By Selena Letain
I had the opportunity to attend the Women of Paramedicine Leadership Summit in November 2019. The event was hosted by several inspiring and accomplished women presenters who spoke with passion about an array of notable topics. There was one quote in particular that resonated with me – own your privilege. These were words expressed by Paige Mason while presenting her study on Female Leadership in Paramedicine (FLiP), and speaking of her privileges in her career. After hearing this, I began to reflect on my career journey and the privileges that I have been afforded as a female paramedic now in a leadership position.
I have primarily worked in a busy urban centre for majority of my career. While it may not be obvious at 2:00 am or after your eighth call of the day, I do consider working as an urban paramedic a privilege with respect to mentoring and sponsorship opportunities. I work closely with paramedics of all provider levels, experience, and rank, and am considered an important member of the broader healthcare team by our hospital and community colleagues. I have been, and still am, encouraged to learn more and challenge myself regularly by my peers and leadership team. It is unlikely that I would have embarked upon many challenges without the ongoing support I have received from everyone as they saw the potential that was not visible to me.
My memory of working in a rural setting at the beginning of my career does not present the same prospect. There was very little support and no supervisors. My partners were often as new, if not newer, to the pre-hospital profession as myself. Paramedics were often viewed as “ambulance drivers” by nurses and physicians with little understanding of our role. Managers were typically service owners and viewed emergency medical services (EMS) as a business versus a valuable community health resource. Transfers to urban centres frequently yielded pitying looks and silence from the city crews.
Now, 20 years later, I have the privilege of serving my community, profession, and colleagues as a rural EMS manager. In my leadership role, I feel compelled to investigate whether the mindset of embracing mentoring and sponsorship has shifted and if access to these kinds of opportunities has improved. If not, what can be done to ensure equitable opportunity?
There is minimal literature that discusses or supports paramedicine mentoring and sponsorship and nothing that speaks directly to rural EMS. It is evident that more research is required in this area. Awareness surrounding the subject has improved over the years, but I do believe that opportunities for paramedics working in the rural setting continue to be fewer than those of their urban counterparts. I have my own theories on why this is, but the best source of information should come directly from paramedics working in the rural setting. I created an informal survey that was distributed to rural and remote services within Saskatchewan to gauge their understanding and experience with mentoring and sponsorship.
A total of 42 Emergency Medical Responders, Primary, Intermediate, and Advanced Care Paramedics from rural and remote Saskatchewan responded, 22 female and 20 male. Most had an accurate idea of the role of a mentor and their relationship with the mentee, but there was a misconception regarding sponsorship and the role it plays in the development and promotion of others.
Fifty seven percent of respondents state they had been mentored: 15 female, 9 male; and 38% had said they have never had a mentor: 6 female, 10 male; the remainder were unsure if they had been mentored. 14% of respondents state they have had a sponsor: 3 female, 3 male; and 74% state they have never been sponsored: 16 female, 15 male; the remainder were unsure. The numbers may be higher if sponsorship was clearly defined and understood.
There were varying reasons as to why respondents felt they had not had a mentor or sponsor, such as:
- high turnover rates
- senior employees do not want to mentor
- no financial compensation
- poor organizational morale
- rural areas are too spread out
- rural has too many transient employees
- no shared vision or goals
- frequently working alone or with another new employee
Of the 42 respondents, 34 expressed mentoring could help in a current role or project, with most seeking assistance in the areas of leadership development, workplace effectiveness, and clinical skills.
Despite the small sample size and informality of the survey, the majority of respondents expressed similar views on the lack of mentoring or sponsorship opportunities for rural paramedics and validated some of my theories. There are a few studies that discuss the barriers for mentorship in rural nursing, which could be applied to rural paramedicine as many of the challenges and concepts are comparable. These include complex environments, minimal staffing and resources, limited professional development opportunities, high turnover rates, psychological distress and emotional exhaustion (1).
Improving access to mentoring and sponsorship in rural areas requires a holistic approach, and is a responsibility of organizations, leadership teams, peers, and mentees. Mentoring has documented benefits for all contributing members of the mentorship experience (1,2), and can be a partial solution to challenges that persist in rural healthcare.
EMS organizations should develop and support formal rural mentorship programs. Data from nursing studies indicate that rural specific formal mentorship programs are effective and a crucial component in facilitating workplace transitions, strengthening community connections, and encouraging recruitment and retention to rural healthcare (1). The program should be developed through engagement from stakeholders in rural communities to ensure that any needs unique to rural paramedicine are met, with defined roles, responsibilities, objectives, and expectations.
With the challenges and priorities faced by EMS leadership teams, it is easy to overlook the importance of being a mentor to your team (3). Paramedics look to those in official leadership positions for direction and guidance. It is imperative to conduct yourself in the same manner you expect of your team and foster an environment of support and respect amongst each other. Equally important is identifying the individual strengths of members and encouraging them to grow while working with the organization to provide the tools necessary for ongoing development and advancement.
A challenge that can present to rural leadership teams is the geographic location of many rural services in relation to their managers or supervisors. The distance between a leader and their team can create barriers for effective communication when communication is an essential component to the success of a professional relationship. While it is impossible to replace the benefit of face to face communication, virtual meetings and other available technology is an option that allows for accessible and ongoing communication.
Paramedics or other industry peers who are not in official leadership roles need to be active participants in the mentoring and sponsorship of others. This is especially true in rural and remote settings where formal mentoring opportunities may not exist or are not as robust as urban systems. The leadership team relies on senior paramedics to provide that guidance. It is also important to understand that there are benefits to paramedics who take on the role of mentor. It enhances the opportunity to learn, grow and develop leadership skills while contributing to the development of others and improvements within the organization (3).
The mentee needs to assume responsibility for their self-improvement, growth and development (3). In doing so, mentees need to take the initiative to seek out a mentor, particularly in areas where formal mentoring programs do not exist. The mentee is partially accountable for the success of the mentoring relationship, and needs to be open and honest with their mentor from relationship onset regarding objectives, roles and expectations. Do not be afraid to express your wants and needs (4) and embrace all feedback provide.
Where a paramedic chooses to practice should not be a barrier to mentoring and sponsorship opportunities. While I have been fortunate in my experiences as an urban paramedic, the same opportunities are not always available for rural paramedics. More needs to be done to improve access to mentoring and sponsorship, and the responsibility requires an effort on behalf of organizations, industry leaders, paramedics, and mentees, as each participating member has opportunity for a positive outcome.
- Rohatinsky N, Cave J, Krauter. Establishing a mentorship program in rural workplaces: connection, communication, and support required [Internet]. Rural and Remote Health 2020; 20: 5640. Available from: https://doi.org/10.22605/RRH5640
- Barishansky RM. Professional development. Part 8: mentoring the next generation [Internet]. EMS magazine 2009; 38(10):93-4. Available from: https://www.emsworld.com/article/10320066/professional-development-part-8-mentoring-next-generation
- Brophy JR. Leadership Essentials for Emergency Medical Services. Sudbury: Jones and Bartlett Publishers; 2010. Chapter 7, Mentoring and Subordinate Development; p. 63-71. 4. Columbia University Medical Centre, Human Resources. Available from: https://www.cumc.columbia.edu/hr/learning-development/informal-mentoring-how-to