Be well. Practice big medicine.

Newman | The Positive Paramedic Project #6 Look, listen & feel

A nugget of EMS organizational wisdom every day. #6 Look, listen & feel.

Look, listen & feel. Those three words were ingrained into my consciousness a long time ago – long before I was ever charged with leading a team of emergency medical services [EMS] providers. And yet, sometimes the most obvious eludes us as we focus on the process and neglect our people. 

Back in the day, Ed Pietroniro was one of our Clinical Team Leaders (CTL) at CSL EMS. He was a superb clinician with strong leadership qualities and the ability to read a problem from many different angles before even attempting resolution. Ed’s a big guy—square shoulders on a solid frame—a human eclipse of a medic. He liked to wear his hair in an early-American-USMC buzz cut. He was intimidating to look at until you saw him caring for a client. Gentle, polite, and decidely delicate for someone who probably didn’t need Fire Department assistance on a Forcible Entry call. Ed was a firefighter/ security officer with Pratt & Whitney Canada. We liked to call him Special Ed.

Special Ed liked to wander into my office—the door was always open. He didn’t knock or say anything to announce his presence. I’d be working on the computer and turn around to see Ed settling into the guest chair in my office. It was a tight fit so he tended to assume a lounging position in the chair. Legs sprawled out in front of him the heels of his boots digging dents in the tragically worn carpet. Ed liked to grab whatever was handy on the end of my desk and twirled it in his hands. It’s usually a distracted conversation for someone so focused. He’d say, “Hal, are you busy?” I’d say, “What’s up, Ed?” and Special Ed would tell me a story.

After going missing-in-action for almost a month on CSL EMS, Ed fell into the guest chair. He had only been named to the Clinical Team Leader position a few days before he had virtually disappeared and I had asked him to resign the post. As Head Coach, I didn’t want to see our crack at a new paradigm shattered before we really got underway. We needed CTLs who formed the heart and soul of their respective teams. I believed Ed hadn’t taken the role seriously—any and all attempts to coax him into The EMS House had been made in vain.

I should have known something was wrong by the way Ed was sitting in the guest chair. Ramrod straight with his eyes focused on a spot on the Old Glory curtain hanging behind my head. Boots held tightly together—knees bent at ninety degrees. “Hal, are you busy?” “What’s up, Ed?” Ed told me a gripping story. His team responded to a call for “a man down” on the sprawling Pratt & Whitney Canada campus. When they arrived they found a fifty-something-year-old male in cardiorespiratory arrest. Using the AED that he had fought so hard for the company to purchase, Ed resuscitated the gentleman. He was elated. Ed has always displayed enormous pride in his thirteen years of emergency services work at Pratt & Whitney. He was always regaling us with stories about new ambulances, and the “Foam Boss” crash/rescue truck they had at their Saint-Hubert Airport Test Facility.

I congratulated Ed on saving a life. It did not seem to register. Special Ed was just staring at me—or more accurately, through me. “What’s wrong, Ed?”

And then the impossible occurred. Special Ed crumpled forward, his eyes filled with tears. The chiseled face dissolved as Ed cried into his big hands. “Pratt & Whitney Canada outsourced the emergency services department. All forty of us have been fired. They’re replacing us with private security guards.” “When did you find out?” “They told us three and a half weeks ago.” The time Ed was missing-in-action. “Why didn’t you let me know.” “I just couldn’t tell anyone. I was devastated. Thirteen years and no warning and that’s it—it’s all over.” A scant six weeks before Christmas 1999 and Special Ed Pietroniro had lost the job he loved.

When I first came to CSL EMS I was fresh out of grad school. I thought I was going to run the EMS World. Tried my damndest to import everything I learned in an American classroom to the halls of The EMS House. First thing I really learned about grad school was that most of what I learned was better left back there. I was a class “A” moron. I managed to alienate most of the members of CSL EMS within just a few months and the rest of them by the end of that first awful year. That’s a really bad thing when you’re running a volunteer shop because that leaves just you to cover all the empty shifts. There were a lot of empty shifts my first year as Director. I didn’t see a lot of home in those first three hundred days.

I evolved slowly as a Head Coach—it took me a while before I realized our volunteers were seeking the same elusive organizational ideal as me. We all wanted a place where we were appreciated and respected—where folks knew you by your first name—and we judged each other on the care we delivered and nothing else.

You’re all thinking, “What the heck does this have to do with Special Ed?”

Sadly, it was a reminder to me that I still had a long way to go before I could say I was a really effective Head Coach. I had always told the leaders in our organization to be farmers instead of mechanics. ‘We ought to be carefully nurturing our members with all the requisite basics instead of just fixing problems as they occur.’ And here I was, the Head Farmer, and I had missed an important clue. One of my herd had gone off his feed and I had done nothing more than wait for him to come back to the barn. I hadn’t called him at home. I didn’t drop by his apartment. I didn’t  pursue Special Ed with any real interest. You can’t ask people to become the heart and soul of an organization when the Head Coach doesn’t display the very passion he’s demanding of others.

I learned from this experience. I pledged to Look, Listen, and Feel for the emotive clues left by our members. Look, listen, and feel. Look out for your people. Watch for signs that they’re having problems. See if they’re having a good time. Look. Listen to your medics. Hear what they have to say. Listen. Feel for your support team. Share your compassion with your colleagues. Care for your whole team. Feel. Back to basics, people.

Look, listen, and feel. Words to live by.

Ed Pietroniro had a long successful run as one of our Clinical Team Leaders. I challenged him to be everything his former employer wasn’t: loyal to his team members, dedicated to their success, interested in their education, approving of their performance, appreciative of their service, and respectful of their individuality. Special Ed eventually left The EMS House to become a career Paramedic in Ontario.

Be well. Practice big medicine.

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