Figuring Out Who Cares
In the COVID Fight, Healthcare Workers Need Safety, Support, & Access to Skills
Frantzted Chanblain recently started his career on the front lines of the COVID-19 pandemic at Boston Medical Center after completing the Certified Nursing Assistant (CNA) program at Jewish Vocational Services. “This is the best time to SHOW not to TELL we have compassion and empathy,” said Frantzted. “Even though it’s risky now, I love what I am doing so far.”
Alongside the doctors we read about in the news, stand the thousands of women and men in the “hidden healthcare workforce” — CNAs like Frantzted, along with licensed practical nurses, emergency medical technicians, medical assistants, home health aides, and others.
According to Bureau of Labor Statistics, the healthcare industry is expected to add more jobs over the next decade than any other occupational group and many of these will be frontline, allied healthcare workers requiring credentialing beyond high school but not a four-year degree.
There were already shortages in these key healthcare occupations before the COVID-19 crisis took hold, but the effort to contain the virus has accelerated demand.
A recent LinkedIn workforce report showed March’s healthcare job postings were 35 percent ahead of January’s pace. CNAs, LPNs, patient care technicians, and medical assistants were among the top ten healthcare jobs being recruited last month. According to LinkedIn’s George Anders, “the boom in job listings closely mirrors the current or expected influx of patients whose coronavirus exposure has led to Covid-19 symptoms.”
So how do we as a nation support our frontline healthcare workers and respond to this dramatic increase in demand? In a recent episode of Skilled America Podcast, I sat down with two individuals working day and night to answer this question: Daniel Bustillo, executive director of the Healthcare Career Advancement Program (HCAP), a national labor/management organization that promotes innovation and quality in healthcare career education, and Van Ton-Quinlivan, CEO of Futuro Health, a non-profit established by Kaiser Permanente and SEIU-United Healthcare Workers West to grow the largest network of credentialed allied healthcare workers.
Daniel and Van were pretty clear about what’s needed to maintain the existing frontline healthcare workforce and increase their ranks to the level needed to respond to the COVID-19 crisis.
Frontline healthcare workers need safety (including access to Personal Protective Equipment), support (including childcare, transportation, housing), and skills (access to essential training to respond to demand and stay safe).
Safety
The shortage of PPE and other essential devices threatens our ability to maintain the existing frontline healthcare workforce because of the physical and mental health threats that equipment shortages pose. As recently reported by Vox, some hospitals are considering do-not-resuscitate orders for COVID-19 patients because close physical contact will put healthcare professionals without adequate PPE at risk.
“We’re seeing more and more front-line healthcare workers get infected or experience fatigue and burnout,” said Daniel.
“We’re really potentially placing workers in the position of making impossible choices on who receives care and who doesn’t,” he said. “We should all be worried about the long-term impacts of all of this…and how this will impact both their physical and mental health post-crisis.”
Support
Access to childcare and other supports is another challenge to maintaining and growing the frontline healthcare workforce needed to respond to COVID-19. Entry-level allied healthcare occupations often come with low pay and occupational segregation. Nearly 80 percent of allied healthcare workers are women, and Black and Latino workers are over-represented in lower paying occupations and are less likely to have the financial resources needed to weather the pandemic.
“They are, the majority, overwhelmingly women,” said Van. “So when schools are closed, the issue of childcare is really causing hardships.”
Daniel agreed, “Workers are really operating under difficult circumstances, oftentimes isolating themselves from family and loved ones, or juggling childcare responsibilities, or braving the use of public transportation to get to work, and more in order to respond to the crisis and save as many lives as possible.”
Adequate childcare, transportation support, housing support and direct cash payments are “all important to consider when we’re talking about an adequate response in support of healthcare workers in this moment,” he said.
Access to Skills
COVID-19 is requiring a training response on a scale that the nation has never seen. To meet the demand, in a matter of weeks, our country will need to train thousands of new healthcare workers. At the same time, hundreds of thousands of existing healthcare workers will need to upskill on COVID-19 protocols or cross-train to move from non-acute to acute settings.
For example, California Governor Gavin Newsom has identified the need for 50,000 new beds in re-purposed, pop-up and existing healthcare facilities across the state. Staffing those beds will require 13,000 new front-line healthcare workers and upskilling and cross-training 100,000 existing LPNs across the state in acute COVID-19 care.
Futuro Health is waiving all fees and tuition for these 100,000 LPNs to complete an online industry recognized credential in pandemic readiness that will help them safely expand their duties to acute care.
Likewise, HCAP is leading efforts to upskill and cross-train frontline healthcare workers on COVID-19 protocols through online modules for clinical caregivers, environmental service workers, and those in long term care like home care and skilled nursing facilities. HCAP is also developing mass distance learning options for transitioning workers from other sectors like hospitality and retail who are now unemployed into occupations like CNA.
The training response required by COVID-19 is accelerating digital learning as a tool for rapid upskilling. Though this comes with some challenges.
“The pandemic is making more obvious the need to be able to ingest training in small bites,” said Van. “For example, in the beginning of your shift or the end of your shift, in small bites. And clearly, mobile-friendly delivery methods are even better because that’s what the healthcare professionals are going to have access to most easily.”
While HCAP has been relying on digital learning during the pandemic, Daniel cautions the need to examine the long-term implications of a massive shift to online education in terms of quality and equity.
“We know that many people struggle with online education, due to either a lack of basic technology — like access to broadband and hardware — and the evidence that we have available to us indicates mixed effects on outcomes from that transition to distance learning programs.” Any shift to digital learning he argues “cannot exacerbate those inequities and inequalities.”
Responding at Scale
One of the defining features of COVID-19 is scale. The scale at which people are losing jobs. The scale at which we need to procure essential equipment. The scale at which we need a healthcare workforce in order to contain an exponentially spreading virus.
Organizations like HCAP and Futuro Health are working on the frontlines of education to respond to these unprecedented challenges. But responding at necessary scale requires policymakers as partners.
So where do they see a role for policymakers, particularly those designing federal stimulus efforts?
For Daniel it starts with guaranteed personal protective equipment and access to training on proper use of equipment and COVID-19 protocols. He also wants to see “massive investments” in capacity and continued redesign of public workforce and college systems as well as supports for frontline workers such as paid sick leave, child care, transportation, housing assistance, direct cash payments, and mental and behavioral health support. He also wants to see training trust funds that support industry partnerships like HCAP that “involve unions and employers who are working together to co-create solutions with the support of regional workforce intermediaries to scale these training solutions.”
Van pointed the National Skills Coalition’s policy recommendations for pandemic response and recovery as “spot on.” She emphasized that policymakers will need to modernize college financial aid to support shorter, high-quality certifications to help people make transitions into and within the healthcare workforce. “This will become extremely valuable as we deal with the aftermath of COVID 19,” she said.
Women and men in the front-line healthcare workforce are putting their lives on the line to contain the COVID-19 pandemic. Congress has an opportunity to ensure this workforce is safe, supported and skilled up to keep fighting.
“The workers we support are truly heroic, while even under the best of circumstances,” said Daniel, a former home health worker, himself. “There’s a real moral quality to the provision of care and healthcare work. I think this is even more evident given the current crisis.”
Certified Nursing Assistant Frantzted’s words bear repeating: “This is the best time to SHOW not to TELL we have compassion and empathy.”
