ABSTRACT
Black women social workers (BWSWs) represent essential workforce members who are burdened by ongoing COVID-19 circumstances. Strategies to deal with highly stressful situations on the job, such as those experienced in 2020, were absent from the research literature leaving intervention strategies to support highly stressed BWSWs unknown. This study aimed to uncover the various ways BWSWs experienced their organizations as they performed work duties. Atlas.ti. 9 was used to analyze verbatim transcripts from 17 semi-structured qualitative interviews given by BWSWs across the United States in February 2021. Hermeneutic phenomenology was implemented to interpret interview data. The convenience sample was drawn from professional organizations where BWSWs claimed membership and volunteered to be electronically interviewed for 2 hours generating themes such as stress perceptions, institutional barriers to efficient work productivity and recommendations for workplace support. BWSWs reported high stress work environments in the past year. Some believed that their health and mental health declined because of the inability to find work-home life balance. Findings suggest BWSWs persevere regardless of high levels of stress and being unsupported in the workplace in order to maintain a livelihood. BWSWs play a crucial role in the lives of vulnerable populations, but need to attend to ways to be healthier given the polarization associated with racism, classism, and sexism experienced. Thematically, the data revealed stressful situations in the workplace and how organizations have failed to implement strategies in order to improve social worker health. Suggestions for workplace supports were also identified. © The Author(s) 2023.
ABSTRACT
Black women social workers (BWSWs) represent essential workforce members who are burdened by ongoing COVID-19 circumstances. Strategies to deal with highly stressful situations on the job, such as those experienced in 2020, were absent from the research literature leaving intervention strategies to support highly stressed BWSWs unknown. This study aimed to uncover the various ways BWSWs experienced their organizations as they performed work duties. Atlas.ti. 9 was used to analyze verbatim transcripts from 17 semi-structured qualitative interviews given by BWSWs across the United States in February 2021. Hermeneutic phenomenology was implemented to interpret interview data. The convenience sample was drawn from professional organizations where BWSWs claimed membership and volunteered to be electronically interviewed for 2 hours generating themes such as stress perceptions, institutional barriers to efficient work productivity and recommendations for workplace support. BWSWs reported high stress work environments in the past year. Some believed that their health and mental health declined because of the inability to find work-home life balance. Findings suggest BWSWs persevere regardless of high levels of stress and being unsupported in the workplace in order to maintain a livelihood. BWSWs play a crucial role in the lives of vulnerable populations, but need to attend to ways to be healthier given the polarization associated with racism, classism, and sexism experienced. Thematically, the data revealed stressful situations in the workplace and how organizations have failed to implement strategies in order to improve social worker health. Suggestions for workplace supports were also identified.
ABSTRACT
The COVID-19 public health emergency caused widespread economic shutdown and unemployment. The resulting surge in Unemployment Insurance claims threatened to overwhelm the legacy systems state workforce agencies rely on to collect, process, and pay claims. In Rhode Island, we developed a scalable cloud solution to collect Pandemic Unemployment Assistance claims as part of a new program created under the Coronavirus Aid, Relief and Economic Security Act to extend unemployment benefits to independent contractors and gig-economy workers not covered by traditional Unemployment Insurance. Our new system was developed, tested, and deployed within 10 days following the passage of the Coronavirus Aid, Relief and Economic Security Act, making Rhode Island the first state in the nation to collect, validate, and pay Pandemic Unemployment Assistance claims. A cloud-enhanced interactive voice response system was deployed a week later to handle the corresponding surge in weekly certifications for continuing unemployment benefits. Cloud solutions can augment legacy systems by offloading processes that are more efficiently handled in modern scalable systems, reserving the limited resources of legacy systems for what they were originally designed. This agile use of combined technologies allowed Rhode Island to deliver timely Pandemic Unemployment Assistance benefits with an estimated cost savings of $502,000 (representing a 411% return on investment). © 2020 Owner/Author.
ABSTRACT
INTRODUCTION: The COVID-19 pandemic has required adaptation and implementation of innovative healthcare practices, including patient triage and limiting staff exposure. Early recognition of deteriorating patients is an imperative step in preventing adverse events, improving outcomes, and limiting unnecessary exposures. Here we describe a critical care medicine (CCM) advanced practice provider (APP) led initiative to implement remote monitoring of non-critically ill COVID-19 patients for signs of deterioration, prompt intervention, and rapid transfer to the intensive care unit (ICU). METHODS: Every admitted COVID-19 patient received an initial remote telemedicine consult by a CCM APP. Patients were then monitored via EMR review once per 12-hour shift for the following indicators: oxygen modality and flow, increase in oxygen requirements, sustained tachypnea, and hemodynamic instability (mean arterial pressure less than 65mmHg or arrhythmias). If signs of deterioration were noted, the APP would remotely reassess the patient, provide recommendations to the primary team, and/or transfer the patient to the ICU. The primary endpoint was avoidance of acute cardiopulmonary deterioration requiring aerosolgenerating procedures (AGPs) outside of the ICU. RESULTS: Over 65 days, there were 2204 total hospital admissions, of which 113 (5.1%) (86 PUIs and 27 SARSCoV- 2-positive) patients were followed by the CCM APPs. Early ICU transfer was initiated on 13 occasions (12 patients, 1 of which had 2 transfer occurrences). Of those transfers, 4 (30.8%) required intubation, 2 (15.4%) required non-invasive ventilation, and 5 (38.5%) required high flow nasal cannula, all of which occurred in negative pressure rooms within the ICU. Vasoactive support was initiated for 5 (38.5%) patients after transfer. Of the 2091 admitted patients not followed by CCM APPs, 9 (0.4%) experienced cardiopulmonary arrest outside of the ICU and 96 (4.6%) required rapid responses. Of the 113 monitored patients, 0 (0%) required rapid responses or experienced cardiopulmonary arrest or required an AGP outside of the ICU. CONCLUSIONS: An APP-led tele-monitoring program may potentially avoid unnecessary viral exposures, decrease the risk of performing emergent AGPs, optimize ICU bed elasticity, and potentially minimize preventable in-hospital mortality.