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EMSSuccess

The!Non"Conformists’!Guide!!

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By:!Steve!Whitehead

ToEMS!

Success!

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This!e"book!is!100%!non"commercial!and!contains!no!affiliate!links.!

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Can you have a successful career in Emergency Medical Services? Is it possible to find long term personal, lifestyle, and financial

fulfillment in our field?

The answer is yes. I wrote this e-book to tell you how.

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What you have before you is a manifesto of sorts. It is not for sale. You have my unbridled permission to copy it, post it, link to it, talk about it, quote it, and excerpt from it. I hope these ideas change your life. Nothing would make me happier than having you send this to all of your friends in EMS. I only ask that you respect the creative commons license bound to it. I do strictly reserve the right to bind and sell this work as a book. You can have the movie rights instead. I request to have Matt Damon play me.

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! !!!The!Non"Conformists’!Guide!to!EMS!Success!2

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The!Non"Conformists’!Guide!Table!of!Contents!!!!!!!!!!!!!!!!!!!!!

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Finding!Your!EMS!Otaku!

My!Apologies,!Have!We!Met?!

What!Do!I!Mean!By!Success?!

What!Does!Non"Conformity!Look!Like?!

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The!Fulfillment!of!Meaningful!Work!

Go!Do!Something!Amazing!

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Part!I:!GROWTH!

Holding Yourself To A Higher Standard Commit To Being Remarkable Commit To Something Greater Than Yourself Commit To The Communal Pursuit of Things That Matter The Case For Optimism A Few People To Avoid Along The Way

Part!II:!LEADERSHIP Your Leadership Doesn't Have What You Need Stop Waiting For Permission Fire Your Boss And Hire Yourself Your Mission Statement Your Annual Performance Review Your Continuing Education Plan Your Mentorship Program Being Willing To Have Difficult Conversations Sounds Great But My Boss Doesn't Agree

Part!III:!CONNECTION Authenticity I Need Your Help Letting Go of Fear Connections We Change Too The Value of the Patient is the Value of the Caregiveree eeee

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! !!!The!Non"Conformists’!Guide!to!EMS!Success!4

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“Going!with!the!flow!is!a!euphemism!for!failing.”!

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!"!Seth!Godin!

What does your work mean to you?

What does it mean to

wear your uniform and do your job?

Does it mean the same

thing that it did when you started?

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Finding!Your!EMS!OtakuThe Japanese word Otaku means the pursuit of something with almost obsessive focus. The word can be combined with any hobby or interest to imply that the pursuit has gone beyond a normal interest. Someone may be accused of having a cooking otaku, gardening otaku or comic book otaku. To some, otaku is an honorific word. Others feel it is an undesirable trait and to a few, the concept of otaku is downright insulting. I'd suggest that otaku can be a powerful thing, when you set your focus and passion on something that is meaningful to you. Perhaps at one point in your career you had an EMS otaku. You felt excitement about going to work each day. You hoped for challenging calls and interesting patients. You hoped that the next tones would be for your rig, someone calling for you.

Maybe you still feel that way. For too many of us the initial excitement of emergency services gives way to disenchantment and regret. Sure you started out excited but many of the people you worked with seemed so unhappy. The more experienced employees looked at you as naive or unseasoned. You felt as if everyone else knew the real deal and you hadn't been let in on the secret yet. Then the "real story" started to unfold. Most of the calls were for minor complaints. Bemoaning system abusers became an art form. Then there was the low pay, the long hours and the fact that none of your friends or family really understood what you did. "So you drive an ambulance, that's interesting." "Why can't you be home on time more often?" "Why do you need to keep attending classes? Didn't you learn it once already?"

If you've been at this for a little while it's quite possible that eventually, you conformed. If you did, let's just make peace with that right now. You bought in to the group-think and let go of your otaku. And worse yet, when the next bright eyed EMT candidate showed up in the bay you looked at them as naive and immature. Maybe you did what you could to get them to sell out and conform too, feeling that this would add validation to your own dissatisfaction. Optimism can be dangerous. Why should they be having fun? Does any of this sound familiar? If not, perhaps you've managed to maintain your EMS otaku. I congratulate you. Let’s see if we can help you build it. If the story I just told you sounds all too familiar, that's even better. Let's help you get it back.

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I need to warn you right here at the start that I'm going to ask you to do some things that might not be entirely comfortable. If keeping you inside your comfort zone was a priority to me, I could have written a guide called, "The Easy Road to Short-Term Success in EMS." That guide surely would have included tips on flying under the radar. I would have extolled the virtues of never conflicting with your leadership team, adopting the mission and values of your organization without question, being blindly ambitious for promotions or authority and giving in to the rampant cynicism and emotional disconnect that many people are convinced is critical to long term success in emergency service. Instead, I'm going to ask you to reconsider all of those things (and more). I'm going to ask you to develop your own unique vision of what you're here to contribute. Even though you may feel like you are drowning in an ocean of unhappiness and burnout, I'm going to encourage you to turn and dive

deeper into the more complex dimensions of our human experience in EMS. I’d like you to examine your experience with an outright refusal to conform to the group-think around you, and instead, contribute something that is uniquely your own. This is not a "me too" guide. I think you’re going to find that the advice I'm going to give you is both unusual and thought provoking. I didn't just cull together a bunch of popular ideas from feel-good sources and regurgitate them. What you have in your possession is a guide to the road less traveled. This is the path to personal success that winds crooked through the hillside and down deep ravines. It requires a greater degree of diligence on your part. You can't sleepwalk your way to retirement on this path. This path will demand that you show up to your life and your job fully engaged. Are you still with me? Let's begin.

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My!Apologies,Have!We!Met?

Many of the people reading this guide will be familiar with me through my blog. !!!!!!!!www.theemtspot.com If so, feel free to skip ahead. But if you and I have never met, let me introduce myself. My name is Steve Whitehead and I'm living my dreams through a successful career in emergency services. I have the exact job I've always wanted in an outstanding organization. I work on several special teams of my choosing and teach regularly in our local EMT program. I also write articles for several popular EMS magazines and regularly speak at industry conferences.

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My blog is enjoyed by thousands of regular readers each month, and I consult for some of the leading bio-tech companies in the world. I also happen to be blessed with an above average income, a loving family, great friends and a home with an amazing view of the Rocky Mountains. I am successful by every definition that I have chosen to accept, and none of this was by accident. All of this happened because I chose to love my job and be open to the myriad of opportunities that were presented to me each day. Yes, I’ve run my share of inter-facility transports and calls at the local detox center. I've stood face to face with violent criminals, comatose drug addicts, and the most self-righteous system abusers you can imagine, and occasionally, I still do. Once upon a time, my story was very similar to the one that I told you at the beginning. And I chose to learn and grow from all of it. !

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That's what made the difference. So what am I talking about when I say EMS success? You want to know what it looks like, right? What are we really moving toward here? I believe there are three requirements or qualifications to be truly successful in EMS. I'll call it my three step success formula. Step 1.) Finding fulfillment in our work. Step 2.) Creating a healthy relationship with our employers. Step 3.) Making meaningful connections with the people in our lives.

What!Do!I!Mean!By!Success?

My!Three!Part!Formula My first requirement asks that you feel fulfilled and enriched by your work. This is what we're going to talk about in Part I: Growth. I want you to be able to do your job with a sense of service and purpose, to feel the excitement of holding yourself to a standard higher than anyone else demands of you. I want you to know that you are living your own highest values and that you are making decisions about your future based, not on fear, but on your own ideas about what fulfills your personal vision of your life. Second, success would mean that you grow up in your relationship with the authority figures in your organization and your life. We’ll dive in to all that in Part II: Leadership.

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There!is!only!one!success,!!

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to!be!able!to!spend!your!!life!in!your!own!way.!

!"!Christopher!Morley!

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Success here would mean that you take control of the direction of your work and the role it plays in your life. Success would mean that you play by the rules, but you also play by your own rules, knowing that you are the ultimate decision maker in your life and choosing to show up to work each day because it is where you want to be. Success on this front would require that you stop looking to your leaders to take care of your needs for acceptance, approval and direction. You take accountability for your own mission. You evaluate your own performance and you stop asking for permission to pursue what matters to you. Here, I’ll ask you to let go of the idea that your leaders hold the keys to your future satisfaction, and I’ll encourage you to have difficult conversations when they are appropriate.

I’m going to ask you to tear up the old social contract of conformity and move in the direction of what matters to you. Your leaders want all of this for you, and you should want it for yourself too. Third, success would mean that you find balance in your life. You aren't successful if you need to be at work each day to keep your head above water. Your work needs to complement your life, not suck your life away in small doses. This is what we'll explore in Part III: Connection. In this section we'll talk about your work complementing the values and direction of your life. I’ll ask you to consider allowing yourself to be changed and challenged by the situations that you encounter in the workplace. You'll explore how to develop your compassion and sense of service and how to recognize the undeniable connection between the value of your patients and the value of your work.

Lastly, we'll talk about finding the sweet spot between life and work where the two halves complement and build on each other. I don't want to sound overly simplistic, but if you aren't enjoying your life, you’re failing at life. I want to help you enjoy your life more. I want you to enjoy working in a service industry and helping others. I want you to feel comfort instead of stress when you interact with your supervisors and bosses. I want you to enjoy the way your work complements your life and makes you feel connected to humanity. You can have all that. There's only one catch. To do it, you're going to have to swim upstream. !

! !!!The!Non"Conformists’!Guide!to!EMS!Success!8

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What!Does!Non"Conformity!Look!Like?!

It's helpful to recognize that you've been conditioned to follow the rules all of your life. Since our birth we were conditioned with approval and affection as a carrot and disapproval and separation as a stick. These are used almost universally because they are so effective at producing results. Your kindergarten teacher gave you smiley faces on your work that met with approval and red check-marks when things weren't up to par. If you really got out of line, you had to leave the class to see the principal, so this higher authority could express a more authoritative sense of disapproval, perhaps documenting his or her official disapproval in writing to be referenced later. Ultimate disapproval could mean being removed from the school altogether.

The pattern continued at work. You came to work and were immediately given the policies and procedures manual. You were oriented to the company's values, mission, and vision statements, and you were expected to adopt and adhere to these values in the workplace. Non-conformity was likely not one of the values listed. You quickly found that there were norms of behavior and attitude, and conforming to them was the simplest path to acceptance. You adapted yourself to gain membership. And, as always, it paid off. Was the payoff worth it? The allure of conformity is powerful for all it offers. On the other side of the conformity dance floor is security, approval, and all the benefits of eventual success. Why wouldn't we waltz? Doesn't everybody? Perhaps that desire within us to do something that matters can be

fulfilled after we've gained the promotions, the love and admiration of our peers, and the power of authority. Then we can start being an advocate for the patient. Then we can start taking good care of the folks who call 911. We can bone up on our skills, attend the conference, and develop the competencies we were putting off until we got the official nod. We'll work hard to improve basic proficiencies, overhaul the broken training and orientation systems, and advocate for safer work conditions. This is all a broken promise the minute we make it. Once we've achieved some degree of success by walking the path of conformity the expectations will only continue to grow. Your leaders, whoever they are, have even less power to step outside the boundaries than you. If there is pressure on you to conform, you can bet there's twice as much pressure on the poor guy

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or gal above you. Poor saps. Non-conformity is stepping back from the speed and thoughtlessness that we tend to operate under. We manage emergencies. Most of our leaders have grown out of this industry that specializes in the fast fix approach. In our business, speed is king, and time is the devil. This creates an environment that doesn't value thoughtfulness or introspection. Asking larger questions about the greater purpose of our industry is frowned upon. Those who follow this path get labeled as pie-in-the-sky dreamers. Non-conformity means being willing to take the time and effort to evaluate ourselves, our performance, and our purpose. It means being willing to stand for something and being willing to stand against something, especially when we stand against the mediocre status quo that pervades our industry.

Are you getting a vision of what I’m talking about here? Let me be even more specific. !

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! !!!The!Non"Conformists’!Guide!to!EMS!Success!10

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EMS Non-conformists: ! Think for themselves. They know their protocols and rules but are guided primarily by their own sense of what is right. Non-

conformists speak with their own voice and hold on to their own values and judgment. They do not choose to be defined by what they do (as our culture would prefer) but choose what they do as an expression of their identity.

! Expect to have their values expressed in their work. They don't check their values and guiding principles at the door when they show up for their shift. On the contrary, they have an expectation that their greatest self can be expressed through their chosen work.

! Believe that their lives and work should stand for something. In this regard, they refuse to be bartered like a commodity. The idea of punching the clock for a day’s pay is taboo to non-conformists. They work because the work is meaningful to them. In doing so, they maintain their power and are accountable for their actions.

! Desire to be a part of a community and a team and seek meaningful connections with others. Our industry is a human industry and non-conformists seek to humanize and personalize their work. They pay attention to the details of their lives and the lives of those with whom they interact each day. In refusing to conform to the sterile, impersonal world of clinical medicine, they dive deep into the tragedy and triumph of medical care and fight to humanize their connections with their patients.

! Hold themselves to a higher standard than the status quo and rally against mediocrity and incompetence. Non-conformists see that their work is worth doing well and refuse to be swayed by the tide of mediocrity that constantly pulls at us to accept what is just good enough as our standard. They always seek to raise the bar.

! Don't expect their leaders to have the solutions to their problems, embody their values, provide their motivation or direct their career path. They don't look for parental nurturing and constant direction from their leaders, and they don't whine and complain about operational minutia like memos and policy changes. Non-conformists seek grown-up partnerships with authority figures and seek common ground and mutually acceptable goals.

! Fearlessly seek performance feedback and relish intelligent coaching and criticism. Non-conformists know who to hear and who to ignore. They consider themselves in a constant state of growth and don't fear failure or mistakes. They look for opportunities to push their boundaries and acknowledge their own imperfections and mistakes without shame or anxiety. Non-conformists know that if they are not making errors, they are not living at the edge of their potential.

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Holding!Yourself!to!a!Higher!Standard!

“If!we’re!growing,!we’re!always!going!to!be!outside!of!our!comfort!

zone.”!

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!"!John!Maxwell!

I’m going to ask you to commit yourself to some

things.

Commitment is something we talk about much more often than we practice it.

You know what I mean.

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Nothing speaks to your commitments quite like your actions. Maybe you can tell me about all the characters on your favorite TV show but you still can't name all the indications for Epinephrine. Or perhaps you could tell me the name and key stats of every player on the starting line-up of your favorite pro football team but haven't learned all the major streets in your primary response area. What you chose to invest your time in shows. What do you have in your life right now that you would consider your passion? Think about how well you understand that thing. How much time are you willing to dedicate to that thing? How much time are you willing to invest? How early are you willing to get up and how late are you willing to stay up for that thing? I'm going to ask you to commit yourself to the following in the same way.

1. Commit to being remarkable 2. Commit to something bigger than yourself (With no expectation of return) 3. Commit to the communal pursuit of things that matter !

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!Remarkable doesn't necessarily mean that you're amazing or that you get gold stars on your paperwork. Remarkable doesn't have to be a comparative or competitive equation. Remarkable simply means that when your name comes up in conversation, people have something to say about you. Remarkable is what happens when you break out of the mold of social conformity and go your own way. It's a sign that you're living some

aspect of your life by your own design, without fear of what others are saying about it. What you do isn't that important. Just make sure it's remarkable (preferably in a good way.)

! Apply for your supervisor’s

job, or his boss’s. ! Better yet, find your ideal job

and apply to that. ! Start a journal club. ! Invite all the EMTs from a

rival agency to a party. ! No rival agencies? Invite

your coworkers. ! Start a “firefighters vs.

paramedics” UFC type fight club and donate the proceeds to charity.

! Write your insights and comments in the margins of the station’s EMS magazines.

! Start a blog or publish on another blog.

! E-mail Nancy Perry or AJ Heightman and tell them your article idea.

Commit!to!Being!!Remarkable

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! Start a monthly prize competition for the crew with the most inter-facility transfers, most miles, or most calls in a shift.

! Go to a conference. If you already go to conferences, apply to be a speaker at the next one.

! Pick a place in the world you really want to see and commit to visiting that place in the next three years. (It isn’t as hard as you think.)

The point isn't what you do, the point is to get you to take your existence off of cruise control and start showing up to your life each day. Not the life someone else wants you to live, your life. The life you were meant to live. If you don't know what life you're supposed to live, we’re going to help you find out. The most important part of starting to live your own remarkable life is simply seeing the world differently. You can’t help it. You begin seeing

the world around you in a different light than average people do. Congratulations, you've decided to live a life less ordinary in a world of averageness. The great news is that the more you learn to live and enjoy remarkableness the more your vision will expand. Once you see how much fun it is to try remarkable ideas, just for the fun of it, you’ll become addicted to it. The simple decision to be remarkable may do more to change your life than any other decision you make. !

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(With no expectation of return) It's interesting that when I ask this of people, their greatest resistance isn't to the idea of a grand commitment.

The resistance is to the idea of no return. Note that I didn't say there would be no return. I asked you to let go of the need for something in return. Holding on to the idea of great return for great investment is like holding onto Jell-O. The tighter you squeeze, the more you lose. We are socially conditioned to buy-in to the barter system of our society. We commit to things because of the positive return we expect from our investment. We go to work because they pay us. It doesn't matter if the work fits our values or goals. It's easy for our employer to objectify us because we objectify ourselves when we voluntarily buy-in to the idea that our labor is something to be bartered. I'd like you to choose a commitment without concern for what's in it for you, just to see what it feels like to not be bartered.

Commit!to!Something!Greater!Than!Yourself!

#2

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There!are!countless!ways!of!attaining!greatness,!but!any!

road!to!reaching!one’s!maximum!potential!must!be!

built!on!the!bedrock!of!respect!for!the!individual,!a!commitment!to!excellence!

and!a!rejection!of!mediocrity.!

!!!!!!!!!!!!!!!!!"Buck!Rodgers!

!!!!!!!!!Baseball!Hall!of!Fame!

While you’re out there finding those remarkable goals or tasks, look for one or two that serve your values and add value to someone else’s life and then pursue it without any thought about what it means for you. It doesn't matter what you do as long as it is in line with your values and there is no clear, defined benefit to you personally when you begin. The work you're holding in your hands is the culmination of over two decades of my personal experiences in EMS as well as hundreds of hours of writing and formatting. It is the largest writing project to which I've ever committed myself. When it's finished, I'm going to give it to you for free and encourage you to pass it on to others. I would never do that if I wasn't fully committed to the idea of detachment from the return. If I were committed to the barter system, I would go looking for a publisher. I would put this work on

Amazon and talk with e-publishers about price points and margins. I'd be concerned with proper Kindle formatting, release dates, and marketing. But that isn't what this is about. This book isn’t part of a marketing gimmick. It's part of my big, audacious goal (We'll talk more about those in a little bit). I want to change your career for the better. I want this book to have a positive lasting impact on the quality of your life and the lives of a lot of other people. The best way to do that is to give it to you with no expectation of return. When you’re done reading it, it will be your turn to figure out your unique contribution and set your big audacious goals and go do something remarkable. But not before you make one more commitment. Oh, and by the way, you were volunteering all along. If you’re still trying to wrap your brain around the idea of expecting

nothing in return, consider that you’ve been volunteering all along. I don’t know if you are paid by your employer right now or if you volunteer, but it doesn’t matter. The truth is you’ve always been a volunteer. Your employer can barter for your back, for your labor, and your skills, but the best of you, those things that can’t be bought, you’ve always offered those voluntarily.

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! !!!The!Non"Conformists’!Guide!to!EMS!Success!16

Nobody ever bartered your passion or your motivation or your attitude. The best within you was always yours to give or to keep at your will.

Twink Dalton didn't start teaching EMTs and paramedics because she thought it would be a quick path to luxury and reward. She was already a talented and successful E.R. nurse. She wanted to do something that mattered for her community. She saw, with frustration, that many of the EMTs that delivered patients to her emergency room were lacking in skills and knowledge that she felt they should have. She also saw how much better they could be with a little help. Instead of sitting around the E.R. desk complaining about it, she started teaching for her local fire service. After a few classes, they invited her to ride along with them on calls. Venturing out on the rigs and

running calls alongside her students, she learned that field EMS was a whole lot different than the medicine she practiced in the E.R. with a very different set of challenges. As the street medics taught her about the world of emergency service outside the hospitals doors, she taught them medicine with an unusually high standard. Pushing their knowledge as well as their idea of what a field provider should know. Today, Twink is one of the most respected EMS educators in the world. And her students (like me) are her biggest fans. She's proven that when EMTs are held to a high standard of knowledge and competence, they don't run for the hills. They get hungry for more. Twink Dalton is an example of what one person can accomplish if they believe in working towards things that matter. Yes, our work matters. The work of the EMT is vital and worth doing.

If it doesn't matter and we choose to do it anyway, we are fools. Since it does matter, it's worth committing ourselves fully. When we do, we are free to support our workplace as a place for meaningful work. Sure, that all sounds good right? It is. But it comes with a bitter pill. A pill that not too many of us are willing to swallow. To recreate our workplace as a place of meaningful work, we need to take accountability for creating it. Not the future, the now. We need to accept that we have created our working environment, and we continue to create it each day. We talk about our work places as if they belong to someone else. We discuss things like morale and culture as if we are only visitors passing through. We speak about it as if it is the responsibility of the faceless “them” to come rescue us and provide us with meaning.

Commit!to!the!Communal!Pursuit!of!Things!That!Matter!

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The truth is, we create the culture. We drive morale. We decide each day what our workplace will be and nobody else. The moment we stand fully accountable for creating our workplace is the moment we become citizens. It is the moment we become owners instead of visitors. And it is the moment we seize control of our future. From the vantage point of citizens, we see clearly that we create our leaders. The students create their teachers. The field personnel create their managers. Long before the script is written, the audience creates the performance. They always have. We create it all, in our image, through the individual lenses of our perception. And we can change it as well. We can create an environment of widespread accountability and ownership.

Optimism is a fantasy. That's probably not what you were expecting to hear from an optimist so I thought I'd put it out there first thing. Now that I got that off my chest, I'd like to point out that pessimism is a fantasy as well. Neither optimism nor pessimism are based in reality. Therefore, they are both a matter of choice. Let me say that again because it is important. As reality flows forward on its unstoppable journey through time, it is neither optimistic nor pessimistic about where it is headed. We choose optimistic or pessimistic viewpoints when we make decisions about what we should focus on. It's as simple as that. Regardless of what we choose, reality will provide us with plenty of examples to confirm our chosen belief.

Right now, as you’re reading this, EMS workers around the globe are underpaid, overworked, and virtually unrecognized as a profession.

The!Case!for!Optimism!

We struggle for identity and consistent standards. We are weighted down by our lack of history and lack of a political voice. Training standards are often miserably low and many working EMT's fall below even that. Very few people outside of the medical field can explain, with any accuracy, what it is that we do. And we are stuck in the middle of it. There has arguably never been a worse time to be a part of pre-hospital care. Feeling down yet? Right now, as you are reading this, emergency care is advancing at an unprecedented rate. Survival rates for critical trauma, cardiac arrest, and sepsis are improving thanks to advancements is care. Research is demonstrating the effectiveness of improved CPR techniques, better airway procedures, and therapeutic

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hypothermia. Advanced monitoring devices like lactate meters and capnography are pushing the envelope of patient assessment. Cardiac, stroke, and sepsis alert programs are bringing the pre-hospital provider together with hospital emergency staff to create a true high performance team. And we are an integral part of all of it. There has arguably never been a more exciting time to be a part of prehospital care. Feeling up yet? I could go on. But I think you can see my point. There is ample reason to believe what you want about the future of our industry. Like every other complex system that you will encounter in your lifetime, EMS has plenty of challenges and plenty of greatness. You have to make a decision about what you want to focus on. Which outlook will serve you best?

What belief system will feed your motivation for the next twenty to thirty years? If you’re going to dedicate yourself to ongoing growth and fulfillment, you’re going to need an outlook that sustains you. You can't do that if you’re focused, all day, on what isn't right. The challenges are there. (Would you have it any other way?) Don't waste any more time bemoaning them. Get to work succeeding in spite of them. I know some folks have a tough time swallowing this optimism thing because they feel some deep commitment to seeing the world realistically. They’re going to tell you that you’re fooling yourself. I’m not about to tell you that you need to feel good all the time or that you need to pump yourself up with lame affirmations.

There is a lot of pain and tragedy and grief in the world. We see plenty of it in our work. Optimism isn’t about denying that reality. It’s about choosing to have power over it.

It’s about deciding to work for change. It’s about choosing to be proactive and claim a role in making things better instead of feeling powerless before the negative aspects of our lives.

A!Few!People!to!Avoid!Along!the!Way!

Don't expect everyone to cheer you on the path to non-conformity. People tend to like the status-quo. The status-quo is comfortable and predictable. Once you go your own way and seek a non-traditional path, you can expect some folks to throw up some hurdles. The three people you can expect to see are critics, the old guard, and the bottom feeders. Let me tell you a little about all three.

! !!!The!Non"Conformists’!Guide!to!EMS!Success!18

Critics: Critics are generally unhappy people. They sort and evaluate everything they encounter by its flaws, and they're good at it. Ask a critic what they did last weekend and they'll tell you about the bad weather at the campground, the bad movie they saw, or the undercooked steak at the restaurant where they ate. The things they notice are the things that aren't quite right. And you can bet that there's some stuff not quite right about you. Critics are scared of putting themselves out there. They don't like risk, so they stand in the corner and throw out criticism and those who do step up and try to do things. This is much easier than adding ideas to the pool of shared knowledge. They fool themselves

into thinking that it's their experience that allows them to have such keen insight, and many of them believe that people really want to hear their negative evaluations of everything around them. In this way criticism is like a security blanket. It is their purpose. Ignore them all. No critic ever changed the world. They are invisible. The Old Guard: The old guard exists in just about every institution and organization. Their purpose revolves around power. The old guard tends to hold the power within the organization and they fight to keep it. They do so through three mechanisms. First, they create the rules. Some of the rules help you to do your job more effectively, and many of the rules make it harder to be a high performer. Nothing concerns the old guard more than people who don't follow the rules.

They don't like change unless they create it, and people who don't follow the rules could influence change outside of their control. Second, they control the flow of information. The old guard creates the channels for information to flow, and then they control those channels. They send out the e-mails, post the memos, and write the newsletters, or they maintain influence with the people who do. They believe that the chain of command should extend beyond operational decision and encompass information flow as well. If you have a question, they think that you should ask them and only them. When you first join the organization they will be sure to explain why you can’t trust the individuals who are not a part of the old guard. You can be certain that they will also explain to the folks who get hired after you why they cannot trust you.

!!!!!!!!!!!!!!"""#$%&&'$()*$#+*'!

Do!what!you!know!in!your!heart!to!be!right.!You’ll!be!

criticized!anyway.!

!"!Eleanor!Roosevelt!

!

!!

Third, they invent the barriers of entry to positions of authority or influence. The old guard decides who should be granted influence within the organization, so they set the standards. They tend to value seniority above all else, experience in the industry that they are experienced in, all of the degrees and certificates that they already hold, respect for the rules, and strict adherence to the proper progression through the ranks. When you run up against the old-guard, keep in mind that they fear you. The more that you push the fringe, the more fear you will create among them. I find that it’s best to respond to their fear with a combination of understanding, pity, and polite respect. Just don’t ever fall into the trap of seeking their approval. Bottom Feeders: These guys have usually been around for a while, but they haven't done much. Bottom feeders stay down low and try not to move,

make waves, or be noticed. The bottom feeders of the organization are the defenders of the status quo. They are frozen in time so they don't want anything around them to change or grow, including you. They often find a critic with whom to partner so they know what to think without having to form their own opinions. Bottom feeders tend to stay where they are for a long time so they will often have experience and seniority, and they will make sure you know about it. They might tell you they know better because they've been doing the job for 20 years. They haven't opened text book or learned anything new since Johnny and Roy were on prime time. When you ask them how they are doing, they say catchy, depressing phrases like, "Too old to work, too young to retire," or "Another day another dollar." They're the ones who are going to tell you that your ambition and motivation are signs of your inexperience.

They think you are naive. They need to believe this to justify their own lack of motivation. Bottom feeders tend to be harmless. Don't let them discourage you. You can try to inspire them. You can also entertain them with your antics and your joy for the job. I tend to appreciate the bottom feeders more than the other two energy drainers. They don't tend to work as hard to bring you down as the critics and the old guard. Just don't be fooled into believing that their "just fill the seat and do the job" attitude is the way you should do your job. You're better than that.

! !!!The!Non"Conformists’!Guide!to!EMS!Success!20

!!!!!!!!!!!!!!"""#$%&&'$()*$#+*'!

“The!supreme!accomplishment!is!to!blur!the!line!between!work!and!

play.”!

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!"!Arnold!Toynbee!

Regardless of how you

feel about their competence, their

qualifications, or their work, you need to let go of the idea that you can’t be happy in your work until you get something

you need from your leaders.

!

!!

Not only do your leaders not have what you need, they may not even have what they need.

Your leaders wake up each morning just as flawed and imperfect as you. They will spend their day sorting through their own needs and trying to live up to the expectations of their jobs. If you’re lucky, they will make good decisions about the future of your organization. Your needs and wants and desires are not their priority, nor should they be. Stop waiting for them to come around and provide you with what you think you need. Even if they gave it to you, it probably wouldn't help. It's time to take responsibility for your own happiness. It's time to decide that your growth, your development, and all of the information that you need is within your grasp.

It's time let go of "If only..." If only they would keep us better informed about what's going on around here. If only they made decisions differently. If only they understood my job better. If only they would just listen to me. Each time we think in this way, we give our power and the keys to our happiness away to the faceless "them." When we come to the realization that our leaders don't hold the keys to our future, we can start about the business of building our own future by our own design. The first step is to stop waiting for permission to do what matters to you. Then you fire your boss and put yourself in control of your growth and development. Next you pick the right mentor (It's not who you think.) And finally, you choose to have the difficult conversations that are currently holding you back. We'll even take a minute to address what to do if your boss doesn't agree with all that.

Your!Leaders!Don’t!Have!What!You!Need!

Stop!Waiting!for!Permission!

Why are you still waiting for someone else to tell you that it's time to do something that matters to you? You don't need permission to start acting on what matters. Are you still showing up each day waiting for the nod, the go ahead, the OK from the people in the know that your time has come. You don't need a ticket to the big leagues. You just need to decide. I want to teach you a magical question. A phrase that will reframe how you decide to take action on the things important to your life. The phrase is, "Who's going to stop me?" Now, just to make sure you're not misunderstanding. There are many things you can choose to do, and someone will certainly stop you. (Or at least try.)

! !!!The!Non"Conformists’!Guide!to!EMS!Success!22

If you're planning on breaking the law or violating established policy, there are plenty of people who will be more than happy to stop you. But, surprisingly, the answer to this question is often, nobody. If there's something you've been waiting to do, and nobody is standing there waiting to stop you, then you're probably just waiting for some meaningless permission. Waiting for permission is your excuse for not going out and taking some action. Nobody is going to show up and hand you your dreams on a silver platter. You're going to have to do it for yourself. I don't know if you've noticed this yet, but

I'm Angry. I'm angry about how this industry uses up its human resources and throws them away.

We count on the fact that there is always going to be a new batch of young hopefuls drawn to the bright lights and the promise of a heroic job where adventure and human drama promise to fill each day. When I look at the amount of really talented people who walk away from this career used-up I feel just plain pissed off. I feel pissed off when private organizations sacrifice competence and fair pay looking for a cash cow at the end of the healthcare/insurance maze. I feel pissed off when public organizations treat medical personnel as second class citizens while they perform 80% of the services requested by the public. I feel pissed off when volunteer agencies tolerate bad behavior, abysmal performance and low training standards out of fear of losing the few personnel that they have.

I feel pissed off when talented caregivers are forced to suffer under poor leadership, awful management, infrequent training, long hours, low pay, and miserable working conditions. That's what you and I are going to change by demanding better and voting with our feet. If you've read this far and you're not willing to change anything about what you do each day. I'm going to save you some time right here. You can stop reading because this book isn't going to help you. Frankly, I'm only interested in having this conversation with people who are willing to act on their convictions and change their lives. If you're not willing to move and act and grow and learn, you can stop now. Thanks for coming. At the beginning of each concert Bruce Springsteen asks the same question. "Is anybody alive out there?" If I could ask the EMS industry just one question, that would be it. It's a valid question.

!!!!!!!!!!!!!!"""#$%&&'$()*$#+*'!

!!

If something inside you wants to scream, “Yes”, here's what you can do to start.

What if I told you that you could have a new boss right now? You could start working for a new employer this instant with better compensation, a better benefits package, and a culture perfectly aligned around your values? From this moment on, let's decide that you work for yourself. Call it “corporation you”. I know it's chintzy but stay with me. We just created a new corporation and we've got some important work to do. I'm going to give you back some of what you lost when you dove into the conformity pool at your current place of work. I want you to take a few of the things that your employer did for you without your consultation, and I want you to do them for yourself.

We're going to do some projects and take back some control over your future.

First I need you to write yourself a mission statement. You know a mission statement right? Your organization wrote one once. They probably hung it on the wall somewhere in the lobby and put it at the front of your policy and procedure manual. They did it for good reason. The problem is, most organizational mission statements are dumb. It's true. They didn't start out that way. Your leadership team went on a retreat. They all practiced trust falls and wrote on big white pads of paper. Then they passed a talking stick around and talked about empowerment and accountability. After days of scribbling and scratching they had it all worked out.

And the end result was something just worthless enough that everyone could be happy with it. "Or challenge is to assertively foster world-class empowerment through economically sound methods of community, integrity and value added service to meet the needs of the customer and the ever-changing future." What?

Fire!Your!Boss!and!Hire!Yourself!

Your!Mission!Statement!

Even the short sweet ones can be equally worthless if nobody buys in. For example, Enron's mission statement was, "Respect, integrity, communication and excellence." Nailed it guys … great job. Buy in is both essential and rare in today’s organizations. Some mission statements are worthwhile, especially the ones that put big audacious goals on the line. Microsoft set out with the mission, "A computer on every desk, in every home, all running Microsoft software." That's the kind of mission statement that can inspire.

! !!!The!Non"Conformists’!Guide!to!EMS!Success!24

!!!!!!!!!!!!!!"""#$%&&'$()*$#+*'!

Amazon's Kindle has the mission, "Every book ever printed, in any language, all available in less than 60 seconds." That, my friends, is a mission. And everyone in that division knows it. The mission and values statements were supposed to define the collective goals and values of the organization. If the organization lives them, then they should be recognized and remembered. But they're not your goals. It's not your mission. Those things were up to you to decide. Have you ever actually written down your own mission/purpose statement? Have you ever made a list of your guiding values? Let’s do it … I mean right now. Open up a blank document on your computer or take a blank sheet of paper. Start with the question, "What is the meaning and purpose of my life?" Write something down. Then erase it. Write the next thing down. Erase that one too. If one of those was supposed to be your mission, it will come back.

Most of the answers you write in the first ten to fifteen minutes will have little to do with your true purpose. They will be what you think your purpose is supposed to be. They will be what you've been conditioned to believe your mission should be. Be willing to take twenty, thirty, forty minutes on this. You may have a lot of crap to get through before the real good stuff starts to flow. But remain true to the question. What is the meaning and purpose of my life? If you keep asking the question, persistently and earnestly, the answer will come. And when it does, you'll know it. It will come from somewhere different, and it will resonate with you. Once you've found it, write it down somewhere and don't be afraid to come back and change it if you find that it doesn't fit.

Note that your mission and purpose doesn't need to be completely congruent with the mission of your organization, but there should be parallels. Your work should reflect your purpose and guiding values. If it doesn't you need to reflect on that. Maybe it's time to move in a different direction. Once you have your personal mission statement, you can't just tuck it in a folder and not look at it for the rest of the year. That's not good enough. Now that you've chosen your purpose for being on this earth, denial just won't do. You need to become accountable for making the purpose of your life come to fruition. It's your responsibility and no one else. This type of total accountability is a part of becoming a citizen of the world you inhabit. Once you've chosen your mission statement, never refer to it as a mission statement again. Refer to it as your mission statement.

!!

You might be curious as to my own personal mission statement. While it might provide an interesting example, I’ve never felt comfortable sharing my mission statement in public forums. I have, however, found great inspiration in the personal mission statements of others, and they serve as a far greater example than mine could ever provide. Perhaps the most inspirational personal mission statement I have ever encountered is that of Mahatma Gandhi: “Let the first act of every morning be to make the following resolve for the day: * I shall not fear anyone on Earth. * I shall fear only God. * I shall not bear ill will toward anyone. * I shall not submit to injustice from anyone. * I shall conquer untruth by truth. And in resisting untruth, I shall put up with all suffering.” - Mahatma Gandhi

Semi-annual and annual performance reviews are one of the most ridiculous things organizations do. They're demoralizing. Regardless of whether you're a top performer or a slouch, the review has no useful purpose. These things are so endemic to our organizations that you may doubt my sincerity, so let me explain. All the feedback you get in a performance review is either redundant or untimely. Feedback needs to be in context and given at the time of the behavior in question. If you do something well, your supervisor should say so right then. If you do something poorly, same deal. You need to know right then. So your employer either did it right and gave you the feedback in a timely manner. If so, to repeat it in a performance evaluation is redundant.

Why are we going over this again? Didn't we cover this when it happened?

Your!Annual!Performance!Review!

Or perhaps your employer didn't say anything at the time the behavior or incident occurred. Now the feedback is untimely. What? You wish I would show up earlier? Why didn't you say something months ago? Here's a secret. Most organizations don't do performance evaluations because they want to "empower your growth" or "mentor and guide your development" or any of the reasons that they told you. Many of the folks who give the evaluations honestly believe that they are guiding and empowering you. But I've fought to abolish the performance evaluation, and I can tell you that when the door shuts and the meeting begins, the reasons we cling to performance appraisal are quite different than the stated objective. Organizations do annual performance appraisals for three misguided reasons.

! !!!The!Non"Conformists’!Guide!to!EMS!Success!26

First, they believe that it protects them from liability in a wrongful termination lawsuit. This is false. Research shows that ongoing written performance appraisals are helpful to the employee in court over 85% of the time. The idea is wrong, but it is pervasive none-the-less. Second, performance evaluation feeds the parental ideology that many upper level managers hold. Your leadership team may really like the idea that wisdom and guidance flows downward to subordinates from above. Once this idea has taken root, performance evaluation seems essential. It's not. Third, everybody does it. It's hard to stand against something so prevalent in organizations as formal written evaluation. The question repeatedly comes up, "If not this ... then what?" There are many great answers to that question, but most managers don't want to hear them.

So the next time you have a scheduled performance evaluation I'm going to ask you to do something dramatic and unexpected. Something that your management team has probably never seen before. Something that's going to put you back in the driver’s seat. This is it. Do your own performance evaluation on yourself before the meeting. You should be doing this anyway. I don't mean that I want you to get a blank copy of your employer’s evaluation matrix. That's the worst thing you could do. That thing is going to be laden with ridiculous criteria like behavior and timeliness. You know all about your behavior, and you can read a watch as well as the next person. You're not going to be evaluating yourself on how well you follow the rules. You're criteria are going to be legitimate measures of success in your life, as you define them.

At least once a year you should be doing a full review of your own performance goals. How did things go last year and what do you want to accomplish in the coming year? What are your most important goals? What tasks will you need to start to achieve those goals? Here's a system you can use to do your own annual review. Don't feel like you need to do this in sync with your employer’s review. They probably aren't terribly concerned with how this all works with your schedule so you don't need to be chained to theirs either. Just have your review ready to reference when your employer’s review is ready to go. A personal annual review: Step one: Who do you want to be? Take a little time to envision yourself ten years from now. How old will you be? What do you want to be doing with your life?

!!!!!!!!!!!!!!"""#$%&&'$()*$#+*'!

“Only!one!who!devotes!himself!to!a!cause!with!his!whole!strength!and!soul!can!be!a!true!master.!For!this!

reason!mastery!demands!all!of!a!person.”

" Albert!Einstein!

!!

Really take a minute, close your eyes and think about yourself in every detail. Don't worry about being realistic. I want you to think about your ideal life. Where do you work? Where do you live? What is your income? Who are the people around you? Before we start mapping out goals it helps to get a good idea where we're going. This little visualization is going to give us the clues we need to start figuring out what we need to be doing in the coming year. A decade is a long time, but it's going to pass faster than you can imagine. You can accomplish a little or a lot in the coming ten years, but either way, the future is coming. You're going to have to decide if you want to arrive in your future or someone else’s future. Be certain of this. If you aren't clear where you want to go, someone else will be more than happy to take you down their path instead.

If you'd like to spend the next ten years helping someone else achieve their future there are plenty of people willing to line up and lead you down their path. Step Two: A general review of the year Let’s start with a list of the five things that really worked this last year. What are they? List your five biggest successes or accomplishments. What things that went really well? Next, write out five things that didn't go well. Five things you wish had gone better. You don't need to write this next part down but look over the list for a while and think about the things that made the good stuff go well and what factors made the bad stuff go poorly. Be honest with yourself. Step Three: Goals for the coming year Now write a list of five to fifteen things you would like to accomplish in the coming year.

Don't get bogged down with the details. Think about this person who you want to be and what you would like to do.

More money? More influence?

More time? More friends?

It doesn't matter how...just yet. Write them down. What's important to YOU in the coming year? In their book, Built to Last: Successful Habits of Visionary Companies, James Collins and Jerry Porras first coined the term “big, hairy, audacious goals.” I love that term and I think about it when I’m creating my goals each year.

! !!!The!Non"Conformists’!Guide!to!EMS!Success!28

!!!!!!!!!!!!!!"""#$%&&'$()*$#+*'!

Don't be afraid to make some of your goals big, audacious, hairy, scary, crazy goals. That's OK. You can't wake up in the morning motivated if you don't have a few goals that scare you just a little. Write them down. Once you've done that I want you to pick out the top five goals. These are the ones we'll focus on first and primarily. The others will become lesser goals. Step Four: Actionable items For each of your top five goals, write down at least three actionable items. What actions would move you closer to that goal? When I say "actionable," I mean that you should be able to physically do this thing now or in the near future. It can't be nebulous or theoretical. "Start considering more healthy food choices" is not an actionable item. "Stock my kitchen with nothing but healthy, nutritious foods." is an actionable item that you could follow immediately.

When you're done, you should have 25 real, actionable items that you can start working on today. Congratulations. You just put your goals on project status. You honestly reviewed your life and set forth on the path of your choosing without any guidance from your supervisor. See how easy that was. Now, when that performance review comes up I want you to pull out your review of your previous year: what you think went well and what you need to work on. Explain what things you're working towards and how your employer could help. Be open to the feedback from your supervisor and identify where the organizations desires and yours meet. If your primary goal for next year is to spend more quality time with your family and your employer’s primary goal for you is to have you work more overtime slots in the coming year, you need to discuss that, honestly and frankly.

Step Five: Check for congruency We’ll do one more final visualization just to check if your goals and path are congruent with your mission and values. If you've never done this one, I have to warn you that it can be a powerful reality check. Close your eyes and imagine that instead of arriving at the future that you envisioned for yourself, you died tragically along the way. Picture your friends and family, all those people you wanted to be with you during your life, all gathering to celebrate you, after your life. What will each one say about you? What will they say your life meant to them. One by one let each one of these people get up and speak. Picture them, ten years older, talking about the last decade. What did you do for them? What will the loss of your life mean for their future?

!!

Remember that they didn't have to agree with the path you chose to take, but did the people you care about feel respected by you? Did they feel needed? This visualization should bring you in touch with your closest values and check if your stated goals are aligned with them. If you struggle with this, your goals may not be in line with your values.

What's your continuing education plan? I don't mean your employers C.E. schedule. I'm not talking about the minimum required education credits to renew your certification every few years. I mean what is your plan for growing and developing your skills, your knowledge, and your competencies. Continuing education isn't a one-size-fits-all prescription.

If your employer already provides your continuing education for you, that's great. But that's their plan for your ongoing education. You need a plan as well. In today’s world of e-learning, amazon.com, EMS magazines and websites, state and national conferences, in-hospital education and a long, long list of potential certifications, you can find the education you need. You can find the education that interests you, appeals to you and supports your particular needs. Too many EMS providers get into the lazy habit of absorbing continuing education like a cow at a trough. Like everything else in your career development, you're going to need a more proactive approach. Your education and development isn't someone else’s responsibility. Sure you should take advantage of continuing education when it's provided, but don't get too comfortable being fed your education by a single organization or, worse yet, a single person.

Let's put another continuing education myth to bed. Continuing education isn't a mandated review of the information you've already learned. Yes, the information you've already learned is important to review, but medical knowledge is a moving target. As my web site says, “medicine moves fast. It's your responsibility to keep up.” There is a stream of research and news that is changing the face of the medicine we practice weekly. Scratch that, daily. If you've decided to make this your career, you're going to need to take responsibility for keeping up with it.

Your!Continuing!Education!Plan!

If you have the resources to get this e-book, you have the resources to keep up with the knowledge vital to your career.

! !!!The!Non"Conformists’!Guide!to!EMS!Success!30

Mentor programs are big deals in organizations these days. Leadership teams feel incomplete or out of date without some sort of formalized mentorship program. Employees feel entitled to a mentoring process. The act of mentorship is recognized as beneficial, and we rush to compartmentalize and formalize something that can't be so easily forced. If you’re going to look for a mentor (and I recommend that you do) I would look for someone outside of EMS entirely. I know that's counter-intuitive to everything you think a mentor is suppose to do for you, but you can get advice on how to do your job from anyone.

A mentor who knows little or nothing about your job will be more likely to focus in the questions that you really need to answer. How are you progressing on your goals? What are your working relationships like? What's holding you back? Are you staying true to your stated values and purpose? This is the guidance you need from a mentor. Someone who can help you work on these questions. A mentor who doesn't know the first thing about a head-to-toe assessment is more likely to be keep you focused on the big questions. If you feel like you simply must have a mentor in this field, try to find one that doesn't work in your organization. If you must violate all of these guidelines, please, please don't pick a mentor who has a supervisory or boss role above you. Understand that your desire to have a supervisor or boss act as a mentor speaks directly to a desire to have your bosses fill a parental need.

This is just another way of looking for your boss to fill an unspecified need for information, skills, insider secrets...something that you feel that you're missing.

Your!Mentorship!Program!

Mentorship isn't about you missing something vital.

!!!!!!!!!!!!!!"""#$%&&'$()*$#+*'!

!!

The elements of a healthy mentorship program:

Being Willing!to!Have!Difficult!Conversations!

The next step in developing a grown-up relationship with your leadership is developing the ability to have difficult conversations when they are needed. Part of us needs to be able to rip up the existing social contract that says we need to speak when spoken to and avoid subjects and conversations that make people uncomfortable. Often our freedom lies on the other side of difficult conversations, and when that chasm needs to be crossed, we need to be ready to bravely take the first steps. Hear this next part clearly. I'm not giving you permission to be an ass. I'm not saying you need to be disrespectful, outwardly angry, obnoxious, or rude.

You don't have an open invitation to squash people’s feelings or say things like, "By the way, everyone thinks you smell," or "did you know that those jeans really make you look fat?" That's not my point.

1.) Both you and your mentor have a choice and chose to be involved in the mentorship relationship. If either you or your mentor are obligated to be in the relationship, then it is a required training, a preceptorship, or an internship. Mentor relationships need to be chosen by the parties involved, and they both have the option to not participate at will. 2.) The relationship needs to be beneficial for both you and your mentor. Both parties should feel that they are learning, growing, and developing as a result of the experience (Though they may be learning different things.)

I'm simply giving you permission to run with the verbal scissors a bit. Develop a willingness to have the difficult conversations that could make real differences in your work environment. I'm willing to bet right now there are a few touchy subjects that people are avoiding addressing at work right now, perhaps a supervisor whose micro-management style is affecting your ability to get back in service in a timely manner, or it may be a coworker who leaves the unit in an unacceptable condition or a partner whose constant gossiping is breaking down the trust of his coworkers.

3.) The mentorship should focus on your growth and your goals. Not on job minutia, knowledge, or skills. Tutors and teachers can help you develop your competency. Mentors help coach you through your life.

What if you approached these individuals with a kind, respectful, but firm approach and had that conversation that you and everyone else has been avoiding.

! !!!The!Non"Conformists’!Guide!to!EMS!Success!32

You might damage your relationship and invite their anger. You can't control that. You might also gain their trust. If you act from a place of respect and truly have their best interest in mind, you may find yourself viewed as a trusted friend. Throughout your career in EMS you are going to have many opportunities to have difficult conversations with your coworkers, and patients. If you choose the path of fear and avoidance, you'll miss the opportunity to have real, honest and meaningful relationships with your coworkers.

!!!!!!!!!!!!!!"""#$%&&'$()*$#+*'!

!!

Sounds Great, But My Boss Doesn’t Agree

I sense that some folks who read this are going to become excited. The non-conformists have been waiting for someone to say this all along. They see the match of personal freedom in their hand, and they're searching for

somewhere to strike it.

On the other side of the coin, the conformists are shaking their collective heads.

“Sure Steve, maybe that works for you, but you don't understand what my workplace is like. You don't know my bosses. My workplace would never tolerate individuals claiming this kind of personal freedom. This all sounds

good here, but it wouldn't work in the real world.”

So let’s just address that resistance right now. What if your supervisors, your bosses, or your institutions don't agree with the idea of you claiming

your personal freedom?

So what?

Are you going to choose your path based on what is right for them or the path that is right for you?

Not everyone is going to be able to accept that. Part of personal freedom is the right to deny the existence of your own personal freedom. Crawling back in to the cave of conformity is the safest option. Inside the cave we can't be held responsible for creating our lives. Conformity does have its

advantages.

!

! !!!The!Non"Conformists’!Guide!to!EMS!Success!34

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“Once!in!a!while!it!really!hits!people!that!they!don’t!have!to!experience!the!world!in!the!way!they!have!

en!told!tobe .”!

!!!!!!!!!!!!!!!!!!!!!!!"!Alan!Keightley!

You’ve probably heard a lot of advice about how to

develop patient rapport and influence.

Here’s the truth.

You can’t fake it.

!

!!

People are a lot more keyed in to marketing today than they were forty years ago. It's no wonder why. In today’s world we're marketed to in some form or another nearly every minute of every day. From the television to the radio to the internet, we are inundated with sales pitches. Our existence is cluttered with the constant inundation of marketer who spend billions to try to interrupt you and convince us for the chance to convince us to see the world just a little differently. The end result is a society particularly keyed in to what is real and what is noise. We're born and raised skeptics. From the first time we send off eight box-tops for our x-ray glasses, we start learning had lessons about what's real and what's phony. And we recognize that you can't always trust the hype. Most folks are pretty good at spotting a fake.

People in the midst of medical emergencies are particularly good at it. Here, at the worst moment of their lives, we arrive with our badges and uniforms and bags filled with mysterious and magical equipment. Our monitors beep and our sirens wail. We create quite a show. And through it all, our patients can see who we are, sometimes far more so than we wish they could. You've probably heard a lot of advice about how to develop patient rapport and influence the conversation. Here's the truth. You can't fake it. It's as simple as this: You can't give away what you don't have. If I told you I'd like to give you an apple and I wasn't holding an apple, you'd immediately be confused. "Thanks Steve, I'd love an apple. Uhhh...where is it?" But we don't consider it quite so obvious when it comes to things like compassion, caring, patience, kindness, or respect. In truth, you can no more

give away these things if they're not in you than you can give away an apple that you don't have.

Authenticity!

If it isn’t in you, it can't come from you. Not authentically. If your desire to take care of people is a lie, your patient will know. And it will affect every interaction and every call. Things like compassion and service can't just be pretty answers to interview questions in this job. You need to be able to live it. If it isn't in your heart to be a servant and care for people, you're always going to feel the stress of living a lie. It will doom your success. The word for living your life congruent with your beliefs is authenticity. Some people have it and some don't. Some folks are drawn to EMS because they care deeply about serving others and some people are drawn to it by their own inflated sense of self-importance. If your job is about you and not about the people you serve, it's going to show. It's the most

! !!!The!Non"Conformists’!Guide!to!EMS!Success!36

common cause of jobs stress and frustration in our line of work. It's pervasive. When the tones go off you can tell the difference between the people who feel a call to action and the people who feel inconvenienced. The patient isn't an inconvenience. They are the reason why we exist. If you want those interactions to flow, if you want to your patient rapport to be a breeze, you don't need any of the tricks and techniques. All you need is to strive for authenticity. You need to feel the call to service and the desire to be there for others in your heart. There is nothing more important to long term success. Everything else can be developed. Authenticity needs to be decided. And only you can decide for yourself.

Once we've decide to be our authentic selves we open ourselves up to the possibility to live and experience our deepest values in our work. I don't want to sound too much like an army recruiter but EMS needs you. Not another warm body...you. Being your authentic self is something more than just a high school cliché or a chapter in a self help book. When I say be yourself, I mean to say that you have something specific and unique to contribute and only you can take responsibility for that unique thing. Choosing to be yourself means that you’re going to have to step up to the plate in a big way and recognize that there are some good things that are not going to happen in the world without your help. Don't look at me. I don't know what those things are. If I did, I'd tell you, but only you can decide. I can only tell you that I'm certain they exist. There is something that you can

bring to EMS that will allow you to leave it better than it was before you came.

I!Need!Your!Help

If you walk away or bury your head in the sand pit of conformity, it won't happen. It's that certain thing that needs you to step up. It's that contribution to the world of EMS that we need you to make. You don't need to know what this thing is right now. But know that if you choose to show up and be present in your job, if you choose to live your deepest values each shift and each call, you are on the path.

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!!

You fear too much. I can say that with confidence because, frankly, we all fear too much. What we fear more than anything is failure. The way little kids fear the boogey man...that's the way grown-ups fear failure. Failure is the grown-up boogey man. We learn to move past a lot of our fears as grown-ups. Spiders, monsters, snakes…we can handle them all. But talk about failure and we go running for cover, especially public failures. Declaring boldly in public that we're going to try to do something hard and then not achieving it is horrifying to us. We struggle to separate our tasks from our selves. Get over that. You've wasted too much time letting fear hold you back. Remember when we were talking about doing your own performance evaluation and you were going to go into the evaluation having some goals for the coming year?

Both personal and professional? I want to encourage you to have some big audacious goals. I'd like you to have at least one goal on your list that makes you a little frightened inside when you think about it, one that you know is going to take a monumental effort on your part. Some fear is good. That fear you feel when you're walking up on a house and you get a sense that there's something sketchy about the place, or the fear you feel out on the highway working an accident with cars driving by a few lanes away…that’s good fear. It motivates you to keep your guard up. The fear you feel when you make a big, audacious, public goal is the same kind of fear. It can inspire you to wake up early and stay up late doing things that matter to you. Embracing that fear can be a powerful thing. Grow comfortable with that anxiety. Another grown-up boogey man is failures cousin, evaluation.

We fear evaluation because we see performance feedback as failure. The longer we stay in our career, the more we tend to fear being evaluated. We start to feel like we should achieve perfection somewhere along the way, and any feedback that suggests anything other than glowing praise represents our failure.

You!Fear!Too!Much!

The simple solution is to avoid any type of evaluation. The problem with that solution is that we stifle our own growth. Instead of aggressively seeking feedback from our chosen teachers, we hide in the break room and write our report. We don't ask the ER staff what we could have done better. We don't ask our respected coworkers for their appraisals. We stop boldly seeking the feedback and input that could help us grow and instead we hide behind our confidence and bravado. If you'd like a real world example of what I'm saying, watch the way people respond when your organization announces that they're doing case reviews.

! !!!The!Non"Conformists’!Guide!to!EMS!Success!38

Fear mediocrity. Fear irrelevance.

Fear the status quo. Fear stagnation.

And fight anyone who

champions it.

Everyone likes case reviews, as long as their trips aren't being reviewed. Only the most confident of the bunch seek to have their cases reviewed. Especially if they've made mistakes. When was the last time you saw an EMT or a medic get up at a review and say, "I'm really glad that we're reviewing this trip because I did some things that I could have done better and I wanted to talk about them?" Maybe at the next case review, you could be that person. While we're at it, let me give you a few things worth legitimately fearing in your life.

When paramedic Jeff Forster struck up a conversation with the wheelchair-bound patient in the back of his ambulance, he wasn't looking for ways to improve the man’s life. He was just making conversation. And he was open to possibilities. Jeff's not the kind of guy who lets other people make the rules for him, and he certainly doesn't wait for permission from someone else. But that's getting ahead of ourselves. That sunny afternoon the man in the wheelchair just wanted to talk about hot rods. Souped-up street cars and chromed out classics were real passions of his. Jeff knew this by the display of hot rods on the shelf in the patient’s room. And this particular patient was probably fairly skeptical when Jeff said, "We should go to a car show together."

Connections His skepticism turned to conviction a few weeks later when Jeff called to invite him to a car show in Denver. Jeff and few friends picked him up in a wheelchair-van, and they spent the morning wheeling him around the enormous show-room floor. They had arranged for the event staff to open the doors early for their special guest, and everyone had a great time learning about hot rods from the middle-aged man who lived in a nursing facility and rarely went anywhere outside of hospitals. You can go your whole career interacting with the public and never make any real connections like the one Jeff made that day. Being willing to truly connect with a patient requires more than just a willingness to observe, treat, and provide care. It requires a willingness to let the patient/caregiver relationships change us. It requires us to reach out beyond what's comfortable and redefine who we are and how we

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!!

choose to inhabit our work. That's the real defining difference between a caregiver relationship and a connection. When we make a true connection with a patient, we change too. We open ourselves up to the idea that we can be changed by the relationship. Instead of delivering care behind a wall of detached observation, we make the choice to fully engage, and in doing so, we bring our whole selves to the task and the relationship. Occasionally, we create the possibility of a connection, a moment in which we are forever changed. That possibility isn’t something we learn to accept or invite in EMS, but it’s a possibility that’s worth exploring.

That’s a scary prospect for some folks. We get this idea that the best way to survive in a job where we interact with so much tragedy and death is to build up a shield and make certain we don’t feel anything regarding our patients, their lives, and their own personal calamities.

If we allowed ourselves to care about those things, wouldn’t it make us less effective caregivers? People want our help and our competence not our compassion, right?

I disagree with these fearful sentiments. When we create these artificial barriers and make up fearful excuses why we’re not supposed to make real connections with the people we serve, we set ourselves up for a tremendous failure.

The problem we create when we create barriers of detachment between ourselves and our patients, is the problem of eliminating the possibility that we might grow from our experience with the patients we serve. We never come to learn the tremendous appreciation that we can develop for our lives by empathizing with the losses of others.

We!Change!Too

We never come to learn about the rich history and life experiences carried around by our patients, our family, and our friends and loved ones until we develop the skills that let us tap into them. Through EMS I’ve learned how to take a complete stranger and make them into a life teacher in less than 15 minutes.

I can get an 80 year old great grandfather to tell me secrets about being happily married for a long time. I can get a disaffected teenager to explain which bands are the best deals on iTunes.

! !!!The!Non"Conformists’!Guide!to!EMS!Success!40

I can get a anxious soccer mom to tell me all about gardening, and I can get a five year old to expand on what makes a really good peanut butter and jelly sandwich.

I can connect with just about anyone, and my life is immeasurably richer for having learned how to do it.

Once you’ve opened yourself up to making these connections, it doesn’t just happen in the 15 minutes between the scene and the hospital. It spills over into your life in amazing ways. You become more connected with your kids, your friends, your relatives, and your neighbors. You can’t help but make connections with people.

You begin to instantly identify the difference between small talk and real human interaction. Regardless of how short the conversation, you refuse to talk about the weather and who won last week’s football game. You’ll find yourself exchanging real

conversation with people you meet on an elevator. And it’s fun.

Here’s a big hidden secret of EMS. For those that choose to develop the skill of real patient rapport and connection, their lives become deeply richer.

! They appreciate more. ! They connect more. ! They learn more. ! They love more. ! They grow more. ! They feel more fulfilled by

their work. ! They feel more fulfilled in

their lives.

But before you can start tapping in to that vast ocean of personal meaning, you have to recognize the immeasurable value of the patient.

The!Value!of!the!Patient!is!the!Value!of!the!

Caregiver!

Before we wrap this up, I want to share with you the single most valuable lesson I've learned in EMS, the one single belief that you could adopt immediately and possibly reframe the entire way you look at emergency services. The failure to understand this principle is responsible for more grief and frustration among people who work in our industry than any other single thing. The value of the patient is the value of the caregiver. You need to recognize that the value of your work is directly and irrevocably attached to the value of the patient being served. You can't avoid that. It may sound obvious, but it's easy to forget. And when we do forget, we begin to devalue our patient,

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!!

and in turn, devalue ourselves. Once you understand that, you'll begin to see it everywhere. You walk around like Neo in the Matrix, just opening your eyes for the first time. In EMS we devalue the patient chronically and habitually. You'll hear it in the way we talk about our patients when we tell stories about the calls we've run. You'll hear it in the jokes we make outside the ER while we're cleaning up and the way we address system abusers and the way we feel about people who are intoxicated or addicted to substances. You'll see it in the attitude we adopt with psychiatric disorders and the way we secretly blame patients for their illnesses and injuries. Some folks make devaluing the patient an art form. We tend to think of the jokes, jests, and downright insulting attitude that we adopt when talking about our patients as harmless. What's the big deal? They’re not present right?

What they don't know can't hurt them right? True. It doesn't hurt them. It hurts us. The way you feel about the people whom you serve is also the way you'll begin to feel about the value of the service we provide. If the people you serve have no value in your opinion, then your service has no value either. If they have little value, you have little value. Here's the good news. Patients, your patients, the human-beings whom we serve, have tremendous value, more so than you can imagine. For a long fulfilling career serving people, it’s essential to believe that there is something intrinsically valuable about being human. There isn’t a sliding scale of value. The guy who sleeps in the cardboard box behind Safeway isn’t any more or less valuable than the guy who drives the school bus for a living or the surgeon down at the local hospital.

The drunken guy who you have to wrestle from his cell down at the local P.D. booking center is just as worthy of respect and dignity as the lawyer who got rear-ended in his BMW or the school teacher who fell on the stairs. They all carry the same intrinsic value of humanity with them and they are worthy of our service. That last line is worth repeating. They are worthy of our service. Once you decide, really decide in your heart, that humanity is worthy of your service, a huge amount of your job frustration will disappear. Try it out. Decide that every form and variety of humanity is worthy of your service. Regardless of socio-economic status, intelligence, race or religion, emotional state, age, health or moral bearing, everyone is worthy of your service. This is the key to your job, for the rest of your life.

! !!!The!Non"Conformists’!Guide!to!EMS!Success!42

For as long as you choose to wear the uniform of a trained E.M.T., you kneel at the feet of humanity and humbly ask the question, “How can I help you?” You’ll never have to question your value again.

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! !!!The!Non"Conformists’!Guide!to!EMS!Success!44

The!Fulfillment!of!Meaningful!work!

“It’s!a!sign!of!mediocrity!when!you!demonstrate!gratitude!with!

moderation.”!

!!!!!!!!!!!!!!!!!!!!!!!!!!"!Roberto!Benigni!

What does your work mean to you?

What does it mean to

wear your uniform and do your job?

Does it mean the same

thing that it did when you started?

!

Fulfillment is a big word. Meaningful is even more (How should we say it?)…meaningful.

Before Victor Frankel’s pioneering book, Man’s Search for Meaning, popular psychology believed that most of man’s motivations were centered in the “will to power.” We do what we do primarily to gain power and influence. Period.

Viktor’s experience in the Nazi concentration camps told him something different. Viktor came to believe that man searches, more than anything else, for meaning. We desire to know that our life has meaning and purpose.

He also took us to task on being accountable for our attitude. Viktor saw that even in the harshest possible human conditions, the human spirit can rise above circumstances.

!

!

"We!who!lived!in!concentration!camps!can!remember!the!men!who!walked!through!the!huts!comforting!others,!giving!away!their!last!piece!of!bread.!They!may!have!

been!few!in!number,!but!they!offer!sufficient!proof!that!everything!can!be!

taken!from!a!man!but!one!thing:!the!last!of!the!human!freedoms—to!choose!one's!attitude!in!any!given!set!of!circumstances,!

to!choose!one's!own!way."

- Viktor Frankel

I agree with Viktor’s model of human motivation.

I’d like to think that many of us in EMS are cut from this same cloth as the men who gave away their bread. I believe that finding that spirit is key to our fulfillment. To do that simply requires us to recognize how deeply meaningful our work is.

I don’t mean to say that those dramatic moments of life saving intervention and dramatic rescues are meaningful. I mean to say that all of our work is meaningful.

Sometimes, when I look at the work I do each day and feel that my impact is insignificant, I’m reminded of the story of the man and the woman walking on the beach.

As the story goes, this man was walking down the beach one sunny, early morning, looking at the thousands of starfish that the evening storm had washed up on the sand.

Now, in the heat of morning, these starfish were clinging to life. Not a one would survive to see the next high tide.

Farther up the beach the man saw a woman walking his way. Every few steps she would bend, pick up a start fish and throw it as far as she could into the water. Stunned by her naïveté, the man couldn’t help but address her when she got closer.

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!!

He smiled and gently chastised her, “Madam, certainly you must understand, there are literally thousands of starfish on this beach. And even if you could throw them all back in to the water, tomorrow night’s storm would likely wash them back up. And even if you returned tomorrow, this same thing is happening on beaches all over the world. Your efforts can’t possibly make any difference.”

The woman smiled back and then reached down and picked up another starfish. And as she threw it far out to sea she exclaimed, “I made a difference to that one!”

Our work is meaningful one patient at a time. We cannot say what impact our kindness, our patience or our competent care will ever have on the people we serve. It’s not for us to know. But we can certainly walk away from each call and say, “I made a difference to that one.”

We should be gracious to our patients for providing us, each day, with such meaningful work.

Remember that “match” of personal freedom that we talked about back on page thirty-four? It’s still right there in your hand. Now it’s your turn. It’s your turn to strike it. It’s a “strike anywhere” match. It doesn’t matter where you begin.

Begin anywhere. Just begin.

You may have been denying and hiding from your personal freedom to be amazing for a long time. But now your time has come.

Don’t be cool. Cool is social fear dressed up in fashionable clothes. Cool is conformity in a cardigan.

Maybe start by making some mistakes. Go have some grand failures. And then celebrate them. See them as right answers to other questions, they usually are. Celebrate your failures like you celebrate the Fourth of July. Love them like you’d love an ugly child.

Go!do!Something!Amazing!

Sure people will stare, so what.

Get off the path and jump some fences, even the ones with warning signs on them. Innovate and use your innovation as an excuse to study and learn and grow.

Then study hard.

Forget about being good. Choose to be growing over being good. Good isn’t a recipe for growth, and not all growth springs from our “good” moments. Strive to be excellent. Value growth. Ignore good. Good is a waste of time.

! !!!The!Non"Conformists’!Guide!to!EMS!Success!46

Appreciate the weirdo’s, the misfit’s, and the freaks. They are living their lives outside the lockstep of normalcy, and for that, they deserve our appreciation. Besides, life around them is so much less boring than being around normal people.

Expect that, if you are living your life with purpose, the spaces between you and others will be filled with conflict and frustration and joy and laughter and the entire rich fabric of human experience.

I want you to know that I wrote this book to speak to the dissatisfaction that you may be experiencing in your work right now. I know that dissatisfaction because I lived it for far too many years.

But more than that, I wrote this book to speak to the part of you that’s searching for something more. The part of you that senses that you are close to something extraordinary.

Something amazing that you need only open yourself to and everything in your life would change.

If there is one idea that I’d like you to carry away from these 46 pages, it is this. Meaningful lives don’t happen on accident. You aren’t going to stumble into a meaningful existence. You’ll find meaning when you make a conscious decision to seek it. Grounded in your values, understanding what’s important to you, planning the road ahead, seek your meaning.

It’s there.

You don’t need permission.

Go do something amazing.

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If you feel like you’d like to say thank you, the nicest form of appreciation I could imagine is to have you pass this on to a friend who you think might enjoy reading it.

!!

! !!!The!Non"Conformists’!Guide!to!EMS!Success!48

One of the best things about taking on a major task like publishing your first e-book is that you need to call on resources outside of yourself if you have any chance at success.

To that end, there are several names that need to be included in this work.

I owe a huge debt of gratitude to my wife Peggy for her support and assistance in creating this work. Without her there would simply be no website, no e-book, no newsletter and no success story to tell. Thank you my love.

I’m also indebted to my brother Brian for offering his design experience.

Thank you to everyone who read the rough-draft and gave valuable feedback, especially Greg Friese of Everyday EMS Tips.

Finally, I owe a fantastically big thank you to the editorial staff of The Lawson Currant. Without them you would have just read 47 pages littered with spelling, grammar, and punctuation errors.

This book is immeasurably better because of the efforts of:

Editor in Chief: Jason Oncay, Assistant Editors:

Finally, I’d love to hear your thoughts and ideas on everything you just read. Feel free to contact me any time at steve@theemtspot.com @stevewhitehead (on twitter) Some.guy.named.steve (on skype) Steve Whitehead (on facebook)

I thank you in advance, Steve

Vinitra, Janice, Gene, Hari, Mihir, Manasa, Mrudula, Jennifer, Jen, Sanika, Yeshwanth, Alex, Pradnya, Illina, Dennis, Anirudh, Rachel, Fiona, Dhairya, Nina, Archita, Bili, Neil, Meena, Elizabeth, Yashashree, Akhila, Suprith

Acknowledgements!