It’s hard. After a career as a hands-on prehospital provider, you get the call.

Supervisor.

You debate whether to take the job. Maybe it’s an easy decision, maybe it’s not. You remember the good supervisors you’ve had, and the bad ones, and wonder which kind people will come to see you as. Whether or not the additional pay will be worth the additional responsibilities. But in the end, you make the choice, and accept the “white shirt” or the bars. So, now what?

Step Back

One of the harder things for new supervisors to accept is that they are now no longer responsible for an individual patient. That they must detach from the call, and run the environment instead. Since most of EMS training is focused on the hands-on, there’s not a lot of training on what to do when your responsibility shifts in this way, and so it’s a difficult transition for many.

They realize that those semi-resentful feelings they may have had when their supervisors in the past “just stood there” were, in fact, a vote of confidence: that the call was being handled well, and so there was no need to intervene with a patient’s care.

That left the supervisor free to handle the things which needed doing outside of managing care: interfacing with family members or bystanders, other responding public safety agencies, keeping the media away from a scene if PD wasn’t there yet, or any of the billion other small tasks which go into effective response.

Those tasks are now your job, so take them seriously and keep your focus on the bigger picture. Keep your skills and knowledge sharp – you’ll still need to be a provider and manage care sometimes, but more importantly, you’ll demonstrate to your crews that you’re still serious about the profession and understand what they’re doing.

Take Charge

Another thing which happens: everything that goes on in a call from an EMS standpoint is now in some way your responsibility while you are present. While that may seem scary, especially with some of your NaCl-enhanced coworkers, or those who are… less than proficient, remember that your role is to be calm, competent, and keep situations in hand.

If you didn’t have these qualities already, you probably wouldn’t have been picked to drive the fly car instead of the truck. Don’t be afraid to display them. The most respected supervisors are respected for demonstrating the above 3 more than anything else, and even the crunchiest of old-school medics understand what they mean.

Another thing: leadership is ownership. That means that you alone are responsible for what you do – don’t blame your crews if something goes wrong while you’re there. It won’t change anything, and you’ll lose respect and trust. Without those two, your job will be impossible.

If something does go wrong, remember that the people you oversee are individuals – talk to them first one-on-one to see what their take on what happened is, and dole out more formalized discipline if it’s warranted. There’s a reason that a personnel file exists: for when things need to be documented. Not everything rises to that level.

Encourage the Positive

Motivation is not generational, it’s individual: while it may be tempting to say that the new guys “just don’t get” the way things are done because of their age, you’re doing a disservice to the profession every time you even think something like that. You are now a leader, and what you say about someone helps decide if they keep their motivation to excel, or give up and become a burnout, in the longer term.

Set a good example. That’s true even for your veteran providers – while some stay stuck in their ways, others may change their practices and attitude if the right leader allows them to. Encouraging those who are motivated, and those who are not, to be the best they can be and keep their passion is what makes for great providers.

Speaking of burnout: don’t ignore it. It’s an important sign that someone is suffering. We do great harm to our coworkers by labeling them as “just crispy” or even thinking that being burnt out is something to aspire to – that those who are that way are tough or hardened and have “been there.” There’s a difference between being burnt out and being experienced, however: we all know what it is, and who falls into each category.

When you ignore the burnouts, you’re reinforcing their pain by telling them that nobody cares and nothing matters. Don’t. Find out what’s going on, talk to them one-on-one as a human being, and find ways to help them. Sometimes people may not realize that help exists. Help them find it. Anyone can have burnout happen to them easily given the things we see in our careers, and it’s easy to lose sight of the good part of humanity.

Bridge the Gap

Sometimes it’s easy for administrative or command personnel to appear to lose sight of what it’s like to be hands-on in the field. As a front-line supervisor, you’re a translator for them – not removed from the scenes, and yet in charge of the scenes.

Speaking both languages and bringing both perspectives, you’re in a unique position to help bridge the gap in understanding between your providers and their command staff. Advocate for your people when they do things well, communicate with your superiors when there are things which should change, and bring changes back to your field crews in a way they can understand when they do come down as policy.

Most of all, don’t fall into the trap of fostering stereotypes by either of them: that command staff are out of touch, don’t care, or think their staff are beneath them, or on the other end, that field providers are just cogs rather than individuals with intelligence, opinions, and valid input. Each side has a necessary function in creating a system, and they must work together if your population is to get the care that it deserves. That can’t happen in an environment where stereotypical patterns dominate thought.

In the end, being a supervisor is going to challenge you in ways you haven’t considered before. You’ll face politics in a new way and gain a greater understanding of what it means to be in charge. Some of that will be good, some may be discouraging if you let it be.

Most importantly, though, you’ll have the opportunity to shape the providers who work under you, and live as an example of doing things right: respecting and taking care of each other as well as your patients, always seeking to further your knowledge and skills, understanding the balance between work and life, and so much more. You’ve been given the opportunity to help define what EMS is in your community – and doing your best every day will keep building what you started as a dedicated, and motivated, field provider.

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Greg Bogosian is certified as a Reserve/Intermittent Police Officer by the Commonwealth of Massachusetts, and spent twelve years working as an EMT-Basic, including four years as a field EMT and dispatcher for the City of Boston EMS. He was additionally a member of a Federal medical disaster relief team for ten years, with experience responding to the aftermath of Hurricane Katrina, and the pre-deployment of resources for Hurricane Ike. Greg currently has a passion for educating public safety professionals about matters which impact their lives every day, and welcomes feedback and suggestions in the spirit of ensuring that best practices make it out there for all to benefit from.