Every EMS agency has a boss like it: dominating and opinionated, immaculately attired and groomed, with close-cropped hair and an abrupt personality. They are hard to understand and even harder to like. They demand respect and are quick to lash out when angered. They demand obedience because "Lives are at stake!" Sometimes they really are veterans of our nation's military, sometimes they aren't. But what they all have in common is a misinterpretation of what "military leadership" really is. The basic misconception of military leadership is that the military demands absolute, unrelenting subservience to the commands of one's superior, that leadership is best done harshly, and that there is no room for error. Yet nothing could be further from the truth.
WHAT IS MILITARY LEADERSHIP? When new recruits enter the Army, they learn the acronym LDRSHIP. This acronym represents the seven Army values that form the core of a philosophy that applies to every aspect of military life. As a soldier moves up in rank and responsibility, these values are reinforced in every class, lecture and field exercise, and the soldier grows beyond just applying them to his own life and learns to apply them as a leader. Army leaders are taught a simple guiding principle that should be part of every leadership decision and action they take: It's all about taking care of soldiers.
Let's look at the LDRSHIP values.
LOYALTY Military loyalty is to your unit, your superiors, your country and the Constitution. In EMS your loyalty should be to your partner, your fellow crews, your supervisor and your service. But what constitutes loyalty? Loyalty is not blind subservience, and it doesn't mean you can't think on your own. It means you take some ownership of the people and things around you and that you work to support them in their efforts. When they are right, you get behind them and defend them, and when they are wrong, you still get behind them and work to make things better.
Loyalty has to be built. Do you know the names of your partner's children and spouse? Are you someone your partner can talk to if they're stressed out about a rough call or problem in their personal life? Do you stand up for your partner when someone accuses them of being rude when you know they're under a lot of pressure at home? When you, as a leader, become involved in the lives of the people you lead, you identify with them, and they become more than just names. Employees in turn begin to understand that you value them, and they develop strong ties to you. Performance becomes tied to a desire to do well because they want you to be proud of them, rather than so they don't get in trouble. When problems do occur, they are easier to address when the employee knows you aren't just there to attack them.
On the other side of the coin, leaders need to remember that a crew member who comes to you with a legitimate question about a decision you made is not necessarily being disloyal, and you should take the time to clear the matter up. You have to know your crew members and what makes them tick, and they have to know that your goal as a leader is to help them be the best they can be.
DUTY Remember our school discussions about our "duty to act"? A leader in EMS has a duty to uphold in the provision of patient care and to their subordinates. Do you communicate your administration's directives clearly? Do you evaluate your subordinates in a fair manner and give them counsel and criticism when necessary? Leaders serve in positions where they are trusted with information, policy enforcement and decision making. Your duty is to balance all of these and be the person in the middle on whom both the administration and crew member can count.
RESPECT This is a key one that is too often forgotten. The leader who fails at this is often one who misunderstands military leadership (and helps to foster the myths about it). If you are a leader, you have to recognize the abilities, education and experience each of your subordinates brings to the table.
In the military, there are two distinct groups: enlisted folks and officers. It is often the case that a new lieutenant will enter the service and be placed in charge of a group of enlisted people with far more age and experience than he has. The foolish lieutenant stands on his rank and position and tries to immediately establish total control. The wise lieutenant recognizes the senior enlisted persons in his unit, acknowledges their training and experience and leans on them for guidance. On both sides, people recognize skills and understand roles and build a team that is far better than any one of them. Through it all, there is understanding that there is another person with emotions, skills, intelligence and ideas, and they have the same fundamental rights you do.
SELFLESS SERVICE Leaders are never to be guilty of taking the cream off the top. Do your organization's policies handle time off in an evenhanded manner? Do you take advantage of your authority to make your job easier or avoid work? If there are overtime shifts available, do you make sure your crews have the chance to sign up first? One standing tradition in the Army is that the enlisted soldiers eat first. If your unit has had a hard day of patrolling and you come back to the chow hall, what does it say about you as a leader if you're in the front of the line while the new young private waits for you to fill your plate? We don't often have the opportunity to implement this exact principle in our business, but the point is that you're concerned for the welfare of your crews and that you sacrifice your own interests to make sure their needs are met.
HONOR You have to have a sense of who you are as a leader and what you're expected to do. You have to own it, be proud of it and always keep it at the front of your mind. When you look at how you handle your employees, are you proud of the way you treat them? Are you willing to stand behind things you say and do on their behalf? You have to be confident that what you say and do as a leader represents what you value as a person and as an organization. That is achieved through constant self-evaluation.
INTEGRITY Do you always do what you know you should do, even when you know you can get away with doing it differently? You are faced with this choice every time you run a call. Think of the choice you make when you're taking an elderly person back to their skilled nursing facility. You know you should check a blood pressure every time a patient enters that ambulance. You also know it would be easier to just write a BP down on your report. The patient will never know, and it's unlikely anyone else will either.
For a leader integrity begins to impact in different areas. Maybe it's admitting to an employee that you spoke too harshly to them, and apologizing. Do you allow one crew to slide by and not clean the truck as thoroughly as another crew? If you have a problem employee who is wrongly accused of something, do you still defend them, even if you really wish they weren't still working there?
PERSEVERANCE It's hard to be a leader. It's hard to walk those thin lines between friend, coworker and supervisor. Seeing your employees continually make mistakes wears you out. It is far easier to just punish them and push to have them fired. But that isn't always the right answer. Are you able to see through an employee who may be having some problems and see that they could really be a shining part of your crew? You have to lead with consistency and thoroughness. Change, in people and in organizations, doesn't come overnight, but rather as a result of a steady movement that focuses on the goal, not the process.
CAN IT WORK IN EMS? With more than three million Americans currently serving in the active and reserve components of our armed forces and millions more listed as veterans, chances are good there are military and ex-military folks in your organization. EMS and the military attract similar personalities. Both appeal to people who seek adventure and autonomy and have the desire to do something different. Both demand intelligence, the ability to make critical decisions based on limited information, and the drive to excel. The elements of our personalities that give us the fortitude to perform a difficult job can also make it difficult to accept leadership. So how do you, as a leader in EMS, successfully convince a group of other leaders to become followers?
Don't confuse military leadership with militant leadership. Army leadership is value driven and focuses on people as individuals and their ability to make the Army successful. The Army's philosophy is to keep these values paramount in a soldier's mind from the day he first puts on the uniform. They are reinforced every step of the way to produce the kind of leader an army or any organization needs.
Your organization has probably done some work along this line already, so as a leader or employee, you need to reexamine those ideas. Are your values pertinent, and does your organization clearly articulate and reinforce them? They should have personal meaning for you as a leader and be a driving force behind everything your service does. This is the kind of introspection you need to give to these ideas if your organization is to stay focused and work as a unified team.
You can't load that stretcher alone. You can't run every call. You need those people on that ambulance, and they need you to be at the forefront, fighting for them and helping them be successful in a difficult job that's all about the people we serve.
This article originally appeared in the July 2008 issue of EMS World Magazine.
Andy Gienapp is EMS administrator for EMS programs in the Office of Emergency Services, Wyoming Department of Health. Previously he served as a field supervisor with Hamilton County (TN) EMS. He is a U.S. Army veteran with nearly 18 years of active and reserve service in a variety of positions and locations, including a tour in Iraq.