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The Silver Tsunami & The Transition

An aging population.. We’ve heard it, we’ve talked about it, and many have said that we need to prepare for it, but yet, few steps have been taken as we enter this new era.

The Emergency Medical Service (EMS) workforce is experiencing a significant transition as baby boomer EMS providers retire without enough new providers stepping up to fill the void. And with no hard feelings towards this retiring group, this transition is being coined the “Silver Tsunami”. According to the 2020 National EMS Assessment, over 51% of all EMS professionals are over the age of 40 and will be leaving or retiring from the field in the coming years. This is the largest demographic group within EMS with decades of experience that we will lose as this trend continues.

The aging population of Emergency Medical Services providers retiring from the industry coupled with a new generation of providers transitioning into the industry creates a unique opportunity for EMS to re-evaluate how it trains, staffs, and uses its providers. While these problems seem daunting, there are solutions to help mitigate this problem and provide value to both new and veteran providers.

Understanding the Forest and How Big It Is

If you really try to grasp the sheer numbers of EMS providers who are preparing to retire from EMS in the next 5 to 10 years; it’s astounding. With just over 1,000,000 licensed EMS providers in the United States, our society needs to train and certify around 500,000 EMS professionals to simply maintain the number of providers just to keep the total number of providers from falling. This doesn’t even account for the increase of professionals that will be needed as 911 call volumes increase and as communities experience growth and need more assistance.

As call volumes increase, opioid and related epidemics still at a crisis level, the need for EMS continues to grow exponentially. As a community and as an industry, we need to look at specific goals and processes that will help with not only training replacement EMS professionals but offset the increased needs for more professionals. On a smaller scale, each year, our state needs to train at least 1,000 new EMS providers at a minimum. This doesn’t include providers who are moving up in certification level, only individuals new to EMS.

Silver Tsunami for Guidance & Support

In many cases, more experienced “EMS veterans” have worked for 30, 40, or 50 years. These individuals have decades worth of training, experience, and institutional knowledge which is lost when they leave the field. This loss is compounded by the challenges of an emerging generational gap between experienced EMS personnel and those who are just entering the

EMS workforce.

We can look to these EMS veterans for support and guidance. Seeking wisdom from those who understand our industry is crucial, but so is embracing the fact that EMS is continually changing and progressing; accepting that we can’t always ‘do it the way we have always done it.’

In addition, engaging these more experienced professionals right now is monumental towards positive change management. Whether you are an experienced EMS professional or newer to the field, having these conversations to get EMS veterans engaged in a conversation about succession planning, transitioning, and setting up your department for continued success should be the goal of every department. This succession planning and transition can be many years in the making. The goal is not to ‘push anyone out’ of the department but rather to seek thoughts and ideas from experienced outgoing staff in order to leave a department successful and prosperous. A ‘leave it better than you found it’ mentality.

All too often we hear that the director or chief has plans to retire in the next year to three years. So what is being done in the interim? It might be a difficult or an uncomfortable conversation, but it’s an important conversation that must be had to ensure that both outgoing and incoming staff voices can be heard; paving the way for the best decisions moving forward. It is also critical that these decisions are in the best interest of the community served. These conversations should include discussions about duties, transitioning management, and engaging new providers. There should be a baseline tasklist agenda at every meeting leading up to that individual’s departure or retirement. Retirees should be interested in leaving the department in the best shape possible, making sure that when they look to retire, everything has been transitioned, tasks continue to be checked off, and that others still within the department know exactly what their roles and responsibilities will be both during and after the transitional process.

What makes this time different?

This era is much different and challenging than any previous generation. This next generation of providers are coming in without the same experience and drive that previous generations had instilled in them. Decades ago, it was all about volunteering, being proud of supporting your community and engaged in helping others. While younger generations still want to support their community and definitely take pride in what they do day-to-day, it’s much different. These new providers have grown up with technology and have a different perspective on life than their predecessors. For the younger generation, they have not been focused on working stressful or strenuous jobs, and they hesitate working harder; especially if an employer doesn’t appreciate their extra efforts. This focus compounded with a stressful work-life balance, stressful economy and society, tends to make things so much more challenging.

EMS professionals are some of the best-kept secrets of the healthcare industry. If we can motivate our current generation of workers to stay and make the profession more appealing to future generations of providers, we can increase the workforce and make it easier for patients to receive quality care in their time of need. So how do we do just that?

How do we change now?

Motivate our current staff by giving them responsibility. Allow them to see the direct change they make when they are engaged. Albeit, not only paying and paying EMS professionals more is a driving force and factor towards getting more individuals into the workforce, it definitely is not the ONLY factor. The younger generations are driven by purpose, engagement, and by the feeling that they are making a difference. From millennials to Gen Z, these generations have been acclimated towards having a purpose that drives them. Departments can capitalize on purpose by trusting individuals with tasks, responsibilities, and looking at outcomes to drive motivation.

Tasking someone with inventory management and ordering supplies seems like a menial and boring job duty to be assigned, but it’s how we frame it and show them the outcome to create that purpose. Engaging this individual [and all members of the staff] to understand the department's budgeting and feeling responsible for making an impact on the department’s budget can show them how ordering supplies could help with recruiting people or paying individuals more. By having this staff member understand that watching the supply budget, looking for the best price or utilizing pricing contracts can help save the department money which could be used for other priorities internally, shows the importance of that role, that task, and how it can directly affect the rest of the department. Supply budgets may be a difficult example nowadays with increased pricing, but even more reason to make sure your department is utilizing the contracts available to them.

Other tasks such as vehicle cleaning, restocking, fundraiser management, social media, technology, or training management should be delegated out so those tasks are not falling on one individual’s shoulders. Let your staff know of available tasks and make an inquiry about who is interested in chairing those tasks. On the flip side, if you have an interest, it is important that you advocate for yourself and ask your service director or chief if you can help with or take over that task. Make them aware of your interest and also about any special skills or prior experience you have had that would make you a good fit for the project(s). Be ready to explain why they can trust you to complete the task correctly and in a timely manner.

Remember that it’s not just about delegating. It’s about challenging your team to see the connection, the importance, and the outcome of any given project. As a leader, you must be transparent with staff about how departmental decisions are made; including about how the budget is spent or how the department is run as a whole. This will instill confidence in your team; because it demonstrates that you trust them and believe in their ability to complete the task and succeed in the mission.

Communication, responsibility, delegation and trust will always be key foundational components to help encourage staff engagement, growth, a sense of belonging and ownership for young and old members alike. Just as we look to attract and retain the new generation, we should also be vigilant in collecting those of the jewels of wisdom mined by the labors of the veterans looking forward to their well-deserved retirement.

In conclusion, the ‘Silver Tsunami’ doesn’t have to be a disaster we drown in… it can be seen as fuel for the future of EMS.

Alan DeYoung is the Executive Director of the Wisconsin EMS Association (WEMSA). He started with the Wisconsin EMS Association back in 2018 as the Sales & Marketing Director. Alan holds a Masters in Strategic Marketing, Bachelors in Information Technology. His experience includes being a small business owner, working for startups, Fortune 100s, and non-profit organizations.

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