The Psychological and Physical Implications of Covid-19 in Healthcare Organizations

In this time of uncertainty and sustained concerns and fears around Covid-19, there has been an extensive impact on the workplace – both physically and psychological. In this article, I address the Covid-19 background and data in the region of the country I live in. I will also cover workplace changes, emotional transitions, re-opening anxiety and ongoing employee stress.

Covid-19 Background

Covid-19, at present date (6/4/2020) has infected 6,563,099 people around the globe and killed 387,568. In the United States, there are 1,859,135 confirmed infections and 107,450 deaths. The fatality rate continues to be criticized while the illness is easily transmitted and acuity is extraordinarily high. In many cases patients are admitted for more than a week to treat a flu-related illness. As a country kid I lived near a very small town of roughly 500 people. While a low fatality rate is criticized, over 100,000 deaths equates to many small towns and communities.

Covid-19 enters and influences social, psychological, community and workplace settings in four key ways. First is the physical implication. Individuals become infected socially without knowing or they become infected from exposure to a known positively tested individual. The second way Covid-19 impacts our world is through overwhelming healthcare systems. Think of the explosion and propped up temporary hospitals in Italy that occurred, and in New York as well. The number of healthcare workers does not automatically go up to treat a virus; patients begin to significantly outweigh safe care practices by number of patients per nurse. As a result, facilities become over-extended and thus increased internal facility virus spread and community health hazards.

Third, Covid-19 implications are a result of media ‘over’ coverage. While awareness is a great thing, over coverage invokes human fear behavior changes that, in this situation, cause people to not go to the hospital for serious life-threatening conditions. Individuals with cardio health conditions that need to go to check-ups suddenly stop going. Those who would go to the ER and urgent care facilities suddenly take the risk in order to avoid Covid-19. Even further, individuals with mental health problems, drug addiction and rehabilitation needs also put off seeking care. Fourth, Covid-19 impacts influence public policy by causing non-essential business and services to come to a halt. This has significantly impacted economic conditions, unemployment and social behaviors in how individuals now are forced, and choose, to respond in different ways.

Data, Re-Opening and Anxiety

In the state of Wisconsin, where I currently reside, the state Supreme Court overturned the state governors stay at home order on May 13, 2020 and allowed businesses to start opening while emphasizing social distancing. At present, roughly 22 days later the state spiked record numbers four times with only three points of brief decline in total cases per day confirmed. What was not getting better suddenly got much worse. However, social settings in the community, such as bars and restaurants, continue to increase in volumes and social distancing is not being practiced while facemasks remain to be used by about half of individuals. In the same window of time, total deaths per day spiked six times with three short lulls in the data.

While the community has mixed emotions on re-opening the economy and communities, there remains a significant amount of anxiety in healthcare. Generally speaking, healthcare facilities are always ‘on guard’ to protect employees, visitors and patients. We look to healthcare for safety, advice and personal and social health. Yet in these times, when you walk into a hospital you’ll notice several things. First of which is empty parking lots; few are seeking care. Next, when you walk in to the front door you immediately come to a table with a large plexiglass barrier and an employee on the other side asking you about symptoms. Then, as you come to see, you and everyone else in the building is required to wear a mask at all times. You’ll also see social distancing markers on the floor in public spaces with waiting rooms with a fraction of the sitting capacity as compared to pre-Covid-19. Finally, you’ll notice the hospital is nearly empty with no visitors in the buildings; patients and clinical staff are the only people in the building. This is a significant difference than what is occurring in the community. It’s as though one exists in preparation for a war zone that the community seems to have forgotten while there is little decrease occurring in positive patients. This is particularly the case in Wisconsin where the total confirmed is rising day by day.

Physical Changes

In addition to the physical changes in the workplace mentioned above, there are other changes that have occurred. In hospitals, customers swipe their own card for payment, they cannot get fountain drinks, there are no salad bars, there is no way to dish food on their own; everything is done by employees. When you go to the Post Office you see an entire barrier of clear plastic across the entire counter with a small gap at the counter to pay for items, give your packages to the clerk and so forth. In some restaurants social distancing markers have been placed on the floors and payment is done touch free where employees do not touch anything in a shared manner.

Healthcare Employee Psychological Impacts

There are several psychological impacts from Covid-19. First, healthcare employees have to continue to digest the changes in their environment; barriers, constant masking, changes in policies, etc. There is also the continued increased level of potential exposures and future waves of infection. They also face increased workload demands and risks as hospitals expand opening of surgical procedures; more patients, less resources. Additionally, workload demands increase because peers resign, retire or quit their positions because of Covid-19.

The stressors of Covid-19 also influence attachment, motivation and organizational commitment. As I have covered before, motivation is determined by the presence and absence of particular workplace factors and the extent to which they are present or absent. Organizational commitment is based in ones emotional attachment to remain with an organization. Attachment is based on the trust and expectation that help and support will be available when it is needed and past experience continue to exhibit support for needs.

During the course of Covid-19, the CDC and hospitals began to bend the rules of acceptable PPE usage. Changes were suddenly accepted as reasonable practice because of the PPE strain and safety quickly exploded as a concern. For example, single use masks were now to be used for an entire working shift and isolation gowns had to be used for the entire shift. Things truly began to look like the Wild Wild West.

Due to environment during Covid-19, motivation factors adversely influenced include Company Policies, Relationship with Supervisors, Working Conditions and Safety. As outlined in my research on motivation and commitment, each construct is highly correlated. So, in other words, the more motivation is influenced, the more commitment is weakened.

As outlined, Covid-19 has wreaked havoc on healthcare employee psychological behaviors, physical changes and social dynamics. With no end in sight these things will continue to put pressure on sensitive areas of humanity.