Thoughts on Managing Paramedics in a Remote Setting

Star of LifeIn 27 years working in EMS, I have had the opportunity to not only talk to multiple Managers/Supervisors of EMS personnel, but also to have spent several years being one of those Managers/Supervisors to varying degrees. A common theme that has been around since I started in this business is: Managing Paramedics is most closely related to “Herding Cats”. They are some of the most willful, opinionated, strongest type “A” personalities you will ever have the pleasure of working with. I say this with love as I am one of them.

Managing these great folks in an urban environment where they are working spread out over a large metropolitan area is challenging enough. Now take those same medics and send them 1000-3000 miles away to a remote camp in the middle of the Arctic Circle, or off to a foreign country and still endeavor to be an efficient and supportive Manager. It is a whole lot more challenging than being able to walk down the hall or even meet up at the local hospital to talk to and support your team members. In such remote environments, management becomes even more important than more traditional office/field environments, and calls for different or enhanced skills to effectively do the job and to facilitate providing the best care possible to the clients that we serve.


Effective CommunicationCommunicating is always the first key to success, but becomes even more critical in a remote working environment.

Do not assume that because your workforce is “remote”, that you will have less communication. In fact, the opposite is true.  Remote workers have the potential to feel isolated, may have difficulty in following SOP’s without direct supervision close by, or become unwilling to work in a “team” environment. I think these things are just human nature, only amplified for us medics.

Regular and consistent communication with remote medics can help to counteract these things. It is not all that difficult to accomplish in this “technical age” with various and easy ways to communicate. For example, Email, text, phone, fax, Facebook messenger, and countless other ways that this technologically challenged medic has probably not even heard of.

Be aware, however, that electronic communication does not include voice inflection, facial expressions, etc., that a face to face communication has. Just be aware of this when using humor in these forms of communications, as it may not come across the same in an email as it would in person. This is just something for you to think about. I am guilty frequently of this, by the way.

It is also even more important for Managers to be more accessible to remote medics in the field. Be more flexible with your time to help alleviate some of the “feelings of isolation” issues that invariably arise. Remote managers need to make sure they are accessible to their employees by multiple avenues, and also flexible with their time within reason. More so than in normal “EMS” circumstances.

Create a “Team” atmosphere

Being part of the team increases morale, motivation, job satisfaction, and creates company success for all.

As a manager, it is important to always be focused on maintaining a “team” environment for all staff members. This works best by communication as mentioned above. Also, at every opportunity that presents itself, get together as a group, even if it has nothing to do with work. Have dinner and/or drinks; find off work interests/activities that you can do as a group whenever possible.


Good Managers respect their medics and foster respect from them as well. They have “been there, done that” and should know what the job entails and keep this in mind as a team leader. If you haven’t “walked a mile in those shoes”, it’s hard to lead by example. Do not fall into the “do as I say, not as I do” mentality. Trust your medics to do the job, unless proven otherwise. It is how you expect to be treated and they deserve nothing less.


TrainingTraining for remote medics is critical for success. Not so much in medical skills but in company SOP’s and procedures. You have already vetted them medically as a part of the hiring process. Sending them to remote locations to fulfill their duties, however, requires attention to detail in company training and in preparing them for success particularly the medics with limited or no experience in working in the remote arena. Set them up for success, not failure!

Initial training should always be conducted face to face, and whenever possible, should include currently working remote medics. They will be able to provide insights to the job that may “slip your mind”.

Regular training meetings should also be scheduled. This also provides time for “team building”, disseminating company information, and getting feedback from field medics outside the normal day to day communications.


Conflicts are inevitable in all aspects of life. On the remote job site, theses can become even more of a problem. Resolving these issues also becomes more time consuming and difficult due to remoteness. But it is important to try to resolve these issues as soon as possible instead of waiting for a more convenient time to avoid the problem escalating on the job site and causing harm to the business relationship with the client as well as detriment to the remote medic’s wellbeing in the job.

Again, building relationships among the team outside of work and regular communication efforts help to resolve these issues before they arise.


burnoutBurnout is a common problem in EMS as a general rule, but can most assuredly be worse in the remote setting. Long periods away from family and friends will take a toll on the remote medic.

While it is always important to keep open the lines of communication, and to be cognizant of employees’ mood and demeanor, it becomes even more important in the remote setting. Be acutely aware of signs of burnout and be prepared to do a crew change out if need be and offer any support you can to avoid burnout. Happy medics make for a happy and successful company for all!

Thanks for reading the thoughts (ravings) of an old medic. Be safe out there.


By Sean Brooks, MICP, NRP