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
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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I am just catching up on this discussion and as a career Paramedic and a volunteer FF I am in total agreement with Anita regarding looking and acting professional. Its not that difficult. There is middle ground here because I have seen career medics who did not appear professional either, they look like dirty cowboys, playing some macho part in a movie. My point is looking professional has many levels from a simple piece of clean and identifing clothing to the clean, pressed uniform. It may not change what you do, but it will change how everyone feels about what has been done, including you. Ask yourself this, why do we clean the firetrucks? Won't a dirty truck pump water and put a fire out just like a cleany shiny one?
One more point. If you review OSHA regs there are many restrictions and recomendations regarding clothing. A few simple points are that wearing dirty clothing to care for the patient puts the patient at risk. Wearing the dirty clothing back to regular non-ems job or to home puts your co-workers and your family at risk. Think about it, the comment by the person who responds from the farm. Not spending time to cover your contaminated clothing or properly disinfect your hands before patient contact may save YOU 2 minutes. It may put your PATIENT in the hospital for weeks with a life threating infection. Think about this, you are sitting down to dinner. You respond to the call for the "ill man" just down the street. You evaluate and take VS on nice man who is weak and has a low grade fever. You send him off to the hospital never knowing the final diagnosis. You take your gloves off and go home, not changing your cloths and finish dinner with your family. You only find out the real story after your child becomes ill and ends up in the hospital. There you discover the nice ill man died from some terrible infection. Only a story, but food for thought, no pun intended. I could go on, but you get the point. Give it some thought.
My 2 cents I am a fulltime EMT and a volunteer chief.My vfd does 1st responder and rescue .In an effort to make us look a little more proffesional I am getting everyone thier own ansi class 2 vest.It is to be worn on all 1st responder calls and anytime we are on a road.We just got coveralls for extrication and you have a choice full turn outs or extrication coveralls and helment.We even give the choice of coveralls on 1st responder calls but everything says FIRE DEPT on it.When we do stand bys at public events its the shirts the department got you for Christmas last year and clean jeans.I am going to get real brave this football season where we stand by at ball games and say ok shirts and black bdus some will gripe and I will comprimise and say by the next game and I've got you a discount and we will all be happy again.I think people perform at the level you expect them to fot the most part
Anita -

Thanks for posting this and for being patient with the brow-beating you appear to be taking.

I share many of Jason's same sentiments, especially when it comes to proper identification of first responders. The excuse that it takes a little extra time to don an appropriate T-shirt, sweatshirt, jacket, uniform shirt or other easy-on apparel is just that - an excuse. Just like "I can't put on my seat belt because it slows me down" is an excuse.

I agree with may of the respondents that, for the most part, the patient doesn't judge you by your attire when you're in the thick of it, saving their life. They may not judge you, but trust me, there are plenty of other people on scene who may: family, bystanders, other responders, etc. And they will remember that when it comes fund drive time.

But let's also be realistic, is every call we respond to a true emergency by definition? Are we not better serving the customer by, whenever possible, wearing appropriate and identifying clothing and in doing so, increasing their confidence in our abilities?

When I was a chief I established a minimum dress code for our responders and that was a reflective vest which we issued to each responding member and/or was available on the apparatus - the benefits of which should be self-explanatory. I told them half-jokingly that when the "defacation hits the rotor," that vest may be the only thing that separates them from the involuntary commitment patients!

For the record, you're not alone in agreeing with the article you posted. Mike Dallessandro thinks along the same lines. Here's a link to an article he wrote, titled: "We are what we wear."

Nobody trusts anyone more than they trust firefighters. The reality is, when chaos is in control, clearly identified and appropriately dressed response personnel command respect. We are firefighters and first responders and it is our uniform that separates us from the common citizen. We should be proud of - and take advantage of that fact at every opportunity.

Thanks for bringing this to the forefront and being successful in conjuring up some thoughtful conversation.

Stay safe. Train often.
I'll restate what I said when this thread started....if Firefighters can stop to put on turnout gear as both protective and identifying clothing, then the same should apply to EMS responders...keep something in your car, keep something on the rig that you can throw on to identify yourself to John Q. Public.

In response to Tiger's post, I pulled a sentence out of the article by Mike Dallessandro that he linked in his comment that sums it up nicely..

The bottom line here is that the first step to insuring you as volunteer firefighters or your fire department as a whole is respected as vital and professional public servants is to project a professional, organized and well trained image 100% of the time to the general public. Remember, you, your department and we as a brotherhood are what you wear.
that's an interesting angle you've mentioned here; one that everyone else missed.
In our squad we have EMS gear, and then we have florescent orange winter and spring jackets, then we have a vest that is the same color as the jackets that we wear. We also have t-shirts with the department name on them. Typically when I am on call I wear one of my t-shirts. If by chance I don't in the summer and have a tank top on then I wear the vest which has our department name and my first name on it. We have had to reinforce to members that sandles is not appropriate protection for your feet. Which I would have thought was a no brainer but, obviously not.. I do agree with everybody you need to look professional and not like a slob even as a volunteer..

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