Health Care Workers Are Putting In Longer Hours—Here’s How Their Time Compares to Others
The year 2023 marked a significant period for labor movements among U.S. healthcare workers. Over 75,000 employees participated in a historic three-day strike, the largest recorded healthcare strike in U.S. history. The primary grievances were stagnant wages despite rising inflation rates and insufficient staffing levels. Traditionally, U.S. doctors and medical residents have not formed unions, but 2023 saw 550 healthcare workers from a Minneapolis-based health system establish one of the nation's largest private-sector physician unions. From January 2021 to November 2023, there were 109 strikes in the healthcare and social assistance sectors, with an upward trend. While medical strikes are more common internationally, they are growing in the U.S. A major health organization analyzed changes in weekly working hours across the healthcare industry using Bureau of Labor Statistics data. A 2023 survey revealed that 70% of healthcare workers found their workload and stress levels unsustainable. Understaffing, burnout, and heavy administrative tasks are key reasons for the protests. The healthcare system is still grappling with the fallout from the COVID-19 pandemic, which exacerbated staff shortages. In 2020, it was projected that physician demand would surpass supply, leading to a shortage of 54,100 to 139,000 by 2033, especially in primary care and rural areas. A November 2023 study noted that while some staffing levels neared pre-pandemic figures by 2022's end, nursing facilities still suffer significant staffing deficits, with nursing staff down by 10.5% and skilled nursing facilities by 12%. Overburdened healthcare staff are about twice as likely to leave their jobs compared to non-overloaded workers, according to a March 2023 study. Burnout, rampant in healthcare, was spotlighted during the pandemic, defined as a syndrome from chronic workplace stress due to job demand-resource imbalances, leading to reduced professional efficacy. A 2023 survey found over 33% of healthcare workers admitted making errors due to sleep deprivation, with 82% noting patient care declines when fatigued. Nursing homes operate with the leanest staff, but BLS data indicates that fewer workers are maintaining similar weekly hours as a larger workforce did in 2000. Ambulatory healthcare professionals now work half an hour more weekly to cover shortages elsewhere: hospital staff work two more hours. Unlike industries like aviation, where workload is tightly monitored, efforts to reduce medical workloads are irregular, mainly targeting trainees, as per a March 2023 medical journal article. EMS professionals often work over 40 hours weekly out of necessity; 71% of surveyed EMS workers in 2020 reported needing overtime or multiple jobs for financial stability. A majority of hospital nurses work 12-hour shifts, excluding commute time, due to 24/7 patient care needs. Over two years, approximately half the nursing staff in a hospital unit left, impacting patient care as excessive workloads can cause mistakes. Overworked staff's errors can be fatal; a 2021 study found that adding a patient to a nurse's caseload raised the patient’s 30-day mortality risk by 16%. In 2021, physicians averaged 50-59 working hours weekly, with 36% working 60-80+ hours, partly due to healthcare consolidation leading to increased administrative duties. Despite heavy workloads, many healthcare professionals take on additional responsibilities. Regulatory bodies have suggested tighter work hour limits than the previous 80-hour weekly cap for medical residents. Proposed staffing minimums for nursing homes could ensure adequate staffing, although the bill faces opposition. Hope may lie in greater hiring process transparency; a recent commentary suggests pay transparency in job listings is becoming expected. In November 2023, 77,000 healthcare jobs were created, mainly in ambulatory services, hospitals, and nursing facilities, potentially easing the strain on current workers. However, the need for more staff remains urgent.
