Understanding paramedic attrition: A scoping review exploring why paramedics are leaving the profession

Area of Science:

• Emergency Medical Services
• Health Workforce Research
• Occupational Psychology

Background:

• Increasing paramedic attrition rates worldwide pose challenges to healthcare systems.
• Experienced paramedics are crucial for patient outcomes and cost-effective operations.
• Existing research often conflates leaving employment with leaving the profession, necessitating a clearer distinction.

Purpose of the Study:

• To identify key factors influencing paramedics' decisions to leave the profession entirely.
• To distinguish between leaving employment and leaving the profession.
• To highlight areas for future research in paramedic retention.

Main Methods:

• A comprehensive scoping review of relevant literature was conducted.
• 1026 articles were screened, with 28 included in the final analysis.
• Content analysis was used to identify themes and subthemes related to attrition.

Main Results:

• Paramedic attrition is influenced by a complex interplay of organizational, occupational, and personal factors.
• Three main themes and 14 subthemes were identified as drivers of attrition.
• The findings underscore the need for distinct retention strategies based on reasons for leaving.

Conclusions:

• Paramedic attrition is a multifaceted issue requiring tailored interventions.
• Further research, particularly from diverse international contexts, is essential.
• Understanding the specific drivers of attrition is key to developing effective retention strategies.