Understanding & Embracing the Multigenerational Workforce

The EMS workforce isn’t representative of the workforce in the United States. The EMS workforce has younger workers and more white males than the overall workforce of the U.S.1 Understanding the characteristics of this workforce, and how to effectively engage it, is crucial to leading a successful organization. In this article, we’ll explore how to recruit, retain, and engage the multigenerational workforce.

Generations, and their associated characteristics, have been a hot topic among both researchers and the popular media. Before we provide an overview of generational characteristics, we must first acknowledge that these are overall trends, and not indicative of every individual within a cohort. 

In the same way that clinical protocols are guidelines–not a substitute for good clinical judgement–an understanding of generational characteristics is an aide to EMS leaders, not a substitute for sound leadership principles and proven experience.

There are currently four generations in the EMS workforce: Boomers (aka “Baby Boomers”), Generation X, Millennials, and a generation yet to receive a name, but sometimes referred to as “post-Millennials.”

Boomers are currently aged 54—72 (i.e., born between 1946—1964); Generation X are currently aged 38—53 (i.e., born between 1965—1980); Millennials are currently aged 22—37 (i.e., born between 1981-1996); and post-millennials are 21 and younger (born 1997 and after).2

Although Millennials receive a lot of attention in today’s media, we have an additional generation of younger individuals, aged 21 years and younger, also within our workforce.


Boomers are known for their work ethic, and it’s well-earned. They grew up in a post-World War II America, when industry was booming, and the economy was expanding. They found loyalty to an employer rewarded and promises by society fulfilled. The politicians of their youth were reputable role models. 

The block grant funding for the development of EMS systems was provided during their youth and the TV show Emergency! aired when they were teenagers and young adults. The Boomers value experience, and many of the Boomers in our industry have been rewarded for loyalty and hard work by serving as our current managers or respected elders.

Generation X

Generation X is known for being skeptical, and who can blame them? They saw their parents work hard and get rewarded, yet they can’t seem to get the same deal. Some of them remember the president resigning from office in disgrace, and others have had their faith in government eroded by a declining economy. 

They’ve seen their jobs outsourced and have a deep skepticism of their employers. They’re willing to work a full 40 hours, but they expect to balance work and life. They think productivity and accomplishment are grounds for promotion, not seniority alone. They, too, are frequently in management positions within our industry.


Millennials are often stereotyped as being entitled. This probably isn’t fair, but it’s certainly the perception. They often had doting parents who provided opportunities for them. They participated in sports and received a trophy for participation. 

The economy was mostly great until 2008, and older Millennials remember the tech boom of the late 90s. Politicians got into trouble, but it wasn’t as much of a surprise. They remember 9/11 and it affected them in some way.

Millennials view their work as an extension of themselves; they need it to align with their values and their lifestyle. They value teamwork and collaboration. Older Millennials are now found in leadership positions within the EMS industry.


Post-millennials, those born between 1997 and now, haven’t received a generational name yet. They’re in the workforce, though, since they’re currently aged 18—21. In time, they too will be studied and generalized, as the generations before them have. 

All we know for certain about them is that, though Millennials may remember the widespread proliferation of the internet, post-Millennials have grown up with high-speed internet and mobile devices as a given. They grew up in a time of ongoing war and economic instability. Time will tell how these early life experiences have affected them.  


Although a competent leader must understand all generations within the workforce, Millennials are the most common generation currently within the EMS workforce, so leaders should make a special effort to learn how to engage them.

The argument for engaging employees is based on economics, in addition to philosophy, since orienting new employees is costly. Once you understand Millennials and how to engage with them, you’ll likely find them to be some of the most loyal, resourceful and beneficial members of your organization.  

Boomers view the paycheck and continued employment as a sign of a job well done, even if nothing is ever said.  Generation Xers view the paycheck as fair compensation for acceptable work and are content to have the job, so compliments mean little. Millennials think the money is “cool,” but they really want you to acknowledge the value they have contributed to the team, and if you don’t then they’ll find another team. Millennials thrive on feedback; you don’t provide it to them, or they’ll seek it elsewhere.

Team Culture

Millennials enjoy being part of a team. If your organization supports a culture of teamwork, then you’ll likely have better luck retaining millennial employees. One strategy for building a teamwork culture is to pair together partners who enjoy working together. 

For Millennials, who they work with may be as important as when they work. A weekend shift with a good partner can become a valued tradition. Consider allowing partners to buddy-bid on shifts so providers can team with those they work best with. There’s published evidence that suggests working with a familiar EMS partner reduces the likelihood of work-related injuries.3


Millennials are the most educated generation in the workforce. It’s increasingly common for members of the Millennial EMS workforce to have college degrees. Although this education may ultimately lead some to leave the profession for other pursuits, there’s an opportunity to harness this valuable human capital. 

Since millennials are ambitious and value career development, EMS leaders should use them for what they can offer. Do you have a special project you haven’t yet had the time to tackle? Is there an issue in your organization you haven’t been able to devote your attention to yet? Assign it to an ambitious millennial or a team of millennials. This creates an opportunity for your employees to develop their skills, while also benefiting the organization beyond performing their typical duties.


EMS leaders should mentor their most promising employees; it anchors them within your organization and pays dividends in the years to come. All future leaders need to gain experience somewhere; by providing mentorship to the next generation of the EMS workforce, you’ll increase loyalty to both your organization, and to you as an individual leader. The benefit may not be immediately apparent, but in the long term, a forward-thinking leader may find they have cultivated many great leaders within the profession.


The workforce is a multigenerational entity. Successful leaders must understand the reality they work in and develop strategies to increase their success. Understanding generational differences can improve morale and employee engagement, and, by decreasing turnover, can reduce operational costs. Strategies to improve engagement also provide benefits to the organization by improving operational and clinical performance. 

Ultimately, the workforce is a diverse place. Leaders who can’t manage diversity will be replaced by those who can.


1. Schafer K, Sutter R, Gibbons S. (Aug. 6, 2015.) Characteristics of individuals and employment among first responders. U.S. Department of Labor. Retrieved May 21, 201, from www.dol.gov/asp/evaluation/analytics-reports/CharacteristicsOfIndividualsAndEmploymentAmongFirstResponders.pdf.

2. Millennials. (n.d.) Pew Research Center. Retrieved May 21, 2018, from www.pewresearch.org/topics/millennials/.

3. Patterson PD, Weaver MD, Landsittel DP, et al. Teammate familiarity and risk of injury in emergency medical services. Emerg Med J. 2016;33(4):280—285.


  • Sean J. Britton, MPA, NRP, is an EMS practitioner, educator and administrator. He's a paramedic with Superior Ambulance Service in Binghamton, N.Y., a board member of the NAEMT, and an adjunct assistant professor of epidemiology and community health at New York Medical College. Contact him at"¯ sean.justin.britton@gmail.com .

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