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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To the general public, the very word "volunteer" conjures visions of untrained, and unprofessional. For the almost 19 years I have been involved with my current department, I have fought hard to instill the concept that we are "Un-paid Professionals". We train and preform to "professional" standards and part of professionalism is also looking the part. If you do not take pride in your appearance, then you won't take pride in your skills or attitude, Whether it is 0200, or 1800 when the call comes in, appearance goes a long way in the perception that we are as professional as any "big city" service.
I agree that uniforms and appearance aren't clinical priorities in treating a medical emergency, and I agree that in rural areas or wherever EMS providers respond from home, it's better to have a come-as-you-are provider on scene quickly than to expect someone to change into a uniform. However, a professional appearance helps secure the confidence of patients, family members and bystanders, and it helps in other ways too. We need and expect to walk into all kinds of properties, including security-conscious office buildings, without being challenged or delayed. We go into places not open to the public. We sometimes have to stop traffic. It helps to look the part of a sworn public safety responder -- it helps with patient care, by minimizing delays and getting us the access and assistance we need.

There's also a practical matter of the hazards of the job, and it's a liability issue for our agencies as much as a safety issue for ourselves: we're issued clothing that's appropriate for the job -- visible to traffic and resistant to flame, blood and sharps. Okay, when the alarm goes off ya do what ya gotta do, but does anyone really want to work a crash scene in shorts and Crocs?
No, I would rather have my white shirt and black pants....Think that's what turn-out gear is for....and for one.... mine is "clean" but far from spotless...I think the saying that one should not criticize till you have walked a mile in my shoes might fit here....I agree with everything said by all....but the situation should be considered.....Heck, two weeks ago I responded to a structure fire in my scrubs from work....then put my turn-outs on and went to work.....You do what you have to do.....Stay safe all..........Paul
I agree with you totally. The funny thing is the article talks about other "unprofessional" things that he has observed but everyone is focused on "pretty" medics. Guess Jason hit a nerve!
Thanks Ted! You said it more simply and eloquently than I.
I'll add another comment here... in the winter time, if the temperature is below say 25 degrees my bunker pants come inside. If there's a call - EMS or fire - my bunkers go on. I show up at the scene with fire bunkers and my nomex EMS jacket. There's no mistaking who or what I am.

If it's REALLY cold out, or snowing, my fire turnout coat comes inside too, and that's my jacket. (This is properly laundered PPE by the way, not dirty reeking stuff.) Sometimes we have to use a Stokes basket to package a cardiac patient and transport them on a pick-up truck bed out to the ambulance. Or slog through snow or slush or whatever to reach the patient. I'm protected, cozy and warm regardless of what we find.

I do get some surprised looks from the ED staff at the hospital when I come clomping in with the patient, leather boots, bulky pants, the works. Perhaps some dirty looks from other "professional EMS" providers? Maybe. I don't care; I guess I want them to know that volunteer fire departments still provide EMS service.
Joe, maybe it's not dirty looks maybe it's awe. I am in awe everyday by my FF brothers and sisters.
I'll agree with you up to a point.....yes, getting there and getting there quickly and safely is paramount....but...

Firefighters stop to don turnout gear....granted, that's a safety issue, but it also guarantees that we all show up looking like we're ready for business.
Nothing wrong with keeping some form of attire on hand that can be donned quickly that has a uniform appearance.
Just my seven cents.
Thanks Sister....its nice to hear sometimes....although a simple thank-you would be just as good....we are, after all in the same game.....Stay safe....Paul
I would like to add one little thought... I went on a medical call for our dept. and had nothing on that showed that I was with the fire dept. the medics thought that I was family or a neighbor and tried to get rid of me till I told them I was with the fire dept and was here to help. I do think we need something to ID us. I have a district ball cap in my car that I put on so that they know that I am with the fire dept.
being from a town that did 4000 calls in ems alone,i have to agree with you that looks make lasting and first impressors. shelton is volunteer at night and on the weekends i have been there in both spots , in a uniform and in street cloths. most people are understanding that we are people that give up our family to help someone that we don't know. they ask i would tell then that i am volunteer , there reply is thats great. i would some times respond in my work cloths on the way home , which at the time was always dirty from the cemerty that worked at ( and yes the shirt was one that said cemetery on it ) that always made for intresting ride to the hosp . good luck
Well, maybe you are right Anita; after all I was basing my assumption on the sometimes strained relationships among the various EMS organizations.

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