# Titles, respected or not?



## Aggressor (Jan 7, 2011)

Hi all,

I'm new to the forum and I am excited to find a group of fellow professionals like yourselves. A quick rundown on myself. Thirty seven, paramedic of fourteen years, employed all years at a private company that employs around four hundred field employees. 
I love my job, but like any other, sometimes I don't like where I do it. My title "aggressor", was meant to be ironic, since I don't do things to patients "just because I can". I'm aggressive when need be.

I have a question for all you folks. In the last few years, our company has developed titles for our field superiors, such as Lieutenants, Captains, etc.
I was enlisted in the military, and there, those titles mean something special.
It seems that all of our ALS field supervisors have the Lt. title, but there is one particular employee, whom is BLS, with less that one year experience, that was given that title, and does her best to enforce it, no matter to whom.

I firmly believe that respect is earned, not given away. However, I also obey my superiors, but it does not mean I respect them.

My question to you is, was giving this one employee, (doesn't matter that she is bls, there are quite a few that are quite good), was a good idea for the moral of the regular bls and als field providers?

Thanks, 

The aggressor


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## abckidsmom (Jan 7, 2011)

I have a really hard time with this.  I'm not military, and sort of stink at this stuff.  I act respectfully, but if people insist on being called by their title, I tend to avoid calling them anything.


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## usafmedic45 (Jan 7, 2011)

Just like the military, the respect goes with the rank.  Whether or not you respect the person is entirely separate.  Anyone who demands to be addressed by rank in EMS or fire is a tool in my book until proven otherwise.  I've held the ranks of lieutenant and captain.   I never made someone address as anything other than "Steve" unless they were in the"Why is the FBI and DEA here asking questions?" kind of trouble?.  Personally I detest being referred to as "sir".  

Actually, the trick to having good leadership presence is the ability to make fun of yourself and not to take yourself too seriously.  My family's heritage is German and I have been picking away at my bachelors in German for several years now.  A couple of my former colleagues thought it would be funny to switch the "EMS Supervisor" sign on my door with one that read "Rettungsfuehrer" (which is literally "EMS leader", although for obvious reasons that I shold not have to explain to anyone the word "Fuehrer" is not used much in that sense anymore).  I chuckled, pulled it off my door, walked into the break room and announced "Hey you jack***es, it's 'Rettungsdienstleider', try to get it right." and went and put the sign back up on my door.  I actually still have it somewhere.


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## Aerin-Sol (Jan 7, 2011)

I work for a private ambulance company as well and imo giving military-style ranks to managers in a private company is just a way for said managers to make themselves feel important.  A new manager who insisted on being called by his/her title would probably improve my morale because I would find it amusing, but if someone actually takes the titles seriously, I can see how that would drain morale.


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## WolfmanHarris (Jan 7, 2011)

Recently the EMS Chiefs of Canada have been pursuing a unified image for EMS in Canada. Part of that includes insignia and ranking systems. Part of changing our ranking system was to put our nomenclature more inline with allied agencies (particularly PD) as well creating a clearer image for the public of the roles of our management staff. As a result in my service titles changed like this:

Lead Paramedic = Paramedic Captain  (not really a management job, more non-supervisory leadership)
Supervisor = Superintendent
Program Manager = Commander
Manager = Deputy Chief
General Manager = Chief

The epaulettes also changed from stripes to a maple leaf system that closely follows those used by the Police Service.

As for addressing people, everyone here goes my first names. My Chief walks into a room and everyone calls him "Norm." Though in official/formal settings he has been referred to by his title.


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## usafmedic45 (Jan 7, 2011)

> My Chief walks into a room and everyone calls him "Norm."



Your service is hereby to referred to as "Cheers".


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## medicRob (Jan 7, 2011)

People who insist on being referred to as "Captain", "Lieutenant", "etc" are almost as annoying to me as people who insist on including, "ACLS, PALS, BLS, NRP, STABLE, PHTLS" at the end of their name on their name tags.


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## cmetalbend (Jan 7, 2011)

I agree with most, titles are useless. I do hate it tho being called JUST an EMT by a paramedic about half my age...:glare:


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## MrBrown (Jan 7, 2011)

We have various titles .... for example

Paramedic
Intensive Care Paramedic
Clinical Standards Officer
Operations Team Leader
Operations Team Manager
District Operations Manager
Regional Medical Advisor 

However these denote various sub-specilisations within the ambulance service.  There is no rank per-se in asmuch as a military style, we used to have it but this was removed several years ago/

There is a clinical structure (ie an Intensive Care Paramedic is more advanced than a Paramedic) and a management structure where a road based Paramedic is lower than the Operations Team Leader these are however not absolute boundaries.

For example the Regional Operations Manager of Auckland Metro is clinically lower qualified than an Intensive Care Paramedic however is higher in management structure than that ICP.


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## 46Young (Jan 8, 2011)

You could just pass a remark such as this: I personally find it pathetic that you need to pull rank everywhere you go, with the "call me Lieutenant" thing to make yourself feel important or whatever. No one's going to take you seriously if you keep up with this. You earn respect by your actions, not by pulling rank wherever you go. But, if you need to be addressed as "Lieutenant" to fill some void in your life, then so be it. 

Or, just call her Lieutanant Probie." She still has less than a year on the job, after all. If she wants to do the whole paramilitary rank thing, then she needs to first go through the probie year before earning any measure of respect. I'm sure when it comes down to it, the company isn't going to screw with an experienced, mature CCEMT-P, and side with a fairly brand new basic.

Tell her that you can't take someone seriously when they have less than one year's experience, and are also of a much lower level of medical certification.

This sounds a lot like the company I work for part time. All you need to be promoted to Lt is a year on the job, and the intent to upgrade to EMT-I or P within a year.

If you prefer instead to be non-confrontational, then just call her ma'am, no matter what she insists on. You're not technically wrong since you're addressing her in a respectful manner. Ask her to show you the S.O.P that requires you to address her solely by rank.


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## usafmedic45 (Jan 8, 2011)

cmetalbend said:


> I agree with most, titles are useless. I do hate it tho being called JUST an EMT by a paramedic about half my age...:glare:



Quite frankly, given the low education level associated with EMTs, I would not expect much more until you have proven yourself.  That said, if he's just being a jerk after you've worked with him for a while (and everyone else thinks you're a sharp provider), then he's just a jerk and should be ignored.


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## LuvGlock (Jan 8, 2011)

usafmedic45 said:


> Your service is hereby to referred to as "Cheers".



Priceless!


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## Veneficus (Jan 8, 2011)

Aggressor said:


> Hi all,
> 
> I'm new to the forum and I am excited to find a group of fellow professionals like yourselves. A quick rundown on myself. Thirty seven, paramedic of fourteen years, employed all years at a private company that employs around four hundred field employees.
> I love my job, but like any other, sometimes I don't like where I do it. My title "aggressor", was meant to be ironic, since I don't do things to patients "just because I can". I'm aggressive when need be.
> ...



I am guessing it wasn't so much for morale but so the BLS providers could be represented in the leadership. 

Somebody with some authority or influence that the BLS staff could go to and raise concerns from their perspective and not feel like they are being marginalized by the ALS staff.

I don't think the isse is the title, so mch as the person doesn't understand the difference between being given a title and earning it in the eyes of those whom he seeks to lead.

There is a big difference between a higher ranking officer and a superior one.


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## Aggressor (Jan 8, 2011)

Thank you all for your valuable and sincere replies. It always helps to gain insight outside the company or service area.  I from now on am addicted to this forum and it's advice.


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## Veneficus (Jan 8, 2011)

Aggressor said:


> Thank you all for your valuable and sincere replies. It always helps to gain insight outside the company or service area.  I from now on am addicted to this forum and it's advice.



just remember what you paid for it


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## DogPoundMedic (Jan 8, 2011)

I can see your issues, like everything else there is opinions, although I get called EMT all the time since everyone else is a basic EMT where I work at and me being the only paramedic. With my line of work nobody knows what the difference is, and probably does not care either that is real upsetting


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## JJR512 (Jan 8, 2011)

A person's title does not have any effect on how much I do (or don't) respect that person. Whether a jerk calls himself a Manager, Supervisor, Bossman, The Big Cheese, The Head Honcho, Captain, Chief, Grand Poobah Overlord, President, Chief Executive Officer, Great God of EMS, or Master Leader doesn't make any difference to me; he's still a jerk, and will be respected as little as any other jerk deserves.


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## MrBrown (Jan 8, 2011)

JJR512 said:


> A person's title does not have any effect on how much I do (or don't) respect that person. Whether a jerk calls himself a Manager, Supervisor, Bossman, The Big Cheese, The Head Honcho, Captain, Chief, Grand Poobah Overlord, President, Chief Executive Officer, Great God of EMS, or Master Leader doesn't make any difference to me; he's still a jerk, and will be respected as little as any other jerk deserves.



Brown agrees .... except for Cardiac Rescue Technicians in the state of Maryland, damn thats an awesome title!


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## JJR512 (Jan 8, 2011)

MrBrown said:


> Brown agrees .... except for Cardiac Rescue Technicians in the state of Maryland, damn thats an awesome title!



Well...you got me there... Yeah it actually does sound more awesome than even Paramedic. "Who is that?" "Oh, he's just a paramedic. But see that guy over there? HE is a _Cardiac Rescue Technician!_" LOL


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## Fish (Jan 8, 2011)

Our system has lt.s capt. cmdrs, etc. Each of these have earned their respect and titles, and are constantly being sent to leadership courses to better themselves as leaders. They do a great job of not micromanaging us and concentrating on the operational aspect of the shift.


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## clibb (Jan 9, 2011)

The only title that has any say to me is "Doctor".


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## Veneficus (Jan 9, 2011)

Fish said:


> Our system has lt.s capt. cmdrs, etc. Each of these have earned their respect and titles, and are constantly being sent to leadership courses to better themselves as leaders. They do a great job of not micromanaging us and concentrating on the operational aspect of the shift.



redacted, sorry, read it wrong. I am going to have some coffee now.


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## cmetalbend (Jan 9, 2011)

clibb said:


> The only title that has any say to me is "Doctor".



My wife calls me "Dr.Love" but it's not certified though. LOL


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## DrParasite (Jan 9, 2011)

usafmedic45 said:


> Quite frankly, given the low education level associated with EMTs, I would not expect much more until you have proven yourself.


Funny, I feel the same way about paramedics, resp therapists, nurses, and a doctor or two.

Clinically, an EMT's education is less that all of the above titles.  However, if an EMT has an MBA, ran a successful business for 10 years, and decided to change careers and get into EMS, would he be a poor leader?

Contrary to the belief of some providers on here, just because a person is an EMT doesn't mean they are a poor leader, no more than if a person is a paramedic means they will be a great leader.

Operationally, an EMT's education has no impact on leadership ability.  What other education does he or she have besides the initial EMT certification?  5 years in the business, a college education, management courses, supervisory experience prior to EMS career, add this to an EMT certification and you might have a good supervisory EMT for an EMS system.

But in order to understand that, you need to get over your bias that only paramedics should be in EMS systems and EMTs have no place in this world.


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## JPINFV (Jan 9, 2011)

DrParasite said:


> Clinically, an EMT's education is less that all of the above titles.  However, if an EMT has an MBA, ran a successful business for 10 years, and decided to change careers and get into EMS, would he be a poor leader?
> 
> Contrary to the belief of some providers on here, just because a person is an EMT doesn't mean they are a poor leader, no more than if a person is a paramedic means they will be a great leader.


It depends on what the person is leading. Take an MCI for an example (MCIs are good because of how many leaders there are needed on scene). Should an EMT be leading the medical branch over a paramedic? Not just "no," but since the medical branch leader is helping to evaluate patients and make clinical decisions, an unqualified, "Hell no." 

Could an EMT be leading the transport branch over a paramedic? Sure, why not. This branch is more logisitic than clinically orientated. 

In regular practice, can an EMT supervise paramedics? Sure, provided the it's not clinical oversight. A supervisor who is an EMT is not unqualified to make sure that station duties are performed and people are conducting themselves properly. However, the same supervisor is not appropriate to, for example, determine the legitimacy of a paramedic's destination decision or other treatment and transport issues of a clinical nature.  




> But in order to understand that, you need to get over your bias that only paramedics should be in EMS systems and EMTs have no place in this world.



To change this point a bit, there's too much short man syndrome in EMS period, be it at the paramedic or EMT level.


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