To represent ourselves as professionals to our communities, like Killingworth (Conn.) Ambulance Association shown here, we must actively teach and enforce professionalism in everything we do.
Jason J. Zigmont, BS, NREMT-P, EMS-I
20080301
2008 Apr 1
A few weeks ago, I walked into a local hospital and saw someone standing next to a stretcher, wearing a ripped pair of jeans and a T-shirt covered in white paint spatters. Trying to be helpful, I asked if he needed anything or was looking for someone. To my surprise, he said he was with the local volunteer EMS crew. He added, “I’m just waitin’ for my partner.”

That encounter reminded me that to be true volunteer professionals, not only do we have to provide competent care, but we must also look the part. The way we look and act while volunteering is a representation of ourselves, as well as our organizations and our profession. Often, when a volunteer is responding from their home in their personal vehicle, the person we see is like the man I met—someone in casual clothes who doesn’t look at all like the emergency medical professional the public envisions. When someone is hurt, they expect to see a member of our community at their door who looks and acts like a professional and makes them feel at ease as they put the life of a loved one in their hands.

But not everyone agrees that professionalism is important. I had quite a debate one day with a medic who said, “When a patient’s dying, they don’t care if my boots are shined.” Although I agree that the patient’s primary concern may be their medical condition, we must be aware that this kind of attitude has a negative effect on EMS. The way we interact with patients absolutely affects them, both physically and mentally. Professional, compassionate care also helps limit the number of complaints lodged by the public and may ultimately help deter legal action.

The Talk & the Walk
Professional actions include everything we do before, during and after a call, and it’s reflected in our actions, speech and appearance. When we’re serving in an EMS capacity, everything we do is under scrutiny. But unfortunately, the level of professionalism we demonstrate in our “day jobs” sometimes doesn’t carry over to our volunteer duties. Some crew members don’t understand what it means to be “professional” or maintain a good work ethic, perhaps because of a lack of mentorship or because they work in a place that condones unprofessional behavior.

Volunteers often catch flack for their members “flying through red lights” with their POVs, cutting off other drivers or other actions before we even get to the call. These behaviors are unprofessional and dangerous. During calls, we often inadvertently act unprofessional by disrespecting our patients or their property. After the call, some of the most unprofessional behaviors can be found in the EMS room or ambulance bays. The extremely unprofessional members are busy writing on the wall, drawing pictures on the CME announcements or talking about their patients in public where anyone, including the patient’s family, has the potential to hear.

Besides talking about our patients in public, which is not only unprofessional but also illegal and a breach of their rights under HIPAA, our communication skills in general often need improvement. We spend quite a bit of time teaching EMTs medical terms so they can sound professional, but we forget to teach them the basics, such as showing respect, using appropriate communication methods in both verbal and non-verbal forms, and avoiding slang or profanity. This is an area where the younger members may fall short, but our more senior members may not be setting the right tone. I know of one department that had to implement a “swear jar” for their meetings. This jar quickly became a symbol of the service’s root problem when many of the senior members and officers started paying in advance for the profanity they knew would come out in a tirade against their own members.

The last part of professionalism is probably the most obvious, and that’s our appearance. The excuse here is that scramble volunteer members don’t have the time to put on a uniform and may have just come from their construction job or working around the house. Although I understand the time constraints, members can always put on a coat, jump suit, work shirt or other item that identifies them as an EMS professional. Volunteer fire departments have a one up on EMS agencies because their turnout gear provides for a great “uniform.” It may be time for us to adopt some type of turnout coat, preferably with a high reflective component, to wear on calls.

Agency in the Mirror
The challenge to volunteer leaders is to develop services and educational programs to actively teach and enforce professionalism in everything we do. Take a look at your membership and your own professionalism the next time you go on a call. A lack of professionalism can’t be fixed overnight, but you’ll be amazed at the amount of respect your department will gain with each step you take toward being a professional volunteer organization.

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Coming from a combination dept. I strongly agree with you about having to walk the walk. On the EMS side I feel a clean apperance is especialy important for many of the same reasons you stated. Just appearing and acting profesional drastical cuts down on the number of complaint that a department gets. I also agree that there should be some sort of jumpsuit or something to slide into in order to make calls. Lets face it some volunteer dept and ambulance services are lucky to be able to afford to put fuel in their vehicles and now they have to buy more uniforms. I myself have come in from working in the field and had to jump in the back up medic with a partner. The fact that a volunteer is wiling to give up time and money to serve fellow man with no compensation, we should probally cut them a little slack on apperance. Many communities understand the staffing issues small dept have. Having said that I am not trying to make excuses, and volunteers need to make every effort to act and appear profesional, I feel I have some of the best volunteers in the country working for me and when we MA other department we blend right in with the full time department.
In general I agree with the points raised in the article. Keeping up appearances in terms of "proper" clothing is another matter.

I am a member of a rural fire department which also runs a volunteer ambulance. We do not stay at the firehouse, nor do we run shifts or duty crews. When a call comes in, we stop what we are doing and head for either the ambulance or the scene, whichever is closer.

Over the years our members have shown up with whatever they were wearing at the time of the call: swim suits, overalls, business casual or formal attire, parade uniforms, and so forth. I don't ever recall a patient looking disappointed or critical because I wasn't wearing a starched white shirt and black pants. Our residents are universally grateful for the service we have provided.

In the last few years we have adopted t-shirts and sweatshirts with our department logo and name printed on. We also bought EMS turnouts with department name on the back, which also helps in identification. We try to show up at EMS calls with some type of ID clothing on, however sometimes it's just not possible, or practical. In fact, as I type this I'm attired in a department sweatshirt and jeans; if there's an EMS call that's what I'll be wearing.

Reaching the patient in an expedient fashion, and providing proper prehospital medical care are higher priorities than showing up in a dazzling uniform and a smiley face.

YMMV.
OK...I have to throw in my 2 cents worht here....I AM a health Professional (My "real" job as an RN) I also am VERY active with both the Fire Service and EMS...(in fact got EMS provider of the year this year)... You have to note here that SOME people are responding from work or other duties to respond to this call....not everyone has a white collar job.....and yes sometimes they get dirty..I know that if I needed some help the clothes they wore wouldn't make much difference to me....I don't like "medics" that look pretty I want someone that knows what the hell they are doing....I have seen many "educated" people in my years in the ER that couldn't put a bandade on without hurting themselves..so please don't be so quick to judge....we oftimes leave our jobs to respond and we don't all have nice clean ones...Stay safe....and think before you criticize
I'm with you Joe.....Some "medics" can sure look pretty on a call....But they aren't out plowing a field or painting a house or changing someone's oil before the call...Give me someone who cares enough to KNOW what is happening and who cares enough to leave to respond to the call....Think sometimes we forget that the most important ingredient in our make-up is the fact that "WE CARE"....and yes we have the same training as those "pretty" medics with the fresh white shirts black pants and enough tools on their belt to build a nuclear reactor....Stay safe all....hope I didn't throw any mud on those clean whites.....Paul
What I have to ask is (and following your "stereotype") when you dial 9-1-1 or someone dials for you, do they care that you have a rip in your jeans? Do they care that you may have paint on your hands? (which are sealed in by the gloves) The answer is no. In a TRUE emergency situation, a patient will be more comforted that a person of competent training and that has the ability to make their crappy situation better. I do think that members should try to look professional as can be, but if a volunteer is coming from work who are you to tell them they need to change their clothes? Professionalism is a lot more than appearances, it is the ability to be fully trained, and execute their training on the scene of their emergency calls. If you run the organization as a concentration camp your membership will be less "voluntary" to respond.
Anita, I have to agree with all of you on this issue. I agree we need to look the part, when we can.... I agree with the other respondants, because I am one of them. I don't get paid to be on call, therefore I will be working on whatever it is I need to for my family, dept, and friends. If I get dirty or messy, so be it. One thing that is always hanging around my neck (on a call) is my department ID, this I believe is very important, that identifies me as a provider even though my clothes may not look the part. I have noticed a few of my fellow vollies wearing shirts with questionable sayings, graphics, etc. They were more than receptive when given a gentle nudge to maybe think before wearing such things while on call, or make an attempt to cover it somehow. We are all professionals deep down, sometimes we all need a reminder to bring us back in line, but when it's all said and done, we get the job done. Proper patient care, good decision making, and going home at night is what is important to everyone. Bless you Anita for wanting to make EMS the best it can be. In a perfect situation we all would always be in proper uniform, but sometimes my dirty pants and shirt are my uniform!
Hey Patrick, I agee with you 100% We are lucky just to be able to assemble a crew for calls on a volunteer basis. And I understand some departments have little or no budget. Killingworth Ambulance donated our old ambulance to a town in Maine that didn't even have an ambulance (when we bought a new one 6 years ago and we only have one in our town). But I have also seen EMS personnel at the hospital in torn off jeans, dirty T-shirts and flip flops.
Although I did not write this article, I agree with Jason, that if their is at least a guidline or SOP stating some minimal requirements. Personnel may make an effort to keep a clean shirt and a pair of shoes in their cars. Personnally, I followed the ambulance once in the medics flycar and was reprmanded at the hospital for wearing shorts and I wasn't even a member of the crew! I also live in a large town and it could take me 15-20 minutes just to get on scean, and the last thing I want to do is change my cloths before I leave. But I get to the scean and see the FF with their trunks open putting on turnout gear. It only takes a minute, just a thought! Stay safe out there!
I also live in a town where it could take me 15-20 mins just to get on scene so I understand completely. I was told at the hospital that a female EMT came in with a patient in a bakini top and shorts. What your department is doing sounds great! My point is if you never draw a line in the sand how do you know when it's been crossed?
Thanks for the imput Joe.
Paul, Killingworth is a rural town with a volunteer ambulance also. Assembling any crew is a challange for most volunteer EMS. Clean doesn't equate to better. But with a choice, looking and acting like a professional is better than not. Just something to think about.
Paul as I said above I am also a volunteere in a large town and it could take me 15-20 minutes just to get on scean, and the last thing I want to do is change my cloths before I leave. But when I get to the scene I see the FF with their trunks open putting on their turnout gear. It only takes a minute to put on a shirt and grab your gear if you have them in your car already.
I agree with you that clothing is what makes a professional, but we are talking extremes here. I am a volunteer also, I live 15 minutes from headquarters. Many times I have to pick up the ambulance and then drive another 15 minutes to the scene. Do you really think I want to stop and change? Of coarse it's more important to get to the scene quickly. A shirt on the back seat of the car could be put on while you are moving, if your, lets say, in your bathing suit which some EMTs have shown up at the hospital in. There has to be a line somewhere. PS I didn't write this article I just posted it for discussion.
Thank Matthew, I didn't write this article, I found it on the JEMS website and was amazed they had a picture of the Killingworth Ambulance Crew that I didn't even have. That was at our annual banquet and beleive me when I tell you, we never look that good when we respond to a call. We are lucky that we have funds for T-shirts and polo shirts and jackets. It is nice when someone responds wearing clothing with insignia but it is not mandatory. As I replied earlier, EMS personnel in our area have responded in bakini tops and shorts, and other extremely inappropriate attire. I agree with Jason, who wrote the article in how hard is it to keep a shirt in your car and throw it on while you walk to the scene? I see FF putting on their turnout gear at a scene. I don't know one fire chief that would say it's OK to walk onto the fireground in flip flops because you were responding from home. It hit a cord with a few people which is good. That is what a discussion is supposed to do!

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