Values and Culture in the Emergency Services
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by John Fisher
Introduction
Values and culture play a pivotal role in shaping the practices, attitudes, and effectiveness of emergency services. Whether addressing burnout, fostering inclusivity, or adapting to societal expectations, these elements are integral to the success of emergency service organizations. Drawing from the reflections of students in ESMG 3150: Principles of Management in the Emergency Services, this article explores key themes related to values and culture in the emergency services. The discussion provides valuable insights into how culture evolves, its impact on teams, and ways to foster positive change in high-stress environments.
Leadership’s Role in Shaping Culture
Leadership, particularly at the captain or company officer level, was a recurring theme in student discussions. Owen Nuttall highlighted the importance of leadership in creating a supportive environment, especially for probationary firefighters, noting, “The captain is the one who will ultimately make the biggest impact when it comes to these cultural changes.” Nuttall emphasized how positive leadership can replace outdated practices, like poor treatment of new recruits, with inclusive and growth-focused strategies.
This idea is supported by Cupp (2023), who discusses the need for intentional leadership to address cultural challenges, noting that “excuses are made in order to not deal with leadership challenges.” Effective leaders play a crucial role in fostering a culture of accountability and respect, ensuring that the treatment of personnel aligns with the values of the organization.
Cordell Martindale highlighted how leadership addresses toxic behaviors, sharing, “There is a culture of being treated rather poorly as a new guy for no real apparent reason... The captain of a crew sets the tone for how things go.” This sentiment aligns with Cupp’s (2023) argument that leaders must actively address cultural issues to prevent perpetuating harmful practices.
Isaac Zabriskie echoed this sentiment, emphasizing the importance of engaging long-standing team members resistant to change: “Captains or leaders can create a supportive and inclusive environment for new recruits, which can break cycles of negativity that might otherwise persist.” Encouraging seasoned members to embrace change fosters a culture of mutual respect and growth.
Addressing Burnout and Promoting Resilience
The impact of departmental culture on burnout was a prominent topic. Heston Warr compared urban and rural EMS departments, explaining, “In busy urban departments, there’s often an unspoken expectation to handle as many calls as possible without breaks, which leaves responders mentally and physically drained.” In contrast, rural departments often emphasize community connection, which can buffer against burnout but introduces unique stressors, such as longer response times.
Research supports these observations. According to Maslach and Leiter (2016), burnout is closely tied to workplace culture, with high workloads and a lack of personal connection contributing significantly to emotional exhaustion and depersonalization.
Elliot Rood added another layer, discussing how guilt and shame affect EMS providers and how cultural shifts toward open communication can mitigate these emotions. He cited Hoff et al. (2022), which found that “Recovery and resilience varied but tended to be positively associated with a culture in which sharing with colleagues was encouraged.” By prioritizing interpersonal coping mechanisms, agencies can promote emotional resilience among their teams.
Safety Culture and Its Connection to Values
Safety culture was another critical focus. Isaac Zabriskie referenced research by Weaver et al. (2012), explaining that “agencies with a strong safety culture tied with mutual respect, open communication, and teamwork can significantly reduce the incidence of workplace injuries and medical errors.” A culture of safety not only protects responders but also enhances patient care.
Similarly, Jamis McPheeters noted the importance of After Action Reviews (AARs) in wildland firefighting, stating, “AARs allow for fighters to openly discuss the day’s operations, point out flaws, and suggest improvements.” This practice fosters a culture of continuous learning and improvement while reinforcing safety values. Research by Gibbons et al. (2014) also highlights the importance of structured debriefings like AARs in improving safety outcomes and team dynamics in high-stakes environments.
Inclusivity and Cultural Sensitivity
The importance of inclusivity and cultural sensitivity in emergency services was another significant theme. Gabe Johnson highlighted how fire departments can strengthen relationships with diverse communities through initiatives like bilingual staff and cultural training. He stated, “When firefighters know about things like language barriers, traditions, or health beliefs, they can respond better in emergencies.”
This aligns with Padela and Punekar (2009), who emphasize the importance of cultural competence in improving patient outcomes and trust in emergency services. They propose actionable strategies such as increasing cultural awareness, accommodating patient preferences, and promoting workforce diversity.
Tiffany Martineau emphasized the value of structured volunteer groups in building trust and resilience. “Untrained, spontaneous volunteers can unintentionally disrupt efforts, but if emergency services work with the community to set up structured volunteer groups, it creates a valuable resource,” she explained. This is supported by Elkady et al. (2022), who highlight the role of structured community involvement in disaster response, noting that well-coordinated volunteer groups enhance operational efficiency and resilience.
Heston Warr reinforced this, sharing, “In rural EMS departments, there’s typically a strong value placed on personal connection and patient care, which fosters a sense of purpose and satisfaction.”
Preston Draney emphasized the importance of cultural competence in emergency medical services (EMS) for improving patient outcomes. He referenced a three-step framework that includes increasing cultural awareness, accommodating patient preferences, and promoting workforce diversity. He highlighted how cultural misunderstandings can lead to poor outcomes, such as delayed treatment.
Adapting to Societal Expectations
Jaxon Tubbs explored how social movements, such as police reform, influence organizational culture. He reflected, “Prior to recent events, police officers were fiercely loyal to one another... Since there has been a greater push for holding officers accountable, we have seen officers become more accountable to the public and also to each other.”
Ashley Evans focused on how law enforcement can align practices with community values to build trust. She highlighted the need for transparency, collaboration, and culturally sensitive approaches, such as social media engagement, to foster stronger community relationships. Ashley noted how varying cultural expectations influence interactions between law enforcement and the public, advocating for strategies tailored to specific community needs.
Avsec (2013) supports this perspective, arguing that storytelling and reflection on historical events shape the culture of emergency services, while accountability and transparency build public trust. These principles are essential in responding to societal demands for reform and maintaining legitimacy.
Balancing Risk and Duty
Wildland firefighting exemplifies the cultural tension between risk-taking and safety. Jamis McPheeters reflected, “Our ‘can do’ attitudes sometimes get us in trouble, creating very aggressive suppression tactics and strategies.” This mindset, while rooted in bravery and duty, must be balanced with safety protocols to protect personnel.
Christian Mangum added a broader perspective, comparing urban and rural firefighting cultures: “Urban departments prioritize structured hierarchy and specialized training, while rural stations emphasize broader community ties and mental well-being.” This diversity of approaches highlights how culture adapts to operational contexts.
Conclusion
Enduring symbols, storytelling, and traditions play a vital role in shaping the culture of emergency services, according to Brian MacLeod. For example, he observed a significant shift in the fire service, moving away from outdated practices like valuing dirty gear as a badge of honor, toward prioritizing firefighter safety and addressing persistent issues such as racism and sexism within the industry. MacLeod emphasized that strong leadership is essential for fostering positive cultural changes.
The discussions in ESMG 3150 reveal the multifaceted nature of values and culture in emergency services. Leadership, safety, resilience, inclusivity, and adaptability are all interconnected elements that shape the effectiveness and morale of emergency service teams. As societal expectations evolve and challenges grow, embracing positive cultural shifts will remain essential for building trust, fostering resilience, and delivering compassionate care. These insights from future leaders in the field offer a blueprint for navigating the complexities of culture in emergency services.
References
- Avsec, R. (2013, December 6). What is the Fire Service Culture? Fire & EMS Leader Pro. Retrieved from https://www.fireemsleaderpro.org/2013/12/06/what-is-the-fire-service-culture/
- Cupp, D. (2023, April 20). The fire department cultural change evolution. FireRescue1. Retrieved from https://www.firerescue1.com/leadership/articles/the-fire-department-cultural-change-evolution-YpzI8wTkoyAEzNal/
- Elkady, S., Hernantes, J., Muñoz, M., & Labaka, L. (2022). What do emergency services and authorities need from society to better handle disasters? International Journal of Disaster Risk Reduction. https://www.sciencedirect.com/science/article/pii/S2212420922000838
- Gibbons, S., Ross, A., & De Villiers, T. (2014). Debriefing as a clinical teaching strategy in nursing education. Curationis, 37(1). https://doi.org/10.4102/curationis.v37i1.1259
- Hoff, J. J., et al. (2022, May). Shame and guilt in EMS: A qualitative analysis of culture and attitudes in prehospital emergency care. Prehospital Emergency Care. https://pubmed.ncbi.nlm.nih.gov/35522078/
- Maslach, C., & Leiter, M. P. (2016). Understanding the burnout experience: Recent research and its implications for psychiatry. World Psychiatry, 15(2), 103–111.
- Padela, A. I., & Punekar, I. R. A. (2009). Emergency medical practice: Advancing cultural competence and reducing health care disparities. Academic Emergency Medicine, 16(1), 69–75. https://doi.org/10.1111/j.1553-2712.2008.00305.x
- Weaver, M. D., Wang, H. E., Fairbanks, R. J., & Patterson, D. (2012). The association between EMS workplace safety culture and safety outcomes. Prehospital Emergency Care, 16(1), 43–52. https://doi.org/10.3109/10903127.2011.614048
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This story was partially written with assistance from OpenAI's ChatGPT (Version 4).
