How the Passion for Saving Lives Shrivels: Does the Healthcare Industry View Frontline Workers as Expendable?
Leah Adams has nightmares.
The ability to heal, to help, is a blessing. But when there are too many sick, it’s a crushing weight that doesn’t lift. The inability to keep up during Adams’ long days in the intensive care unit (ICU) follows her into even longer nights.
She has nightmares about her job, about too many occupied beds, about too many lives to help. She wakes up feverish and shaken. But there’s no time to dwell on it because she has work to do. People to care for. Waves upon waves of people.
When the COVID-19 pandemic crept into America in March 2020, Adams gained a new title other than Texas ICU nurse: frontline hero. High tide came crashing in and never left. Her days dissolved into untamed chaos.
Before a shift, anxiety set in like a livewire beneath her skin. Walking into the ICU meant never knowing what’s coming — will there be 10 ICU COVID patients? Will there be overflow areas that had limited ICU resources on top of 30 or more COVID patients?
One shift could mean coding and chest compressions on numerous patients, saving slim to none. Others, no one would pass, but they’d place patients on ventilators knowing their chances of coming off would be low.
She started shifts with the ritual of donning full personal protective equipment (PPE), including stifling respirators that caused pressure injuries to the face when worn for long periods of time, which Adams and her coworkers did for 13 hours at a time.
The rest was the same each day: a vicious beginning and an unforgiving end.
Through it all, Adams and others almost never had the chance to even sit down during a shift. There were little to no breaks to eat, or to sip water, to use the restroom. Each moment was a fight against the kind of exhaustion that ached in their bones, that they had to force their legs to wade through as if the air turned to molasses.
Adams and her coworkers managed to win those fights and show up to help care for those who need it.
They’re all heroes. Our heroes.
The media sang praises of thanks to healthcare workers across the world for putting themselves at risk to help others. They were recognized by the United Nations and were given a moment of celebration at the Super Bowl. Countless headlines and stories were dedicated to those on the front line. Even janitors were given moments to shine. The Vicksburg Post went as far as to say Time magazine made a mistake when naming President Joe Biden and Vice President Kamala Harris as their Person of the Year in 2020 — that they really should have picked our frontline healthcare workers instead.
But take away the thankful messages and the reality of many healthcare workers’ situations was this: beyond the weariness of day-to-day life, those who provided care for a living were not receiving care from the medical industry.
Understandably, there was confusion at the beginning of the pandemic because experts knew so little about the virus. Treatment plans, PPE/isolation guidelines and more would change each day, and those in Adams’ ICU unit were overwhelmed with keeping up with constant back-and-forth while dealing with overfilled maximum capacity of horribly sick patients.
“Some days, I didn’t know if my coworkers and I were properly protected because of so much conflicting information,” said Adams.
But at least there was hazard pay, right?
“My place of work didn’t pay us any kind of hazard pay,” Adams said. “On top of that, if you developed COVID after working with the patients, you had to use your personal paid time off to take time off of work.”
At the beginning of the pandemic, all seemed optimistic in terms of raised pay for essential workers as the House of Representatives came out with $200 billion in hazard pay funds. Except, The Brookings Institute reported that few frontline workers have received hazard pay, and multiple proposals regarding hazard pay have been dropped.
But because of the passion they had for their work, they didn’t complain. Not even in the beginning when only nurses were allowed in the COVID units in Adams’ place of work, which meant on top of everything they were giving to their work, they also had to be environmental services.
Cleaning toilets, mopping the floors, scrubbing counters and walls. Stocking all their own supply and medical rooms and supervising themselves. If something broke or stopped working, maintenance wouldn’t come to help fix it — they had to take care of it or just go without that resource.
“The nurses and respiratory therapists started doing the jobs of four [or more] other people with more patients and the same pay,” said Adams.
Another healthcare worker in Texas, registered nurse (RN) Ana Prescott said, “We’re all burned out.”
Specifically, she works in the emergency department of a level one trauma center in Temple. She dealt with horrors, sank beneath the weight of a mountain of PPE each shift, and only received hazard pay for a brief moment at the beginning of the pandemic.
When friends and family called COVID-19 a hoax, complaining across social media, Prescott watched the virus kill patients right before her eyes. She went to work and held the hands of those whose families couldn’t visit them due to restrictive policies. And as they passed, she would tell them, “I will be here. I will not leave you alone.”
Still, Prescott kept going. She stayed strong, even when there were days she broke down in her car after a shift. Even when there was no compensation for the danger she put herself in. Even when part of society disregarded her work, saying it wasn’t real.
Many nurses ended up leaving their jobs according to RN Noah Harris in Austin, Texas. They moved to the few places that paid them 10 times the amount they made before at Harris’ place of work. Or, they looked to get away from bedside nursing, searching for administration jobs instead.
Harris himself said, “The pandemic has shown me I’d like to pursue further education which would get me away from the bedside.”
Was it the stress of the pandemic that caused them to find another path? Perhaps. Or, maybe it was a combination of things.
One nurse, Laura Castle, didn’t work during the peak of the pandemic, but she watched the effects of the last year on all of her old colleagues across the country. She knows one thing for sure about the industry’s view of their frontline workers:
“When you choose a career like this, you go into it knowing you’re going to watch people suffer. You know you’ll put your own life at risk being close to the sick,” said Castle. “But this…you just feel so expendable. They don’t care about you at all.”
Adams’ experience as a frontline worker turned even more stressful not long after the beginning of the pandemic when she became pregnant. Though she could do her job as well as her coworkers, as more information came out about COVID’s effect on mothers and their unborn children, she wanted to protect herself as much as she could. But this wasn’t taken into account at her workplace.
“Staffing and other units, like the ER, pressured me multiple times to go in and care for the COVID patients [despite] research,” she said.
There was no thought of the health of Adams and her baby in those moments, and definitely no thought of compensation for the potentially horrible consequences contracting COVID could have brought on her and her unborn child.
In cases like hers, it makes sense why people are maneuvering their way to positions they feel are safer. It makes sense why the motivation peters out, why workers like Adams have nightmares.
For Adams, days in the ICU during the pandemic were like the answer to a chilling riddle: All around you lies ashes and grief. You go up in flames and drown at the same time. Where are you?
Work.
For the entirety of healthcare workers, it was a whole war just to keep going to work day after day.
“My place of work abandoned their frontline staff,” Adams said. “They left us to deal with issues way above our paygrade [every day]. There was never any help.”
She shared that so many of the staff have quit this year, it was like flies dropping from the air. “I hope they know the majority of that is on them,” said Adams, “not the pandemic itself.”
The one saving grace was seeing the strength and resiliency of her coworkers, the other frontline staff. “They’re the only ones that saved me both at work and as a shoulder to cry on after,” she said.
And with only themselves to lean on for support, there was nothing to do but band together, give away pieces of themselves to the pandemic, a starving abyss eating everything in sight, never satisfied.
Moving forward is the only option, now. Whether that means taking time off like Adams is doing with her newborn, accepting the new normal like Prescott or changing paths like Harris, these frontline workers made it through.
Perhaps, when the world settles, the industry will be left with a legion of exhausted and upset employees wanting to see changes because all that’s left for them are their dampened views of their passions. There’s no one to blame for that but the industry.
Will there be any change, though?
“I really hope so,” said Prescott. “I think ER nurses should get hazard pay anyway — at least at a higher acuity hospital.”
About the future, Harris said, “I don’t think there will be any changes.” He gave no further explanation.
Adams shared her view, saying, “Because healthcare workers are [inherently] the selfless people that they are, hospitals took advantage of that and got away with it. They will try it again.”
It seems rather bleak, then. Healthcare workers fought — some are still fighting — battle after battle with little to no backup. Sure, the media gave them titles and kind words, but that doesn’t negate the truth that those in the industry uncovered — their blatant expendability.
However, Adams’ point stands: it takes a selfless person to enter the healthcare field anyway. Even if security never strengthened and compensation never comes for their sacrifice, most would keep trudging onward.
“We became nurses to help the sick, to help people get better,” said Adams.
But what will it take for the industry to help them in their endeavor to help others?
