Want to Help Fix EMS? Let Them Leave!

A headshot of Jonathon W. Jenkins.
Jonathon W. Jenkins

I was in my office at work recently when a I heard a soft knock on the open door. This was not a happy knock, but rather one that silently said, “I am going to ruin your day.” When I looked up, I found an exceptionally talented young paramedic who asked, “Do you have a minute?”

At this point I was quietly thinking, “This cannot be good,” but I said yes, poured him a cup of coffee, and asked what was on his mind. He took a deep breath, sighed, and said, “I am resigning at the end of the month.” There were a few seconds of silence as I processed what he had told me. In total transparency, I was not expecting it.

After a few seconds of silence, I asked him if I may inquire as to why. He informed me that he had accepted a position as a paramedic at a nearby agency, at which he would have a schedule more conducive to his family, increased clinical advancement opportunity and the ability to continue growing as a professional clinician and leader. A few more seconds of silence went by, and I smiled at him wishing him nothing but enthusiastic congratulations. It was at this time he said something that I will never forget:

As I was congratulating him, he looked at me and said, “… Aren’t you going to yell at me?”

When he said this, I thought I had misunderstood him, so I excused myself and asked him to repeat it, at which time he said, “Aren’t you going to yell at me for quitting and tell me what an awful mistake it is?” Unfortunately, he affirmed what I thought I had heard, and now I was even more perplexed. The only thing I could think to ask was, “Why on Earth would I yell at you?”

A few more seconds of silence passed, and he said to me, while holding back tears, “You are the only person who has congratulated me. Everyone I have notified thus far has berated and degraded me for leaving.” In this moment, I knew we had a major problem.

EMS recruitment and retention has been a hot topic within the industry for the last few years. We have spent countless hours, resources, and labor working to invent (and in some cases reinvent) ways to improve the appeal of EMS amongst potential recruits, and to create longevity for them once they are certified and functioning within the field. But how do we do this? If you ask me, we must fix our culture from the inside before we can appeal to anyone on the outside, and the first step to doing that is letting our best clinicians leave.

Now, I know what you are thinking, “If we let our best clinicians leave, we will be left with no one, or perhaps worse, the undesirables, who will never help us drive the industry forward.” Respectfully, I disagree. Allow me to explain why. Let’s use my colleague for example, we will call him “Rick.”

Rick began his journey with our agency about six years ago as an EMT. During the first three years of Rick’s tenure, he completed his baccalaureate degree at a local university as well as became certified as a paramedic. In the most recent three years of Rick’s tenure, he has worked as a paramedic, paramedic preceptor, field mentor for new employees, and held seats on various organizational committees. Rick has evolved into an outstanding and talented young paramedic serving our organization proudly.

However, as anyone does, Rick has reached a point in his career where he feels as though he needs to broaden his horizons and expand his knowledge and expertise into areas, he is unable to explore at our agency due to the logistical layout and service lines offered. Because of this, Rick has two choices:

  1. Remain stagnant in his development at our agency because it is easy.
  2. Cherish the time spent with our organization by valuing what he has learned and move on to continue growing as a clinical professional, which will help the EMS industry as a whole and our agency.

As a leader, I choose the latter. Now, with that said, don’t get me wrong, losing Rick hurts. But the way I see it, I was going to lose him anyway. I was either going to lose Rick to another EMS agency who will take over the task of developing him into an outstanding professional which ultimately betters the industry, or I was going to lose Rick to himself in the form of his performance and attitude within our organization due to stagnation, and risk him becoming a negative influence on the staff.

As EMS leaders, it is imperative that we support our staff when they are making decisions to assist in their betterment, personally and professionally. Certainly, we should not condone regression or lateral movements (in most cases), but when someone like Rick enters your office and says, “It’s time for me to move on,” we need to be their biggest cheerleader. Throughout our careers. we have all had individuals support and mentor us through difficult decisions. If we do not do the same for our subordinate staff, they will never have the opportunity to grow into the clinicians we know they can be.

As an EMS industry it is time that we stop looking for individuals to sign-up for a thirty-year career. If a “lifer” comes along, we should undoubtedly support them with pride and give them the longevity and opportunity needed to do so. But, when someone like Rick comes along who is using your EMS agency, and EMS as a whole, as a steppingstone to something else, that’s OK too!

Whether EMS is the steppingstone to nursing school, physician assistant school, medical school, another EMS agency, or otherwise we must foster these clinicians and help them be the best they can be during their time with us, as well as assisting them in achieving their endmost goal, which will ultimately leave them with a positive, lasting impression of EMS.

I would argue that these individuals who “leave” EMS, with a lasting positive impression, are not actually leaving EMS, but are transitioning to serve EMS differently. Those who move on to medical school with a positive impression of EMS go on to become medical directors, educators, and EMS advocates, which our industry desperately needs more of.

In Rick’s case, he is transitioning to another agency to better himself personally and professionally but is leaving our agency with a positive and thankful impression, which will allow him to remain a friend of the organization and continue to assist with education, knowledge sharing, and even employment referrals for those who are just starting out.

As an EMS industry, it is time that we change our culture from, “How dare you leave!” and “Aren’t you going to yell at me?” to, “I appreciate everything you have done here, how can I help you be successful in your next chapter?”

By being a positive promoter of change, continued education, development, advancement and work-life balance, we will begin to fix our retention problem. That will then ultimately fix our recruitment problem. So, if you want to be part of the solution, let them leave!

Author’s note: This manuscript and opinions therein are my own.

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