Why do Emergency Medical Services (EMS) Professionals Leave EMS?

Abstract

Objective: The objective was to determine why Emergency Medical Technician (EMT)-Basics and Paramedics leave the Emergency Medical Services (EMS) workforce. Methods: Data were collected through annual surveys of nationally registered EMT-Basics and Paramedics from 1999 to 2008. Survey items dealing with satisfaction with the EMS profession, likelihood of leaving the profession, and likelihood of leaving their EMS job were assessed for both EMT-Basics and Paramedics, along with reasons for leaving the profession. Individuals whose responses indicated that they were not working in EMS were mailed a special exit survey to determine the reasons for leaving EMS. Results: The likelihood of leaving the profession in the next year was low for both EMT-Basics and Paramedics. Although overall satisfaction levels with the profession were high, EMT-Basics were significantly more satisfied than Paramedics. The most important reasons for leaving the profession were choosing to pursue further education and moving to a new location. A desire for better pay and benefits was a significantly more important reason for EMT-Paramedics' exit decisions than for EMT-Basics. Conclusions: Given the anticipated increased demand for EMS professionals in the next decade, continued study of issues associated with retention is strongly recommended. Some specific recommendations and suggestions for promoting retention are provided. IntroductionRetention is an ongoing and important issue for the Emergency Medical Services (EMS) workforce.1 The costs of replacing EMS professionals include recruitment, selection, and training, as well as "lost productivity" as new EMS professionals catch up to the performance levels of experienced professionals leaving EMS.2 The demand for additional EMS workers is expected to increase in the future. The Bureau of Labor Statistics (BLS; Washington, DC USA) projects a need for an additional 62,000 Emergency Medical Technician (EMT)-Basics and Paramedics in the next decade to fill new jobs and replace workers who leave the profession.3 Given this projected demand, studying why EMTBasics and Paramedics leave EMS is important, and is the goal of this paper.General work psychology research has long-acknowledged five types of distinct interrole work transitions: entry (into the workforce); intracompany (transfer); intercompany (leave organization but remain in profession); interprofession (leave profession); and exit (leave workforce). 4 Patterson et al 5 studied turnover and the cost of turnover by following a convenience sample of 40 EMS agencies over a 6-month period. Results showed a lowerthan-expected overall weighted mean annual job turnover rate of 10.7%, with slight variations depending on staff mix. Job turnover rate was measured by combining voluntary quits and involuntary terminations. It is not known if the job leavers also left the EMS profession. Research suggests that it is generally easier to leave one's job and stay in that profession than to leave one's job and profession due to the "sunk cost...

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