Healthcare in Crisis: Interview with a Hospital Worker

S is an ASCP-certified Medical Laboratory Technician from Ohio and a member of the Independent Socialist Group

Can you describe what you do and what working conditions were like prior to the pandemic? 

I work in a large regional hospital with a Level 1 trauma center, so we have always been very busy. We handle inpatient, ER, and outpatient specimens. There has been a shortage of lab techs for over a decade, but the workload was manageable if brisk before COVID.

How have working conditions changed since the COVID outbreak? 

The biggest changes have included the implementation of COVID testing, exacerbated staff shortages, dramatic increases in critically ill patients, higher inpatient specimen volumes, and stress.

COVID testing by PCR is performed in our hospital lab. It has become a full-time job to keep up with the volume of testing and reporting of results, but we have not added any staff to do so. Additionally, there has been a shortage of PCR testing supplies, so we have had periods of relying on antigen testing, which is not as reliable and requires more digital paperwork.

We have had many people out due to COVID quarantines or illness throughout the hospital. The entire health system has had to sustain operations with a reduced workforce, which causes disruptions in workflow and forces the remaining staff to take on additional responsibilities, contributing to burnout. For example, one of my colleagues frequently stays late to ensure that the lab and bathrooms are stocked with paper towels, hand soap, antibacterial cleaning wipes, hand lotion, and toilet paper. This is a job normally performed by environmental services The governor of Ohio deployed National Guard troops to help out in the hardest-hit hospitals in our state. We have had nearly 100 National Guard members working at my facility.

We have had more critically ill inpatients as well as a dramatic increase in the number of people visiting the emergency room. Patients who are sick with COVID require intensive patient care that results in an increase in specimens handled by the lab. People who are hospitalized without having COVID are often sicker because they have delayed care due to COVID or due to an inability to get an appointment with their provider. At one point we increased our usual inpatient beds by nearly 400 to accommodate all the COVID patients. This meant that people with non-COVID illnesses had to wait for care because so many of our resources were devoted to COVID care.

All of this has contributed to overworked employees. In the lab, we are both busier during our scheduled shifts and facing the necessity of working overtime to cover for our absent coworkers. Sustaining this over two years has become untenable. People are at the breaking point. Some are choosing retirement. Others are leaving to work in smaller, less-busy hospitals or outpatient settings that are not open 24/7/365. Watching patient after patient die, feeling undervalued and underpaid, and seeing Repeated emails from administration cheering us on and exhorting us to keep working hard is demoralizing.

Additionally, it is incredibly frustrating to be out in the community and see people flouting COVID guidelines and acting like COVID isn’t a threat or don’t care if they are putting others at risk. I am constantly exposed to people with COVID and those who are working with people with COVID. Many of our patients are vulnerable due to age, medical condition, socioeconomic status, etc., or care for someone who is vulnerable. They don’t deserve to be at risk just because some people aren’t willing to implement COVID mitigation strategies. It makes me angry that people expect the healthcare system to be there for them when they need it, but they don’t seem to care that their actions are contributing to a breakdown in that same system and unnecessary stress for the people who work in it. 

Healthcare workers at your facility are not currently unionized. What do your co-workers think about unions and do you think recent union action across the country has had an impact on their opinion?

Most of my coworkers are open to the idea of a union. There are a few who believe the lies that unions just take your money and don’t do anything for you, but watching management do little to help us during COVID has increased the number of people who think that collective bargaining is the best way to get what we need. I do think that the upswing in unionization efforts and the strikes have made the idea of unionization more visible and more positive.

There is a need for all workers in all workplaces to unionize. Specific to my facility and my colleagues, we could unite around issues of better healthcare benefits, higher pay that is on par with our specialized training and certifications, retention bonuses for current employees instead of hiring bonuses for new staff, more time off to help cope with stress, and mandatory staffing levels so we are not chronically understaffed. I have watched management reduce the definition of “fully staffed” several times over the coursework of the pandemic; we are being required to do more with less and told that this is the new normal.

What is the mood among healthcare workers towards universal health care, in your experience? What has the pandemic shown you about healthcare under capitalism?

People are divided on the issue of universal healthcare. There are still people who cling to the idea of “personal responsibility” and feel like they shouldn’t have to pay for other people’s healthcare. When you are working a high-stress job for relatively low wages, perhaps struggling to pay for childcare or car repairs, the idea of handing over more of your wages to the government makes little sense. My colleagues get very frustrated when the ER is clogged up with people who have come in for a sore throat or a pregnancy test or a cold. But when I point out to my coworkers that we live in a system that forces people to get basic care at an ER, a system that forces people to make weekly visits to the ER just to get some food and a warm place to stay for a while, they see that the problem is not the people but the system. They seem to realize that it’s not a problem of individuals or a lack of personality responsibility, but a problem of how those in charge of our society chooses to allocate resources. I talk to people about the idea that “we all do better when we all do better” and that healthcare isn’t a privilege of those who have high-paying jobs.

The pandemic has shown me that healthcare under capitalism means massive disinvestment in public health, healthcare infrastructure, and massive inequalities in people’s access to healthcare. This is because healthcare companies are either explicitly for-profit or, if they are non-profit, still have to operate under a “cost-benefit analysis” that always puts cost ahead of benefit.

Image Credit: Delaware National Guard via Flikr // CC-BY SA 4.0