Social Suicide

This blog post is a part of  the second “What If We’re Wrong Blog-a-thon.” You can find the other posts here. The premise of this event is to play the devil’s advocate and argue the opposite view on a topic we normally cover.

In my lecture, “Selfie Sabotage” I discuss how to use social media to your advantage as a tool to promote your EMS career and increase your professional prospects. My personal experience using social media as an EMS provider has been a positive one; I have been able to advance my exposure in the industry over the past three years promoting my writing and making key connections with other EMS leaders using social media applications. Most others with an eye on improving their career prospects and the inclination or appropriate training have minimal issues with using these applications professionally or difficulty keeping their personal life out of their professional one… but we all know at least one story about a professional meltdown with social media as the weapon of choice.

AngryTwitter

Social media use is not a right. Unfortunately, most use it with abandon and no method of policing themselves or ability to pause before posting something controversial. There are reasons agencies place restrictions on their employees use of these applications; yes, you may “say” what you like, but there are always repercussions in real and virtual life.

 

  • “It’s on the internet, so it must be true.” I am a fan of curation in addition to producing content, however many social media users do not check the sources behind information, whether articles or photographs, that they share with their followers. The next people don’t check their sources and share and so on until a lie becomes the “truth.” Obviously, there are entertainment spoof sites like The Onion and Gomerblog, which most understand are tongue in cheek and not real news. Outside that, what do you look like to other providers and prospective employers when you share inaccurate information on a clinical level? What if you take a “clinical” article as gospel and it’s wrong? Could that be detrimental to patients in your care? It’s up to the reader to vet their sources and sadly most don’t.

 

  • Misrepresentation is rampant on the internet – and not just for online dating. It’s easy to slip past embellishment in a virtual environment; the virtual nature implies privacy and anonymity, but could not be further from the truth. I have been a witness to many conversations in chat groups or comment threads where one provider knows another and calls them to the carpet on the fib related to their stated experience or certification. I have also witnessed others researching a provider purporting to be someone their not and revealing the true status or level of their certification or employment. Not exactly the best way to be noticed.

 

  • It’s much easier to put your foot in your mouth with the insulation of the internet. That ranges from outlandish tweets to insensitive memes to inadvertent missteps. The results are wide ranging: insulting patients, offending your coworkers or peers, breaking agency protocols leading to your dismissal (and possible blackballing from emergency services), to causing safety concerns for yourself, your partners, and other emergency agencies in your area.

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Many EMS providers, and people at large, place too much faith in the content they find online. Just yesterday a friend posted an article that was an absolute lie, many people knew it was inaccurate and informed him; others commented and took it blindly as the truth. Posting on any social media site requires the same mindset as face to face interaction. If you are not willing to invest the time to pause before you post when you are unsure or ranting then you should limit your social media use. These missteps makes EMS look foolish as a whole.  If you don’t have anything nice to say – just don’t say anything at all.

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.

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?

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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.

 

 

 

 

 

 

 

Dress for the job you want.

 
Dress for the job you want, not the job you have.  This adage is commonly used in reference to the business sector, but maintaining a professional and appropriate image is as applicable in EMS as on Wall Street.  People may not be investing their money in our bank, but they are investing a treasure that is greater than any monetary fund, they are entrusting us with their lives or those of their loved ones.  According to research by Harvard Medical School and Massachusetts General Hospital, people assess your competence and trustworthiness in a quarter of a second based exclusively on how you look.  You haven’t even made it up the sidewalk to the patient and they already know what they think of you and how you will care for them.  Patients are not the only people we encounter that are making judgments based on what we look like.  Bosses, nurses, doctors, police officers, firefighters, politicians, and every citizen on the street are looking at you, how you act and what you are wearing.  If you look like a mess, your organization looks like a mess.  Being mindful and aware of your appearance not only benefits your personal career, it benefits the advancement of EMS as a whole.
 
When I was a “new guy” I will admit I was quite a hellion.  Of course, you can’t properly raise hell without looking the part.  Short red hair with a white stripe in the front and shaved to the skin in the back, ears full of hoops (definitely more than four) and of course Doc Martins.  Begrudgingly I wore my super-hot and absolutely uncomfortable, polyester, French blue shirt and navy pants with matching stripe.  You can imagine my poor partners’ horror every day they had to work with me, “that guy.”  Not because I couldn’t lift or was a poor clinician, but I made THEM look bad because we were associated by the uniform. I didn’t get much respect from the old timers and surely not from nurses and doctors that I just met.  Time went on and my unique hairstyles evolved.  In the late 1990s there was a popular hairstyle that was long and straight in the back with “sprockets” or multiple twists that looked like battery coils at the crown.  Yes, I was enamored and loved to wear this style all-the-time.  One day at work our most infamous homeless guy called the ambulance, for the fourth time in six hours to go back to the hospital he just left.  A discussion turned into a rather heated debate with a police officer about what to do in the situation since taking this gentleman back to the hospital was not really what he wanted (that would be food and a cool place to sleep).  The police officer commented on my silly hairstyle during this argument.  The officer had deduced that I had no real responsibilities in life and had no liability to be concerned about when making patient care decisions because I wore unprofessional hairstyles to work.  I am just thankful no one has a photo.  If you do have one, please burn it.
 
When you put on your uniform, you are no longer your own unique individual.  Yes, you bring you and all your gifts and attributes to work, but the uniform signifies your representation of an organization of unified practitioners.  You can be unique and as fancy or silly or slovenly as you want to be on your own time.  When you are at work, you are not you, you are the job.  Uniforms are not all bad.  They can inspire authority, not only in patients’ eyes, but within our psyche as well.  On EMTLife.com, Adamjh3 states, “I’m way more confident in my uniform than I am normally, it’s like I’m a whole different person.”   Uniforms can inspire unity between employees, assisting in producing a team environment.  They also help others identify what role you play if they need assistance.  Uniforms can offer safety via blood borne pathogen or fire protection within the garments.  Most of the common complaints I have noted in reference to a uniform appearance for EMS workers deal with how the practitioner is wearing the garments or their appearance while in uniform.
 
Some commonly noted uniform faux pas are:
Wrinkled uniforms:  I recently attended a funeral for a fellow EMT. One of the mourners, also an EMT, had on a uniform shirt that looked like he pulled it out of the bottom of the hamper.  On a regular day that is awful, at a funeral it was disrespectful and disgusting.  Iron your stuff, or at least throw it in the dryer (I won’t tell).
Dirty Uniforms:  Some of us wear light blue or white shirts and dirt from various sources finds its way right to the front of the shirt for everyone to see, it is part of the job.  If your shirt is grey or brown and it wasn’t that color when it was issued, please wash your uniform.  I won’t mention all the other things living on a dirty uniform, you can imagine on your own.
Ill-fitting uniforms:Too big and too small look equally bad.  All your parts should be covered without looking like you borrowed your Dad’s clothes.
Shirt tails:  Tuck your shirt in!  This was the big winner when I asked providers for their feedback on their biggest uniform peeve.  This one thing can instantly make you look slovenly and lazy.
Wear a t-shirt:  In addition to having an extra layer of protection against the gross things our uniform shirts attract, a t-shirt makes what is under your uniform shirt opaque and protects you from wardrobe malfunctions. As a new EMT rebelling against my unfashionable uniform, I did not wear a t-shirt.  One day while driving back to headquarters I looked down to find my shirt wide open!  Three buttons “malfunctioned” and all I could think about was how to button my shirt without my partner noticing.  Thankfully, he was a gentleman and made up an excuse about going to the corner store and left me to fix my shirt in peace.  Guys, this goes for you, too!  No one wants to see your Magnum PI chest hair through your shirt.  White, navy or black are typical colors that compliment most uniforms, but of course wear what your organization’s SOPs direct.
 
Hair: Since my days of rebellion via coif I have been reformed and now stick to either blond or red that could occur via nature.  My professional life has improved greatly.  Yours can, too.  Men, keep your hair cut or styled (the ladies like it, too).  Shave your face if it looks bad and follow your organization’s SOPs for facial hair. Ladies, if you have long hair or loose where it could get into bodily fluids that aren’t yours (yes that happened) please secure it.  This is a blood borne pathogens issue and a security issue.  If you are attacked by someone your beautiful hair can be used as a weapon against you.
Piercings and jewelry: No, you should not wear your septum piercing and Marilyn Manson gauges to work.  Granny may have a conniption and the goal is to not upset your patient any more than they already are.  In reality all jewelry should be avoided for safety and security reasons, someone can attack you and rip out your piercings, use a necklace to choke you; your rings can get caught on many items in your truck or on a scene.  Everyone wants to go home at night with all their parts intact.
Accessories:  Please wear a belt.  A belt can hold your radio and many other doodads you may need at work.  A belt can also help with that pesky shirt tail that won’t stay tucked in or pants that are a little too large.  If you note that your boots are looking scuffed, dirty or broken down, please clean and polish them or replace them.  The lady with the white carpet does not care that you were at a cow pasture last week; you are not getting into her house with those boots.
We do a job that requires exertion at times and yes, we sweat and that can be quite fragrant.  You should not be malodorous BEFORE your shift.  Good hygiene benefits your partner and your patients who will be in close quarters with you and your aroma at some point.  It benefits you as well since you don’t want to be “that guy” no one wants to work with.  Clean, neat hands are important in our profession since they are our tools to administer treatment to patients.  Not only can they carry disease, but like our uniform they demonstrate our attention to detail.  No one wants to be touched by grubby hands, even when enclosed in gloves.
I recently 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.  In our business our message can affect our own or others’ lives, what message could be more important?