caregivers. The recently released 2nd edition of this classic text includes seven new features: Death notification skills; suicide intervention strategies; safe procedures for defusing and, when necessary, restraining violent people; cases intended to illustrate the lessons of People Care; and strategies for reconceptualizing burnout and managing it as a balance issue. Click here to order.

Thom is also a member of the EMS World editorial advisory board. E-mail