What Are You “Saying”

While getting my nails done a few weeks ago my manicurist had CNN on the television, Donald Rumsfeld was talking about the United States response to one of the many violent events occurring in the world today. It struck me how eloquent this man was under pressure. I wondered how could this translate into my own deportment and why don’t EMS providers sound like this?

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Merriam Webster’s dictionary defines eloquence as: discourse marked by force and persuasiveness; the art or power of using such discourse, or the quality of forceful or persuasive expressiveness. These are all requisite to be even moderately successful health care providers and advocates for our patients. How can we convince a truly sick patient that they NEED to be in the hospital to curtail serious or deadly consequences if we don’t have the method to communicate this to them? How do we demonstrate our professionalism and passion to other related professions, healthcare providers, and politicians that also play a hand in advancing or restraining the future of EMS if we are not able to communicate well? Presentation is as important in EMS as it is in the business or entertainment setting. Good presentation is not just about tucking your shirt in and wearing new boots if you open your mouth ruin the illusion.

 Public Speaking

It’s not as difficult as it seems to “sound smart.” There are a few ways we can all start to improve our vocabulary.

  1. Stop using profanity. Cursing does not illustrate your point, shock, make you seem important, or benefit you in any way. It really just agitates people and that doesn’t really work positively most times.
  2. Be aware of your tone and volume. How you speak may be more important than what you are actually saying. I used to work in an area with an excellent provider, but the care he gave was often missed by everyone on scene because his tone was harsh and the volume of his voice was much too loud. Many patients were disturbed and several asked for him to “stop yelling at me.” It doesn’t matter if you are the best provider in the department if your care is marred by your tongue.
  3. Use appropriate (and correct) terminology. If you want to be treated like a medical professional, you should sound like one. Honestly, you should also write your documentation like one. If you don’t remember medical terms from your days of EMT school, bust out your book and study or take a course on medical terminology. This small investment of time and money will go a long way in increasing your stature with other medical providers.
  4. Think before you speak. Many times our vocabulary faux pas is not related to the words we misuse, but because we don’t police our tongues and end up offending people. This can lead to more than disciplinary action, inciting violence on scene and placing you and your partner in danger.
  5. Listen to understand, not to respond. When you are speaking with patients or their families listen to what they have to say so you can understand what the true problem is, not just your perception. Then you can respond appropriately and sound professional. Sometimes people speak to us because we are the only ones they trust to listen without passing judgment. We in turn are often entrusted with their life experiences and they end up imparting a gift to us.
  6. Read. Reading might seem incongruous with improving your speaking abilities yet how do you learn new words and ideas without reading? Read things you wouldn’t normally read. Read from all topics, not just related to EMS although you should try to keep up with current events within our field.
  7. Look the part. I attended a seminar at a prestigious university where a speaking coach was discussing how to have your message heard. The very first thing she talked about was visual presentation. People make their decision about whether or not you are worth listening to within milliseconds. That may not seem “fair”, but it is what we have to work with when attempting to deliver our message and treat our patients.

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The list above is not exhaustive, but it’s a good place to start. It won’t be easy, but changing your vocabulary and way of speaking is possible with mindfulness and persistence. Don’t give up if it feels like the change is long in coming, it takes 3 weeks to make a habit. Changing how you speak won’t only improve your professional life, but can transform your entire life for the better.

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How many A-holes work at your agency?

I was recently reading a piece by a gentleman named Olivier Blanchard called Brand Management: The Asshole Effect.  I was so excited while reading it because in a parallel life to my EMS career, I worked at a popular coffee emporium.  I was expected to and enjoyed providing awesome customer service (it’s possible that my caffeine addiction helped me fulfill that achievement).  About half way through the article, I had an “AHA!” moment. I realized that this is not just about business as we traditionally recognize it, but can also be applied to agency reputation and customer service within EMS.

 

Whether popular culture in our field regards EMS as a business or not, it is a business and we need to keep the money coming in to continue operations. We are a service provided to citizens.  Smiling at a patron while wearing my trademark green apron and handing them a paper cup filled with their caffeinated prescription is the same as smiling at a patient seated on my stretcher while wearing my clean and neat uniform bearing my agency patch.  I am representing my brand.  I am promoting my agency’s reputation.

 sbuxThe author in a parallel life

Mr. Blanchard posits that every “customer” facing agency with the least amount of a-holes wins.  Essentially, this means that people make a positive association with an agency for every positive experience they have with that agency.  Similarly, for every negative experience, people make a negative association with that agency.  Traditionally, if a customer has a great experience with a company they may tell 1 friend.  If a customer has a bad experience they will tell at least 10 friends. With the advent of the internet the 10 friends receiving bad information about your agency has increased exponentially. This theory does not only apply to customers we interact with directly, but everyone in the vicinity that might witness the event.  One glaring example involves modern technology. I am sure most of you have had some experience in the street with witnesses or family members with cell phone video cameras.  Some are just busybodies who want something cool for YouTube, but others have malicious intent and ambulance chasers on speed dial.  Civilians are not our only “customers.”  Our fellow responders such as police, fire, emergency management and hospital staff are our customers, too.  What if an asshole (I know you have one in mind) was on that scene representing your agency?

 ambchaser

I used to work at an agency that was regarded as “elite” by some in our area.  We had expensive uniforms, nice ambulances with cool reflective lettering, and more toys than you could count in our garage.  Our positive reputation as an agency didn’t last long because no one checked the a-hole count.  One fine afternoon, my per diem partner and I responded to a little old lady with flu like symptoms at her home.  She had difficulty walking more than a few steps and lived on the second floor so we had to carry her down the stairs.  I set up the stair chair and assisted her to a seated position and secured her to the chair.  My partner and I move toward the stairs with our equipment and patient in tow.  I positioned myself on the stairs to carry the bottom of the chair and let my partner know I was ready.  I waited about 30 seconds and stated I was ready again.  30 more seconds passed, I leaned over and looked around the chair to find him texting away at the top of the chair.  He was totally checked out of reality. The police officer and the bystanders on scene saw it, too.  Our real “customers” now viewed our agency as a joke.

 

Customer Service at its Finest

Pride. Respect. Professionalism. Honestly, those are not adjectives I conjure immediately when I think about EMS. The adjectives that come to mind when I imagine describing my chosen profession are: lazy, slovenly, and unqualified.  Let me make a disclaimer: There are some shining examples of pride, respect, and professionalism among EMS agencies and individual providers, and looking disheveled does not make you unqualified for your job, it makes you LOOK unqualified for your job.  Being an a-hole is not limited to verbal communication. Visual communication speaks volumes.  Every time you wear your shirt wrinkled or untucked, every time your boots aren’t tied, every time your truck is dirty, every time you text while you are on a call indicates that you don’t care about the “customer’s” experience.  It indicates that you, and your agency by proxy, are a-holes.

 

Resolving this issue should be important to EMS agencies, although experience shows us this is not always the case.  (This is when people start to send me hate mail.)  The reputation of an agency is of the utmost importance because it influences all aspects of the organization.  The most obvious of these is related to securing funds.  If your agency uses fundraisers to secure operational funds for continuity of operation, you must have awesome “customer” service.  Who is going to GIVE their money to an organization they regard as a bunch of jerks?  The same goes for attracting new members or employees and retaining your current staff.  People volunteer or work for and agency for a variety of reasons, one of which is to belong to a group they believe in and identify with.  Even one a-hole can cause others to find new employment or volunteer at another agency or lead to a dedicated member resigning.  Now you don’t only have to find a new “body,” you have to pay for pre-employment checks such as a background check and a physical and new uniforms and training.  If you think the politicians in your town aren’t your customers, then you need to talk to agencies that have been cast aside, not by poor clinical performance or low response statistics, but because of poor customer relations.  Some politicians will reroute 911 service to the provider of their choice and then your agency is nothing more than a social club with fancy jackets.

 1781436_10202196788858772_1855065837_nThe best agency I ever worked for, felled by politics.

Mr. Blanchard proposes the awesome service you provided 10 years ago is soon forgotten, what is important to people is what you did WRONG last week.  We must provide awesome customer service continually! 20 years ago, before the widespread use of the internet and smart phones, it was easy to contain the fallout from the a-holes that afflict your organization, but now one small misstep can tarnish your agency exponentially.  Be aware of your behavior, and if you are part of the leadership structure, be cautious of who you hire or accept for membership in the first place.