`Anxiety and fear': plight of health-care workers
Jane E. Mcarthur, James T. Brophy, Margaret M. Keith and Michael Hurley unveil stories behind the statistics.
Health-care workers in Ontario — often among a workforce of predominantly racialized women — are especially vulnerable in the COVID-19 pandemic.
The risk of infection, lack of government preparedness, little success in arguing for better protection and barred from publicly speaking has left health-care workers angry, fearful and sacrificed. The physical and mental health impacts affect healthcare delivery to the public.
Health-care workers have been disproportionately infected, comprising 20 per cent of cases. Shortages of N95 masks influenced protection guidelines.
After the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak, an independent commission provided a roadmap for future pandemics. Recommendations included that N95 masks be available to healthcare workers at all times. But governments have disposed of expired N95s and failed to replace them.
Health-care workers in need of protection from COVID-19 confidentially reported these decisions and their impact in our study published in New Solutions.
The study unveils the stories behind the statistics of health-care workers who have been infected with COVID-19. Health-care workers cannot talk publicly about their working conditions, out of fear of being disciplined or fired for speaking out.
Anonymous telephone interviews with health-care workers brought out psychological distress, the inadequacy of protection, inconsistencies in policy, government failings and agency barriers.
During our study recruitment, potential interviewees said they were too afraid to participate for fear of losing their jobs.
A hospital clerical staff person interviewed for the study said: “All the front-line workers fear reprisal. We are told, `You can't talk to the media'… It's just such a travesty and these issues need to be said and people need to know what's really going on.”
Health-care workers share society's background mental distress as well as stressors related to their work. Interviewees reported that the risk of contracting COVID-19 and infecting family members or patients created anxiety. With understaffing and increased workloads, health-care workers are suffering from exhaustion and burnout.
“There's a lot of anxiety,” said one. “When COVID-19 is over, the employer won't have enough counsellors on hand to handle what I think is going to hit. Because people are anxious; people are fearful. They come to work; they don't know if they have the illness or not because sometimes you're asymptomatic. They're afraid to go home; their families are scared of them. It is just horrendous. And the morale is as low as it can be.”
A personal support worker (PSW) in a long-term care facility described difficulty coping with added stress, increased workload and longer hours to keep up care.
“There's definitely extra stress and some days, you just break down and start crying,” she said. “Our workload is crazy, and the girls are just running on the floor to keep up.… Before the pandemic, we had a shortage of PSWS and now we have more and more people going off work because they're afraid. A lot of the staff are working double shifts.”
Ontario's health-care system has been eroded by economic strains, understaffing, diminished capacity and regulatory inadequacies.
Health-care workers at risk of COVID-19 exposure are without adequate protections, including personal protective equipment (PPE), administrative and engineering controls and lack of adherence to the precautionary principle, as explicitly recommended in the SARS Commission Report.
The controversy around the aerosol transmission of SARS-COV-2 affected healthcare workers' safety.
N95 masks, which protect against virus transmission, have not been widely available to health-care workers as authorities debated the science that established airborne transmission.
Several health-care workers said requests for N95s were ignored. Supervisors warned nurses, as detailed by one: “You are not to wear an N95 mask; you do not need it, you are fine to be wearing the mask with a shield and if I catch you with one on again, you can be fined.”
Another nurse told us after being told she couldn't wear her N95, resorted to hiding one she had purchased herself under a medical mask.
There is little trust in government decisions and policies for protection.
A long-term care PSW explained to us: “It makes it difficult when we feel that the best decisions for our safety — especially in regard to PPE — are not truly the best practice. … That's a big concern for us on the front line.”
Another health-care worker interviewed pleaded: “All we are asking is, please protect us.”
Our study uncovered implications for health-care workers and health-care provision. We concluded with recommendations.
They include:
Increased staffing levels in Ontario's hospitals and long-term care. Changes to the workplace culture so health-care workers are heard. Strong management support to mitigate mental distress. Improved working conditions and PPE. Legislated protection to allow staff to speak without reprisal. Co-authored by: Jane E. Mcarthur, University of Windsor, James T. Brophy, University of Windsor, University of Stirling, Athabasca University; Margaret M. Keith, University of Windsor, University of Stirling; Michael Hurley, OCHU-CUPE. This article was modified from its original version published in
The Conversation Canada.