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The Midlife Medic: Lower Your Voice

A friend of mine came to work at one of my employers. I was excited at the opportunity not only to work with him but for him to experience a new and different environment.

One morning during his orientation, I came in and asked him how his shift went. He excitedly told me about some of the critical cases he’d gone to, then he grew quiet—he was afraid what he was about to say next might hurt my feelings. In talking about a trauma case, he made this observation about the supervisor on scene: “What I don’t get is, what’s with all the screaming?” On a couple of the trauma cases, the supervisor had used a raised voice to bark rapid orders into the radio. He cut himself off frequently, expressed frustration at a lack of quick responses and otherwise acted agitated. In reality he’d been on hundreds of similar calls.

I knew what my friend was talking about. We all do: Those high-acuity, low-frequency calls where stress or fear takes over, and the tone and volume of voice escalate on a steady curve that demonstrates a lack of self-awareness. I am not implying a matching lack of ability; simply that it is an unprepared response to stress. Most of the time people don’t realize they’re yelling.

In this era where we recognize the importance of developing resilience and strengthening the abilities of responders to withstand the unavoidable stress they face in EMS, we should be aware of the importance not only of what we say but how we say it. If your voice is the only thing I hear until I arrive on scene, I have no other way to tell if things are critical or even hazardous, and my stress response is going to react accordingly.

Emergency responders are inherent observers. We learn to pick up on any cues we can find, verbal or otherwise. How you speak matters.

Responders are not the only ones responsible; a dispatcher’s entire career may hinge on their ability to communicate verbally. They have to intake and refine huge chunks of fragmented information and translate them into a functional response. They are literally a vocal emotional telegraph—whatever they put out we are going to pick up. So we will listen to intonation and choice of words and determine if the voice on the mic is cranky, distressed, happy or just plain lost.

The dispatcher’s voice alone can impact the stress level and response of responders, as well as their mood and type of interactions they have with the public. Anger, stress, fear, humor—they will all come through in equal measure.

If you are looking to improve the operational impact of your radio communications, consider the following:

Practice—Everyone thinks it’s as easy as a phone call…until they have to pick up the radio and push that button. (This is usually when all that organized information in your head evaporates.) Take radios and practice. Touch them, turn them on and off, use them like you would on a scene. Take the fear factor out of it.

Train—A lot of yelling is a response to that rise in stress level. The only sure way to reduce your stress and raise your confidence is to train until your responses are second nature. Take it seriously and do it—then do it again, and then once more.

Use radio etiquette—Think before you click. Feedback or squelch may be funny to you, but it hits dispatchers’ eardrums from a couple of centimeters away. It hurts. Make sure your other sources are turned down or off and your siren is turned off for the couple of seconds it takes to talk, or move to an area with less ambient noise (if possible). Repeating oneself is frustrating all around.

Practice a pause—Pick up the radio and listen for three seconds. Make sure you’re not going to step on someone else. Then push the button and count to three, giving time for the channel to open so you don’t cut yourself off by speaking too quickly.

Lower your voice—It works not only in avoiding arguments with spouses but reduces stress levels naturally.

Effective verbal communication is a skill set. Listen to those providers and dispatchers whose voices impact you in a positive way. What’s the cadence? The pitch? How do they space their responses and directions? Emulate what works and see the responses you get.

Be the calm you wish to bring to your scene—lower your voice.

Tracey Loscar, NRP, FP-C, is a battalion chief for Matanuska-Susitna (Mat-Su) Borough EMS in Wasilla, Alaska. Her adventures started on the East Coast, where she spent the last 27 years serving as a paramedic, educator and supervisor in Newark, NJ. She is also a member of the EMS World editorial advisory board. Contact her at or

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