I did a short piece for the Missouri EMS Association on the making of an EMS conference. It can be viewed here:
The ICE Spring Break Conference wrapped up earlier this week. Day 3 was another big day of awesome presentations, and I thought that I was all set to share it with my friends in the blogosphere. Then my mobile devices (plural) and laptops (yes, also plural) began dying off from three days of only intermittent recharging. The sad fact was that my hotel room had only enough power outlets for the furnished lamps, television, and perhaps two more devices. What was a traveling tech-nerd to do? My idea of unplugging all the lights and television met with considerable ire from my roommate, so I had to compromise and put my devices on a rotating schedule of recharging. This little geeky misadventure led me to one conclusion. I will have to start traveling with a power strip. I’m not sure if this is the correct conclusion, but I’ll give it a try.
Leaders Make Mistakes Too!!
Chris Cebollero is the EMS Chief for Christian Hospital’s EMS Division in the St. Louis metro area. In this class, he outlined the common pitfalls made by leaders on a daily basis. Besides presenting an appealing a topic, Chris piqued my interest by simultaneously recording his presentation for the EMS Leadership Podcast. Podcasting is like catnip for tech-nerds, so I was downright giddy within the first few minutes of his talk.
Chris outlined a laundry list of mistakes most common to EMS leaders. Some of the most notable are…
- Failing to communicate well
- Failing to delegate
- Failing to develop a vision
- Not setting goals with employees
- Not listening
- Failing to learn
- Not managing change
- Not making time for employees
- Not recognizing employee achievements (even if it’s something as simple as picking up a shift on a holiday)
- Going for quick fix over lasting solutions
- Taking it all too seriously
- Say/Do Conflict (leadership is what you do – not what you say)
- Punishing the many for the sins of the few
- Confusing sameness with fairness (one size does not fit all – acknowledge the individual)
- Not forgetting the paperwork in the desk (if they were written-up last month, fine – leave it in the file and get back to setting them up for success)
I think procrastination was on the list, too. But we can talk about that some other time. Even with the several items I left out, his list is quite long. I could recall times when I had made many of those same mistakes, back in the days of… wait, I think I did most of those last month. Some twice.
His challenge to recognize and correct our mistakes was compelling to say the least. I decided I needed to stay put for his next breakout session.
Getting Things Done Without Getting Done In
In a little over an hour, Chris had managed to help me feel better about my piteous history as a leader. He presented the audience with copies of the workbooks he uses to develop leaders in his organization. The focus of the material is to equip new leaders with the four primary skills of a leader: planning, organizing, motivating, and controlling. Without being able to offer the PDF to you, all I can say is they definitely have their act together at Christian Hospital’s EMS Division. Well done, Chris!
Inspiration and Perspiration
Rommie opened the conference with a rousing keynote lecture, and he also did a great job of sending us on our merry way as the last speaker. Though he is the consummate professional and wouldn’t complain about a job he loves, I couldn’t help thinking that the opening and closing speaker really gets a raw deal. Rommie was either having to wake people up on the morning of the first day or keep them awake on the afternoon of the last day. He was certainly up to the task, though.
He described his role on 9/11/01 at Ground Zero, and the events that later gave him a unique opportunity to comfort a firefighter’s widow and her son. Events such as these often fuel our fires as educators. They inspire us to teach the ones who will be in the field on the next “big one.” The sweat from the brows of the field providers is really where it’s at, but they need inspiration, too. As educators, that’s part of our role in EMS. That’s what it’s all about – Inspiration and Perspiration.
I had a great time at the 2012 ICE Spring Break Conference, and I encourage EMS educators in the midwest to join us there for next year’s event!
Yesterday was day two of the ICE Spring Break Conference for me, and I’m continuing to learn all kinds of new information. For instance, I learned that after the lectures have wrapped up on a particular conference day, many participants attempt to drink the Anheuser-Busch Company out of business. This was all reported to me after the fact, though. Like any good clinical educator, I was back in my room memorizing protocols and asleep by 9:00 pm. Yep, that’s my story and I’m stickin’ to it.
The Nature of Emergency Services: A Beekeeper’s Perspective
Perhaps not everyone left the pre-con to study protocols the night before Rommie’s early morning opening lecture. Easily half of those present were sleepwalkers, but had somehow managed to get dressed. Rommie definitely woke them up. His presentation style is 70% solid info & tactics, 30% humor, and 10% atomic-level energy. Don’t question the math, just go with it.
He has been an emergency services lecturer since 1992, so he knows how to work a crowd. Rommie shared with the crowd all the parallels between EMS and his favorite hobby: beekeeping. He claims, “The parallels between the work of a beehive and the work of emergency services are astounding. Bees have an organization with an overall goal that is achieved by selfless individuals each with a specific job to do. As in emergency services, every beehive has rank and structure, discipline and seniority, leadership and field work, all pulling together for the community.”
I was more than a little skeptical when I read the conference brochure, but he made a lot of great points. Among them were…
- Bees can make honey out of all kinds of stuff. We have to do that to make EMS work in our local areas, too. Whether we are municipal, private, fire-based, or flight; we have to learn to deliver the same product given a variety of environments.
- Beehives may look the same, but they aren’t created equal. Although identical (like many ambulances and stations), some hives are high-performers and others are nearly dormant. EMS agencies can’t be judged solely on seeing ambulances/employees roll in and out of the station.
- Honey bees are the perfect employees. They wake up ready to work, always meet the dress code, clean up after themselves, bring the right tools, etc. They don’t get upset about bees in another hive or policies in their own hive. They have a singular job and they do it well.
Cleverly woven into the energy and humor, Rommie made many other points about serving and leading in EMS. His unique off-topic approach drew the audience’s attention, too. He probably did not set out to learn beekeeping in order to prepare this lecture. At least I hope he didn’t, because that would be possibly the lowest imaginable return on investment. Rommie simply found a novel way to blend profession and pastime. I would love to do the same, but I’m drawing a blank on analogies between EMS and my new pastime… going bald.
The Art of Being Preceptor
Linda was a science teacher before coming into EMS, so I was really looking forward to hearing her views on EMS education and precepting. She immediately caught my attention by encouraging us to drop the term “preceptor” and turn to the term “mentor.” She believes that the latter helps convey the relationship that should be cultivated between the student and the training officer. I couldn’t agree more!
She also stressed that the core qualities of a preceptor are integrity, patience, and BEEEEP, BEEEEP, BEEEEP!!! No, Linda didn’t launch into a list of expletives. The fire alarm went off and the building was evacuated! Seriously, I can’t make this stuff up, people!
Blogger’s Note: For my FTO peeps, I highly recommend the book Field Training Officer: Tips and Techniques by Nepon & Eberly.¹
Cultivating Your Agency’s Medical Director
Dr. David Tan, MD, FAAEM
Dr. Tan was recently elected to the Board of Directors of the National Association of EMS Physicians, so when he speaks people listen. His topic was perfect for those services with part-time Medical Directors who are only able to make it into the office occasionally. Obviously my math and guesstimation abilities suck eggs, but I’m pretty sure 99% of our Medical Directors fit that bill.
He advised, “Many agencies see the value in having a dedicated individual in charge of overseeing medical operations. Most progressive agencies will appoint an EMS Lieutenant, EMS Captain, Chief Medical Officer (CMO), or similar designation to oversee Quality Assurance and to work directly with their Medical Director. However, the process in selecting these individuals is highly variable, and the individuals themselves often have no formal training or qualification other than ‘senior paramedic’ on a crew.” Dr. Tan shared a list of best practices to consider when promoting your next CMO.
Additionally, he gave a list of issues of which CMO’s must be well aware…
- Controlled Substances Act. Do you know all the forms required for tracking your narcotics and how your regional DEA agent wants them filled out?
- Nationwide Drug Shortages. Understand the Active Pharmaceutical Ingredient (API) quality concerns and manufacturing profitability issues that drive the shortage. Have a plan for your agency.
- Continuing Education. Many agencies require NO direct laryngoscopies of their paramedics before saying, “Here’s your bag of drugs and sharp instruments!” How about yours?
- Annual Skills Testing / Crew Competency. Make no assumptions regarding provider competencies.
- QA and CQI. Know the difference between Quality Assurance and Continuous Quality Improvement. Know the importance of feedback to the providers. You need to PDCA; plan, do, check, act (also known as the Deming Cycle).
For those veteran CMO’s he advised getting professional credentialing endorsed by the National EMS Management Association and the International Association of Fire Chiefs EMS Section.
Dennis is currently the paramedic education coordinator at HealthONE EMS and a bi-monthly columnist for JEMS online. His delivery style if very engaging and the presentation was primarily focused on initial EMS education. He encouraged the use of computers and mobile devices in the classroom for their quick-search abilities, but acknowledged that students are probably using them to talk to each other. This made me feel far less guilty for sitting on the front row and using three different mobile devices!
Though I don’t provide initial education, I still gleaned some nuggets of wisdom from Dennis. Make sure that all your handouts are updated. It’s funny how often people will remember the wrong/outdated information you forgot to take out. Likewise for skill demonstrations. Take the time to produce an accurate skills video that can be used for consistent instruction. Experiment with your classroom setup. Don’t be afraid to deviate from the traditional lecture hall arrangement of tables and chairs.
My favorite part of his presentation was an exploration of a quote from Chris Le Baudour. He shares this on the first day of class and though it’s not an exact quotation, the gist is, “Questions are not allowed in class… (long pause for effect)… until you’ve asked two classmates and consulted one reference source on your own.” I would bet half of my readers just fell out of their chairs. Most simply fell asleep from reading this drivel, but a few were violently shaken by the idea of students not coming to the instructor for information (commonly known as “Shaken Reader Syndrome”). The concept of encouraging our students to look elsewhere for information may initially give us heartburn, but think about it in the context of field work. Once students get their boots on the streets, they’ll be encountering far more issues that require team learning. Let’s get them used to doing it now.
Pimp My Classroom
Tim Bobbitt is a fresh new face on the conference circuit in our area. He started his EMS career in 2003 and is currently working for St. Charles County Ambulance District as an Assistant Supervisor, Primary EMT Instructor and Paramedic Adjunct. In his free time (not a term with which I’m familiar), he is also an independent item writer, editor, and contributor for Elsevier.
This interactive class was all about sharing “outside of the box” ideas used for the classroom. Tim’s presentation was over an hour of nonstop genius, and I wish I would have had the presence of mind to record it. Here are just a few of his “pimp my classroom” tactics:
- The manikins you see in the mall can often be found on the cheap if you’re willing to do some hunting store-to-store or search on Craigslist.
- If you don’t have $2-3K in your budget to drop on a Smart Board, you can use simple technology to do the same thing with any projector and screen. Check out this great TED Talk on the subject.
- Idea Paint at Lowe’s. This will turn any surface into a dry erase board.
- Your local butcher probably throws away a lot of stuff that could be used for comparative anatomy or airway labs. Pig lungs (or any other organ, for that matter) are often free for those who simply ask nicely.
- Harness your students’ skills at beer pong for something educational. “EMS Pong” can be played in the classroom with similar rules and test review questions in each cup.
- Think your PowerPoint tricks are amazing? Chances are good that many have already seen them done. Prezi is a more affordable presentation format that offers an immersion feel for your audience.
- Tired of the same old topic posters or flashcards? Add some contemporary design to your teaching using Wordle.
- Zygote Body is an amazing website for teaching human anatomy.
- Trainer’s Warehouse is a great place for purchasing instructional aids.
- Here are a ton of ECG teaching resources.
Tim also has his own website where you can see the other cool stuff he does. He’s definitely a guy to watch over the next few years, and I hope I can get him to start blogging or podcasting to share more of these ideas (hint, hint, Tim).
1. Nepon, Bruce, and Barry Eberly. Field Training Officer: Tips and Techniques for FTOs, Preceptors, and Mentors. Sudbury, MA: Jones and Bartlett, 2008.
Every year, the Missouri Ambulance Association and the Missouri Emergency Medical Services Association host the ICE Spring Break Conference at the beautiful Lake of the Ozarks. “ICE” stands for “Instructors-Coordinators-Examiners-Managers-EMS Providers” according to the brochure. Something seemed odd with that acronym, but this is my first year at the conference so I decided to just smile and nod. Perhaps someone will fill me in later.
I’m here for three days taking part in several classes and doing my best to offer up some color commentary. If you’re the Twitter-ing type, you can also follow the hashish-tag, #ICEconference.
Preconference: NAEMT Safety Course
Taz Meyer & Jim Fingerhut
Call me a nerd, but I was pretty excited to take this course for three reasons. My boss was equally happy to send me due to his general belief that my very presence on scene is a safety concern. In retrospect, I can admit that my “rollerskating paramedics” plan for saving time on scene was a bad idea.
First, safety is a huge concern for EMS managers. Our brothers and sisters in fire and law enforcement certainly encounter their share of hazards. But overall, EMS has higher rates of missed time and medical evaluations than both fire and police.¹ Whether it’s back-filling shifts for injured employees or the sticker shock of your updated work comp modifier, if you’re a manager it’s on your radar.
Second, I know a couple of guys who contributed to the development of this course. Greg Friese had a hand in the physical conditioning topics and audio/visual aid development. By the way, Greg, I loved the “Nobody Flying the Plane” slide! Another friend of mine, Kip Teitsort, wrote a ton of solid material on patient, practitioner, and bystander safety for the curriculum. Knowing that a couple of my friends worked on this course made me feel like part of the “in” crowd. That feeling will probably fade when I go to the conference mixer later, but I’ll enjoy it for now.
Third, it’s a lot of information I can put to use immediately. I’ve developed an interesting characteristic over the years that I didn’t have as an EMS Newbie. I call it Spidey-sense, but most biologists would call it, “self-preservation instinct.” This valuable quality is generally lacking in toddlers, bull riders, and many of the patients we transport after 1:00 AM. It’s the ability to predict and avoid incidents that are likely to be un-good for everyone in splattering distance. Field experience can’t be bestowed in an 8 hour course, but simple exercises and tactics to keep us safe can go a long way toward self-preservation. My field experiences regarding scene safety have taught me a lot, but I love courses like this for new information on the topic.
If you haven’t taken the time to check out the curriculum, take a minute to check it out. From the NAEMT website: “NAEMT’s EMS Safety course aims to promote a culture of EMS safety and to help reduce the number and intensity of injuries incurred by EMS practitioners in carrying out their work. It helps increase students’ awareness and understanding of EMS safety standards and practices and develop their ability to effectively implement them. EMS Safety is the first national and most comprehensive education program of its kind that teaches techniques on how to best achieve safety on the job.”²
On the whole, this offering of NAEMT’s EMS Safety course was great. I give a lot of credit to Taz Meyer and Jim Fingerhut of St. Charles County Ambulance District (SCCAD) for their polished delivery. SCCAD employees and apparatus can be seen throughout the manual, so they were intimately familiar with the materials. The course manual is straightforward without much theoretical fluff, and the audio/visual aids are dynamic. Best of all, there are relatively few barriers to entry for instructors wanting to deliver this course in-house. Unlike many classes that require providers to go through another instructor course before teaching, NAEMT Safety Course participants can go straight on to delivering the course after passing the provider course.
Just as listening to an anesthesiologist’s lecture won’t make us airway superheroes, attending this safety course won’t make us safer. EMS providers become better at managing airways by attending great training, having access to the best equipment, and creating a culture of high performance. We, as an industry, will become safer when providers accept personal responsibility for creating a safety culture. This same idea is the final slide in the course…
“The Next Steps are YOURS.”
1. Suyama, Joe, Jon Rittenberger, P. Daniel Patterson, and David Hostler. “Comparison of Public Safety Provider Injury Rates.” Prehospital Emergency Care 13.4 (2009): 451-55.
2. “EMS Safety.” NAEMT. Web. 16 Apr. 2012. <http://www.naemt.org/education/EMSSafety/EMSSafety.aspx>.