Health-care workers feel muzzled and alone: Study
Health-care workers in Ontario are on the frontlines in the fight against COVID-19, but according to a new study, they are feeling “sacrificed” and “violated” by their employers and the provincial government.
Researchers affiliated with the University of Windsor in collaboration with CUPE’s Ontario Council of Hospitals Union co-authored a report titled “Sacrificed: Ontario Healthcare Workers in the Time of COVID-19.”
Health-care workers represent 20 per cent of all COVID-19 cases in the province, according to the study, a number that is much higher than the global rate of 14 per cent.
Due to fear of reprisal, those on the frontlines are extremely hesitant to speak out – but those who participated in the study told a story of “dismal” working conditions and “unrelenting” stress.
“Health-care workers in Ontario are suffering from much higher rates of COVID-19 infection than the general public,” said Dr. James Brophy, one of the lead authors of the new study.
“While we are all facing COVID-fatigue and worry, health-care workers are suffering disproportionately from serious psychological distress. They are burning out from overwork, fear and anxiety.”
Led by Dr. Brophy and Dr. Margaret Keith, the study examines in-depth, anonymous interviews conducted with 10 health-care workers who work in hospitals and long-term care facilities throughout Ontario.
The respondents, who work in facilities that range from small northern-rural to large urban, were contacted by phone in April and May.
Frontline workers, including PSWs, RNs, RPNs, and custodial and clerical staff, all reported feeling unprotected and unsupported in their place of work.
“We have lost about 100 staff who have either taken a leave of absence because of fear or have taken a leave to go work other jobs. We have a few who have taken early retirement,” said a participant in the study.
“When I leave this interview, I’m heading into work and I’m going to work 44 out of the next 60 hours. I’ve prepared enough food for six meals and they’re in two shopping bags right now. That’s what it’s doing to me.”
Some interviewees reported going home to cry after their shifts, sleeping in separate bedrooms away from their spouses, and experiencing increased social isolation because they fear infecting their family and friends.
“The words on the page cannot convey the level of emotion we heard in the voices of healthcare workers we interviewed,” said Brophy.
“We did not expect to hear the degree of anger and desperation that came out. The stories they told us were tinged with anger, frustration and fear.”
There are a number of factors that contribute to the distress of health-care workers in the province, including inadequate protection against the virus, government failings, and barriers to exercising their agency.
The study suggests that the provincial government, for example, has not applied the “precautionary principle” identified by the SARS Commission in 2006 which stipulates that, when in doubt, policies should err on the side of caution.
“An ongoing debate that has direct impact on health-care workers’ safety is whether or not the virus can be transmitted through airborne particles,” said the study.
“The evidence has grown that SARS-CoV-2 can indeed become aerosolized through coughing, sneezing, or even just breathing.”
These tiny, aerosolized particles can breach surgical masks, according to Brophy. Researchers have recommended the use of N95 masks or powered air-purifying respirators for more adequate protection.
Surgical masks are still considered safe for use in a health-care setting under most circumstances, although the health-care workers that participated in the study expressed some skepticism.
“I had an infected patient on one of my shifts. I had my own N95 mask and I had my own goggles, and I had my own hair cover and I made sure I double gloved,” said an interviewee.
“I put the cheap level two mask over top of my N95.”
The study suggests that the government’s policy was probably “supply-based rather than science-based.”
Another contributing factor is the health-care workers’ lack of recourse when it comes to addressing these challenges.
Employers generally don’t allow their workers to speak publicly about their experiences at work, and, according to reports, the Ministry of Labour has been unhelpful.
“All the frontline workers fear reprisal. We are told, ‘You can’t talk to the media. You have to send your manager to talk to them. We have corporate relations. You can’t be outside holding signs',” said one individual.
“It’s just a travesty and these issues need to be said and people need to know what’s really going on.”
Another said that they were “disheartened” by the Ministry of Labour during the pandemic.
“They’ve totally taken the employers’ side and not the workers. There is no consultation with any frontline worker,” they said.
“The ministry is not showing up to calls. They’re doing a lot of phone calls, but it’s not how they should be working. They still need to be out there on the frontlines. They should use PPE and come out to the hospital if we’re saying it’s not safe.”
Michael Hurley, the president of CUPE’s Ontario Council of Hospitals Union and co-author of the study, explained that health-care workers have a limited right to refuse unsafe work.
“They can’t refuse if it would result in a danger to a patient or resident,” said Hurley.
“The evidence shows that in every case when the Ministry of Labour was called in, they did not support the workers.”
To address these issues, the study recommends increasing staffing levels, adequate PPE and protective administrative and engineering controls, increased mental health supports, and reinvestment into a “weakened public health-care system.”
There also needs to be a chance in workplace culture so that health-care workers concerns will be heard, respected, and addressed.
“Health-care workers' health and wellbeing is essentially being sacrificed. We all need to pay attention to their pleas during this frightening time,” said Dr. Margaret Keith.
“Not only does their wellbeing matter, but we also need to realize if they are not being kept safe, they can’t properly care for their patients or residents.”
The Local Journalism Initiative is made possible through funding from the federal government.
Colleen Romaniuk, Local Journalism Initiative Reporter, The Sudbury Star