National survey of frontline health care workers finds fear, unsafe working conditions

.A report details the results of a national survey of frontline health care workers during the early days of the COVID-19 pandemic, finding that many respondents reported unsafe working conditions and retaliation for expressing their concerns to employers.

The survey, launched in May 2020 by staff and student researchers at the George Washington University, provides a snapshot of the experiences of frontline health care workers providing care for millions of Americans during the pandemic.

According to David Michaels, a professor of environmental and occupational health at the George Washington University and former administrator of the Occupational Safety and Health Administration, the survey gives a voice to US health care workers who have been on the frontlines of COVID-19.

"Health care workers have valuable first-hand knowledge about this pandemic and this report offers recommendations that could help keep the US on a steady course now and in the future,” he said in a statement.

There are more than 18 million health care workers in the US and those on the frontlines of the pandemic have much to say about what should be done to prevent future exposures to the virus and other issues. The GW researchers developed an online survey to better understand the experiences of health care workers, including questions about working conditions and safety related concerns.

About 1200 health care workers from all 50 states and the District of Columbia took the survey and the GW researchers analyzed the data collected during a two-month period from the beginning of May 2020 until the end of June 2020.

Among the concerns frequently expressed in the survey responses:

• Frustration with unsafe working conditions, especially failed access to adequate personal protective equipment.
• Instances of retaliation and at times bullying for voicing their safety concerns to employers.
• Perceptions that employers prioritized hospital profits over worker safety and created an unhealthy work environment where workers felt devalued and threatened.

A key issue was a lack of PPE, a constant refrain from healthcare professionals who worked on the frontlines of the pandemic. Many were forced to make masks at home, wear trash bags instead of medical gowns, and craft their own face shields from household refuse.

The survey included responses from nurses, many whom worked in a hospital setting. When it came to safety, many health care workers mentioned the lack of personal protective equipment during the early days of the pandemic as a concern. The respondents also said they lived with the fear of losing their job if they voiced their concerns and they also expressed frustration with constantly changing employer and national guidelines.

"The responses to the survey contain important insights that cannot be gleaned from statistics alone," Nathan L. McCray, a lead author of the report, said in a statement. "Workers voiced a range of experiences during the first few months of pandemic, including those that were positive and others that were excruciating."

McCray worked on the report while a research associate at the GW Milken Institute School of Public Health.

For example, some workers reported that their employer had taken steps to provide them with the protective equipment they needed to stay safe while others described being devalued or treated as disposable. Still others said they were afraid of getting sick or bringing the virus home to vulnerable family members.

Brenda M. Trejo Rosas, a research associate and doctoral student at the GW Milken Institute School of Public Health, as well as lead author, said the survey was anonymous and health care workers said they appreciated having a safe space to share their concerns.

"Our report exposes the impact of power dynamics in the work environment,” she said in a statement.

The survey also asked frontline workers for solutions to some of the problems they described in the survey. Health care workers stressed the need for improved communication and worker protection policies based on scientific evidence.

They also recommended that the federal government step up and increase the national stockpile of personal protective equipment. Such a stockpile would help the nation better prepare for the next wave of this pandemic or a future pandemic, they said.

In addition, the health care workers who participated in the survey called for employers to treat them with respect and asked for labor rights such as time off, mental health care and zero tolerance for bullying or retaliation.

Authors of the report include McCray, Trejo Rosas, Shamet Qejvani, Shateara Hall, Bani Bhattacharya, Laura M. Neumann and Ans Irfan--all of whom worked on the survey as part of the GW Milken Institute School of Public Health Department of Environmental and Occupational Health. Multiple Milken Institute School of Public Health students also assisted with the qualitative coding and promotion of the survey.

Michaels and Melissa Perry, a professor and chair of the Department of Environmental and Occupational Health, provided guidance in producing the report. The McElhattan Foundation and the Institute for New Economic Thinking provided financial support for the survey and the report.