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Survey Highlights Pandemic’s Toll on Health System Employees’ Career Development, Childcare Needs


Survey responses illustrate the impact COVID-19 has had on health system employees, including considerations of leaving the workforce and concerns about childcare.

New research published in JAMA Network Open shows a substantial number of a health system’s employees and trainees experienced major stress and work disruptions due to the COVID-19 pandemic.

Previous research shows that as U.S. workers transitioned to remote work in March 2020, many were required to provide childcare and schoolwork assistance for children. “Employed women, in particular, were likely to face greater burdens because they spend 22% more time on unpaid household and care work compared with their male counterparts, with Black or African American and Latina mothers spending nearly twice as much time as men on unpaid housework,” authors wrote.

Women also account for the majority of hospital employees and make up an important cohort of essential clinical workers. In addition, employees and trainees who must present to work or training in person can face new childcare expenses. These life changes have prompted concern for their impact on careers and well-being on faculty, staff, and trainees.

To better understand the associations of the pandemic with career development and subsequent work culture and childcare needs of employees and trainees, researchers conducted a survey study between Aug. 5 and 20, 2020 at the University of Utah Health.

A total of 27,700 faculty, staff, and trainees received a Qualtrics survey via email as part of a quality improvement initiative at the academic medical center, while 5,030 participants anonymously completed the entire survey. Although the survey was mostly quantitative, it did include several open-ended questions.

Mean participant age was 40 years. Despite more women completing the survey than men (75%), “the proportion is similar to that of women within the health system,” researchers wrote. The majority of respondents were also White or European American (86%) while 11% were Latino or Latina, Black or African American, American Indian, Alaska Native and Native Hawaiian or Pacific Islander and 6% were Asian or Asian American.

Around one-half of the sample reported working in a clinical setting and having at least one child aged 18 or younger. Sixty-six percent of those surveyed were staff, 16% were faculty and 13% were trainees.

Analyses revealed:

  • Nearly one-half of parents reported that parenting (1,148 participants [49%]) and managing virtual education for children (1,171 participants [50%]) were stressors
  • Across all participants, 1,061 (21%) considered leaving the workforce, and 1,505 (30%) considered reducing hours
  • Participants who were younger, married, a member of an underrepresented racial/ethnic group, and worked in a clinical setting reported greater consideration for leaving the workforce
  • 449 faculty (55%) and 397 trainees (60%) perceived decreased productivity, and 2,334 participants (47%) were worried about COVID-19 impacting their career development, with 421 trainees (64%) being highly concerned
  • Of 2,412 participants with children aged 18 years or younger, 1,589 (66%) reported that they did not have childcare fully available, and 783 of 2,747 (33%) reported being comfortable taking their child to school or a childcare facility

As the interaction between gender and having dependent child(ren) was significantly associated with consideration for leaving the workforce and reducing hours, results indicate the association between parenthood and career outcomes varies for mothers and fathers.

Furthermore, 1,932 of 2,456 participants (81%) reported “finding it somewhat or extremely difficult to balance childcare and work responsibilities.”

Helpful strategies listed for managing home and work-balance included the continued opportunity to work from home, flexibility in scheduling, and a better understanding of work-life struggles by the person to whom employees report.

Findings may not be generalizable to wider populations as they only represent respondents at one institution, while selection bias may have played a tole with regard to employees who chose to complete the survey, marking limitations to the study.

“Health systems must develop effective strategies to ensure that the workplace acknowledges and supports employees during this unprecedented time, not only within the work environment, but also in managing unanticipated childcare responsibilities due to lack of childcare or in-person school,” researchers concluded. “In doing so, health systems will improve the likelihood of retaining generations of well-trained clinicians, scientists, and staff.”

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