Frontline, Essential, and Invisible: The Needs of Low-Wage Workers in Hospital Settings During COVID-19.

BACKGROUND: Frontline health care workers are particularly vulnerable to burnout and diminished well-being as they endure COVID-19 pandemic-related stressors. While physicians and nurses are the public face of those experiencing burnout in hospitals, these stressors also affect low-wage workers such as food and housekeeping/janitorial service workers whose roles largely remain "invisible" when conceptualizing the essential health workforce and understanding their needs. This study sought to understand the experiences of frontline essential workers to better support them and prevent burnout. METHODS: Using a semi-structured interview guide, we conducted 20 in-depth qualitative interviews with workers in three U.S. states. Thematic content analysis was conducted to code and analyze interviews. RESULTS: Workers had an average of 5.8 years in their jobs, which included food services, housekeeping/janitorial, and patient transport roles. Analysis revealed four prominent stressors contributing to worker burnout: changes in duties and staff shortages, fear of contracting or transmitting COVID-19, desire for recognition of their job-related risk, and unclear communication on safety precautions and resources. Protective factors included paid time-off, mental health supports, sense of workplace pride, and self-coping strategies. CONCLUSION/APPLICATION TO PRACTICE: As health systems continue to grapple with care delivery in the context of COVID-19, identifying best practices to support all workers and prevent burnout is vital to the functioning and safety of hospitals. Further consideration is warranted to create policies and multipronged interventions to meet workers' tangible needs while shifting the culture, so all members of the health workforce are seen and valued.

The Low-Wage Essential Worker: Occupational Concerns and Needs in the COVID-19 Pandemic-A Round Table.

BACKGROUND: Planning occupational health and wellness services and support directed toward low-wage, essential workers in the COVID-19 pandemic has posed a number of challenges across work settings. This article explores the concerns and needs of low-wage essential workers as understood by experts in the field. METHODS: Leading experts in the areas of occupational health and safety, risk management, insurance, and professional education/training were identified and invited to participate in a Round Table discussion. Questions posed to experts were based on literature that addressed COVID-19, essential workers, low-wage workers, infection transmission, education/training, and social justice. FINDINGS: Experts agreed that special considerations must be in place to address the concerns and needs of the low-wage essential worker. These special considerations should address not only the worker's occupational experience but their family and home environment, fears and anxieties, and the economic impact of the COVID-19 restrictions and requirements. CONCLUSION/APPLICATION TO PRACTICE: The occupational health professional is a key resource to employers charged with addressing the concerns and needs of low-wage, essential workers during the COVID-19 pandemic.