Emergency medical technicians (EMTs) are critical to outof-hospital care, but maintaining staff can be difficult. The study objective was to identify factors that contribute to recruitment and retention of EMTs and paramedics. Information was drawn from three focus groups of EMT-Basic, EMT-Intermediate, and EMT-Paramedic personnel recruited from participants at an annual conference. Thoughts and feelings of EMTs and paramedics were investigated using eight questions designed to explore entry into emergency medical services, what it is like to be an EMT or paramedic, and the EMT educational process. Data were analyzed at the group level for common themes using NVivo. For a majority of respondents, emergency medical services was not a primary career path. Most respondents entered the industry as an alternate or replacement for a nursing career or as a second career following military medic service. The majority of respondents believed the job was stressful yet rewarding, and although it negatively affected their personal lives, the occupation gave them a sense of accomplishment and belonging. Respondents expressed a preference for EMT education resulting in college credit or licensure versus professional certification. Job-related stress produced by numerous factors appears to be a likely contributor to low employee retention. Recruitment and retention efforts should address study findings, incorporating key findings into educational, evaluation, and job enhancement programs. J Allied Health 2005; 34:153-162.
EMERGENCY MEDICAL SERVICES (EMS) is a vital part of the health care continuum for victims of trauma or sudden debilitating illness. Like many allied health practitioners, emergency medical technicians (EMTs) form the front line of their service. The EMS workforce can often go unnoticed until called upon and thus receives little attention from the public on issues challenging the workforce on a day-to-day basis. An issue of particular significance to the EMS system and one that has received little public attention is recruitment and retention.
In 2001, state EMS directors from across the nation identified difficulties in recruiting and retaining EMS personnel.1 Barriers to recruitment and retention identified by the U.S. Fire Administration include inadequate emotional support after a critical incident, scheduling conflicts, family commitments, fear of disease spread, and excessive training requirements.2 Perceived patient abuse of the EMS system has also been identified as a contributor to low retention of EMTs.3 Although anecdotal evidence and small studies are available, a substantial literature exploring recruitment and retention of EMS personnel does not exist. Such literature, however, does exist in other areas of allied health, where the relationships between job stress and job satisfaction and job turnover in the workplace are well established.4-6
The study by Flanagan and Flanagan of correctional nurses, for example, identified a link between job stress and job satisfaction.5 As perceived stress increased among correctional nurses, reported job satisfaction declined.5 Other research has identified a relationship between job stress and job satisfaction with absenteeism, illness, productivity degradation, and turnover.4,6,7
Although research has yet to establish similar relationships in EMS, several EMT occupational factors have been identified as sources of high job stress and low job satisfaction.8-13 Boudreaux et al. found high levels of job-related stress among a sample of EMTs in Louisiana, linking high stress to patient care activities and demanding work schedules.9,10 According to other EMS researchers, job stress originates from numerous sources12,14,15 and has been shown to negatively affect employee attitudes and employee/management relationships.8,11 Job-related stress negatively affects the home life of EMTs and paramedics as well.8 One study of EMT burnout showed a decrease in employee morale as stress and burnout increased. …