Employee Healthcare Worker Morale, Safety Concerns Rise Without OSHA ETS Protections

OSHA withdrew a majority of provisions in its Healthcare Emergency Temporary Standard in December 2021.

OSHA's withdrawal of non-recordkeeping portions in its Healthcare Emergency Temporary Standard (Healthcare ETS) on December 21, 2021, which protected healthcare workers from COVID-19 in healthcare settings, is causing employee safety and worker morale concerns, says Liz Borkowski, senior research scientist at George Washington University’s Department of Health Policy and Management.

Borkowski explains that whenever OSHA adopts a temporary standard, like the Healthcare ETS for healthcare workers last June 2021, six months is then allotted in the OSH Act for the agency to create a permanent standard.

However, OSHA was unable to finalize a final Healthcare ETS rule within the timeframe, stating delays due to the recent surge of COVID-19 variants. OSHA withdrew a majority of provisions in its Healthcare Emergency Temporary Standard in December 2021.

Among the requirements in the Healthcare ETS were the designation of a safety coordinator to monitor compliance with the COVID plan specific to the workplace; limiting and monitoring points of entry to areas where patients are treated; screening patients, visitors, and non-employees for symptoms; and providing and enforcing the use of masks, as well as social distancing.

In its statement announcing its withdrawal of non-recordingkeeping provisions in the Healthcare ETS, OSHA stated it would "vigorously" enforce the general duty clause and its general standards to protect healthcare employees.

"OSHA does not have a standard for every single thing that might appear in a workplace, but the general duty clause basically means that they expect employers to be keeping up on what the hazards in their industry, in their workplace [are], and to have protections for those," Borkowski says.

The enforcement of the general duty clause is, of course, dependent on employers being proactive and evaluating potential hazards (in this case, the possibility of getting COVID), having protective measures in place, and OSHA holding employers accountable through inspections. Yet, with OSHA not having enough inspectors to visit every workplace, Borkowski says there's a possibility some employers could see this as an opportunity to cut corners.

Amid a surge of omicron variant COVID-cases and worsening healthcare staffing crisis, organizations like National Nurses United have pleaded with OSHA to implement a permanent standard and to reimplement the temporary Healthcare ETS, holding a National Day of Action on January 13 to demand the Biden administration take action to protect the nurse workforce.

"Our employers claim there is a 'nursing shortage,' and that's why they must flout optimal isolation times, but we know there are plenty of registered nurses in this country," Zenei Triunfo-Cortez, NNU president, said in a statement. "There is only a shortage of nurses willing to work in the unsafe conditions created by hospital employers and this government's refusal to impose lifesaving standards. So this is a vicious cycle where weakening protections just drives more nurses away from their jobs."

That same day, the U.S. Supreme Court voted in favor of the Biden administration's authority to mandate that all healthcare workers be vaccinated. However, the court also ruled against requiring employees for large businesses to be vaccinated.

"It's always up to the employers to protect [their] employees. They've always had this duty to protect their employees, to have safe and healthy workplaces," Borkowski says. "The difference now is that OSHA—if they're going to be using the general duty clause rather than a specific standard—employers might feel that they have more wiggle room and that they don't have to do quite as much."

Borkowski adds that her hope is that employers, including those outside of the healthcare sector, recognize that keeping their workers healthy is the best way to keep their workers at their organizations.

In a survey by the NNU, 83% of nurses said half their shifts are "unsafely staffed." Sixty-eight percent said they've considered leaving their current position.

With healthcare workers handling the brunt of the stress and strain of the pandemic, Borkowski isn't surprised at the low morale many of them feel.

"People—potential and current healthcare workers—might think twice about entering or staying in a job where they don't feel like they are protected or they don't feel like employers are looking after their health," she says. "If we don’t protect healthcare workers now, not only are many of them going to get sick, but we will have fewer healthcare workers doing these essential jobs into the future."