Are You Failing to Communicate?

Communication is difficult in an emergency medical service environment. It's not like an office environment where you can walk over to someone's desk and have a conversation. Typically, personnel are deployed at several different sites over different shifts. When two EMS providers do meet, it may not necessarily be the proper time to hold a conversation, such as on the scene of a multi-casualty event.

Even during face-to-face encounters in an office or training environment with no outside interference, people fail to listen. The failure to listen can be attributed to many things. First is attention span. If the subject does not interest people, or if they are thinking about some other priority, they will not listen. If the speaker is mumbling, talking too fast or slowly, speaking in a monotone voice or mispronouncing words, they will usually lose the attention of the person they are trying to speak to. Another problem is the "word whisker." A "word whisker" is someone who begins or ends every sentence with "you know what I mean," "uh" or "that's what I'm talking about."

There is a whole concept of being a listener versus one who does the talking. If you are doing the talking, you cannot be listening. EMS managers should guard against pre-judging a conversation with an employee. Just because you don't think an issue is important does not mean the employee doesn't think it is. He may have rehearsed the conversation with you over and over in his mind for the last two days. Remember, you are an authority figure in the organization and may ultimately have to make a decision based upon the conversation.

Being an active listener also means avoiding distractions. Common distractions in an EMS manager's office can include an interrupting phone call, looking at papers on your desk, reading e-mail on your computer or thinking about your child's upcoming soccer game while someone is talking to you. If you are distracted, you are not an active listener.

In order to avoid these distractions, I always found it useful to take notes when an employee was talking to me. This accomplishes two things: The employee feels you are empathetic to the issue if it is important enough to take notes, and it keeps you focused on the subject matter, since you must pay attention to what is being said in order to take notes. Another aspect of communicating with an employee is to maintain eye contact. Further, pay attention to nonverbal communication and body language, which signals when an employee is trying to make a point.

Sometimes it is good to be repetitive during a conversation-repeat back to the communicator, "I hear what you are saying," or "What I think you are saying is..."

If you are the communicator, keep the three Cs in mind: Verbal communication should be clear, concise and complete. One poor habit during communication is failure to provide all the facts in an organized and complete fashion. The listener then fails to get the whole picture and is not truly informed to make a decision on the subject.

Former President Ronald Reagan was known as the "Great Communicator" for his ability to speak in front of an audience or into a television camera and hold the listeners' attention while delivering his point. Many attributed this to his earlier training as an actor. After his second term in office, a reporter asked Reagan his secret for communicating to a television audience. He replied that he merely looked past the camera lens and deep into the camera. This simple act connected him with his audience.

You do not need training as an actor to be a good communicator, but you do need good skills to be an active listener and be able to convey your message in a conversation with clarity. Managing an emergency medical service system is about managing the people who work in the system. Inability to communicate with those people will make you an ineffective manager.