Summary - Is There a Right to Not Work During COVID 19?
In the current pandemic, weakened guidance, a lack of personal protective equipment, and high infection rates among health care workers have exacerbated the tension between front line health care workers’ professional duty to serve and their personal duty to keep their families safe. The webinar Emergency Health Workforce Policies to Address COVID-19, explores this topic and asks whether health personnel have the right NOT to work when they feel their health or their family’s health, or life, is in danger.
Moderator Dr. Patricia (Polly) Pittman of the Mullan Institute is joined by three panelists from different parts of the country, institutional settings and professions: Dr. Sonal Batra is an Assistant Professor of Emergency Medicine at the George Washington University and a member of the Mullan Institute; Dr. Cheryl Taylor chairs Graduate Nursing Programs at Southern University and A&M College; and Angelina Del Rio Drake is the COO of PHI, an organization that advocates for the direct care workforce.
Dr. Batra works in one of the most precarious health care settings during this pandemic: the emergency department. Despite this, she asserts that times of crisis do not morph her overall approach to being a doctor, which is deeply rooted in promoting health equity (minute 03:48). The challenges patients face day-to-day persist during a crisis, maintains Dr. Batra, and although the way she addresses them may change, her resolve to do so does not. Despite Dr. Batra’s commitment to health equity and her patients, she warns that the obligation of physicians is not infinite, nor unconditional (minute 30:55). “There is a reciprocal obligation of employers and society as a whole to make sure that we are adequately protected,” states Dr. Batra, adding that how this balance plays out during COVID-19 will set a precedent for future crises.
Angelina Del Rio Drake is an advocate for a sector of the health workforce she describes as invisible to many: direct care workers. Despite the critical role these 4.5 million workers play in long-term care, they are underpaid, undervalued, and underutilized (minute 06:45). Direct care workers, like personal care assistants and home health aides, often make poverty wages, lack employer benefits and paid leave, have little job support, and receive minimal training. Further, these workers are often racially and ethnically discriminated against, compounding the economic and professional challenges they face.
For these reasons, Ms. Drake emphasizes that deciding whether or not to work during a crisis like COVID-19 is especially difficult for direct care workers (minute 26:15). “Every risk bearing factor that goes into making an assessment about whether to work right now is magnified when you’re making low hourly wages,” she states. Workers’ economic vulnerability and a sense of obligation to the clients who rely upon them make it hard for direct care workers to turn down cases. For those who choose not to work, little if any guidance is available on how to do so without falling into economic ruin or compromising the well-being of their clients. “We’ve heard from direct care workers across this country that they feel like they’re on their own,” states Ms. Drake. She points out that the widespread lack of support and guidance in direct care puts workers, their families, and their clients at risk.
Dr. Taylor has equally fervent concerns around the rights and well-being of nurses during COVID-19, while acknowledging the strong demand and need for their services (minute 13:20). A resident of Louisiana, she sees the same response from nurses to this crisis that she witnessed after Hurricane Katrina: a rush to care for others, often at the expense of their own self-care. She appeals to employers and nurse managers to remember that ‘health care worker’ is a label nurses have willingly taken on, but they are first and foremost human beings with their own health needs and families, and they deserve to be cared for.
Demand for nurses, coupled with the sense of guilt they may feel for not going to work, puts vulnerable members of this workforce in harm’s way, and this, in turn, makes solving workforce shortages all the more difficult. This is particularly true in nursing, where one-fifth of the workforce is over the age of 55. Ms. Taylor believes this risk can be mitigated to some extent by implementing supportive management and deployment practices (minute 21:25), for example by assigning nurses to tasks or units based on what they are fit and able to do, as opposed to automatically reassigning all nurses from one unit to another.
The policies and resources needed to support domestic care workers and nurses – both in their decision to and not to work – vary, but Ms. Drake and Dr. Taylor both call for an immediate response that is integrated across systems, collaborative, and inclusive. Ms. Drake says the public and policy makers must first recognize the critical contribution direct care workers make in ‘flattening the curve’ by keeping long-term care patients out of acute care settings (minute 08:10). Direct care workers can be supported by federal provisions that explicitly designate them as members of the essential health care workforce, which would allow them access to relief and assistance, as well as through paid leave policies and access to social support services, community aid, and unemployment benefits (minute 10:45). Local health departments should provide clear guidance to workers and their employers that is contextualized to the home care setting. To establish these provisions, it is crucial to include direct care workers in conversations around worker protections and integrate them more systemically in health care delivery (minute 26:20).
Nurses can be supported by employee health departments through the provision of child care and temporary housing, which could mitigate the risk of family members becoming infected (minute 21:25). Further, nurses’ emotional well-being must be cared for by providing grief counseling, especially in the wake of COVID-19 when nurses are witnessing a potentially overwhelming among of death. Ms. Taylor also stresses that at a time when many standards are being relaxed, it is imperative for managers to protect workers by maintaining the integrity of their intention, noting that standards are developed based on what we know works (minute 29:00).
Dr. Batra believes physicians can play a role in supporting their colleagues during this time (minute 18:05). As highly visible (by comparison) health care workers, she points out that physicians have an especially important podium during this pandemic, and it should be used to advocate for all health care workers. Other health care settings contribute to people ending up in the hospital, she points out. For this reason, and out of respect for all health care workers, advocacy efforts need to extend beyond those that work in acute care.
Moderator Dr. Patricia (Polly) Pittman of the Mullan Institute is joined by three panelists from different parts of the country, institutional settings and professions: Dr. Sonal Batra is an Assistant Professor of Emergency Medicine at the George Washington University and a member of the Mullan Institute; Dr. Cheryl Taylor chairs Graduate Nursing Programs at Southern University and A&M College; and Angelina Del Rio Drake is the COO of PHI, an organization that advocates for the direct care workforce.
Dr. Batra works in one of the most precarious health care settings during this pandemic: the emergency department. Despite this, she asserts that times of crisis do not morph her overall approach to being a doctor, which is deeply rooted in promoting health equity (minute 03:48). The challenges patients face day-to-day persist during a crisis, maintains Dr. Batra, and although the way she addresses them may change, her resolve to do so does not. Despite Dr. Batra’s commitment to health equity and her patients, she warns that the obligation of physicians is not infinite, nor unconditional (minute 30:55). “There is a reciprocal obligation of employers and society as a whole to make sure that we are adequately protected,” states Dr. Batra, adding that how this balance plays out during COVID-19 will set a precedent for future crises.
Angelina Del Rio Drake is an advocate for a sector of the health workforce she describes as invisible to many: direct care workers. Despite the critical role these 4.5 million workers play in long-term care, they are underpaid, undervalued, and underutilized (minute 06:45). Direct care workers, like personal care assistants and home health aides, often make poverty wages, lack employer benefits and paid leave, have little job support, and receive minimal training. Further, these workers are often racially and ethnically discriminated against, compounding the economic and professional challenges they face.
For these reasons, Ms. Drake emphasizes that deciding whether or not to work during a crisis like COVID-19 is especially difficult for direct care workers (minute 26:15). “Every risk bearing factor that goes into making an assessment about whether to work right now is magnified when you’re making low hourly wages,” she states. Workers’ economic vulnerability and a sense of obligation to the clients who rely upon them make it hard for direct care workers to turn down cases. For those who choose not to work, little if any guidance is available on how to do so without falling into economic ruin or compromising the well-being of their clients. “We’ve heard from direct care workers across this country that they feel like they’re on their own,” states Ms. Drake. She points out that the widespread lack of support and guidance in direct care puts workers, their families, and their clients at risk.
Dr. Taylor has equally fervent concerns around the rights and well-being of nurses during COVID-19, while acknowledging the strong demand and need for their services (minute 13:20). A resident of Louisiana, she sees the same response from nurses to this crisis that she witnessed after Hurricane Katrina: a rush to care for others, often at the expense of their own self-care. She appeals to employers and nurse managers to remember that ‘health care worker’ is a label nurses have willingly taken on, but they are first and foremost human beings with their own health needs and families, and they deserve to be cared for.
Demand for nurses, coupled with the sense of guilt they may feel for not going to work, puts vulnerable members of this workforce in harm’s way, and this, in turn, makes solving workforce shortages all the more difficult. This is particularly true in nursing, where one-fifth of the workforce is over the age of 55. Ms. Taylor believes this risk can be mitigated to some extent by implementing supportive management and deployment practices (minute 21:25), for example by assigning nurses to tasks or units based on what they are fit and able to do, as opposed to automatically reassigning all nurses from one unit to another.
The policies and resources needed to support domestic care workers and nurses – both in their decision to and not to work – vary, but Ms. Drake and Dr. Taylor both call for an immediate response that is integrated across systems, collaborative, and inclusive. Ms. Drake says the public and policy makers must first recognize the critical contribution direct care workers make in ‘flattening the curve’ by keeping long-term care patients out of acute care settings (minute 08:10). Direct care workers can be supported by federal provisions that explicitly designate them as members of the essential health care workforce, which would allow them access to relief and assistance, as well as through paid leave policies and access to social support services, community aid, and unemployment benefits (minute 10:45). Local health departments should provide clear guidance to workers and their employers that is contextualized to the home care setting. To establish these provisions, it is crucial to include direct care workers in conversations around worker protections and integrate them more systemically in health care delivery (minute 26:20).
Nurses can be supported by employee health departments through the provision of child care and temporary housing, which could mitigate the risk of family members becoming infected (minute 21:25). Further, nurses’ emotional well-being must be cared for by providing grief counseling, especially in the wake of COVID-19 when nurses are witnessing a potentially overwhelming among of death. Ms. Taylor also stresses that at a time when many standards are being relaxed, it is imperative for managers to protect workers by maintaining the integrity of their intention, noting that standards are developed based on what we know works (minute 29:00).
Dr. Batra believes physicians can play a role in supporting their colleagues during this time (minute 18:05). As highly visible (by comparison) health care workers, she points out that physicians have an especially important podium during this pandemic, and it should be used to advocate for all health care workers. Other health care settings contribute to people ending up in the hospital, she points out. For this reason, and out of respect for all health care workers, advocacy efforts need to extend beyond those that work in acute care.