When the healthcare worker becomes the patient

The state of healthcare is a topic of heated discussion among not only lawmakers and presidential candidates, but ordinary Americans.

Is ObamaCare working? Should it be repealed? Why are healthcare costs so expensive? Are insurers hiking premiums? Are there enough affordable options available?

On top of this barrage of questions, there are a host of new questions.

Should immigrants, including undocumented immigrants, have access to affordable healthcare? Would U.S. taxpayers be footing the bill for healthcare costs associated with increased immigration and the resettlement of refugees from Syria and Iraq? What about providing healthcare to unaccompanied immigrant children fleeing violence in Central America?

{mosads}Our conversations are focused on patients; those accessing healthcare to receive care. Rarely, in these discussions, is there consideration of what all this means for healthcare workers — those providing care.

With the healthcare landscape shifting beneath their feet, are they prepared to care for the ever-growing numbers of patients and ever-expanding locations where care is provided (including pharmacies)? What is being done to take care of the caregivers? How is their safety been addressed? Is this part of the conversation?

Today, healthcare workers are doctors, nurses, therapists, emergency personnel, transporters, laundry workers, those in technical trades and environmental services, and so many others. And tomorrow, as healthcare shifts further out of hospitals into homes and alternate sites, it will include many other specialties and caregiver types.

This summer, the Occupational Safety and Health Administration (OSHA) started this conversation. They reported that in 2013, there were nearly 58,000 work-related injuries and illnesses in U.S. hospitals. That amounts to 6.4 work-related injuries and illnesses for every 100 full-time employees: almost twice as high as the overall rate for any other industry in the private sector, including manufacturing and construction. The costs associated with these worker injuries are extensive and are borne by not only by their employers but, ultimately, by the healthcare system.

In response, OSHA announced that because healthcare, including both hospitals and nursing care facilities, is so hazardous for those working in it, they will step up enforcement in order to prevent overexposure to hazards.

Explaining the heightened attention to workplace safety in the healthcare sector, Dr. David Michaels, OSHA assistant secretary, said that “workers who take care of us when we are sick or hurt should not be at such high risk for injuries — that simply is not right. Workers in hospitals, nursing homes and long-term care facilities have work injury and illness rates that are among the highest in the country, and virtually all of these injuries and illnesses are preventable.” I could not agree more.

The greatest hazards include musculoskeletal disorders (relating to patient or resident handling); workplace violence; bloodborne pathogens; tuberculosis; and slips, trips and falls. They also includes exposure to superbugs and multi-drug resistant organisms, such as Methicillin-resistant Staphylococcus aureus (MRSA), and exposures to hazardous chemicals such as sanitizers, disinfectants, anesthetic gases and hazardous drugs.

With flu season upon us and vaccination rates lower than what is ideal, healthcare facilities will be accessed more frequently, whether by the 17.6 million American people who have ObamaCare and use it or more likely, by those that don’t have any insurance. Emergency rooms and patient wards will be crowded, with longer wait times and no available beds. This means that healthcare workers will be overwhelmed adjusting for the change and injuries may be more likely. This may result in the worker becoming the patient, especially if the Ebola virus or another globally emerging disease hits our borders again this year.

All of these elements and risks now in healthcare beg the question: Are we doing enough to address the safety and security of those workers providing healthcare to us? Are we accounting for and adjusting our conversation based on the value they provide?

As debate intensifies on healthcare reform, particularly among presidential candidates, it is critical that the conversation expands to include consideration of what we should be doing to ensure that when Americans need care, those who are trained to provide it can do so.

Mitchell, DrPH, M.P.H., C.P.H. is the president and executive director of the International Safety Center and the Public’s Health.