Hiring and retaining the best and the brightest – What we can learn about retention from EMS rising stars

By December 19, 2022No Comments

George Lombardo, field supervisor, lead field training officer, and paramedic with Superior Mobile Health. He began his career at the young age of 19 as an EMT-basic. He has over 15 years in the pre-hospital industry. Lombardo has held multiple positions as a lead medic on MICU capable ambulances and clinical settings. He came to Superior Mobile Health as a strong clinical provider and leader, which was quickly recognized by management. He was first promoted to FTO, then to field supervisor.

The EMS Trend survey has identified recruitment and retention as top issues impacting the field for years, though staffing challenges have only been exacerbated by the pandemic.

We learned recently that turnover rates for paramedics and EMTS increased in 2022 to 20-36%. On average, EMS agencies experience a full staff turnover every 3-4 years and more than one-third of all new hires turnover within their first year of employment.

But on the other side of the equation are the rising stars of EMS – the students, recruits and EMTs who find a passion for prehospital medicine, advance their education and climb the ranks, improving their patient care and their organizations as they climb the ladder.

To better understand what inspires greatness and career longevity in EMS, I interviewed several rising leaders about their career path, their joy in work and their secrets to success. At the end of this article, download insights from these leaders on retention, career advancement and what makes EMS great.


I found many common threads in my conversations with these leaders.

Many – in fact, most – began with an interest in the fire service, but fell in love with prehospital medicine (though many noted EMS is not quite what they expected). Though our panel has found EMS to differ from the television-depicted, back-to-back, time-sensitive, life-or-death ALS calls, the common themes in what has made EMS a satisfying career are excellent recruitment tools. Here’s what our leaders love about EMS:

  • The constantly changing, evolving environment of pre-hospital care
  • The mentally challenging nature of the work
  • The opportunity to bring a little order to a chaotic world
  • The level of autonomy and personal responsibility EMS provides

These are the characteristics that should be driving your recruitment campaigns.

I also asked these rising stars what their agencies have done to retain them. Here, the common threads wove three distinct themes when it comes to retaining top talent:

  1. Don’t give them a reason to leave. Many of these leaders started with their organization at the very outset of their career, as an EMT or even while still in school. What’s kept them loyal? Opportunities for growth, a culture that makes coming to work each day something to look forward to, and a competitive compensation and benefits package.
  2. Fund training and education. Almost every leader I interviewed raved about the opportunities for continuing education their organization provides. Internal CE, specialized courses, industry conferences, tuition reimbursement – if you want to grow your own EMS superstars, you need to give them the opportunity, the time and the funding to seek the training that will further their development.
  3. Provide opportunities to make a difference. All EMS providers in some way join the emergency services with a hope of making a difference for their patients. It stands to reason that the best of the best will seek to make a difference in bigger ways as well – for their agency and for their colleagues. One of the things that stood out the most for me when speaking to these leaders is how they appreciate how their agencies foster their desire to get involved in programs, initiatives and decisions that shape how EMS is delivered in their communities.

Learn more about these standout organizations and leaders by downloading your copy of EMS1 Rising Leaders