First Responders and the COVID-19 Pandemic: How Organizational Strategies Can Promote Workforce Retention

• Published date: 01 January 2024
• DOI: http://doi.org/10.1177/02750740231192968
• Author: Christa L. Remington,Kaila Witkowski,N. Emel Ganapati,Andrea M. Headley,Santina L. Contreras
• Date: 01 January 2024

First Responders and the COVID-19

Pandemic: How Organizational Strategies

Can Promote Workforce Retention

Christa L. Remington

1

, Kaila Witkowski

2

, N. Emel Ganapati

3

,

Andrea M. Headley

4

and Santina L. Contreras

5

Abstract

Workforce retention is a current challenge for public administration, and there are continued questions about the impact of

the COVID-19 pandemic on the public safety workforce and their willingness to serve. Past studies have shown there are

limits to what f‌irst responders will endure during complex and uncertain emergencies, leading them to potentially leave

their position. Using a nationwide survey (n=3,582), in-depth interviews (n=91),and a visual methodologycalled

PhotoVoice, this study examines the factors impacting threats to workforce retention (i.e., role abandonment and turnover

intentions) among f‌irst responders and the ways public organizations can mitigate this negative impact. The results show per-

sonal or family risk may contribute to f‌irst responders’decisions to quit, while an understanding of public risk may promote

retention. We identify several organizational strategies (e.g., emotional safety, suff‌icient protective equipment, standard oper-

ating procedures) that may reduce retention threats.

Keywords

f‌irst responders, COVID-19, workforce retention, resilience

Public health emergencies are becoming increasingly more

common and complex. Ebola, H1N1, the opioid epidemic,

and the long wave of the COVID-19 pandemic are all exam-

ples of health crises in the 21st century that have required

coordinated government responses and have taken a consid-

erable toll on the public safety workforce. The highly infec-

tious nature of COVID-19 across the globe, coupled with

changing disease trends, led to uncertain and unpredictable

crisis phases, posing specif‌ic challenges for f‌irst responders

(i.e., police off‌icers, f‌iref‌ighters, and emergency medical

service (EMS) workers) who were on the frontlines of

COVID-19 response efforts in 2020 and beyond.

Because of the nature of their jobs, f‌irst responders not

only encountered a disproportionate risk of infection from

the coronavirus but also risked infecting their family

members and friends. Specif‌ic personality traits, a willing-

ness to put oneself in harm’s way, and high public service

motivation (PSM) are a hallmark of f‌irst responders who

view their career as a calling instead of a job (Benincasa

et al., 2022). For many f‌irst responders, the risks and

impacts of the COVID-19 pandemic, coupled with organiza-

tional stressors, prompted them to consider leaving their

calling by not showing up to a shift (i.e., role abandonment),

quitting their job (i.e., turnover), or leaving their f‌irst

response careers altogether. Workforce retention is an

ongoing challenge for public administration, as many

employees, especially street-level bureaucrats and public

health workers, are trading public-sector jobs for private-

sector employment (Tavares et al., 2021). A 2021 nationwide

poll showed that one in f‌ive healthcare employees quit their

jobs during the pandemic, deeming the risk of infection

and the additional burden not worth the pay (Galvin,

2021). Another survey of 258 EMS organizations found

that nearly a third of ambulance workers left their jobs in

2020, opting for less risky jobs with similar salaries

(Weixel, 2021). This indicates a need to understand which

factors contribute to workforce retention to ensure that

there is a public workforce willing to serve during crises.

In the broader literature on the pandemic, more attention

has been paid to other “essential”workers who were

unable to work from home and were disproportionately

impacted by the pandemic, including hospital medical

workers (e.g., doctors and nurses), grocery store employees,

and meat plant employees (e.g., Bandyopadhyay et al., 2020;

1

University of South Florida, Tampa, FL, USA

2

Florida Atlantic University, Boca Raton, FL, USA

3

Florida International University, Miami, FL, USA

4

Georgetown University, Washington, DC, USA

5

University of Southern California, Los Angeles, CA, USA

Corresponding Author:

Christa L. Remington, University of South Florida, 4202 E. Fowler Ave,

Tampa, FL 33620, USA.

Email: clremington@usf.edu

Article

American Review of Public Administration

2024, Vol. 54(1) 33–56

© The Author(s) 2023

Article reuse guidelines:

sagepub.com/journals-permissions

DOI: 10.1177/02750740231192968

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Galbraith et al., 2020; Li & Tang, 2022; Mallet et al., 2021).

Despite the well-documented adverse work-related effects on

f‌irst responders (Alshahrani et al., 2022; Haugen et al., 2012),

the emerging public administration literature on public health

crises has paid limited attention to these street-level bureau-

crats, specif‌ically to the factors that might lead them to

abandon their shift or consider exiting their career all together

(Trainor & Barsky, 2011).

To f‌ill this gap in the literature, this study asks the follow-

ing research questions. During public health crises, (1) which

factors impact turnover and role abandonment intentions

among f‌irst responders? (2) How can organizations reduce

threats to workforce retention? While retaining staff is a tre-

mendous challenge for all public agencies, public safety

organizations, in particular, have been facing a crippling

workforce shortage during a time when their services are

most needed by the public. By focusing on how best to

prevent role abandonment and turnover intentions, the

study can inform public safety organizations on how to

retain their workforce to provide effective, uninterrupted

delivery of services in times of public health crises.

This study utilized a mixed methodology, which included

collecting data from f‌irst responders via a large nationwide

survey (n=3,582), in-depth interviews (n=91), and a

visual photographic methodology (PhotoVoice). The survey

results identif‌ied factors that increased or decreased role

abandonment and turnover intentions (e.g., threat perception)

and revealed several organizational strategies (e.g., job

autonomy, emotional safety, suff‌icient supplies, and protec-

tive equipment), which were associated with reducing these

intentions during the COVID-19 pandemic. The qualitative

results provided a deeper understanding of the survey f‌ind-

ings by demonstrating how threat perceptions and turnover

intentions were linked based on who was at risk (i.e., loved

ones, community).

This article is structured in f‌ive sections. The next section

summarizes the literature on work-related consequences for

f‌irst responders including role abandonment and turnover

intentions, while identifying the impact of organizational

strategies and public health threats on workforce retention.

The study’s methodology follows, which triangulates multi-

ple data sets and sources. Next, the article displays the quan-

titative results and qualitative f‌indings. The article concludes

with a discussion on organizational mitigation strategies and

guidance on how f‌irst response agencies can reduce threats to

retention and better support their frontline workers during

public health disasters.

Literature Review

Work-Related Risks and Consequences

Although the work of f‌irst responders is often fulf‌illing to

individuals who have chosen to enter the profession, there

are well-documented risks and consequences of the job

(Benincasa et al., 2022). First responders regularly witness

death, illness, injury, and destruction and are tasked with

saving lives and preserving property during emergencies.

Research from emergency management, psychology, and

public health shows that these high-pressure situations, com-

bined with frequent sleep disturbances, irregular schedules,

and the sustained hypervigilance of waiting for the “next

call,”can have negative physical and mental impacts on

f‌irst responders (Lebeaut et al., 2020; Regambal et al.,

2015; Vujanovic et al., 2021). Specif‌ically, when compared

to other professions, f‌irst responders and other emergency

workers experience a higher prevalence of negative health

(e.g., cancer, heart disease) and psychological impacts

(e.g., post-traumatic stress disorder (PTSD), acute stress

disorder) than that of those in other jobs (Daniels et al.,

2013; Kaplan et al., 2017; Kroll et al., 2021; Stanley

et al., 2016). Research from public administration has

examined the negative impacts of burnout and sustained

emotional labor on those serving the public during a

crisis, burnout, and PSM of frontline emergency workers

(Kroll et al., 2021; Mastracci et al., 2012; Miranda &

Godwin, 2018).

Changing roles and responsibilities (Webb et al., 1999),

exhaustion and stress (Carroll et al., 2010), and exposure to

traumatic events and PTSD (Kroll et al., 2021; Palm et al.,

2004) are all common work-related consequences during

disasters. The impacts of these stressors can contribute to

absenteeism (Marmar, 2006), early retirement, and shortened

careers (Castellano & Plionis, 2006). Public health crises,

like the COVID-19 pandemic, add the additional stressor

on f‌irst response employees of personal infection and the

risk of contagion to their families. Recent research suggests

a signif‌icant negative impact of the pandemic on employees

in healthcare and frontline medical positions (Baskin &

Bartlett, 2021). Studies from diverse academic f‌ields such

as psychology, sociology, and social work have demon-

strated impacts on frontline medical workers’levels of

stress (Goh et al., 2020; Lorente et al., 2020;

Luceño-Moreno et al., 2020), burnout (Hu et al., 2020),

anxiety (Barzilay et al., 2020; Benincasa et al., 2022;

Lapum et al., 2020), and resilience (Jose et al., 2020;

Labrague & Santos, 2020; Pink et al., 2021). Notably, there

is still much unknown about how the COVID-19 pandemic

or public health crises, in general, exacerbate work-related

consequences among f‌iref‌ighters, law enforcement, and

emergency medical workers comparatively and collectively.

Threats to Retention

During disasters, f‌irst responders and other emergency

workers can be exposed to a range of circumstances that

threaten their ability to remain on the job. These retention

threats can be divided into intentions to quit a job, known

as turnover intentions, and role abandonment intentions,

which are intentions to leave a shift or not show up to

34 American Review of Public Administration 54(1)