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The on-going COVID-19 pandemic has drastically impacted healthcare systems worldwide. Understanding the perspectives and insights of frontline healthcare workers caring for and interacting with patients with COVID-19 represents a timely, topical, and important area of research. The purpose of this qualitative action research study was to assist one US healthcare system that has an expansive footprint with the implementation of a needs assessment among its frontline healthcare workers. The leadership within this healthcare system wanted to obtain a deeper understanding of how the COVID-19 pandemic was impacting the personal and professional lives of its workers. Further, the organisation wanted to solicit employees’ feedback about what they needed, understand the issues they were facing, and solicit their ideas to help the organisation know where to take action.

This qualitative research employed 45 focus groups, referred to as virtual listening calls (LCs) in this organisation, which were held over a four-week period. A total of 241 nursing staff, representing healthcare facilities across the country, attended 26 of the LCs. A total of 19 LCs were held with 116 healthcare workers who are employed in other clinical roles (e.g. therapists) or administrative functions.

Extending beyond the available research at the time, this study was initiated from within a US healthcare system and informed by the frontline healthcare employees who participated in the LCs, the findings of this study include the perspectives of both nursing and other healthcare workers, the latter of which have not received considerable attention. The findings underscore that the COVID-19 pandemic has wreaked havoc on the personal and professional lives of all of these healthcare workers and has exacted an emotional toll as noted in other studies. However, this study also highlights the importance of listening to employees’ concerns, but more importantly, their recommendations for improving their experiences. Notably, the organisation is in the midst of making changes to address these frontline workers’ needs.

The study, inclusive of nursing and other healthcare staff, demonstrates how an organisation can adapt to a crisis by listening and learning from its frontline employees.

The COVID-19 pandemic, and the responses to it that were required from frontline healthcare providers and others working in healthcare settings including environmental, clerical, and security staff, has challenged our healthcare systems in unprecedented ways. The threats to the financial, physical, and psychological well-being of healthcare professionals – many of whom entered the field due at least in part to a deep commitment to caring for and helping others – will have profound and long-lasting personal and professional impacts. Early in the pandemic response, healthcare professionals knew little about the risks they, their patients, and their loved ones faced from COVID-19 as they operated under crisis standards of care and without adequate supplies of personal protective equipment. As the pandemic response progressed, the lack of clear, science-based guidance, and the politicization of the pandemic presented new medical, ethical, and moral dilemmas. New psychological support mechanisms, including crisis counseling and evidence-based interventions, are needed for all workers in healthcare settings, regardless of their job role.

Much of the research on the mental health impacts of the COVID-19 response have been focused on frontline healthcare workers (FHCW). However, other essential workers (OEW) have also faced many mental health challenges due to exposures associated with their employment status, which may be compounded by higher levels of social vulnerability. This chapter describes disparities among FHCW, OEW, and the general public regarding mental health outcomes associated with the pandemic. In addition, it considers the role that structural racism (e.g., historical redlining of neighborhoods and biased lending practices) plays in the higher vulnerability of OEW to the mental health impacts of the COVID-19 pandemic response. Mental health inequities overall, and among essential workers, must be addressed as part of the recovery from COVID-19 to build resilience to future public health emergencies. The model used by New York City to more equitably distribute mental health resources and support services is shared.

The stressors, and subsequent mental health sequelae, associated with being a part of the frontline, patient-facing healthcare response to the COVID-19 pandemic have been clear from the very start of the pandemic. However, a broader group of workers, perhaps typically not considered to be part of the frontlines of a public health emergency response, have also been deemed essential to the response to the COVID-19 pandemic. Protective service workers, including law enforcement and emergency services, those working in food production, processing, and dietetics, maintenance and environmental service workers, and laboratory workers are among those unable to work from home, yet potentially unaccustomed to the stressors of being an essential workers during a public health emergency. Changes to many systems – including health insurance and other benefits, provision of personal protective equipment, and prioritizations for vaccinations and other pharmaceutical and nonpharmaceutical interventions – are needed going forward to retain and protect essential workers during future public health emergencies.

Unions and worker cooperatives have long represented distinct approaches to building worker voice. This paper draws from observations of the work of the “Co-op Exploratory Committee” of 1199SEIU, the nation’s largest union local, which is seeking to expand the development of unionized worker cooperatives. Described by Martin Luther King, Jr, as his “favorite” union, 1199SEIU has a storied history of organizing frontline healthcare workers and includes large numbers of women of color and immigrant workers among its membership. Since 2003, it has also represented workers at Cooperative Home Care Associates, the nation’s largest worker cooperative. Drawing from discussions among union officials, co-op leaders, and rank-and-file union members about the potential role of unionized worker cooperatives within the labor movement, the paper examines the creative tension between stakeholder and democratic logics in efforts to expand this model. It argues that continued union decline, heightened interest in economic alternatives, and systemic frailties exposed by Covid-19 may create new opportunities for building unionized worker co-ops at scale.

Employee recognition systems are ubiquitous in organizations (WorldatWork, 2019) and have positive effects on work outcomes (e.g. Stajkovic and Luthans, 2001). However, psychologically meaningful recognition relies on the recognition giver being motivated to observe and recognize coworkers. Crises such as the COVID-19 pandemic may impact recognition giving in varying ways, yet little research considers this possibility.

This longitudinal field study examined the impact of the COVID-19 crisis on recognition and acknowledgment giving among frontline and nonfrontline healthcare workers at daily and aggregated levels. We tested the relationships between publicly available daily indicators of COVID-19 and objectively measured daily recognition and acknowledgment giving within a web-based platform.

We found that the amount of daily recognition giving was no different during the crisis compared to the year before, but fewer employees gave recognition, and significantly more recognition was given on days when COVID-19 indicators were relatively high. In contrast, the amount of acknowledgment giving was significantly lower in frontline staff and significantly higher in nonfrontline staff during the pandemic than before, but on a daily-level, acknowledgment was unrelated to COVID-19 indicators.

Our results suggest that organizational crises may at once inhibit and stimulate employee recognition and acknowledgment.

Our research is the first to empirically demonstrate that situational factors associated with a crisis can impact recognition giving behavior, and they do so in ways consistent with ostensibly contradictory theories.

The governmental public health workforce provides essential public health services to communities from public health agencies operations at the local, state, and federal levels of government. The roles and duties of public health workers range from infectious disease tracking and control to healthy eating promotion to checking food service establishments for safety. Unfortunately, most of the time, the general public is unaware of, and unconcerned with, public health’s primary mission of disease prevention. This behind-the-scenes, service-oriented workforce has responded to the COVID-19 pandemic by working long hours, extra days, and ever-changing job roles, all while becoming targets of political attacks and enduring substantially elevated psychological distress and burnout. Though this workforce is not well enumerated, existing studies indicate that public health workers face higher anxiety, depression, post-traumatic stress disorder, and burnout than other frontline healthcare workers during the COVID-19 pandemic response. Several strategies have been suggested to address these vulnerabilities, including increasing the amount and stability of available funding, implementing organizational-level policies and programming to boost resilience, and providing individual-level social support, both instrumental and emotional, to protect against burnout and other psychological distresses.

The institutional conditions of primary care provision remain understudied in low- and middle-income countries. This study analyzes how primary care doctors cope with medical uncertainty in municipal clinics in urban India. As street-level bureaucrats, the municipal doctors occupy two roles simultaneously: medical professional and state agent. They operate under conditions that characterize health systems in low-resource contexts globally: inadequate state investment, weak regulation and low societal trust. The study investigates how, in these conditions, the doctors respond to clinical risk, specifically related to noncommunicable diseases (NCDs).

The analysis draws on year-long ethnographic fieldwork in Pune (2013–14), a city of three million, including 30 semi-structured interviews with municipal doctors.

Interpreting their municipal mandate to exclude NCDs and reasoning their medical expertise as insufficient to treat NCDs, the doctors routinely referred NCD cases. They expressed concerns about violence from patients, negative media attention and unsupportive municipal authorities should anything go wrong clinically.

The study contextualizes street-level service-delivery in weak institutional conditions. Whereas street-level workers may commonly standardize practices to reduce workload, here the doctors routinized NCD care to avoid the sociopolitical consequences of clinical uncertainty. Modalities of the welfare state and medical care in India – manifest in weak municipal capacity and healthcare regulation – appear to compel restraint in service-delivery. The analysis highlights how norms and social relations may shape primary care provision and quality.

The concept of “Workplace Spirituality (WPS)” in the field of management has gained great interest in the last decade, especially due to its connection with profitability. There has been a rapid increase in research related to the topic. It is assumed that employees who spend a significant part of their time at work are willing to satisfy their spiritual needs at the workplace. Such unprecedented challenges as the COVID-19 pandemic have posed many difficulties for organizations to remain agile, develop and grow, and innovate to survive. At this very moment, the importance and meaning of WPS for managers appear to have increased even more. Workplace spirituality is related to motivation, belongingness, and loyalty, and the pandemic seems to have created significant issues concerning these topics with employees. Employees have been forced to work from home due to prolonged restrictions and have faced difficulties in returning to work post-pandemic. Workplace spirituality has the potential to help employees stay motivated in their work, increase their job performance, enhance job satisfaction, and improve their mental health during this difficult period. Organizations can support their employees by implementing different practices to develop workplace spirituality. In this article, approaches to satisfy the spiritual needs of employees post-pandemic, and the efforts of workplaces to meet these needs, are examined with insights from theoretical and practical life.