Dealing with difficult employees in EMS

CarolinaFireJournal - By Bradley Dean
By Bradley Dean
07/05/2011 -
Lennie has been working as an EMT-Paramedic for your EMS agency for about six months when you begin to notice some strange behavior. It seems as though lately he has been having communications difficulties with just about everyone around him. When you attempt to talk to him about it, he states that he likes being “independent,” “doing things his own way” and “never has problems with his coworkers, only the boss.” image

You have no real problems with his work product, or patient care, but as time goes on you are getting more and more frustrated with his general attitude. It also seems as though his favorite words are “I told you so,” and “this will never work ... why don’t you just listen to me?” Every day seems like a battle of wills and the rest of the staff feels the tension as well. You do not have a problem with any of the other employees who report to you, but you seem to be spending an inordinate amount of time managing this one employee.

What is happening? Did you make a bad hire and not see some of these interpersonal issues, communications or attitudes? Can his behavior be modified in any way? What do you do? Let us examine some real-world strategies and techniques to help you survive this challenging employment issue.


As difficult as it may sometimes seem, or be, always communicate with your employees in a professional, non-emotional manner, especially when confronting an employee — even if it means taking time to cool off. This can be done in person, in writing or via e-mail. Remember that communication is one of the most basic elements of any relationship. It is also an element that needs to be kept strong if there is to be a harmonious, or even tolerable, work environment. Learn how your employee communicates, and develop a communications style for the two of you. Realize that both of you might be saying the exact same thing in different ways. Be aware that communicating by e-mail will leave a permanent record of your interaction, which can both help and hurt you.

Put Yourself in the Employee’s Shoes

Is there a reason why your employee is acting or reacting in a certain way? Has this been verbalized to you, even in a subtle or understated manner? Take time to think about this. Does your employee think you are micromanaging him or her unnecessarily? Did he recently get a less-than-stellar performance review or evaluation? There are reasons why your employees act the way they do. It may be that they do not have a good overall organizational picture to understand where they fit in. It is your responsibility to explain what you expect of your employees, including appropriate behavior and attitudes.

Is it Me?

Sometimes, a good long look in the mirror is necessary as well. What if the problem is with you rather than the employee? Do other employees have similar problems with this employee or does it seem to be a problem only you have? Do you have this problem with all your staff or only this one person? Although it is easy to blame others and more difficult to reflect on ourselves, sometimes your own actions may be at the root of the problem. Do you bark orders? Are you less than understanding about commitments outside of the workplace, including those involving children and spouses? Think about the short- and long-term impact these actions can have on employees.

Shared Vision

Your employees need to know that all the changes you want to implement will be beneficial to the organization as a whole. When everyone has a working knowledge of future goals, current strategies and implementation plans, it not only gives you the ability to communicate better, but to understand where everyone is coming from in their approach. Realize that you might have different perspectives based on education, experience and personal interests. Knowing your employees’ perspectives and concerns will help you pitch your points in projects and ideas more effectively and also speak to theirs — thereby accomplishing both your goals. This is true whether you are dealing with implementing a new quality-improvement strategy, an updated training program or even upgrading CAD software.

Look Before You Leap

Never be afraid to ask difficult questions during an initial employee interview. Your interview questions should explore real-life situations where the interviewee has experienced conflict. A question such as “what is the biggest lesson you have learned in the past year?” is a start. Creampuff questions like “where do you see yourself in five years?” and “what is your biggest strength?” add little to an interview. Look at the candidate’s resume for “job jumping.” Also, try digging a little deeper in regard to what is said — as well as not said — on the resume. Finally, always check references — and do not be afraid to ask them real-life questions about the prospective employee.

Document, Document, Document

Documentation is key. Always keep copies of employee’s performance appraisals, letters of commendations, letters of complaint, etc. Also, keep contemporaneous notes of important issues that have been discussed, whether at meetings or otherwise. You should also keep track of your employees’ responses to inquiries, as well as all pertinent follow-ups. This way, you have got something to show, if and when an employee says, “I can’t believe I’m getting disciplined/suspended/fired/etc. — what did I do?” You will have plenty of documentation to show the pattern of unacceptable behavior. If need be, set up a daily worksheet to keep the employee on track with work accomplished, as well as future plans, including the attitude changes you require. Consult with your city, county, human resources or corporate attorney to ensure that you are proceeding in an above-board, legal manner. Remember that documentation works both ways, and may be subject to public-records requests.

Firing the Employee

The final step in this interpersonal chess game may be that you have to fire an employee. This should only come at the end of a solid paper trail that includes documentation of all the issues you experienced with him as well as his overall performance. Your human resources department or attorney should be able to tell you if your documentation is strong enough.


Many managers in EMS hope that they never see a situation like the one in this scenario, but it happens all too often. Not every employee will be as cooperative as you like; some will not communicate in the manner to which you are accustomed. Interpersonal interaction can be difficult at the best of times and you need to be aware of that fact as an EMS supervisor, manager, or chief officer. More important, you need to be familiar with the kinds of strategies that will help to lessen those difficulties.

Dean currently works as one of the Assistant Regional Emergency Response and Recovery Coordinator for the Triad Region of North Carolina through Wake Forest University Baptist Medical Center Trauma Department. He is a faculty member for the EMS Programs at Alamance Community College, a paramedic with Davidson County Emergency Services and a volunteer with Thomasville Rescue, and Holly Grove Fire Department.
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