Preparing for Supervision

     Chris stood at his station's bulletin board and studied the position opening for a shift supervisor. Chris had thought about getting off the road and moving up the career ladder. The patients were getting heavier, and he wasn't getting any younger. Chris' partner said it was a great move: "You could change all those things you don't like about this place." Chris interviewed for the job and received it. After all, his boss said, he was one of the best medics at Green County EMS.

     Ten months later, Chris called dispatch to say he would not be coming to work today. Most of the friends he'd made over the last five years didn't talk to him anymore. His suggestions for changes to help the crews had infuriated his boss, and he found himself outside the "loop." Yet the crews now referred to him as one of "them." Lately, there had been several heated meetings with his boss over his time management skills and priorities. He felt like he was in over his head and didn't know how to approach some of the assignments that landed on his desk. Chris found himself depressed on the evenings before his shifts, and he often became ill on the drive to work. Later that day, he stopped at his boss' office to tell him he was resigning to start a new job in Central City.

     Stories like Chris' are not uncommon in EMS. Often, promotions are based on a candidate's clinical competence. Little, if any, training is provided to help supervisors succeed. You may be like many EMS providers who look to move up the career ladder—but are you ready? There are several steps you can take to prepare for entry into EMS management. These start with a self-assessment, an assessment of the desired position and organization, and obtaining the job-specific knowledge, skills and attitudes required of a supervisor.

ASSESS YOUR SITUATION
     One of the first things you do on a call is assess the situation. Moving into EMS management is no different. Just as a careful assessment of the patient and his environment is vital for a successful call, a careful assessment of yourself and the organization is essential for a successful move into management.

     The decision-making skills developed over years in the field can be beneficial to a line supervisor. But in practice, your clinical skills will have little to do with your success on the business side of supervision. This isn't to say clinical skills aren't important; they are. Exceptional clinical skills set a good example for the organization's providers and give you credibility with subordinates. However, intubation and IV competence have little impact when trying to fill a schedule or mediate a customer's complaint. The aggressive approach that may be appropriate in a cardiac arrest or trauma resuscitation may alienate subordinates and the organization's customers, internal and external, when applied in day-to-day business operations.

Self-Assessment
     As an aspiring supervisor, you should try to become self-aware. How are you viewed by others? What is your attitude toward coworkers, coresponders, hospital staff and patients in general? If you don't get along well with partners, or find yourself in constant conflict with firefighters, nurses and medical control physicians, you may not do well in a supervisory capacity. If you don't have a liking and respect for the unique personalities of those in EMS, you won't be able to command the respect to perform in a management role.

     Ask yourself if you have the capability to learn planning behaviors. EMS people are good at being reactive--managing rapidly changing scenarios on a moment's notice is what we do. However, managing people in a reactive mode can create chaos. Just like a lawyer arguing a case in court, supervisors lose credibility with their bosses and subordinates when they react based on inaccurate information. When you spend your time reacting to and putting out fires, minor items (which are major issues to someone else) slip through the cracks. Egos can be trampled, feelings hurt, and subordinates can be left feeling ignored and frustrated. Having all of the facts before acting will build a positive reputation and make you a successful leader.