About Dave Konig

Dave Konig has been a career EMS Provider since 1995 and has acted in various supervisory/leadership roles since 1997. His leadership experiences includes time as a Field Training Officer, a Field Supervisor, an Operations Manager, a Communications Manager, and as the Director of Operations in New York City and its surrounding regions. In addition to his career experience, he has also been elected to various leadership positions at the Forest Hills Volunteer Ambulance Corps where he continues to volunteer, serving the community since 1994.
He maintains his personal blog at DavidKonig.com and you can follow him on Twitter @DavidKonig.

POLL: Dispatchers – Supervisors Or Not Supervisors?

Today I’m crowdsourcing answers and opnions to this question:

Dispatchers – can what they do be considered supervising and therefore would you consider them a level of supervision over field staff? If so wouldn’t you then consider them Supervisors through job function although not through title?

Can Dispatchers, through job function and not by title, be considered Supervisors?


Yes, the function of a Dispatcher is to provide direction, guidance, and oversight to field staff

No, the function of the Dispatcher is simply to provide call information to units and funnel their needs to the appropriate resources, therefore there is no oversight

View Results

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My Case As To Why They Can Be Considered Supervisors

I argue that, although their title is Dispatcher, the role they play is more of a first line of oversight and/or supervision. I argue this mostly with people from outside the Emergency Medical Services (such as the fine folks in Human Resources) who do not actually understand what the function of a Dispatcher is. Allow me to explain why I see it that way by starting with the definition of Supervisor:

Supervisor___Define_Supervisor_at_Dictionary_com

The definition of a Supervisor clearly defines them as someone who supervises workers or the work done by others. Now let’s look at the actual definition of supervises:

define_supervises_-_Google_Search

The word supervises clearly indicates that the activity includes directing workers to complete a task (ie assigning them a call), directs the work of someone (ie sending a unit to post or reassigning the unit), and the synonyms include both oversee and monitor (ie signal updates).

So since I’m on a definition kick, let’s look at the actual definition of Dispatcher:

Dispatcher___Define_Dispatcher_at_Dictionary_com

The second definition specifically uses the work “oversees” which is a synonym for the definition of supervise and therefore, in essence and job function but not in title, I would argue that a dispatcher is a Supervisor figure to field staff. Keep in mind that they are for all intense purposes the command and control element for the resources at work. Although they are doing it from a remote location

Please let me know if you agree or disagree (and why) through voting above and/or in the comments below…

(…To Be Continued…)

The Importance Of A Smile

Smiles.

So simple and yet so very powerful. They alone have the ability to break through indifference, warm the emotions of others around, and when used at the right time can influence what others will do. Smiles are relatively cheap in comparison and virtually every budget is able to afford as many smiles as you need.

smiling blondeSmiles are one of the most important tools that you will have as both a provider and a leader when dealing with people from all occupations and social classes. Provided that our happiness in life will depend largely on how we interact and manage a connection with others, a sincere smile is the most effective way to establish a relationship and build a rapport and compatibility with others. A smile will maintain the attention of the person you are speaking to, helps boost openness through body language, helps reassure the other person of your attentiveness to what they are trying to communicate, and genuineness at being willing to help or aid them.

Smiles are also a true mood changer. Feeling negatively or being in a bad mood often results in similar body language such as frowns, furrowed brows, scowls, and lower lip biting. Consciously choosing to smile instead of displaying the aforementioned negative characteristics has the power to change the mood of yourself and those around you who may also be having negative feelings. Smiling in these moments will help lift your own spirit, improve your outlook on the situation, and lead you to making positive decisions using good judgment that is no longer tainted by the negative atmosphere.

Want to know the best part about a smile? Everyone has one, including you! Use it to your advantage in reaching your goals with others.

What Drives People To EMS?

What motivates someone to come into EMS?

After unscientifically scouring my notes from hundreds of interviews with prospective new employees, the vast majority who are looking for their first job in EMS, here are the top 3 answers provided:
Great Career Ahead

  • I want to save lives
  • I want/like to help people
  • I want a career in the medical field doing (insert something OTHER than EMS here) and EMS is a great place to start, or so I’ve heard

Looking at that list, let’s take a moment to be honest with ourselves about how likely each of those things are.

The Life Savers

In July of 2011 the Centers for Disease Control and Prevention (CDC) published a report on Out-of-Hospital Cardiac Arrest (OHCA) Surveillance(1). The report is derived from 31,689 OHCA cases submitted from locations throughout the country. The overall survival rate through hospital discharge was a mere 9.6%.

Now if the police department only enforced 10% of the laws and the fire department only extinguished 10% of the fires, could they claim that they are doing a good job? If McDonald’s only served their food fast only 10% of the time, could they claim that they are fast food?

The answer is no. So why do we continue to perpetuate that we save lives when statistically in any other industry, public service sector, or healthcare we would be considered a failure? Is “saving lives” the only thing we do?

I’m sure some of you are going to argue that the statistic above is because of how response times are measured and we only need to drive faster. Perhaps you’ll argue that rural areas cause longer times in general and so everyone should be forced to move closer. There can always be the argument made that those arrests include other variables of which we have no true control.

To those of you who wish to challenge the 9.6%, I offer that the Utstein Survival Report for OHCA Events Witnessed by a 911 Provider(2) has 3,367 OHCA cases submitted. Out of those 3,367 cases there was a total of 625 discharged from the hospital alive for a whopping 19%. Even with response time removed from the equation our percentage only increases by 10%.

The fact is that while we may tout ourselves, allow others to believe, and recruit under the guise of being lifesavers the cold hard statistics show that we are, at the very least, deplorable at doing it. This is a hard truth that those who come to EMS in order to be “Lifesavers” have trouble handling. Their expectations are never met, they often become bitter and burned out leaving EMS angry at the professionals who continue on and at the perceived deception they have fallen for. Sometimes they don’t leave but rather vent their frustration and bitterness out on others, including patients.

The Helpers

The other day I received a complaint from a woman about where one of my crews had chosen to park. They were in front of a clinic building just posting for a call when she asked them to move so she could park there and pick up her mother who had issues ambulating, was frail, and required assistance. The crew explained to her that she couldn’t park there because it was “Ambulance/Ambulette” parking only, which was the truth.

The woman exploded emotionally and verbally to the crew. One of the crew members, fearing for his safety from an angry woman, ran across the street to get the local law enforcement involved. Surprisingly to the crew, although not to myself, they really did nothing to the now more enraged woman other than ask her to back her vehicle up so the crew could respond to an assignment they had received while this was unfolding.

As expected, the woman called to complain. When I asked the driver, who the woman had specifically singled out in my conversation, as to why he didn’t just move the ambulance he cited the signs. I inquired if he was moonlighting as a Parking Enforcement Agent, to which he denied being empowered to enforce parking regulation. When I asked him why he didn’t move the ambulance to help this woman out, he said it was because she wasn’t a patient. He also didn’t recognize that the simple act of moving the ambulance, although it may have been inconvenient for him to do so, was helping someone.

I’m always intrigued by people who say that they want to “help others.” I think that if that were truly the case then they would have joined a mission or an order where vows of poverty and service are above board, open, and mandatory. Of course EMS may be the right place for them because they take those vows without knowing it, but I often wonder why they choose EMS as that venue. Some of them, upon further prodding, recall a time when either they or a loved one were helped by an EMT or a Paramedic. It was that display of compassion, caring, and empathy that motivates them to come to EMS.

I often find myself trying to explain that a desire to “help others” does not necessarily mean EMS is the right place for a person. The fact is I can walk out in jeans and sneakers with a sandwhich board that reads “FREE DIRECTIONS’ and an iPhone with Google Maps installed, go to Times Square, and help the gazillion people who are lost from using Apple Maps. I’m helping people just as much, but I’m not required to have a certification or an ambulance to do so.

The Medically Oriented

There are those who in the course of their lives are looking for something satisfying to do and the idea of working in healthcare is appealing to them, but they remain unsure. The best way to ensure that this is the sort of work they want to do is to get an entry level position and give it a test run. A number of these people choose EMS to test the healthcare waters.

This can be seen as both good and bad. It is good because their time spent in EMS will give them an idea what they are in for should they continue down the path of nursing, becoming a physician’s assistant, or even on the road to medical school. It can be bad because EMS ends up as a training ground for other professions and is constantly under the strain of a brain drain.

We need to be ready to constantly challenge these providers with new and interesting information, techniques, processes, and procedures. They are the Hungry Hippos of formalized education demonstrated in real world scenarios. While its true they may choose to move on, hopefully their experience will be positive enough that they will at least keep some level of involvement with EMS.

So What Do We Do?

There are so many debates about ourselves. Are we Public Safety or Healthcare? Should we be referred by our certification level or should one title encompass us all? Are we truly pre-hospital care providers or healthcare entry point providers? Do we save lives and if not (which I think I’ve already demonstrated through citation) then what do we do?

The truth is that we change lives. Fundamentally at our very core we are agents of change for the millions that call us each year, not necessarily being able to increase the quantity of someone’s life but rather always working to improve the quality of it. We need providers who are motivated to be agents of change for the better to those who are unable to do it for themselves. We need leaders who understand that motivation, embrace it, encourage it, foster it, and are willing to help it grow.

Motivation is an important factor to any organization. It is important that we identify the motivations of our providers and foster their growth using what we know about their motivation to challenge them both professionally and personally. Engagement and stimulation will help their performance thereby helping you as their leader and ultimately helping the agency as a whole.

Not sure what motivates your providers? Well then ask.

References


1. Centers for Disease Control and Prevention, July 29 2011 Out-of Hospital Cardiac Arrest Surveillance on the Internet at http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6008a1.htm (visited January 6, 2013)

2. Utstein Survival Report Page 3 Cumulative Data October 1, 2005 – December 31, 2010 on the Internet at http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6008a1.htm#Fig9 (visited January 6, 2013)

5 Ideas For Celebrating Victories

No matter how small we may think it is, we need to celebrate our victories. Here are 5 ideas for recognizing and commencing that celebration with your providers:

  1. A Written Letter of Commendation from “The Boss – Telling someone they did a good job is important, but taking the time to put it in writing helps increase the value of that message. Not only is it great that they can show their co-workers that you truly value their service, that’s something they can take home and show their friends and family. It can even be something that they display in their home, a source of professional pride, for others to see for years to come
  2. A “Thank You” Card – greeting cards have traditionally been used for close friends and family on special occasions. Isn’t a positive customer service report such an occasion? Don’t you want those who report to you to feel as if they are a part of something bigger, like an extended family? “Thank You” cards can go a long way to deliver that
  3. A Cup of Coffee with “The Boss – It will cost at most $21 (if you go to Starbucks) and 15 minutes of your time and undivided attention to make your Providers feel great about their performance, their career choice, and your Agency. Want to know the funny thing? Your time and undivided attention will often be appreciated more than the coffee…
  4. A Public Posting of Praise – It’s important to be sure that your Providers are recognized among on another. Whether it be a memo, flyer, or copy of the letter of commendation that you’ve written put up on a bulletin board, crew room, or locker room goes a long way to achieve that. It not only provides some recognition for those who have done a good job, but provides some incentive for others to do the same
  5. A Mention In Your Agency’s Social Media Stream – Is your provider on Facebook? Is your agency on Facebook? Hopefully they both are (if you’re agency isn’t, then read this post) and then posting a photo on your Agency’s Facebook Page and tagging your provider in it does two things simultaneously. First, it recognizes the Provider to your Agency’s audience as well as the Provider’s friends and family. Second, it gives your Agency some content for their Social Media Presence. It’s a win-win for all those involved

What does you agency do to celebrate the victories? Let us know in the comments…

The “B” Word

There is one thing that the Fire Service has universally created, fostered, and grown throughout its history that I truly admire, respect, and wish we could bring to the Emergency Medical Services.

Brotherhood.

You hear the word come out quite often from all levels of the Fire Service when discussions are about work conditions. You see the word in action during times of crisis, usually during a line of duty injury or death, to support and provide whatever is needed. You feel the word when you walk into a firehouse at dinner time and sit down at the kitchen table to break bread, laugh, and swap tales from calls long past.

This is what truly differentiates the Fire Service from both Law Enforcement and the Emergency Medical Services.

Why It Matters

There is a reason why the fire service is perceived to be as strong as it is. The unity that the sense of brotherhood provides has brought great power to bear when situations, both political and civil in nature, need to be resolved for the betterment of the whole organization. When I talk about the “whole organization”, I mean the Fire Service itself and not an individual department. Admittedly this is more of a global perspective that we aren’t necessarily used to looking from, but we need to start looking at it this way sooner rather than later.

Chief Mick Mayers of Firehouse Zen, one of my favorite fire service and leadership reads, recently had this to say in a post titled Labor Day Conflict:

When individuals choose to advance their personal values over the needs of the whole, they lose track with the reality that the organization is an organism which has many parts and systems. If any of those parts fails due to the neglect or lack of community with the whole, then the whole perishes. You can’t kill off a part to your benefit if you expect the whole organization to keep producing, and yet, it continues, mostly because of greed, selfishness, and ego.

KnockoutWe spend too much time and effort promoting and furthering ourselves and our individual organizations while putting other organizations with the same mission down. While some will cite commercial entities competing against one another as the inherent source of this evil nature, why then do municipal agencies and volunteer squads openly malign them for this capitalist behavior? If the commercial entities are the source, why then do the career municipal agencies join them equally in criticizing the volunteers for inexperience and providing a lack of consistent quality service? Why do the commercial entities and volunteers condemn career municipal agency members for the perceived lackadaisical response times and overall laziness in responding to calls? The only aspect in common with all three is that they equally rail against the other two.

As Chief Mayers pointed out, you can’t kill off a part and expect the whole to keep producing. This includes agency types. The sooner we realize that we are all part of the greater whole that is the Emergency Medical Services, the sooner we can promote some unity, the sooner we can develop ourselves into a caring brotherhood like the fire service, the sooner challenges will be able to be overcome with the power of that purpose.

So what’s stopping us? Let me know your thoughts in the comments…

Celebrate The Victories

Looking at the organization of a number of EMS Agencies we often see departments dedicated to quality. Whether it be a Quality Assurance, Quality Improvement, or Investigations units we take complaints pretty seriously.

How many of you have ever eaten at a fast food restaurant? Whether it be McDonald‘s, Burger King, Wendy‘s, Taco Bell or any of the countless others you would have had to deal with a cashier at the counter.

How many times have you gone into one of these restaurants, placed an order, paid your money, received back the correct change, and then have the cashier deliver the order correctly on a tray for you to take away and dine on?

Once at the table you see the order is correct, relatively hot, and from a food service perspective you received a good meal. Has that ever happened to you?

Thumb up with good job written on a blackboardIf you answered “Yes” to all three of those questions then please answer this one: Have you ever gone home and written a letter to the manager of that fast food restaurant for the service you received? Have you ever called the manager at the restaurant to commend the cashier for a fine job? Have you, on the way out the door, every stopped to speak to the manager and thank them for the job they and their staff have done for your meal? If you answered “Yes” to any one of those three questions then you are in the absolute vast minority.

Expectation of good service is part of our cultural DNA. There is a sense that it is owed to us for the patronage we provide to the establishment or service provider. When we receive it we think nothing special about it. When we don’t receive it, we make sure the manager or the establishment knows that we were unhappy.

As a society we are quick to complain and reluctant to commend when it comes to service.

When we do get a commendation or positive feedback we need to make sure that we celebrate that just as much, if not more, then when we investigate and discipline for a complaint. We need to put as much focus and energy on the good our providers perform alongside the questionable.

Ask yourself, who handles the good in your organization? If you have a department dedicated to investigations and quality control are they the ones who do it? Is it a function of Human Resources or does your agency have a separate Commendations and Celebrations Unit? If not, then you need to ask who does do it.

If the answer you receive is no one, then it’s time to step up and change that. If you wanted to be a leader, now is your opportunity to become one. If you already are a leader then you’re providers are overdue.

Always celebrate the victories. No matter how small they may seem to you, to those being celebrated it’s a whole lot bigger.

What If Gordon Ramsay Was An EMS Leader?

I am a big fan of Gordon Ramsay. I thoroughly enjoy his Kitchen Nightmares show and desperately want to be a diner in Hell’s Kitchen. So when John Harrington wrote a post on what Gordon can teach photographers, I began to wonder about what Gordon would do if he was an EMS Chief.

EMS is, in no uncertain terms, a service based industry. We do not create products for our customers, we create experiences. EMS can be related to the restaurant business in a simple comparison:

  • Servers – On an ambulance the servers are the EMTs and Paramedics. They need to be courteous and communicate effectively with both the customer and the “kitchen”
  • Food – The overall customer experience from the time the call is placed to the follow-up
  • Decor – The actual ambulance itself, both exterior and especially the interior
  • Hostess Stand – The call receiving center/dispatcher where the initial call is actually received
  • Kitchen – The dispatch center/garage where the experience is crafted before reaching the customer
  • Roaming Manager – The Quality Assurance follow up on the call and the satisfaction level of the customer

All of these areas are critical to creating the experience for the customer.

Ramsay in no uncertain terms demands excellence. When he does not see or taste excellence, he clearly communicates his displeasure. While his methods are usually brash, abrasive, and can be considered over the top, the fact is that he gets his displeasure and his demands across effectively and makes no apologies for them.

As brash as Ramsay may be, what he also does is provide positive feedback and praise when his demands and expectations are met or exceeded. This is a vital aspect often overlooked whenever discussion of his comparatively behavior ensues but an important aspect to understand. Providing feedback constructively, whether it is for a negative or a positive performance is something every EMS Leader (admittedly including myself) needs to do more of.

Do you think Gordon Ramsay would make a good EMS Leader? Let us know your thoughts in the comments…

Understanding Unit Hour Utilization

Unit Hour Utilization (UHU) is one of the most widely used and misunderstood measurement metric used in the vast majority of EMS Agencies today. The metric has gained notoriety thanks to Jack Stout’s System Status Management solution for ambulance deployment. It has become the universal EMS measuring metric for agencies to gauge performance regardless of agency type or primary goal.

How To Calculate UHU

Blackboard / chalkboard texture. Empty blank black chalkboard wiThere are actually a couple of different ways to calculate UHU but the simplest way (what we will call Simple UHU) is calculated by dividing the number of hours a unit works into the number of assignments it handles. For example, a unit that works 10 hours and handles 5 assignments would have a simplified UHU of a .5. Generally the higher the number is the more effective and efficient the system is considered to be.

There are a few other ways to calculate UHU that you may need to understand.

Payroll UHU – For the budgetary minded system there is the Payroll UHU. To determine this UHU you take the total number of hours worked by your field providers, divide that by 2, then take that number of hours and divide it into the number of reimbursable assignments handled. This type of UHU is generally used for specific garage locations

For example: You have a total of 20 Medics who worked 10 hours for a total of 200 hours and have completed 50 reimbursable assignments. We divide 200 by 2 for 100 Unit Hours (it takes two to make an ambulance crew) and then divide that into 50 to get a Payroll UHU of .5. If we took the same numbers and did a Simple UHU, we would have 10 units working 10 hours (100 hours) and completing 50 assignments for a Simple UHU of .5 as well.

Suppose that out of those 50 assignments there were only 45 reimbursable assignments (for argument’s sake there were 5 Refusals) then we would be dividing 100 into 45 for a .45 Payroll UHU.

Now let’s say that 1 of those 20 Medics didn’t come to shift due to an upset stomach. Instead of sending him home you used his partner for the 10 hours in Logistics fixing regulators and stocking trucks. If we calculated the Payroll UHU, we would divide 190 (because one person of 10 hours is out) by 2 for 95 Unit Hours divided into the 50 assignments to get a Payroll UHU of .53 (it’s 0.52631579 rounded up to the nearest one hundredth). If only 45 of the assignments were reimbursable then the Payroll UHU becomes .47 (it’s .47368421 rounded down). If we calculated a Simple UHU, we would have 9 units working 10 hours (90 hours) and completing 50 assignments for a Simple UHU of .55.

Notice the difference? When you start adding the variables of a unit not being out there but still paying for half a crew and having assignments that are not reimbursable, the UHU starts to get worse and worse.

In Service UHU – For the performance minded system there is the In Service UHU. Unlike the other UHUs, some systems do not consider a higher number as being better. To determine this UHU you take the total number of hours your units are in service and divide it into the number of assignments handled. This type of UHU is generally used for system-wide assessments.

For example: You have a total of 10 units scheduled to work 10 hours each and they handle 50 assignments. This would give you 100 unit hours divided into 50 for a Simple UHU of .5. It takes each unit 15 minutes to check out their ambulance and come in service with the dispatcher, so that is 2.5 hours (150 minutes) of time where they are technically out of service. That means that your In Service UHU is actually 97.5 unit hours divided into 50 for an In Service UHU of .51. If one of your units breaks down for 2.5 hours, your In Service UHU becomes .53 because now you only have 95 hours of in service time.

Which UHU Is Right For You?

The type of agency and the goals of the service will direct you towards which UHU is best to use in order to measure your agency. Many managers misunderstand UHU as the be all end all of efficiency and that simply is not true. UHU provides the metric to measure and compare efficiency when planning to meet the needs of your system and is only one tool that the successful EMS Manager and EMS Leader needs in their toolbox.

System Status Management 101

Blackboard / chalkboard texture. Empty blank black chalkboard wi

Many EMS systems are designed around a model called System Status Management (SSM). It was introduced in the 1980s by Jack Stout as part of the Public Utility Model for EMS systems[1]. SSM has become the most widely accepted management methodology for managing EMS resources. The fundamental concept has two major pieces that shape the lives of the Medics it manages, Dynamic Deployment and Peak Demand Staffing.

Dynamic Deployment becomes utilized once you are already on the shift. Depending on probability trended over time, your unit will be assigned a posting or a place at rest. This location is considered to be in an area where there will be a demand in the immediate to near future. As units are assigned calls and the day progresses, these postings will change with the probability of a need increasing or decreasing for a potential assignment nearby. A truly dynamic system will see the fluid movement of units from posting to posting to ensure the entire area is covered with maximum statistical efficiency.

Peak Demand Staffing requires schedules that put the appropriate number of resources into the system to meet the anticipated demand for those resources. Shifts (referred to as tours by some agencies) in EMS can vary widely depending on where you are in the country, the demands on the system, and the type of agency that you belong to. Your shift can be as short as 4 hours and as long as 24 hours. I haven’t heard of an agency with a 36-hour or 48-hour shift but I wouldn’t be surprised that it exists somewhere.

Demands on the system often dictate the schedule type and shift times for an agency. Agencies in urban centers often see peak call volumes during the “9 to 5” timeframe, when the urban centers are open for business and people are at work. Agencies serving suburban areas may see peak call volumes both before AND after the “9 to 5” timeframe, catching the members of the community before they travel to their workplace in an urban center and after they return home from a typical “9 to 5” job.

[1] Public Utility Model
Wikipedia
Source

The Shrinking Difference Between Leadership And Management

The difference between management and leadership used to be very easy to delineate. Alan Murray, the author of The Wall Street Journal Essential Guide to Management: Lasting Lessons from the Best Leadership Minds of Our Time, writes that “The managers job was to plan, organize, and coordinate. The leaders job was to motivate and inspire.[1]” Managers managed resources through edict or memorandum to a metric or a set of metrics, leaders led resources through inspiration to achieving an outcome or a goal. Some Agencies would go so far as to bestow titles on both their managers and their leaders, while others opted for a less structured organization.

In today’s world leadership and management have lost some of that separation. Murray contends that, “People look to their managers, not just to assign them a task, but to define for them a purpose. And managers must organize workers, not just to maximize efficiency, but to nurture skills, develop talent and inspire results.[2]” I can’t help but agree with him based on just the past 5 years of seeing freshly minted providers come into the field with less preparation as those who came in before them, and even the providers 10 years back really weren’t coming in too prepared.

When writing this post I originally titled it “Leadership vs. Management“. After drafting it, pondering, and editing I decided to change the title. Leadership and Management are not in opposition to one another. A leader does not necessarily have to be a manager and, similarly, being a manager does not automatically make you a leader. To be truly successful in this day and age you do need to have skills from both toolboxes.

What remains dangerous is the assumption that because someone is good at one, that they would automatically be good at the other. A good manager is not necessarily a good leader, and a good leader does not necessarily make a good manager. Making this assumption in terms of the food service industry, a good server does not necessarily make a good chef, and a good chef does not necessarily make a good server. While they both work in the food service industry, their roles in a restaurant are quite a bit different.

This is an assumption we often make in EMS. We think that a good provider who can manage an airway will make a good supervisor. We promote them, give them some basic instruction, and then wonder why they don’t know everything there is to managing people. We forget that they’ve had plenty of practice in the classroom managing airways to meet the standard of a model airway. When they got to the field they were able to manage the airway. Granted, that first, second, and probably third managed airway may not have been the prettiest airway, but they managed it, learned from it, and improved upon it. Each improvement brought them to the point where they were able to match the model of a managed airway that was already presented to them. If we just judged their ability to manage airways by that first and second airway, we’d be wondering why they don’t know everything there is about managing airways.

As the differences between managers and leaders shrinks we need to be able to marry the two. While it may not be pretty the first few times, we need to believe in those who have been selected to lead AND manage others. More importantly is that we must give them a model to strive for and set the example for them at every chance we get.

If the providers have been coming out ill prepared for the reality of working in the Emergency Medical Services, then we need to make sure their Manager/Leader is prepared to help them succeed. The failure of one results in a failure, at some level, of all.

[1][2]What Is The Difference Between Management And Leadership?
The Wall Street Journal
Alan Murray
Article