“You Have to Keep in Mind That You’re Dealing with People's Lives”: How Hospital Service Workers Enact an Ethic of Care

The COVID-19 pandemic heightened the need to examine the health and safety of all workers, especially frontline workers, like hospital service workers (HSWs). Given ongoing pandemic-related challenges like healthcare labor shortages, attention to HSWs is essential. This paper draws from 3 waves of in-depth interviews conducted with HSWs from 2017 to 2020 to understand the evolving nature and challenges of their work from their perspectives. By analyzing the interviews, we found their approach to labor consistent with a feminist ethic of care. The ethic of care framework understands care as a public responsibility necessary for a functioning society. Workers perceived the ethic of care to be consistently violated by their employer, which contributed to poor working conditions, threatening the well-being of workers and patients alike. Drawing from workers' experiences and insights, the ethic of care framework can inform organizational changes to improve both occupational health and patient care.

[1]  L. Punnett Response to NIOSH Request for Information on Interventions to Prevent Work-Related Stress and Support Health Worker Mental Health , 2022, New solutions : a journal of environmental and occupational health policy : NS.

[2]  L. C. Myers,et al.  The COVID-19 Pandemic Strikes Again and Again and Again. , 2022, JAMA network open.

[3]  Janette Dill,et al.  Structural Racism And Black Women's Employment In The US Health Care Sector. , 2022, Health affairs.

[4]  L. Galuppo,et al.  Care Ethics Management and Redesign Organization in the New Normal , 2021, Frontiers in Psychology.

[5]  J. Anema,et al.  A Context Analysis with Stakeholders’ Views for Future Implementation of Interventions to Prevent Health Problems Among Employees with a Lower Socioeconomic Position , 2021, Journal of Occupational Rehabilitation.

[6]  Anita L. Schill,et al.  Ethics and Total Worker Health®: Constructs for Ethical Decision-Making and Competencies for Professional Practice , 2021, International journal of environmental research and public health.

[7]  A. Gkiouleka,et al.  A Scoping Review of Psychosocial Risks to Health Workers during the Covid-19 Pandemic , 2021, International journal of environmental research and public health.

[8]  Sriya Bhattacharyya,et al.  Beyond the Nurses and Doctors: Structural Racism and the Unseen Frontline Service Workers During the COVID-19 Pandemic. , 2021, Psychiatric Services.

[9]  J. Etchegaray,et al.  Home Care Aide Safety Concerns and Job Challenges During the COVID-19 Pandemic , 2021, New solutions : a journal of environmental and occupational health policy : NS.

[10]  Rachael M. Jones,et al.  Factors Associated with Environmental Service Worker Cleaning Practices in Healthcare Settings: A Systematic Review of the Literature. , 2021, American journal of infection control.

[11]  OUP accepted manuscript , 2021, Health & Social Work.

[12]  N. De Brier,et al.  Factors affecting mental health of health care workers during coronavirus disease outbreaks (SARS, MERS & COVID-19): A rapid systematic review , 2020, PloS one.

[13]  J. Dennerlein,et al.  The future of research on work, safety, health and wellbeing: A guiding conceptual framework , 2020, Social science & medicine.

[14]  S. Surani,et al.  Psychological effects of the COVID 19 pandemic on healthcare workers globally: A systematic review , 2020, Psychiatry Research.

[15]  S. Hecker Hazard Pay for COVID-19? Yes, But It’s Not a Substitute for a Living Wage and Enforceable Worker Protections , 2020, New solutions : a journal of environmental and occupational health policy : NS.

[16]  M. Christian,et al.  Mental health care for medical staff and affiliated healthcare workers during the COVID-19 pandemic , 2020, European heart journal. Acute cardiovascular care.

[17]  M. Austin,et al.  An Investigation of Healthcare Worker Perception of Their Workplace Safety and Incidence of Injury , 2020, Workplace health & safety.

[18]  Connecting Healthcare Worker Well-Being, Patient Safety and Organisational Change , 2020, Aligning Perspectives on Health, Safety and Well-Being.

[19]  F. Song,et al.  Prevalence of workplace violence against healthcare workers: a systematic review and meta-analysis , 2019, Occupational and Environmental Medicine.

[20]  J. Brophy,et al.  Breaking Point: Violence Against Long-Term Care Staff , 2019, New solutions : a journal of environmental and occupational health policy : NS.

[21]  Ruqaiijah Yearby Racial Disparities in Health Status and Access to Healthcare: The Continuation of Inequality in the United States Due to Structural Racism , 2018 .

[22]  R. Sarmiento,et al.  Workplace violence injury in 106 US hospitals participating in the Occupational Health Safety Network (OHSN), 2012‐2015 , 2018, American journal of industrial medicine.

[23]  A. Tipple,et al.  Biological risk among hospital housekeepers , 2016, Archives of environmental & occupational health.

[24]  M. Woods An Ethic of Care in Nursing: Past, Present and Future Considerations , 2011 .

[25]  J. Tronto,et al.  Creating Caring Institutions: Politics, Plurality, and Purpose , 2010 .

[26]  S. Kumagai,et al.  [Occupational health of endoscope sterilization workers in medical institutions in Osaka Prefecture]. , 2006, Sangyo eiseigaku zasshi = Journal of occupational health.

[27]  S. Sevenhuijsen The Place of Care , 2003 .