Coach Class


Coach Class

By Mike Rubin Dec 14, 2011

A few months ago I swapped e-mails with Paul, a close friend and ex-partner from New York. Paul and I are in the autumns of our EMS careers—late November or early December, I’d say. We were discussing how hard it will be to leave. Is it possible, we wondered, to find another activity as stimulating as prehospital care, but without the physical challenges made even more formidable by age?

After reading “Personal Best,” Atul Gawande’s compelling piece about coaching in the Oct. 3, 2011 issue of The New Yorker, I think I might have an answer. Gawande, a surgeon, discussed the benefits of inviting a respected retired instructor to monitor his cases. Gawande credits that process—live observation of technique, followed by debriefing, critique and forward-looking strategy sessions—with lowering his complications rate and reinvigorating his practice.

Is there a need for coaching in EMS beyond certification-driven objectives? I think so. I know I would have been sharper with periodic practical tune-ups that went beyond review of the same skill sheets I’d mastered two or three years before. Even today, after almost 20 years in this industry, I’m sure there are aspects of my performance that could be improved through impartial observation by an experienced associate, followed by customized feedback.

Some would say EMS already provides coaches; they’re called preceptors or field training officers (FTOs). I disagree. Those titles imply senior-junior or teacher-student hierarchies. Newbies rarely get to pick their FTOs, nor do they have a say in the goals or scope of that interaction. Coaching veteran providers requires a different skill set than guiding novices through their earliest field interventions. For example, a good coach might lack limitless patience for rookie mistakes, while a good preceptor might find it hard to offer advice constructively and diplomatically to a coworker with as much or more experience. Consider those who carry the title coach in sports; they haven’t necessarily performed as long or as well as their charges. With so many media outlets competing for the attention of the coachable, I think modern coaches need exceptional communication skills more than been-there-done-that pedigrees. That’s fortunate for me, because I’ve never done a cric with a car key or started a central line in an elevator shaft.

Is coaching equivalent to mentoring? Similar, perhaps, but not the same. Coaching involves direct, ongoing oversight with real-time guidance. Mentoring is more of a passive activity, without mandate or even mention. I can imagine asking a trusted colleague to be my coach, but not my mentor. I doubt any of the mentors I’ve had in journalism, sports, engineering or EMS knew they were playing that role. (Thanks just the same, Stan, Neil, Glenn and Paul.)

A prerequisite to coaching is someone who wants to be coached. That might be trickier than it sounds. To those of you with more than a few years in this field, how willing are you to endure scrutiny and criticism of your work habits? Could you consider suggestions impersonally, in the spirit of well-intended quality improvement? Sometimes that’s hard for me, even when I know my patients or readers or clients would be the beneficiaries. My first reaction to recommendations is often “But…” If I were coaching me, I’d put a stop to that.

Here’s what I’d want from a coach:

Distinguish style from substance. Doing things differently isn’t necessarily wrong; however, I’m willing to try almost anything to improve my performance that doesn’t lead to a court appearance or a YouTube video gone viral.

Don’t limit feedback to what you think I want to hear. I already know enough people who do that. I’m not saying I don’t like it sometimes. I just think positive reinforcement means a lot more when it’s balanced by constructive negatives.

Be of service. Your job is to help me. If you’re good at that job, you’ll meet your needs by sincerely addressing mine.

Continue Reading

I wouldn’t be surprised if many retired EMTs and medics met those criteria. They’re occupational skills. We don’t forget how to do those things just because we’re on the sidelines. I hope I can leverage my share of life experience to help others in EMS long after my last paycheck.

Come see me in a few years. I’ll be the one with the patch that says Coach.

Mike Rubin, BS, NREMT-P, is a paramedic in Nashville, TN, and a member of EMS World’s editorial advisory board. Contact him at

In a conference about the opioid crisis, former Congressman Patrick Kennedy (and a former addict) pleads with the public to treat addiction as a disease, not a moral failure, and offer effective treatment accordingly.
Don’t we have enough to worry about—and be liable for—already?
Local EMS honored 13-year-old Marcus Weekly with an "Outstanding Citizen Award" after he jumped into a pool to pull an unconscious boy from the bottom of the deep end.
As summer time donations dwindle to a severe shortage, first responders ask eligible donors to consider giving blood to help save lives of patients in critical conditions.
By providing basic health and household information, emergency responders can better assist in 9-1-1 calls, especially if callers are unable to speak or struggle with dementia.
The new ordinance will impose countywide fees on residents to help pay for a replacement for one of the rescue squads in addition to aiding the fire department.

After responding to a call at La Familia Adult Day Center in Brooklyn, an FDNY paramedic brought smiles to the residents with some smooth moves.

Terror attacks are among the hardest calls for Israeli volunteers to answer

On June 16, the sanctity of the Jewish sabbath was shattered. The sanctity of Jerusalem was shattered. In one moment life changed irrevocably for some, as the air around the Old City of Jerusalem was filled with the bullets of three gunmen intent on creating havoc and killing as many innocents as possible. The terrorists began shooting innocent bystanders and border police officers near the Damascus Gate just as the Jewish sabbath began in our capital city.  

Should the unthinkable happen on duty, your service will be honored and remembered

Each year in May, representatives from the National EMS Memorial Service, National EMS Memorial Foundation and National EMS Memorial Bike Ride gather in Arlington, Va., to pay tribute to fallen EMS and air medical providers during the National EMS Weekend of Honor. This story was written by a rider from the National EMS Memorial Bike Ride’s east coast route who attended the National EMS Memorial Service for the first time.

These hospice transfers are the days these families will remember forever.
Just in time for National CPR and AED Awareness Week, eight Ohio community parks are equipped with AED stations.
The opioid epidemic has taken a large toll on first responders and taxpayers, resulting in a retaliatory lawsuit filed against pharmaceutical companies and doctors who strongly advocate prescribing opioids for pain management.
The Emergency Operation Center is encouraging residents to have 72 hours worth of supplies in the event of a severe storm without rescue.
A new law goes into effect Sept. 1 that will make it illegal to operate retired ambulances for marketing, transportation or even as party buses or "slambulances"
Camp Crane was the only training ground for the U.S. Army Ambulance Service