Ambulance 5 responds to a major vehicle accident. Its crew is Ben, a paramedic; Randy, who is driving; and Cindy, an Intermediate EMT assisting Ben in the back. On their way to the scene, Ben asks his team how they will prepare for this incident.
Randy says he will position the ambulance close to the scene, but not close enough to inhibit responders’ activities. Cindy says she will obtain the trauma bag and oxygen tanks to assist Ben on the scene. She recommends Randy get the backboards, neck braces and stretcher out of the ambulance when they arrive. Randy agrees. Cindy then recommends Ben go immediately to the patients to start their evaluations so they can prioritize and begin addressing their injuries.
Ben thanks both members of his team for their recommendations. He acknowledges that he enjoys working with them, and the support they provide helps establish a positive and effective environment for the successful treatment of patients.
Treatment of the accident victims is smooth. Both are transported to the nearest emergency department and treated effectively in route. On the way back from the hospital, Ben provides positive feedback to both his teammates. He also encourages Randy to remember to respond immediately to the dispatcher when they arrive at scenes in order to establish their time on scene. Randy relates that he forgot to do that, but says it won’t happen again and that he appreciates Ben’s feedback. Cindy also responds positively to Ben’s support and says she’s proud to be on the Ambulance 5 team.
Leadership and Followership
Good followership can greatly assist leadership in any organization, but they are particularly intertwined in EMS. There are several reasons why followership is important to leadership. First, individuals shift into and out of the dual states of followership and leadership. Second, building and sustaining a friendly and proactive relationship between the leader and follower is very important. Third, both leaders and followers exhibit many of the same qualities that are desirable in establishing a good organizational team.
According to leadership expert Richard Daft, there are five styles of followership.
1) The first is the alienated follower. These are often effective followers who have experienced setbacks and obstacles, perhaps promises broken by their leaders. They think independently but are often cynical and do not participate in developing solutions to problems they encounter. They allow hostility and cynicism to permeate their work environment. The leader needs to work with these individuals to turn them around into active and effective parts of the EMS team.
2) The second style is the conformist. Conformists participate actively in EMS organizations but do not utilize critical thinking skills in task behavior and accomplishment. Normally, conformists simply follow the orders of leaders without providing feedback. They work with the team, but do not provide critical thinking to support improving the operational environment or patient care.
3) The third style is the pragmatic survivor. Pragmatic survivors, according to Daft, emerge when organizations go through desperate times, and followers find themselves doing whatever is needed to get through. According to Daft, 25%–35% of the followers in an organization are pragmatic survivors.
4) Passive followers are the fourth style. Basically they exhibit neither critical nor independent thinking and are not active participants in the organization. Passive followers leave the thinking to the leader. Their leader may be the type that overcontrols or gets carried away with punishment, which leads to their followers being passive just to survive. This is poor leadership and must be changed to establish a constructive and participative EMS team.