In a field where members rely on each other to work on critical cases in tandem, to survey the scene to keep each other safe, and to lend a listening ear after a traumatic call, maintaining the integrity of the department and trust between members is essential. This EMS1 special coverage series identifies the top disciplinary issues facing EMS leaders and what they can do to prevent and mitigate bad behavior while preserving trust among the community and members.
One of the many realizations that have emerged as the COVID-19 pandemic is slowly subsiding is that, like a natural disaster, the pandemic has exerted pressure on individuals, groups and systems that reveals challenges that were masked by good times.
Research, legal action on bullying, harassment in EMS
One of the challenges revealed is that bullying in the workplace is highly prevalent, and emergency medical services organizations are no exception. Moreover, research suggests that little has changed throughout the modern history of EMS in the United States relative to protecting workers from bullying, harassment and violence. What is also accurate, and has been for a while, is that 65% of bullies are those who are in a position of power; bosses, supervisors, managers and others in leadership roles. Therefore, to eliminate bullying, harassment and violence from the culture requires that leaders model respectful behavior and be held accountable by the organization.
Amid a changing view of psychological safety, efforts to legislate change are on the horizon. In 2021, the United States House of Representatives reintroduced and passed the “Workplace Violence Prevention for Health Care and Social Service Workers Act.” This act includes several provisions intended to create a safer environment for healthcare workers. The new law has bipartisan support, and while Senate passage is not by any mean a guarantee, legislation to protect healthcare workers is likely in our near future. If/when it is enacted, it will apply to emergency medical services, including those provided by fire rescue or other EMS organizations.
In June 2021, a resolution by the International Labour Organization went into effect. “R206 Violence and Harassment Recommendation” is the first international treaty on violence and harassment in the workplace. The treaty recognizes an environment free of violence and harassment as a fundamental right of all workers. Compliance with international and national laws relative to treating workers properly at work will be much easier for organizations with systems of dignity and respect in place.
Abusive tendencies to root out
For organizations interested in correcting a culture that could result in harassment or violence, it is crucial to identify the behaviors that could escalate, especially for supervisors and managers. Often, supervisors and managers create, participate in or facilitate cultures that are abusive to workers.
A tool that can be used to identify abusive behaviors was first developed for targets of domestic violence. The Domestic Abuse Intervention Programs (DAIP), otherwise known as the Duluth Model, is one of the most widely used psychoeducational community-based intervention programs for men who have been identified as batterers. The Duluth Model’s “Power Control Wheel” has application to workplace bullies and is evidenced by eight abusive tendencies:
- Intimidation by intentionally attempting to make workers feel uncomfortable or afraid by using looks, gestures or actions
- Emotional abuse makes the worker feel bad about themselves, including mind games, humiliation, name-calling or other efforts to make workers feel guilty
- Isolation by controlling what workers do, who they talk to, what they are exposed to and limiting outside involvement
- Minimizing, denying and blaming by making light of concerns raised by workers, not taking matters seriously, or shifting responsibility for the abuse
- Using coworkers by sending messages or sowing discord in workgroups as a method of controlling the group
- Exploiting employer privilege by treating workers like servants or slaves, including making decisions without worker involvement, limiting the ability of others to make decisions
- Economic abuse, including threatening workers with termination or reduction in pay
- Coercion and threats, forcing workers to engage in unsafe or illegal behavior, making threats that will hurt the worker either physically or psychologically
Create a culture of kindness
Recruiting can improve, turnover be reduced and the organization’s reputation improved by creating a culture where bullying is replaced by kindness, dignity and respect. As the saying goes, it starts at the top, and the leadership of an organization is the key to ensuring that these behaviors are modeled and encouraged. Key steps to reduce bullying and improve culture include:
- Defining and committing to core values that include safety, caring and kindness
- Proving integrity and civility training to all supervisors and managers
- Conducting 360-degree performance assessments of managers to ensure that they are not only modeling behaviors consistent with the values but that those they work with can provide feedback
- Be present – professionally, personally, emotionally, mentally, physically for the entire organization, but with a particular emphasis on those within supervisory levels
EMS organizations that dare to reimagine traditional hierarchical command and control leadership models will likely have an advantage when attracting top talent.
Rather than returning to normal; emergence from the pandemic is an opportunity to transition to a new normal with a focus on dignity, respect and caring for everyone in the organization that is modeled from the top of the organization.
