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

Over the past decade, health care and ambulance organisations worldwide have reported increasing paramedic attrition rates, with many of these leavers exiting the profession entirely. Retaining experienced paramedics is necessary to improve patient outcomes, decreasing onboarding costs, and to continue the progression of the profession. Understanding paramedic attrition has gained more interest in the literature; however, studies have mainly focussed on paramedics leaving their place of employment rather than the profession altogether. It is important that this distinction is made as the influencing factors likely vary, requiring different retention strategies. This scoping review aimed to determine the main factors influencing paramedics to leave the profession and identify areas for further research. A total of 1026 articles were screened, of which 28 were included in the final review. Content analysis of their key findings led to the identification of three main themes and 14 subthemes that illustrate the main factors influencing paramedics' decisions to leave the profession. This review found that paramedic attrition is driven by a complex combination of organisational, occupational, and personal factors. More research, especially from outside the United States, is needed to better understand why paramedics are leaving the profession and to identify targeted retention strategies.