This case study (Stake, 1995) examined the perceptions of long-term Emergency Medical Technicians (EMTs) to identify factors influencing their decision to remain employed as EMTs for the duration of a career. EMT retention plans frequently utilize data from either employee exit interviews or workers with intent to leave, and since privacy law often keeps these data from immediate supervisors, they are not of immediate use in making any changes to enhance retention strategies. Proactive retention strategies are scarce; no effective pre-employment personality screening tests are currently in widespread use. Studies of employee retention and turnover provide a wealth of data, but few qualitative studies are specific to emergency medical technicians; fewer still utilized case studies with semi-structured interviews. This study, then, explored a retention rationale for purposeful sharing of perceptions between experienced EMTs and new EMTs. Eight individual career EMTs from rural southern Idaho were observed at work, work-related documents accessed, with individual participant perceptions gathered during two semi-structured interviews. The perceptions that the EMT participants felt positively influenced their decisions to stay in the prehospital care profession were listed and explored. Subsequent interviews provided further enlightenment of specific factors that participants felt impacted their decision to stay in emergency medicine. Based on theory and evidence from this study, a model of EMT retention is posited demonstrating intrinsic aspects of management issues. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]