This is a reprint of a blog I wrote for Fire Chief Magazine in 2012.
In EMS, It’s All About Relationships
A few years back Charles Werner, chief of the Charlottesville (Va.) Fire Department, offered these words of wisdom at a conference: “It’s all about relationships.” In other words, people are more likely to act favorably with people with whom they previously have had positive interactions, as opposed to those they’ve never met. Very similarly, a speaker at another EMS conference said that your 15-minute interaction with a patient could make or break their opinion of your organization.
The point of this article is to highlight how critically important relationships are to you and your organization, both in terms of 1-to-1 interactions and making a connection to larger groups of stakeholders. In this regard, simply having a relationship with someone isn’t enough — what type of relationship do you have? Are your relationships built on trust, reliability and giving? Are you empathic and understanding with your patients and co-workers during their time of distress? How you enter into and build relationships will determine how much they trust you.
Picture the following situation, which you’ve experienced many times before. A salesman is trying to sell you a car. You are torn between two models, as your assessment finds them very comparable. The salesman tells you that one is a slightly better car. However, a good and reliable friend is with you. She has owned the other model for the past 10 years and believes that it is the better vehicle. To whom will you listen? The Salesman is well-versed on both cars. Your friend has a great relationship with one car, and little or no experience with the other model. Who influences your decision the most? The smart money is on your friend. Why? Because you not only have a relationship with her, you also trust her.
One of the great things about EMS is that it provides you with multiple chances to develop and build new relationships every day. Each patient gives you a great opportunity to present you and your organization in a positive light. By engaging in a supportive and empathetic relationship, you are helping someone having the worst day of their life work through their stress and fear. Most fire and EMS personnel pride themselves on their technical abilities, e.g., starting IVs and interpreting EKGs. However, the skill you will use the most in your career is related to human interaction.
We spend way too little time in educating our emergency providers on interpersonal relationships and interactions. In recent years, this has been recognized by many medical schools that have added curriculum related to improving interpersonal skills, as they are the key to treating any patient. These classes were added because they found that there was an overwhelming need to introduce new doctors to this lost art that is so valuable in treating the whole patient. Indeed, the ability to effectively communicate with patients in a more personal way—which involves the lost art of listening — makes them much more capable in assessing their patient’s condition.
Studies of patient satisfaction surveys indicate that how nice an emergency responder was directly correlates to whether the patient felt that the experience was positive, even when the EMT’s clinical skills were lacking to some degree. On the other hand, if you are a great clinician but lacking in people skills, you and your organization most assuredly will get a bad review. People assume that you are competent just by being in this profession; however you can change that impression of you and your service quickly by not displaying empathy and true concern for your patient’s well being. This will take you from hero to heal in an instant in their eyes.
Relationship-building in EMS goes far beyond individual patient interactions. It is used in every part of your job. It includes your interactions with ER nurses and doctors, the police, and any others with whom you work daily. Ask yourself this question: What level of success do you think you would have in trying to convince a doctor you just met that the back and shoulder pain your patient is experiencing is really cardiac-related, as opposed to having that same interaction with a doctor you’ve known for years who trusts you? Which one do you think is going to support your assessment?
Further, what type of proactive relationships have you built with your stakeholders? They include the politicians and voters who fund your department. With these groups, relationship-building has to be proactive and based on the mantra, “It’s not what your politician can do for you, but what you can do for your politician.” In this regard, you can substitute “senior citizen group,” or other community groups, for “politician.”
The first time that you meet with your Rotary or local political leaders, it shouldn’t be with your hand out. Instead, start by just getting to know them, listen to them, and find out what interests them. Better yet, find what common interests you have. Build relationships for the sake of building positive karma. If your primary reason in developing a new relationship is to get something, you’re going to be disappointed with the outcome most of the time. As Edward Deming advised the Japanese as he helped them rebuild their country after World War II, “You don’t just do business, you build relationships.” And you want to be doing business in your town for a long time.
Be warned that even with great relationships, there are times that you won’t get what you want—a good example would be the recent economic downturn. In such situations, you must share in the sacrifices of those you serve. This is where commitment will show your true colors as part of a solid relationship. There might be pain, but it won’t be as much pain you would experience if you didn’t have a solid relationship. In a relationship you share the gain and the pain. In the long run it is much more rewarding for both parties when you do it together.
This year’s EMS Week theme is, “EMS: More Than a Job, It’s a Calling.” If EMS has called you — or even if you do it because it has become a necessary part of the job — developing all of the different types of relationships that are part of your job in a positive and productive manner will leave you much more fulfilled and your organization more highly regarded. Follow Dr. Deming’s philosophy and strive to be your community’s single supplier of EMS, based on loyal and trusting relationships at every level.
Anthony Correia is a 34-year member who currently serves the Burlington Township (N.J.) Fire Department as director of fire services and as an active paramedic with the Bucks County (Pa.) Rescue Squad.