Unsung housekeepers key in fight against COVID

Low-wage workers there with doctors, nurses in hospitals

Juli Winters likes to chat with patients while cleaning the emergency room at Texas Vista Medical Center, but the man in the room at the end of the hall was so sick with COVID-19 that he couldn’t speak.

Even under the plastic surgical gown that usually makes her sweat, Winters felt chills. When she finished cleaning, she stepped into the hallway and made the sign of the cross. “He’s blue,” she said. Winters, 58, has worked in hospitals for almost 40 years. She can sense when a patient won’t pull through. She paused for a moment, then added: “It’s sad, but it’s the truth.”

She never knows what each day will bring. Whether she’ll end up cleaning the rooms in the emergency department 53 times or 20. Whether the hospital will have another housekeeper on staff in the ER to help her or if she’ll be solely responsible for the two lobbies, the doctors lounge and nurses station, the medical supply room, eight bathrooms and more than two dozen patient rooms.

Lately, it’s been so busy with COVID-19 patients that the hospital on the Southwest Side has

run out of rooms, so she must also clean as many as a half-dozen hospital beds lining the ER hallways.

Armed with gloves, mops and bleach, Winters and her co-workers have labored alongside nurses and doctors in the battle against COVID-19 for the last 18 months.

But for the most part, the billboards and advertisements praising “health care heroes” have featured the higher-paid doctors and nurses, posing in scrubs and white coats.

Winters sanitizes every surface of the emergency room that’s touched by patients. She changes bed sheets, scrubs feces thrown on walls by patients in psychiatric crises, empties containers full of used needles and wipes blood from the floor. On rare occasions, she’s cleaned the refrigerated trailer used to store bodies.

Pay starts at about $9.35 per hour.

“Her team members have the hardest job in the hospital as far as physical demands,” said Evan Bircher, the regional vice president of operations at HHS, the staffing company that employs Winters. “And you’re probably the lowest-paid person at the hospital.”

HHS contracts with Texas Vista and other hospitals to provide nonclinical employees. In parallel with a nursing shortage caused by pandemic burnout, the company is facing a lack of housekeeping workers. HHS has about 31 people cleaning Texas Vista, about nine short of ideal staffing.

Low-wage workers — particularly women — were dealt the pandemic’s worst economic blows, often losing income when they were forced to care for children and sick relatives at home.

“We have people that have lost upwards of six family members, so they have to be home because they don’t have that support system anymore,” said Mycah Rex, director of Texas Vista’s environmental services department, which oversees cleaning and infection control.

The hospital’s housekeepers didn’t receive hazard pay, but when doctors and nurses are slammed with patients, Winters is the one who sometimes notices the unanswered call button. She brings patients blankets when they’re cold, puts socks on their feet when they can’t reach down on their own and sometimes sits with them and holds their hands when loved ones can’t be there.

“I wouldn’t want somebody to neglect me,” Winters said. Housekeepers are often patients’ only interaction with someone who isn’t there to draw blood, take their vitals or talk about their prognosis.

“We take the time to listen,” she said.

Sometimes, Winters said, a patient asks: “Do you think I’ll make it?”

“That’s scary,” she said. “Because it’s like, ‘You’re asking a housekeeper, baby.’”

She’ll promise to find a nurse, only to hear the patient say: “No, he didn’t answer. … So I’m going to ask you.’”

Patients start ‘pouring in’

Winters’ alarm rings at 3:20 a.m. She dresses in scrubs and packs a lunch, umbrella, change of clothes and Tylenol — she’ll need it for what could be another 14 hours until she returns home again. In the dark, she walks a mile to her bus stop.

Winters usually arrives at the hospital around 6 a.m., an hour before her shift. She starts by calling a nurse supervisor to find out how many patients are in the hospital — that’s how many beds she and her co-workers will have to clean. She stocks her cart with toilet paper, rags, trash bags, disinfectant and gloves, then begins her rounds in the ER.

In the hallway, Winters stopped at a trash can that was emptied by a colleague finishing up the night shift. The plastic liner was slightly loose.

“This is what you call halfassed,” Winters said. She took off the lid, retying the bag so it fit snugly around the top of the can.

Although she stands 5 feet, 1 inch tall, Winters is a commanding presence in Texas Vista’s ER. Some of her co-workers call her “New Orleans” because of her booming voice and thick Cajun accent. She isn’t afraid to call down the hall to the nursing station to ask why a chair is out of place or why the door to a patient’s room isn’t closed all the way.

In ERs, even the housekeepers

work under pressure, with the possibility that tragedy could strike anytime. Winters thrives in that environment, and before Hurricane Katrina shuttered Charity Hospital in New Orleans in 2005, she oversaw cleaning in its ER. There, she said, housekeepers were well paid, but it still had its fair share of turnover because “it was depressing to be around so many gunshots.”

Paramedics wheeled in children, men and women at all hours. To this day, Winters said, she may have a hard time reading words on a computer screen, but she can spot a speck of blood down the hall.

Winters moved from Louisiana to San Antonio after losing a home to flooding for the fifth time. She’s worked at Texas Vista for three years. There, until the pandemic struck, things were much slower.

Even in its early days, many people avoided ERs. But the pace began to pick up this summer, Winters said, when people who’d delayed medical care for much of the pandemic started “pouring in.” Then came the delta variant, which brought with it a new wave of COVID-19 patients.

On the busiest days, when rooms in the ER are full, Winters has cleaned “hallway beds” a couple dozen times over the course of a shift, she said. Another new phenomenon is her “dailies” — the rooms she must clean once a shift. They house patients who are being held in the ER, sometimes for days, because there aren’t rooms open on the general floor.

Sometimes Winters ends up cleaning the rooms of people she knows. While Winters was wiping down the sink in a room recently, the patient recognized her.

“You don’t look the same without your red hair,” the woman said.

Winters said she’d shaved off her hair the year before for cancer awareness month, and when it grew back, “It came back white,

instead of red.”

Winters chuckled: “And I ain’t coloring it.”

‘Double burden’

Winters likes to make her coworkers and patients smile, so she often wears novelty earrings to work. She has pairs in the shape of toilet paper rolls and studs made of screws, she says, for “screw COVID.”

Under her scrubs, she wears a brace on each knee and a hernia belt around her waist. Every hour and a half, she pops a Tylenol. In the fanny pack she keeps on at all times, she carries gabapentin, for nerve pain on the worst days.

Housekeeping is punishing work. It’s heaving bags of linens down hallways, lugging boxes of cleaning supplies and bending on achy knees to wipe bodily fluids off the floor.

During the pandemic, it’s become even more grueling because each room with a COVID-19 patient must be sterilized from top to bottom whenever they leave.

For Winters and the other housekeepers, that means lifting the mop high overhead, sweating under a plastic surgical gown, while they push it across the wall to sanitize every inch.

In San Antonio, the typical pay for a housekeeper, including those who work at hospitals and hotels, is about $11.42 per hour, according to federal data — less than the estimated $15- to $30per-hour wage needed to afford a two-bedroom apartment.

Some of them take on extra jobs, including Winters, who sometimes cleans homes for coworkers and patients she meets in the hospital.

At Texas Vista, about 70 percent of employees across all departments are women, many of whom have children or elderly relatives to care for at home.

“So often, caregivers are people that find themselves working in hospitals, and they assume caregiver identities in their extended families as well,” said Jon Turton, president of Texas Vista Medical Center.

“They kind of have a double burden on them,” he said.

Extra eyes and ears

With the clinical staff stretched thinner than ever, housekeepers like Winters have become extra eyes and ears for doctors and nurses.

On a recent trip to the supply closet, Winters noticed through the hospital room blinds that a patient was shifting around in bed. She thought it was strange: The patient, who’d been there a while, had always lain still.

Winters peered into the room and realized the breathing machine, which had delivered the patient livesaving oxygen, had been disconnected.

“Help!” Winters screamed as the patient began thrashing in the bed. Monitors beeped. Nurses ran into the room to refasten the device.

One of the nurses, Hipolito Mojica, said of Winters: “She gave the patient a fighting chance.”

“She’s part of our team,” he said. “We don’t consider her just a housekeeper.”

Photos by Jessica Phelps / Staff photographer Juli Winters is a housekeeper at Texas Vista Medical Center on the Southwest Side. She works in the emergency room, making sure the rooms are clean for new patients, but her job has become more hectic with an influx of COVID patients.

Winters has worked in hospitals for almost 40 years, the last three of which she’s spent cleaning Texas Vista’s ER.

Photos by Jessica Phelps / Staff photographer One of housekeeper Juli Winters’ tasks is sanitizing all of a COVID patient’s room when they leave Texas Vista Medical Center.

Winters must wear an N95 mask while she cleans rooms holding COVID-19 patients. Some co-workers call her “New Orleans,” partly because of her thick Cajun accent.

Lately, Texas Vista has been so busy with COVID-19 patients that it has run out of rooms, so Winters also must clean as many as a half-dozen hospital beds lining the ER hallways.

In ERs, even housekeepers such as Winters work under pressure, with the possibility that tragedy could strike anytime. Winters thrives in that environment.