Being that leadership is a journey and should evolve constantly, it’s important not that you make mistakes (because you most certainly will), but that you learn and grow from those experiences.  With that in mind, I would like to tell you about some lessons I learned about leadership from way back in the day when I was a young paramedic.  It made me realize how much is expected from those in leadership and how little training is received before you’re placed in those positions.  Here’s the run:

I was a young paramedic full of piss and vinegar with a burning desire to save the world, all the while not having a clue how to save anything and with not enough experience to know my limitations.  We had a run just outside of town, on a four lane stretch of highway that was unlit.  It was also dark at the time.  I was sitting in the lead paramedic seat (yes I know I shouldn’t have been, due to my lack of experience, but that’s how it was done back then), and the call was for an auto accident with injuries.  Also because we were outside of town, we had another fire department assisting us, but we knew from experience that we would be the first EMS unit on scene. 

On our arrival, the scene was quite chaotic as it usually is.  We were met by a cop who was almost uncomprehendable and he literally dragged us to the front seat to witness an unbelievable sight.  What we worked out later was that a semi truck with a flatbed trailer whose lights were not working, had backed out into the highway.  An auto traveling at 55 mph or more never saw that trailer and hit it head on.  No one in the auto was buckled up.

After the initial impact the front passenger door flew open and a 15 year old boy started sliding out the door.  Tragically, the auto then turned into that door and the boy was caught between the door and the door frame.  He popped like a raw egg, ripping open his chest and face and blowing off the top of his skull.   I had never seen anything as repelling and fascinating at the same time as that sight and I just stood there as mesmerized and useless as the cop.  Luckily my partner came to his senses quickly and searched the car.  There was no sign of the driver (who later was found up the highway with a concussion and ultimately recovered fully, at least physically), but my partner found a seven year old girl with three open head wounds jammed down behind the drivers seat. 

By now the fire department, in whose jurisdiction we were in, had arrived and we extricated the patient and took her to the ambulance where we attempted to stabilize her.  During the course of that operation, a couple of the fire department personnel, who had only recently joined up, kept coming to the back of the ambulance, opening the door (against all protocol) and with stunned and blank looks on their faces, they kept  placing pieces of the boys skull that they had found on the floor.  I must ashamedly confess to yelling and threatening them in no uncertain terms and finally screaming at the cop to make them stop (these two individuals must have quit the department that night or shortly thereafter as I never saw them again).  We did manage to stabilize the little girl and took her to the hospital where, except for some expected short term memory loss, she left the hospital some weeks later relatively unscathed, again at least physically.  

That run has stayed with me to this day for the leadership lessons that I learned from it.  We had been taught over and over to make sure the scene was safe (which I promptly forgot two seconds after we arrived), but no one had ever taught us to properly manage a scene and lead the people involved in it. 

So there you are.  Can you spot the mistakes made?  They are numerous and embarrassing but important to any leader’s evolution. Try not to focus on tragedy of the run itself as that was to illustrate that when we lose sight of the big picture or get distracted (and this run was a doozy), we can forget what our greater responsibilities are and we can forget that there is much more to be done than just take care of patients (though that still remains a high priority).  Let us know what you think!

Thank you for your response to our forum article.  It was both perceptive and articulate.  You obviously have a great deal of experience in this arena as well as the leadership arena.  You hit most of the nails on the head.  It was apparent there were many more “victims” of this incident than were treated.  Initially, we should have realized that the scene was completely unsafe from many viewpoints (fire, EMS, and police) and we should have immediately called in second waves of assistance for all three.  After not fully securing the scene, the next huge mistake was not making sure of the number of victims.  The truck driver was unaccounted for, the driver of the auto was also unaccounted for and we had no idea of the number of passengers that either one of them was transporting.  We also did not set up a line of communication between the jurisdictions to eliminate duplication and to make sure all the details were covered.  And finally, as you so eloquently pointed out, this was a run that cried out for some type of debriefing.  Without it, we know we lost at least two people who at one time had been willing to join one of the “highest calling professions”.  Although this run was in the profession of “protective services”, the leadership decisions or in this case the lack of leadership decisions are transferable to all professions.  The biggest mistake made in leadership, without question, is in keeping your focus on what is important for the team and what the team is trying to accomplish and making sure that the decisions made benefit the majority and not just the decision maker.  Again, thanks Glenn, keep up the good work and let us know how things are going.