It’s pretty incredible…
how many EMSers secretly hate their jobs.
And how many top-performers up and leave EMS and air medical.
At first glance, it makes no sense.
Why would anyone loved and respected by their co-workers, considered expert in their field and top of their profession, suddenly quit a job most people would kill to have?
From the outside looking in, getting paid to fly a helicopter and save lives is incredible.
Most people would kill for the opportunity.
So why then do some of the very best in the field consistently leave EMS and air medical?
Don’t get me wrong.
There are good EMS managers.
But one bad manager can scare away a lot of good people.
Managers tend to blame their high employee turnover on everything under the sun, while ignoring the truth of the matter.
Here’s the truth:
People Don’t Leave Jobs; They Leave Managers
The sad irony is how easily this can be avoided. All that’s required is a new outlook and some extra effort on the manager’s part.
Is correcting EMS Manager mistakes worth the time?
Organizations know how important it is to have motivated, engaged employees, but most fail to hold managers accountable for making it happen.
When organizations don’t hold anyone accountable, everyone suffers.
Gallup research shows that a mind-boggling 70% of an employee’s motivation is influenced by his or her manager.
So the next time you hear about how horrible employee XYZ is doing, consider the source and remember it’s a direct reflection of the manager in charge.
Managers of course don’t like or want to hear these facts. But it doesn’t matter.
“Heavy lies the crown,” as the saying goes. Or, if you’re ex-military, this probably rings more familiar – “With great authority comes great responsibility.”
Regardless of your training or background, managers play a huge role in your success or failure in EMS.
So, let’s take a look at some of the worst things that managers do that send good people packing.
Bad EMS Manager Mistakes
#1) They overwork people
If you work EMS or air medical, you are no stranger to fatigue on and off the job. Sadly, it’s a lot easier for managers to ask their top performing employees for help than others.
Because they know their best employees will help them without a fight.
The challenge is to spread extra work as equitably as possible. It’s easy to do. All it really takes is self-awareness about who does the lion’s share of extra shifts. On a side note: if you’re one of the top performers working all kinds of extra shifts and thinking your manager notices and cares, you’re more than likely fooling yourself.
Managers care about shifts getting covered, not so much about who works them.
Change may require going to your manager and showing them why you’re not taking extra shifts the next time she asks you. Show her how many shifts you’ve already worked and the reasons why you believe others may be a better and fairer choice.
This gives your manager an easy option of showing the same information to less helpful employees.
#2) They Don’t Recognize Contributions And Reward Good Work
When I consult with air medical companies, I’m always stunned by how few recognize employee milestones.
Keeping track of how many flights or cases individual employees have responded to is easy work. If you’ve already spent thousands of dollars on software to track other “more important” details, adding this to your software system is usually an easy and almost zero-cost, fix.
Here’s why it matters:
Recognizing your top performers matters. Top performers keep score, and they want their managers to keep score too.
You don’t want extra money for working extra shifts to be the only incentive. It’s not enough to keep your top performers on board.
#3) They Fail To Develop People’s Skills
Some EMS and air medical managers are anti-education. You read that correctly.
Some EMS and air medical managers are threatened by employees with solid educational credentials (and skills). It’s true and it’s easy to spot.
When I first started flying, I of course included all my experience and education on my resume. It seemed an easy decision.
But when I gained more experience in air medical, I quickly starting updating my resume by downgrading my experience.
Because it was obvious EMS and air medical managers didn’t want the best candidates, they wanted candidates they could control. Candidates they considered non-threatening. And one easy way to make yourself non-threatening is ensuring you have less education (on your resume) than the person interviewing you.
I’m not encouraging you to do the same, but I am encouraging you to do your homework.
Research the education of the managers in charge of the positions you’re applying for. Then do what makes the most sense.
#4) They Don’t Care About Their Employees
This is a big one.
Have you heard the adage “people don’t care how much you know, until they know how much you care?” It’s true in EMS and air medical.
Narcissistic EMS managers are easy to spot and easy to manage. To manage them, all you have to do is smile and nod your head occasionally when you listen to them. Basically, “happily” endure being in their presence and move on as quickly as you can.
But it’s also this type of manager that chases away the very best employees. Sooner or later, top performers get tired of pretending their managers are competent.
Top performers notice every time a manager rewards friendship over merit or hard work. They know they can get another job anytime they want.
So when bad managers exhaust them, top performers leave.
#5) They Have No Honor
Say what you mean, mean what you say.
Sounds simple, right?
And it is simple, until managers start making promises they can’t keep.
You see this phenomenon a lot with promotions that have no performance merit attached to the promotion. An EMS manager’s friend gets promoted because of the friendship.
The newly promoted manager genuinely means well and is highly motivated to create positive change.
Two weeks later reality sets in when the new manager tries to implement…anything. It then becomes brutally obvious their management authority is paper only.
No decisions allowed without 100% prior approval of the manager “friend” who promoted them. It’s a real problem and lack of honor extends well beyond promoting friends. It permeates all aspects of the job.
#6) They Hire And Promote The Wrong People
In the 13 years I flew civilian EMS, I never saw a performance-based promotion. Never.
Every single promotion (including my own) was based on past friendships, past relationships (military) or recommendations from friends or colleagues.
Performance was rarely even considered, and when it was considered, it was always after the real decisions were already made. A rubber stamp to protect the human resources department and current management team from litigation.
The bad karma of promoting friends instead of the most qualified employees always catches bad managers. In the moment, it seems like there’s no justice, but over time there is.
How do you spot a non merit-based promotion?
The same way you spot a fractured sternum or half missing skull. It’s obvious. Nothing but common sense is required to spot the most egregious efforts of bad managers attempting to hire and promote the wrong people.
Here’s a couple quick examples:
- Mechanics in charge of pilots.
- Medics in charge of nurses.
- Housekeeping in charge of surgeons.
You get the idea.
The results of hiring and promoting the wrong people are quick and obvious.
Here’s the disturbing part: poor results almost never reverse the decision.
You can watch your flight program shrink from five or six helicopters to 3 or 3 1/2 helicopters, and nobody lifts a finger to rid the organization of the manager. Why?
Because the high level decision makers who promoted the manager are more concerned about protecting their own reputations than fixing the problems. It happens a lot in EMS.
#7) They don’t let people pursue their passions
It takes about six months to get a 90% comfort level with flying EMS. After six months, things quickly become routine.
The EMS honeymoon ends.
Motivated employees start looking for new ways to contribute to the organization’s success.
This is a huge opportunity for both the manager and the employee. Done well, it’s the proverbial “win-win” situation.
Bad EMS managers fail at letting top performers pursue their passions for two reasons: first, they don’t know what their employee’s passions are. Second, they don’t care enough to find out.
Why not assign the person with a marketing background or interest in marketing to the outreach committee? Why not take a minute to learn how new employees want to contribute to success?
It seems obvious, but reality is that it rarely happens.
EMS is full of examples of missed opportunities and wasted talent.
#8) They fail to engage creativity
Imagine calling your current EMS boss and saying something like this:
“Hey boss, I have this idea about how to increase our outreach in the southern portion of our operations area. Myself and a couple others at our base would like to head down there and do some public relations stuff for the good of the program.
Do you have any problem with that?”
If you’re experienced EMS and laughing, stop. I’m being serious.
The sad truth: an employee who asked a question like the one above would be lucky if all they got was reprimanded, and not fired.
Bad EMS managers are not secure enough to let other people make decisions. Any decisions, much less decisions dealing with the public at large or outreach.
The irony of course is that dealing with the public and outreach are baked in to almost all EMS and air medical jobs from the start.
#9) They don’t challenge people intellectually
When you have people on your team who literally bring people back to life, it’s important to challenge them intellectually.
Adult coloring books will more than likely fall short…
Although, adult coloring books are very popular as of the writing of this article (seriously).
The days of you drive the ambulance from point A to point B to point C, ask no questions, and never complain or question anything, are pretty much over.
Top performers expect to be challenged. They’re easily bored and wicked smart.
This is the reason you see a fair amount of flight nurses leave their flight nursing positions and move on to nurse practitioner or higher education opportunities. They simply get bored with flying and the politics that surround flying and working for bad EMS managers.
What To Do Now
So what do you do now?
If you want your best people to stay, you need to think carefully about how you treat them. While good EMS employees are as tough as nails, their talent gives them an abundance of options. You need to make them want to work for you.
What other mistakes cause great employees to leave? Share your thoughts in the comments section below.
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