The Non‐Conformists’ Guide                                        By: Steve Whitehead



To EMS EMS  Success Success 

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



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.

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.




The Non‐Conformists’ Guide to EMS Success 

The Non‐Conformists’ Guide Table of Contents 

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



Finding Your EMS Otaku  My Apologies, Have We Met?  What Do I Mean By Success?  What Does Non‐Conformity Look Like?  ‐‐‐‐‐‐‐‐‐‐‐  ‐‐‐‐‐‐‐‐‐‐‐  The Fulfillment of Meaningful Work  Go Do Something Amazing 

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

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








“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?





The Non‐Conformists’ Guide to EMS Success 

I congratulate you. "So you drive an ambulance. Then there was the low pay. Maybe you did what you could to get them to sell out and conform too. If you did. the long hours and the fact that none of your friends or family really understood what you did. To some. that's interesting. perhaps you've managed to maintain your EMS otaku. Maybe you still feel that way. Let's help you get it back. you conformed. let's just make peace with that right now. For too many of us the initial excitement of emergency services gives way to disenchantment and regret.                 www. Others feel it is an undesirable trait and to a few.Finding Your EMS Otaku The Japanese word Otaku means the pursuit of something with almost obsessive focus. And worse yet. Bemoaning system abusers became an art form. You hoped for challenging calls and interesting  . someone calling for you. You hoped that the next tones would be for your rig. when the next bright eyed EMT candidate showed up in the bay you looked at them as naive and immature. You bought in to the group-think and let go of your otaku. Perhaps at one point in your career you had an EMS otaku. that's even better. otaku is an honorific word. the concept of otaku is downright insulting. feeling that this would add validation to your own dissatisfaction. You felt excitement about going to work each day. Let’s see if we can help you build it. Most of the calls were for minor complaints. The more experienced employees looked at you as naive or unseasoned." "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. Then the "real story" started to unfold. I'd suggest that otaku can be a powerful thing. If the story I just told you sounds all too familiar. Someone may be accused of having a cooking otaku.theemtspot. Optimism can be dangerous. The word can be combined with any hobby or interest to imply that the pursuit has gone beyond a normal interest. when you set your focus and passion on something that is meaningful to you. Why should they be having fun? Does any of this sound familiar? If not. You felt as if everyone else knew the real deal and you hadn't been let in on the secret yet. Sure you started out excited but many of the people you worked with seemed so unhappy. gardening otaku or comic book otaku.

This path will demand that you show up to your life and your job fully engaged. and instead. I also write articles for several popular EMS magazines and regularly speak at industry conferences. Instead. contribute something that is uniquely your own. If keeping you inside your comfort zone was a priority to me. I'm going to ask you to develop your own unique vision of what you're here to If so. I’d like you to examine your experience with an outright refusal to conform to the group-think around you.   6     The Non‐Conformists’ Guide to EMS Success  . My name is Steve Whitehead and I'm living my dreams through a successful career in emergency services. adopting the mission and values of your organization without question. It requires a greater degree of diligence on your part.         www. I'm going to encourage you to turn and dive deeper into the more complex dimensions of our human experience in EMS. This is not a "me too" guide." That guide surely would have included tips on flying under the radar. 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. I didn't just cull together a bunch of popular ideas from feel-good sources and regurgitate them.     My Apologies. "The Easy Road to Short-Term Success in EMS. But if you and I have never met. I have the exact job I've always wanted in an outstanding organization. You can't sleepwalk your way to retirement on this path. 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. I'm going to ask you to reconsider all of those things (and more).theemtspot. Even though you may feel like you are drowning in an ocean of unhappiness and burnout.    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. I work on several special teams of my choosing and teach regularly in our local EMT program. I could have written a guide called. I think you’re going to find that the advice I'm going to give you is both unusual and thought provoking. feel free to skip ahead. Are you still with me? Let's begin. I would have extolled the virtues of never conflicting with your leadership team. let me introduce myself. Have We Met? Many of the people reading this guide will be familiar with me through my blog.

not on fear. 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. great friends and a home with an amazing view of the Rocky Mountains. but on your own ideas about what fulfills your personal vision of your life. to feel the excitement of holding yourself to a standard higher than anyone else demands of you.theemtspot. Step 1. success would mean that you grow up in your relationship with the authority figures in your organization and your life. www.) Finding fulfillment in our work. I want you to know that you are living your own highest values and that you are making decisions about your future based. and I consult for some of the leading biotech companies in the world. So what am I talking about when I say EMS success? You want to know what it looks like. a loving family. and occasionally. and none of this was by accident. right? What are we really moving toward here? I believe there are three requirements or qualifications to be truly successful in EMS.                           What Do I Mean By Success? My Three Part Formula My first requirement asks that you feel fulfilled and enriched by your work. I'll call it my three step success formula. This is what we're going to talk about in Part I: Growth. That's what made the difference. and the most self-righteous system abusers you can imagine. We’ll dive in to all that in Part II: Leadership. And I chose to learn and grow from all of it.) Creating a healthy relationship with our employers. Step 2.) Making meaningful connections with the people in our lives. I’ve run my share of interfacility transports and calls at the local detox center. Once upon a time. I also happen to be blessed with an above average income. I've stood face to face with violent criminals. I still do. I am successful by every definition that I have chosen to accept.My blog is enjoyed by thousands of regular readers each month. comatose drug addicts. my story was very similar to the one that I told you at the beginning.  . I want you to be able to do your job with a sense of service and purpose. Second. Step 3.

we'll talk about finding the sweet spot between life and work where the two halves complement and build on each other.    ‐ Christopher Morley  Lastly. I’ll ask you to let go of the idea that your leaders hold the keys to your future satisfaction. I want you to enjoy the way your work complements your life and makes you feel connected to humanity.   There is only one success. In this section we'll talk about your work complementing the values and direction of your life.   to be able to spend your   life in your own way. Third. You evaluate your own performance and you stop asking for permission to pursue what matters to you. You take accountability for your own mission.    Success here would mean that you take control of the direction of your work and the role it plays in your life. I don't want to sound overly simplistic. 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. There's only one catch. 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. This is what we'll explore in Part III: Connection. approval and direction. Success on this front would require that you stop looking to your leaders to take care of your needs for acceptance. you're going to have to swim upstream. not suck your life away in small doses. You can have all that. but you also play by your own rules. You aren't successful if you need to be at work each day to keep your head above water. Your leaders want all of this for you. Your work needs to complement your life. success would mean that you find balance in your life. Success would mean that you play by the rules. Here. I want to help you enjoy your life more. 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. but if you aren't enjoying your life. I want you to feel comfort instead of stress when you interact with your supervisors and bosses. and you should want it for yourself too. you’re failing at life. I want you to enjoy working in a service industry and helping others. I’ll ask you to consider allowing yourself to be changed and challenged by the situations that you encounter in the workplace. To do it.     8     The Non‐Conformists’ Guide to EMS Success  . and I’ll encourage you to have difficult conversations when they are appropriate.

attend the conference. If you really got out of line. Then we can start taking good care of the folks who call 911. You adapted yourself to gain membership. and advocate for safer work conditions. You came to work and were immediately given the policies and procedures manual. you can bet there's twice as much pressure on the poor guy It's helpful to recognize that you've been conditioned to follow the rules all of your life. and the power of authority. and all the benefits of eventual success. Ultimate disapproval could mean being removed from the school altogether. These are used almost universally because they are so effective at producing results. If there is pressure on you to conform. approval. 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. Non-conformity was likely not one of the values listed. and develop the competencies we were putting off until we got the official nod. mission. overhaul the broken training and orientation systems. perhaps documenting his or her official disapproval in writing to be referenced later. You were oriented to the company's values. And. On the other side of the conformity dance floor is security.theemtspot. 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. so this higher authority could express a more authoritative sense of disapproval. have even less power to step outside the boundaries than you. We can bone up on our skills.    What Does Non‐ Conformity Look Like?  The pattern continued at work. the love and admiration of our  . you had to leave the class to see the principal. Was the payoff worth it? The allure of conformity is powerful for all it offers. This is all a broken promise the minute we make it. Your leaders. whoever they are. and conforming to them was the simplest path to acceptance. it paid off. and you were expected to adopt and adhere to these values in the workplace.                 www. Then we can start being an advocate for the patient. You quickly found that there were norms of behavior and attitude. as always. and vision statements. Since our birth we were conditioned with approval and affection as a carrot and disapproval and separation as a stick. We'll work hard to improve basic proficiencies. Once we've achieved some degree of success by walking the path of conformity the expectations will only continue to grow.

  Are you getting a vision of what I’m talking about here? Let me be even more specific. Most of our leaders have grown out of this industry that specializes in the fast fix approach. our performance. It means being willing to stand for something and being willing to stand against something. Poor saps. and our purpose. Non-conformity means being willing to take the time and effort to evaluate ourselves.                                             10     The Non‐Conformists’ Guide to EMS Success  . Non-conformity is stepping back from the speed and thoughtlessness that we tend to operate under. Asking larger questions about the greater purpose of our industry is frowned upon. In our business. speed is king. This creates an environment that doesn't value thoughtfulness or introspection. Those who follow this path get labeled as pie-in-thesky dreamers. and time is the devil.    or gal above you. We manage emergencies. especially when we stand against the mediocre status quo that pervades our industry.

they have an expectation that their greatest self can be expressed through their chosen work. Non-conformists know that if they are not making errors. Non-conformists seek grown-up partnerships with authority figures and seek common ground and mutually acceptable goals. Expect to have their values expressed in their work. Believe that their lives and work should stand for something. In refusing to conform to the sterile. In doing so. They look for opportunities to push their boundaries and acknowledge their own imperfections and mistakes without shame or anxiety. impersonal world of clinical medicine. Nonconformists speak with their own voice and hold on to their own values and judgment. In this regard. Desire to be a part of a community and a team and seek meaningful connections with  . Hold themselves to a higher standard than the status quo and rally against mediocrity and incompetence. and they don't whine and complain about operational minutia like memos and policy changes. They always seek to raise the bar.          • • • • • •          www. They know their protocols and rules but are guided primarily by their own sense of what is right. They pay attention to the details of their lives and the lives of those with whom they interact each day. Nonconformists 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 don't check their values and guiding principles at the door when they show up for their shift. they maintain their power and are accountable for their actions. On the contrary. they refuse to be bartered like a commodity. provide their motivation or direct their career path. They don't look for parental nurturing and constant direction from their leaders. embody their values. 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 dive deep into the tragedy and triumph of medical care and fight to humanize their connections with their patients.theemtspot. Our industry is a human industry and non-conformists seek to humanize and personalize their work. 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. Fearlessly seek performance feedback and relish intelligent coaching and criticism. 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. Don't expect their leaders to have the solutions to their problems.EMS Non-conformists: • Think for themselves. they are not living at the edge of their potential.

Holding Yourself to a      You Higher Standard    know what I mean.”                                     ‐ John Maxwell                            I’m going to ask you to   commit yourself to some   things. we’re always                    going to be outside of our comfort    zone.   12     The Non‐Conformists’ Guide to EMS Success  .     Commitment is something   we talk about much more   often than we practice it.                                         “If we’re growing.

Start a journal club. Remarkable doesn't have to be a comparative or competitive equation. E-mail Nancy Perry or AJ Heightman and tell them your article idea. Invite all the EMTs from a rival agency to a party. Commit to being remarkable 2. or his boss’s.                 www. people have something to say about you. Write your insights and comments in the margins of the station’s EMS magazines. Start a blog or publish on another blog.theemtspot. Remarkable is what happens when you break out of the mold of social conformity and go your own way. Remarkable simply means that when your name comes up in conversation. 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. without fear of what others are saying about it. Better  . Just make sure it's remarkable (preferably in a good way. No rival agencies? Invite your coworkers. Start a “firefighters vs. Commit to something bigger than yourself (With no expectation of return) 3. What you do isn't that important. paramedics” UFC type fight club and donate the proceeds to charity. 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. find your ideal job and apply to that. It's a sign that you're living some • • • Apply for your supervisor’s job. Commit to the communal pursuit of things that matter aspect of your life by your own design.) • #1       Commit to Being   Remarkable • • • • •   Remarkable doesn't necessarily mean that you're amazing or that you get gold stars on your paperwork.Nothing speaks to your commitments quite like your actions. What do you have in your life right now that you would consider your passion? Think about how well you understand that thing. 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. 1.

Commit to Something  Greater Than Yourself  (With no expectation of return) It's interesting that when I ask this of people. You can’t help it. apply to be a speaker at the next one. The life you were meant to live. The most important part of starting to live your own remarkable life is simply seeing the world differently. their greatest resistance isn't to the idea of a grand commitment. Once you see how much fun it is to try remarkable ideas.     #2     The resistance is to the idea of no return. just for the fun of it. Holding on to the idea of great return for great investment is like holding onto Jell-O. you've decided to live a life less ordinary in a world of averageness. The simple decision to be remarkable may do more to change your life than any other decision you make. We go to work because they pay us. Not the life someone else wants you to live. or most calls in a shift. your life. you’ll become addicted to it. If you don't know what life you're supposed to live. The tighter you squeeze. Congratulations. The great news is that the more you learn to live and enjoy remarkableness the more your vision will expand. we’re going to help you find out. Pick a place in the world you really want to see and commit to visiting that place in the next three years. the point is to get you to take your existence off of cruise control and start showing up to your life each day. (It isn’t as hard as you think.    • • • Start a monthly prize competition for the crew with the most inter-facility transfers. I asked you to let go of the need for something in return. I'd like you to choose a commitment without concern for what's in it for you.) the world around you in a different light than average people do. The point isn't what you do. most miles. We are socially conditioned to buyin to the barter system of our society. It doesn't matter if the work fits our values or goals. Note that I didn't say there would be no return. the more you lose. You begin seeing 14       The Non‐Conformists’ Guide to EMS Success  . It's easy for our employer to objectify us because we objectify ourselves when we voluntarily buyin to the idea that our labor is something to be bartered. We commit to things because of the positive return we expect from our investment. just to see what it feels like to not be bartered. Go to a conference. If you already go to conferences.

www. I would put this work on                 Amazon and talk with e-publishers about price points and margins. and your skills. 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. and marketing. it will be your turn to figure out your unique contribution and set your big audacious goals and go do something remarkable. I'd be concerned with proper Kindle formatting.                    ‐Buck Rodgers           Baseball Hall of Fame  nothing in return. I want to change your career for the better. I would never do that if I wasn't fully committed to the idea of detachment from the return. consider that you’ve been volunteering all along. I would go looking for a publisher. and by the way. It's part of my  . those things that can’t be bought. But that isn't what this is about. Oh. you’ve always offered those voluntarily. a  commitment to excellence  and a rejection of  mediocrity. you were volunteering all along. It doesn't matter what you do as long as it is in line with your values and there is no clear. This book isn’t part of a marketing gimmick. but the best of you. 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. for your labor. If I were committed to the barter system. Your employer can barter for your back. But not before you make one more commitment. It is the largest writing project to which I've ever committed myself. release dates. I don’t know if you are paid by your employer right now or if you volunteer. 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. audacious goal (We'll talk more about those in a little bit). When it's finished. I'm going to give it to you for free and encourage you to pass it on to others. but any  road to reaching one’s  maximum potential must be  built on the bedrock of  respect for the individual. When you’re done reading it. If you’re still trying to wrap your brain around the idea of expecting There are countless ways of  attaining greatness. defined benefit to you personally when you begin. The truth is you’ve always been a volunteer.theemtspot. but it doesn’t matter.While you’re out there finding those remarkable goals or tasks.

nurse. She wanted to do something that mattered for her community.R. Venturing out on the rigs and   Yes. running calls alongside her students. they invited her to ride along with them on calls. and we continue to create it each day. She's proven that when EMTs are held to a high standard of knowledge and competence. When we do. that all sounds good right? It is.R. Today. that many of the EMTs that delivered patients to her emergency room were lacking in skills and knowledge that she felt they should have. We talk about our work places as if they belong to someone else. After a few classes. As the street medics taught her about the world of emergency service outside the hospitals doors. To recreate our workplace as a place of meaningful work. she taught them medicine with an unusually high standard. Twink Dalton is an example of what one person can accomplish if they believe in working towards things that matter. We speak about it as if it is the responsibility of the faceless “them” to come rescue us and provide us with meaning. the now. She saw. #3  Commit to the  Communal Pursuit of  Things That Matter  Twink Dalton didn't start teaching EMTs and paramedics because she thought it would be a quick path to luxury and reward. But it comes with a bitter pill. Twink is one of the most respected EMS educators in the world. she started teaching for her local fire service. we need to take accountability for creating it. with frustration. 16     The Non‐Conformists’ Guide to EMS Success  . They get hungry for more. A pill that not too many of us are willing to swallow. with a very different set of challenges. Not the future. She was already a talented and successful E. If it doesn't matter and we choose to do it anyway. We discuss things like morale and culture as if we are only visitors passing through. Pushing their knowledge as well as their idea of what a field provider should know. our work matters.R. we are fools. it's worth committing ourselves fully. The work of the EMT is vital and worth doing. desk complaining about it. And her students (like me) are her biggest fans. She also saw how much better they could be with a little help.    Nobody ever bartered your passion or your motivation or your attitude. Sure. Since it does matter. she learned that field EMS was a whole lot different than the medicine she practiced in the E. Instead of sitting around the E. we are free to support our workplace as a place for meaningful work. they don't run for the hills. We need to accept that we have created our working environment. The best within you was always yours to give or to keep at your will.

through the individual lenses of our perception. the audience creates the performance. they are both a matter of choice. We choose optimistic or pessimistic viewpoints when we make decisions about what we should focus on. we see clearly that we create our  . We decide each day what our workplace will be and nobody else. emergency care is advancing at an unprecedented rate. in our image. We can create an environment of widespread accountability and ownership. and sepsis are improving thanks to advancements is care. with any accuracy. Neither optimism nor pessimism are based in reality. The Case for Optimism  Optimism is a fantasy. As reality flows forward on its unstoppable journey through time. I'd like to point out that pessimism is a fantasy as well. we create the culture. Research is demonstrating the effectiveness of improved CPR techniques. We are weighted down by our lack of history and lack of a political voice. The field personnel create their managers. better airway procedures. and therapeutic                 www. It is the moment we become owners instead of visitors. Regardless of what we choose. The students create their teachers. reality will provide us with plenty of examples to confirm our chosen belief. Survival rates for critical trauma.theemtspot. Right now. and virtually unrecognized as a profession. The moment we stand fully accountable for creating our workplace is the moment we become citizens. overworked. Feeling down yet? Right now. Training standards are often miserably low and many working EMT's fall below even that. We drive morale. Let me say that again because it is important. as you are reading this. It's as simple as that. what it is that we do. Very few people outside of the medical field can explain. And we can change it as well. And it is the moment we seize control of our future. Long before the script is written. That's probably not what you were expecting to hear from an optimist so I thought I'd put it out there first thing. There has arguably never been a worse time to be a part of pre-hospital care. They always have. as you’re reading this. Now that I got that off my chest. Therefore.The truth is. And we are stuck in the middle of it. We create it all. From the vantage point of citizens. EMS workers around the globe are underpaid. We struggle for identity and consistent standards. it is neither optimistic nor pessimistic about where it is headed. cardiac arrest.

Advanced monitoring devices like lactate meters and capnography are pushing the envelope of patient assessment. A Few People to Avoid  Along the Way  Don't expect everyone to cheer you on the path to non-conformity. The three people you can expect to see are critics. Feeling up yet? I could go on. The challenges are there. You can't do that if you’re focused. 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. Let me tell you a little about all three. and sepsis alert programs are bringing the pre-hospital provider together with hospital emergency staff to create a true high performance team. the old guard. But I think you can see my point. 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.    hypothermia. Get to work succeeding in spite of them. There has arguably never been a more exciting time to be a part of prehospital care.   18     The Non‐Conformists’ Guide to EMS Success  . We see plenty of it in our work. 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. stroke. They’re going to tell you that you’re fooling yourself. and the bottom feeders. EMS has plenty of challenges and plenty of greatness. You have to make a decision about what you want to focus on. And we are an integral part of all of it. There is a lot of pain and tragedy and grief in the world. all day. It’s about deciding to work for change. (Would you have it any other way?) Don't waste any more time bemoaning them. It’s about choosing to have power over it. Cardiac. Once you go your own way and seek a non-traditional path. 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. Optimism isn’t about denying that reality. you can expect some folks to throw up some hurdles. on what isn't right. I know some folks have a tough time swallowing this optimism thing because they feel some deep commitment to seeing the world realistically. People tend to like the status-quo. you’re going to need an outlook that sustains you. The status-quo is comfortable and predictable.

Critics: Critics are generally unhappy people. It is their purpose. Nothing concerns the old guard more than people who don't follow the rules. They fool themselves into thinking that it's their experience that allows them to have such keen insight. they control the flow of information.                    ‐ Eleanor Roosevelt  www. and then they control those channels. and people who don't follow the rules could influence change outside of their control. The things they notice are the things that aren't quite right. They sort and evaluate everything they encounter by its flaws. or the undercooked steak at the restaurant where they ate. Second. and they're good at it. They believe that the chain of command should extend beyond operational decision and encompass information flow as well. and write the newsletters. Critics are scared of putting themselves out there. Do what you know in your  heart to be right. They send out the emails. Ask a critic what they did last weekend and they'll tell you about the bad weather at the campground. The old guard tends to hold the power within the organization and they fight to keep it. and many of the rules make it harder to be a high performer. They don't like change unless they create it. the bad movie they saw. And you can bet that there's some stuff not quite right about you. they think that you should ask them and only them. so they stand in the corner and throw out criticism and those who do step up and try to do things. They do so through three mechanisms. post the memos. Ignore them all. or they maintain influence with the people who do. In this way criticism is like a security blanket. They are invisible. First. they create the rules. You can be certain that they will also explain to the folks who get hired after you why they cannot trust    . The Old Guard: The old guard exists in just about every institution and organization. They don't like risk. This is much easier than adding ideas to the pool of shared knowledge. and many of them believe that people really want to hear their negative evaluations of everything around them. The old guard creates the channels for information to flow. You’ll be  criticized anyway. Their purpose revolves around power. No critic ever changed the world. If you have a question. 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. Some of the rules help you to do your job more effectively.

keep in mind that they fear you. They haven't opened text book or learned anything new since Johnny and Roy were on prime time. make waves. all of the degrees and certificates that they already hold. When you run up against the oldguard. Bottom feeders stay down low and try not to move. The more that you push the fringe. The bottom feeders of the organization are the defenders of the status quo. They don't tend to work as hard to bring you down as the critics and the old guard. The old guard decides who should be granted influence within the organization. pity. 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. and polite respect. You're better than that." or "Another day another dollar. They need to believe this to justify their own lack of motivation. too young to retire. but they haven't done much. 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 are frozen in time so they don't want anything around them to change or grow. Just don’t ever fall into the trap of seeking their approval. the more fear you will create among them. so they set the standards. Bottom feeders tend to stay where they are for a long time so they will often have experience and seniority. including you. Bottom feeders tend to be harmless. they say catchy." They're the ones who are going to tell you that your ambition and motivation are signs of your inexperience. experience in the industry that they are experienced in. or be noticed. respect for the rules. They often find a critic with whom to partner so they know what to think without having to form their own opinions. and strict adherence to the proper progression through the ranks. You can also entertain them with your antics and your joy for the job. they invent the barriers of entry to positions of authority or influence. 20       The Non‐Conformists’ Guide to EMS Success  . When you ask them how they are doing. depressing phrases like. They tend to value seniority above all else.    Third. Don't let them discourage you. They think you are naive. I tend to appreciate the bottom feeders more than the other two energy drainers. I find that it’s best to respond to their fear with a combination of understanding. "Too old to work. You can try to inspire them. Bottom Feeders: These guys have usually been around for a while.

or their  . their qualifications.theemtspot.“The supreme accomplishment is to  blur the line between work and  play.”                                   ‐ Arnold Toynbee                  Regardless of how you feel about their competence. 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.   www.

You just need to decide. Even if they gave it to you.. nor should they be. Then you fire your boss and put yourself in control of your growth and development. If only they understood my job better. they will make good decisions about the future of your organization. If only they would just listen to me. If you’re lucky. Your leaders wake up each morning just as flawed and imperfect as you. 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. It's time to decide that your growth. If only they made decisions differently. just to make sure you're not misunderstanding. they may not even have what they need.) 22     The Non‐Conformists’ Guide to EMS Success  .   It's time let go of "If only. You don't need a ticket to the big leagues.) And finally. (Or at least try. the OK from the people in the know that your time has come. and all of the information that you need is within your grasp. It's time to take responsibility for your own happiness. A phrase that will reframe how you decide to take action on the things important to your life. Are you still showing up each day waiting for the nod. The phrase is. and someone will certainly stop you. Next you pick the right mentor (It's not who you think. "Who's going to stop me?" Now. Your needs and wants and desires are not their priority. Each time we think in this way. Stop waiting for them to come around and provide you with what you think you need. I want to teach you a magical question. we give our power and the keys to our happiness away to the faceless "them. we can start about the business of building our own future by our own design. you choose to have the difficult conversations that are currently holding you back.. it probably wouldn't help. the go ahead. They will spend their day sorting through their own needs and trying to live up to the expectations of their jobs.    Your Leaders Don’t Have  What You Need  Not only do your leaders not have what you need." When we come to the realization that our leaders don't hold the keys to our future. your development. We'll even take a minute to address what to do if your boss doesn't agree with all that." If only they would keep us better informed about what's going on around here. There are many things you can choose to do. The first step is to stop waiting for permission to do what matters to you.

the answer to this question is often. When I look at the amount of really talented people who walk away from this career used-up I feel just plain pissed off. and miserable working conditions. I feel pissed off when volunteer agencies tolerate bad behavior. At the beginning of each concert Bruce Springsteen asks the same question.theemtspot. and nobody is standing there waiting to stop you. I'm only interested in having this conversation with people who are willing to act on their convictions and change their lives. 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. then you're probably just waiting for some meaningless permission. "Is anybody alive out there?" If I could ask the EMS industry just one question. infrequent training. You can stop reading because this book isn't going to help you. That's what you and I are going to change by demanding better and voting with our feet. Frankly. I feel pissed off when talented caregivers are forced to suffer under poor leadership. You're going to have to do it for yourself. If you've read this far and you're not willing to change anything about what you do each day. abysmal performance and low training standards out of fear of losing the few personnel that they have. I'm Angry. awful management. there are plenty of people who will be more than happy to stop you. surprisingly.                 www. that would be it. low pay. I'm angry about how this industry uses up its human resources and throws them away. If there's something you've been waiting to do. you can stop now. Waiting for permission is your excuse for not going out and taking some action. If you're not willing to move and act and grow and learn.If you're planning on breaking the law or violating established policy. 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. long  . But. It's a valid question. I'm going to save you some time right here. Thanks for coming. I don't know if you've noticed this yet. nobody. but 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. Nobody is going to show up and hand you your dreams on a silver platter.

Some mission statements are worthwhile. We're going to do some projects and take back some control over your future. They all practiced trust falls and wrote on big white pads of paper. "Respect. Fire Your Boss and Hire  Yourself  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. here's what you can do to start. They probably hung it on the wall somewhere in the lobby and put it at the front of your policy and procedure manual. Enron's mission statement was. and I want you to do them for yourself. communication and excellence. integrity and value added service to meet the needs of the customer and the everchanging future. They didn't start out that way. 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. Your Mission Statement  First I need you to write yourself a mission statement. 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. integrity.   24     The Non‐Conformists’ Guide to EMS Success  . I want you to take a few of the things that your employer did for you without your consultation. I know it's chintzy but stay with me. Microsoft set out with the mission. in every home. They did it for good reason. The problem is. We just created a new corporation and we've got some important work to do. Buy in is both essential and rare in today’s organizations." What? Even the short sweet ones can be equally worthless if nobody buys in. especially the ones that put big audacious goals on the line." Nailed it guys … great job. "Or challenge is to assertively foster world-class empowerment through economically sound methods of community." That's the kind of mission statement that can inspire. “Yes”. most organizational mission statements are dumb. For example. It's true. Call it “corporation you”. Your leadership team went on a retreat. You know a mission statement right? Your organization wrote one once. And the end result was something just worthless enough that everyone could be happy with it. let's decide that you work for yourself. and a culture perfectly aligned around your values? From this moment on. "A computer on every desk. all running Microsoft software.    If something inside you wants to scream. a better benefits package.

Erase that one too. 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. Refer to it as your mission statement. is a mission. but there should be parallels. denial just won't do. Be willing to take twenty. They will be what you've been conditioned to believe your mission should be. all available in less than 60 seconds. If it doesn't you need to reflect on that. Write the next thing down. It's your responsibility and no one else. you'll know it. They will be what you think your purpose is supposed to be. But they're not your goals. my friends. you can't just tuck it in a folder and not look at it for the rest of the year. Once you have your personal mission statement. Start with the question. If the organization lives them. That's not good enough. the answer will come. then they should be recognized and remembered. Your work should reflect your purpose and guiding values. Open up a blank document on your computer or take a blank sheet of paper. You need to become accountable for making the purpose of your life come to fruition. Note that your mission and purpose doesn't need to be completely congruent with the mission of your organization. But remain true to the question. "What is the meaning and purpose of my life?" Write something down. It's not your mission. Then erase  . persistently and earnestly. And when it does. it will come back. thirty. You may have a lot of crap to get through before the real good stuff starts to flow. What is the meaning and purpose of my life? If you keep asking the question. in any language. www. It will come from somewhere different.theemtspot. Those things were up to you to decide. The mission and values statements were supposed to define the collective goals and values of the organization. Now that you've chosen your purpose for being on this earth.Amazon's Kindle has the mission. forty minutes on this. Maybe it's time to move in a different direction. and it will resonate with you. This type of total accountability is a part of becoming a citizen of the world you inhabit." That. Once you've chosen your mission statement.                 Most of the answers you write in the first ten to fifteen minutes will have little to do with your true purpose. And everyone in that division knows it. If one of those was supposed to be your mission. 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. never refer to it as a mission statement again. "Every book ever printed.

* I shall not submit to injustice from anyone. Now the feedback is untimely. I have. You need to know right then. Many of the folks who give the evaluations honestly believe that they are guiding and empowering you. Why are we going over this again? Didn't we cover this when it happened? Or perhaps your employer didn't say anything at the time the behavior or incident occurred. so let me explain. While it might provide an interesting example.   26     The Non‐Conformists’ Guide to EMS Success  . and I can tell you that when the door shuts and the meeting begins. Regardless of whether you're a top performer or a slouch. the review has no useful purpose. Organizations do annual performance appraisals for three misguided reasons. and they serve as a far greater example than mine could ever provide. * I shall conquer untruth by truth. * I shall fear only God. 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. If you do something well. They're demoralizing. But I've fought to abolish the performance evaluation.” . Feedback needs to be in context and given at the time of the behavior in question. I shall put up with all suffering. 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. What? You wish I would show up earlier? Why didn't you say something months ago? Here's a secret. If you do something poorly. found great inspiration in the personal mission statements of others.Mahatma Gandhi Your Annual  Performance Review  Semi-annual and annual performance reviews are one of the most ridiculous things organizations do. So your employer either did it right and gave you the feedback in a timely manner. And in resisting untruth. These things are so endemic to our organizations that you may doubt my sincerity. the reasons we cling to performance appraisal are quite different than the stated objective. your supervisor should say so right then.    You might be curious as to my own personal mission statement. If so. same deal. to repeat it in a performance evaluation is redundant. however. * I shall not bear ill will toward anyone. All the feedback you get in a performance review is either redundant or untimely. I’ve never felt comfortable sharing my mission statement in public forums.

Third. as you define them. Research shows that ongoing written performance appraisals are helpful to the employee in court over 85% of the time. It's hard to stand against something so prevalent in organizations as formal written evaluation. then what?" There are many great answers to that question. This is it. performance evaluation seems essential. "If not this  . 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. You're criteria are going to be legitimate measures of success in your life. It's not. That thing is going to be laden with ridiculous criteria like behavior and timeliness. This is false. Something that your management team has probably never seen before. A personal annual review: Step one: Who do you want to be? Take a little time to envision yourself ten years from now. Your leadership team may really like the idea that wisdom and guidance flows downward to subordinates from above. Just have your review ready to reference when your employer’s review is ready to go. everybody does it.. Don't feel like you need to do this in sync with your employer’s review. Once this idea has taken root. and you can read a watch as well as the next person. You should be doing this anyway. You know all about your behavior. Second. At least once a year you should be doing a full review of your own performance goals. Something that's going to put you back in the driver’s seat. You're not going to be evaluating yourself on how well you follow the rules. So the next time you have a scheduled performance evaluation I'm going to ask you to do something dramatic and unexpected. How old will you be? What do you want to be doing with your life?                 www.First. That's the worst thing you could do. 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. I don't mean that I want you to get a blank copy of your employer’s evaluation matrix. The question repeatedly comes up. performance evaluation feeds the parental ideology that many upper level managers hold. but it is pervasive none-theless. but most managers don't want to hear them. The idea is wrong.. they believe that it protects them from liability in a wrongful termination lawsuit. Do your own performance evaluation on yourself before the meeting.

someone else will be more than happy to take you down their path instead. Built to Last: Successful Habits of Visionary Companies.just yet. 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. If you aren't clear where you want to go.. 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. 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. A decade is a long time. Write them down. “Only one who devotes  himself to a cause with his  whole strength and soul can  be a true master.” I love that term and I think about it when I’m creating my goals each year. You're going to have to decide if you want to arrive in your future or someone else’s future. hairy. Five things you wish had gone better. write out five things that didn't go well. 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. What's important to YOU in the coming year? In their book.   28     The Non‐Conformists’ Guide to EMS Success  .” ‐ Albert Einstein  Don't get bogged down with the details. What are they? List your five biggest successes or accomplishments. but it's going to pass faster than you can imagine. Be honest with yourself. James Collins and Jerry Porras first coined the term “big. Be certain of this.    Really take a minute.. I want you to think about your ideal life. close your eyes and think about yourself in every detail. You can accomplish a little or a lot in the coming ten years. but either way. the future is coming. What things that went really well? Next. 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. More money? More influence? More time? More friends? It doesn't matter how. Step Two: A general review of the year Let’s start with a list of the five things that really worked this last year. audacious goals. Think about this person who you want to be and what you would like to do. Don't worry about being realistic. For this  reason mastery demands all  of a person.

That's OK.Don't be afraid to make some of your goals big. It can't be nebulous or theoretical.                 When you're done. "Stock my kitchen with nothing but healthy. honestly and frankly. Write them down. These are the ones we'll focus on first and primarily. Picture your friends and family. Once you've done that I want you to pick out the top five  . Step Four: Actionable items For each of your top five goals. If you've never done this one. after your life. scary. 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. all those people you wanted to be with you during your life. Now. write down at least three actionable items. actionable items that you can start working on today. crazy goals. Be open to the feedback from your supervisor and identify where the organizations desires and yours meet. You can't wake up in the morning motivated if you don't have a few goals that scare you just a little. Picture them. You honestly reviewed your life and set forth on the path of your choosing without any guidance from your supervisor.theemtspot. 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. "Start considering more healthy food choices" is not an actionable item. What actions would move you closer to that goal? When I say "actionable. I have to warn you that it can be a powerful reality check. you died tragically along the way. you should have 25 real. nutritious foods. 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. The others will become lesser goals. all gathering to celebrate you. See how easy that was. Explain what things you're working towards and how your employer could help. One by one let each one of these people get up and speak. Close your eyes and imagine that instead of arriving at the future that you envisioned for yourself. ten years older." I mean that you should be able to physically do this thing now or in the near future. Congratulations. hairy." is an actionable item that you could follow immediately. You just put your goals on project status. What will each one say about you? What will they say your life meant to them. audacious. you need to discuss that. talking about the last decade. What did you do for them? What will the loss of your life mean for their future? www.

If your employer already provides your continuing education for you. you're going to need to take responsibility for keeping up with it. Scratch that. I mean what is your plan for growing and developing your skills. Sure you should take advantage of continuing education when it's provided. It's your responsibility to keep up. Continuing education isn't a mandated review of the information you've already learned. If you struggle with this. the information you've already learned is important to review.” There is a stream of research and news that is changing the face of the medicine we practice weekly. you have the resources to keep up with the knowledge vital to your career. daily. schedule. Yes. a single person. amazon. you're going to need a more proactive approach. Like everything else in your career development. I'm not talking about the minimum required education credits to renew your certification every few years. 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. Your education and development isn't someone else’s responsibility. long list of potential certifications. Continuing education isn't a one-size-fits-all prescription. As my web site says. that's great. EMS magazines and websites. Let's put another continuing education myth to bed. in-hospital education and a long. you can find the education you need. If you've decided to make this your career. But that's their plan for your ongoing If you have the resources to get this e-book. worse yet. In today’s world of e-learning. Your Continuing  Education Plan  What's your continuing education plan? I don't mean your employers C. and your competencies.E. your goals may not be in line with your values. “medicine moves fast.   30     The Non‐Conformists’ Guide to EMS Success  . but medical knowledge is a moving target. but don't get too comfortable being fed your education by a single organization or. Too many EMS providers get into the lazy habit of absorbing continuing education like a cow at a trough. state and national conferences. appeals to you and supports your particular needs. You can find the education that interests you.    Remember that they didn't have to agree with the path you chose to take. You need a plan as well. your knowledge.

If you feel like you simply must have a mentor in this field. try to find one that doesn't work in your organization. but you can get advice on how to do your job from anyone. 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. 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..something that you feel that you're missing. 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.Your Mentorship  Program  Mentor programs are big deals in organizations these days. insider secrets. skills. and we rush to compartmentalize and formalize something that can't be so easily forced. Leadership teams feel incomplete or out of date without some sort of formalized mentorship program. 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. If you’re going to look for a mentor (and I recommend that you do) I would look for someone outside of EMS entirely. Mentorship isn't about you missing something vital. Employees feel entitled to a mentoring process. If you must violate all of these guidelines.                 www. The act of mentorship is recognized as beneficial. I know that's counter-intuitive to everything you think a mentor is suppose to do for you.. please don't pick a mentor who has a supervisory or boss role above you.theemtspot. please. Someone who can help you work on these  .

I'm not giving you permission to be an ass. growing. I'm not saying you need to be disrespectful.) The mentorship should focus on your growth and your goals. What if you approached these individuals with a kind. Develop a willingness to have the difficult conversations that could make real differences in your work environment. then it is a required training. but firm approach and had that conversation that you and everyone else has been avoiding. knowledge. If either you or your mentor are obligated to be in the relationship. obnoxious. or skills. we need to be ready to bravely take the first steps. Mentors help coach you through your life. and they both have the option to not participate at will.) 3. I'm willing to bet right now there are a few touchy subjects that people are avoiding addressing at work right now. Hear this next part clearly.  The elements of a healthy   mentorship program: 1.) Both you and your mentor have a choice and chose to be involved in the mentorship relationship. Tutors and teachers can help you develop your competency. I'm simply giving you permission to run with the verbal scissors a bit. Mentor relationships need to be chosen by the parties involved. 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. and when that chasm needs to be crossed. perhaps a supervisor whose micro-management style is affecting your ability to get back in service in a timely manner. outwardly angry." or "did you know that those jeans really make you look fat?" That's not my point. or an internship. 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. Not on job minutia. You don't have an open invitation to squash people’s feelings or say things like. Both parties should feel that they are learning. 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. a preceptorship. and developing as a result of the experience (Though they may be learning different things. 2. Often our freedom lies on the other side of difficult conversations. respectful. "By the way. or rude.   32     The Non‐Conformists’ Guide to EMS Success  .) The relationship needs to be beneficial for both you and your mentor. everyone thinks you smell.

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

Conformity does have its advantages. On the other side of the coin. 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. your bosses. This all sounds good here. The non-conformists have been waiting for someone to say this all along. but it wouldn't work in the real world. Inside the cave we can't be held responsible for creating our lives.     34     The Non‐Conformists’ Guide to EMS Success  . but you don't understand what my workplace is like.    Sounds Great. What if your supervisors. “Sure Steve. They see the match of personal freedom in their hand.” So let’s just address that resistance right now. You don't know my bosses. My workplace would never tolerate individuals claiming this kind of personal freedom. Crawling back in to the cave of conformity is the safest option. Part of personal freedom is the right to deny the existence of your own personal freedom. and they're searching for somewhere to strike it. maybe that works for you. the conformists are shaking their collective heads. But My Boss Doesn’t Agree I sense that some folks who read this are going to become excited.

theemtspot.”                         ‐ 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.“Once in a while it really hits people  that they don’t have to experience  the world in the way they have  been told to.

It will doom your success.   36     The Non‐Conformists’ Guide to EMS Success  . The word for living your life congruent with your beliefs is authenticity. You can't fake it. I'd love an apple. you're always going to feel the stress of living a lie. or respect. From the first time we send off eight box-tops for our xray glasses. 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. caring. In today’s world we're marketed to in some form or another nearly every minute of every day. If your job is about you and not about the people you serve.. we are inundated with sales pitches. From the television to the radio to the internet. We create quite a show. If it isn’t in you. Here's the truth. Uhhh. Here. Most folks are pretty good at spotting a fake. 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. your patient will know. we arrive with our badges and uniforms and bags filled with mysterious and magical equipment. we start learning had lessons about what's real and what's phony. We're born and raised skeptics. sometimes far more so than we wish they could. kindness. it can't come from you. it's going to show. It's as simple as this: You can't give away what you don't have. And through it all. patience. The end result is a society particularly keyed in to what is real and what is noise.. If your desire to take care of people is a lie. "Thanks Steve. It's the most And we recognize that you can't always trust the hype. Our monitors beep and our sirens wail. Not authentically. You need to be able to live it. at the worst moment of their lives. Things like compassion and service can't just be pretty answers to interview questions in this job.    Authenticity  People are a lot more keyed in to marketing today than they were forty years ago. you'd immediately be confused.where is it?" But we don't consider it quite so obvious when it comes to things like compassion. And it will affect every interaction and every call. If it isn't in your heart to be a servant and care for people. It's no wonder why. People in the midst of medical emergencies are particularly good at it. 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 selfimportance. If I told you I'd like to give you an apple and I wasn't holding an apple. You've probably heard a lot of advice about how to develop patient rapport and influence the conversation. our patients can see who we are. In truth.

When I say be yourself. There is something that you can bring to EMS that will allow you to leave it better than it was before you came. I'd tell you. If you want those interactions to flow. 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. I don't know what those things are. Being your authentic self is something more than just a high school cliché or a chapter in a self help book. You don't need to know what this thing is right now.                 www. And only you can decide for yourself. It's that certain thing that needs you to step up. I Need Your Help 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 can only tell you that I'm certain they exist. you don't need any of the tricks and techniques. There is nothing more important to long term success. Not another warm body. It's that contribution to the world of EMS that we need you to make. All you need is to strive for authenticity. if you choose to live your deepest values each shift and each call. you are on the 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. But know that if you choose to show up and be present in your job. It's pervasive.. They are the reason why we exist.theemtspot. The patient isn't an inconvenience. it won't happen. I mean to say that you have something specific and unique to contribute and only you can take responsibility for that unique thing. Authenticity needs to be decided. If I did.common cause of jobs stress and frustration in our line of work. Don't look at me. If you walk away or bury your head in the sand pit of conformity. Everything else can be developed. if you want to your patient rapport to be a  . I don't want to sound too much like an army recruiter but EMS needs you.. but only you can decide. You need to feel the call to service and the desire to be there for others in your heart.

We learn to move past a lot of our fears as grown-ups. 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. one that you know is going to take a monumental effort on your part. Embracing that fear can be a powerful thing. But talk about failure and we go running for cover. monsters. We stop boldly seeking the feedback and input that could help us grow and instead we hide behind our confidence and bravado. frankly. We don't ask our respected coworkers for their appraisals. It motivates you to keep your guard up. Grow comfortable with that anxiety. The simple solution is to avoid any type of evaluation. 38     The Non‐Conformists’ Guide to EMS Success  . I can say that with confidence because. The fear you feel when you make a big.. Instead of aggressively seeking feedback from our chosen teachers. Spiders. We struggle to separate our tasks from our selves. Failure is the grown-up boogey man. evaluation. or the fear you feel out on the highway working an accident with cars driving by a few lanes away…that’s good fear. 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. public goal is the same kind of fear. Another grown-up boogey man is failures cousin. Some fear is good. especially public failures. watch the way people respond when your organization announces that they're doing case reviews. If you'd like a real world example of what I'm saying. The way little kids fear the boogey man. audacious. The longer we stay in our career. You've wasted too much time letting fear hold you back. We fear evaluation because we see performance feedback as failure. Declaring boldly in public that we're going to try to do something hard and then not achieving it is horrifying to us. we all fear too much.    You Fear Too Much  You fear too much. What we fear more than anything is failure. It can inspire you to wake up early and stay up late doing things that matter to you. the more we tend to fear being evaluated. We start to feel like we should achieve perfection somewhere along the way. we hide in the break room and write our report. 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. Get over that. We don't ask the ER staff what we could have done better. snakes…we can handle them all.. The problem with that solution is that we stifle our own growth.that's the way grownups fear failure. and any feedback that suggests anything other than glowing praise represents our failure.

                www. you could be that person. And fight anyone who champions it. Fear the status quo. Especially if they've made mistakes. Being willing to truly connect with a patient requires more than just a willingness to observe. It requires us to reach out beyond what's comfortable and redefine who we are and how we Fear  . And this particular patient was probably fairly skeptical when Jeff said." His skepticism turned to conviction a few weeks later when Jeff called to invite him to a car show in Denver. Jeff knew this by the display of hot rods on the shelf in the patient’s room. let me give you a few things worth legitimately fearing in your life. Fear stagnation. Fear irrelevance. Jeff's not the kind of guy who lets other people make the rules for him. Souped-up street cars and chromed out classics were real passions of his. And he was open to possibilities. That sunny afternoon the man in the wheelchair just wanted to talk about hot rods. "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. He was just making conversation. "We should go to a car show together. While we're at it. treat.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. 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. Jeff and few friends picked him up in a wheelchair-van. and provide care. he wasn't looking for ways to improve the man’s life. You can go your whole career interacting with the public and never make any real connections like the one Jeff made that day. They had arranged for the event staff to open the doors early for their special guest. But that's getting ahead of ourselves. and they spent the morning wheeling him around the enormous show-room floor. When was the last time you saw an EMT or a medic get up at a review and say.theemtspot. Connections When paramedic Jeff Forster struck up a conversation with the wheelchair-bound patient in the back of his ambulance. It requires a willingness to let the patient/caregiver relationships change us. and he certainly doesn't wait for permission from someone else.

a moment in which we are forever changed. and in doing so. we bring our whole selves to the task and the relationship. That's the real defining difference between a caregiver relationship and a connection. is the problem of eliminating the possibility that we might grow from our experience with the patients we serve. We open ourselves up to the idea that we can be changed by the relationship. I can get an 80 year old great grandfather to tell me secrets about being happily married for a long time. 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. That possibility isn’t something we learn to accept or invite in EMS. We Change Too That’s a scary prospect for some folks. their lives. We never come to learn about the rich history and life experiences carried around by our patients. Occasionally. we make the choice to fully engage. We never come to learn the tremendous appreciation that we can develop for our lives by empathizing with the losses of others. I can get a disaffected teenager to explain which bands are the best deals on iTunes. and our friends and loved ones until we develop the skills that let us tap into them. If we allowed ourselves to care about those things. we create the possibility of a connection. Through EMS I’ve learned how to take a complete stranger and make them into a life teacher in less than 15 minutes. right? I disagree with these fearful sentiments. and their own personal calamities. we change too. but it’s a possibility that’s worth exploring. Instead of delivering care behind a wall of detached observation. When we make a true connection with a patient.   40     The Non‐Conformists’ Guide to EMS Success  . wouldn’t it make us less effective caregivers? People want our help and our competence not our compassion. The problem we create when we create barriers of detachment between ourselves and our patients.    choose to inhabit our work. our family. 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. we set ourselves up for a tremendous failure.

Here’s a big hidden secret of EMS. I can connect with just about anyone. The value of the patient is the value of the caregiver. and my life is immeasurably richer for having learned how to do it. They feel more fulfilled in their lives. You begin to instantly identify the difference between small talk and real human interaction. And it’s fun. and I can get a five year old to expand on what makes a really good peanut butter and jelly sandwich. They grow more. They love more. For those that choose to develop the skill of real patient rapport and connection. but it's easy to forget. But before you can start tapping in to that vast ocean of personal meaning. • • • • • • • They appreciate more. you have to recognize the immeasurable value of the patient. You need to recognize that the value of your work is directly and irrevocably attached to the value of the patient being served. Regardless of how short the conversation. I want to share with you the single most valuable lesson I've learned in EMS. They learn more.I can get a anxious soccer mom to tell me all about gardening. www. you refuse to talk about the weather and who won last week’s football game. They connect more. their lives become deeply richer. your friends. Once you’ve opened yourself up to making these connections. It may sound obvious. it doesn’t just happen in the 15 minutes between the scene and the hospital. and your neighbors. we begin to devalue our  . 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. And when we do forget. You can’t help but make connections with people. It spills over into your life in amazing ways. The Value of the Patient  is the Value of the  Caregiver  Before we wrap this up. You become more connected with your kids. You can't avoid that. They feel more fulfilled by their work. You’ll find yourself exchanging real                 conversation with people you meet on an elevator. your relatives.theemtspot. the one single belief that you could adopt immediately and possibly reframe the entire way you look at emergency services.

it’s essential to believe that there is something intrinsically valuable about being human. health or moral bearing. That last line is worth repeating. Patients. Try it out.D. In EMS we devalue the patient chronically and habitually. age. race or religion. and downright insulting attitude that we adopt when talking about our patients as harmless. It doesn't hurt them. There isn’t a sliding scale of value. You'll hear it in the way we talk about our patients when we tell stories about the calls we've run. then your service has no value either. You walk around like Neo in the Matrix. Some folks make devaluing the patient an art form. really decide in your heart. You'll see it in the attitude we adopt with psychiatric disorders and the way we secretly blame patients for their illnesses and injuries. 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. more so than you can imagine. 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. jests. you have little value. Once you decide. just opening your eyes for the first time. For a long fulfilling career serving people. intelligence. that humanity is worthy of your service. If the people you serve have no value in your opinion. 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. devalue ourselves. What's the big deal? They’re not present right? What they don't know can't hurt them right? True. We tend to think of the jokes. have tremendous value. They all carry the same intrinsic value of humanity with them and they are worthy of our service.   42     The Non‐Conformists’ Guide to EMS Success  . Once you understand that. a huge amount of your job frustration will disappear. everyone is worthy of your service. the human-beings whom we serve. 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. for the rest of your life.    and in turn. Regardless of socioeconomic status. Here's the good news. If they have little value. It hurts us. This is the key to your job. They are worthy of our service. Decide that every form and variety of humanity is worthy of your service. your patients. The drunken guy who you have to wrestle from his cell down at the local P. you'll begin to see it everywhere. emotional state.

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

”                            ‐ 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 The Fulfillment of  you that it did when Meaningful work  started?   44     The Non‐Conformists’ Guide to EMS Success    .    “It’s a sign of mediocrity when you  demonstrate gratitude with  moderation.

Every few steps she would bend. www. We desire to know that our life has meaning and purpose. Viktor came to believe that man searches. looking at the thousands of starfish that the evening storm had washed up on the sand. giving away  their last piece of  . Viktor’s experience in the Nazi concentration camps told him something different. As the story goes. for meaning.Fulfillment is a big word. Viktor saw that even in the harshest possible human conditions. 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. I’m reminded of the story of the man and the woman walking on the beach. 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.                     "We who lived in concentration camps can  remember the men who walked through  the huts comforting others. 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. the man couldn’t help but address her when she got closer. Farther up the beach the man saw a woman walking his way. Before Victor Frankel’s pioneering book. Not a one would survive to see the next high tide. To do that simply requires us to recognize how deeply meaningful our work is. pick up a start fish and throw it as far as she could into the water. They may have  been few in number. Man’s Search for Meaning. popular psychology believed that most of man’s motivations were centered in the “will to power. early morning. Period.Viktor Frankel I agree with Viktor’s model of human motivation. He also took us to task on being accountable for our attitude. in the heat of morning. the human spirit can rise above circumstances. this man was walking down the beach one sunny. these starfish were clinging to life.” We do what we do primarily to gain power and influence. Meaningful is even more (How should we say it?)…meaningful.  to choose one's own way. Stunned by her naïveté. more than anything else. Now. ." Sometimes. I believe that finding that spirit is key to our fulfillment. when I look at the work I do each day and feel that my impact is insignificant.theemtspot.

Don’t be cool. Good isn’t a recipe for growth. there are literally thousands of starfish on this beach. And then celebrate them. even the ones with warning signs on them. We cannot say what impact our kindness. Go have some grand failures. Get off the path and jump some fences. You may have been denying and hiding from your personal freedom to be amazing for a long time. Go do Something  Amazing  Remember that “match” of personal freedom that we talked about back on page thirty-four? It’s still right there in your hand. It’s a “strike anywhere” match. It doesn’t matter where you begin.” The woman smiled back and then reached down and picked up another starfish. Just begin.   46     The Non‐Conformists’ Guide to EMS Success  . they usually are. “I made a difference to that one!” Our work is meaningful one patient at a time. Good is a waste of time. Forget about being good. And even if you returned tomorrow. Your efforts can’t possibly make any difference. And as she threw it far out to sea she exclaimed. Choose to be growing over being good. “Madam. so what. and not all growth springs from our “good” moments.” We should be gracious to our patients for providing us. It’s your turn to strike it. Ignore good.    He smiled and gently chastised her. Celebrate your failures like you celebrate the Fourth of July. this same thing is happening on beaches all over the world. Cool is social fear dressed up in fashionable clothes. Now it’s your turn. But we can certainly walk away from each call and say. Maybe start by making some mistakes. Cool is conformity in a cardigan. certainly you must understand. Value growth. tomorrow night’s storm would likely wash them back up. It’s not for us to know. And even if you could throw them all back in to the water. each day. But now your time has come. See them as right answers to other questions. Then study hard. Strive to be excellent. Sure people will stare. “I made a difference to that one. Begin anywhere. with such meaningful work. Innovate and use your innovation as an excuse to study and learn and grow. Love them like you’d love an ugly child. our patience or our competent care will ever have on the people we serve.

You’ll find meaning when you make a conscious decision to seek it. The part of you that senses that you are close to something extraordinary. But more than that. Go do something amazing. I wrote this book to speak to the part of you that’s searching for something more. it is this.                 www.theemtspot. If there is one idea that I’d like you to carry away from these 46 pages. planning the road ahead. It’s there. Meaningful lives don’t happen on accident. Grounded in your values. Something amazing that you need only open yourself to and everything in your life would change. Besides. I know that dissatisfaction because I lived it for far too many years. life around them is so much less boring than being around normal people. if you are living your life with purpose. understanding what’s important to you. They are living their lives outside the lockstep of normalcy. Expect that. and the freaks. and for that. You don’t need  . they deserve our appreciation.Appreciate the weirdo’s. 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. seek your meaning. the misfit’s. You aren’t going to stumble into a meaningful existence. 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.

Dennis. This book is immeasurably better because of the efforts of: Editor in Chief: Jason Oncay. grammar.named. Elizabeth. Thank you my love. Rachel. no newsletter and no success story to tell. Illina. Dhairya. Alex. Fiona. Yashashree. Feel free to contact me any time at steve@theemtspot. Archita. Anirudh. Assistant Editors: If you feel like you’d like to say thank you. Yeshwanth. no e-book.guy. Meena. @stevewhitehead (on twitter) Some. Without her there would simply be no website. Akhila. Neil. Mrudula. Without them you would have just read 47 pages littered with spelling. Bili. Hari. Finally. especially Greg Friese of Everyday EMS Tips. Mihir. Nina. Sanika. there are several names that need to be included in this work. I owe a fantastically big thank you to the editorial staff of The Lawson Currant. Gene. Thank you to everyone who read the rough-draft and gave valuable feedback. Jen. To that end. 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. Pradnya. I thank you in advance. Steve Vinitra. Janice. Suprith Finally. Jennifer.    Acknowledgements  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.steve (on skype) Steve Whitehead (on facebook)   48     The Non‐Conformists’ Guide to EMS Success  . I owe a huge debt of gratitude to my wife Peggy for her support and assistance in creating this work. and punctuation errors. I’d love to hear your thoughts and ideas on everything you just read. I’m also indebted to my brother Brian for offering his design experience.

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