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Behind the Mask of a US Physician’s Assistant

Blindsided by furloughs and financial insecurity

In the US, the effects of the COVID-19 pandemic on a Physician’s Assistant were personal. Because while the pandemic started almost as a non-event, its first true impact came in a form that took her and her ER colleagues completely by surprise .

“When COVID first started spreading across the United States we were told the emergency room was going to be completely overwhelmed and we would need to work more hours. “

Fear of contracting the virus quickly set in among the US population, and as cities shut down and the death toll rose, she watched and waited for the surge to come and overwhelm them. However, being based in Florida meant that the virus simply didn’t appear, emptying out the ER, rather than filling it up.

“A lot of people that were [previously] coming in and using us as a walk-in clinic or coming in for non-emergencies, they just stayed home. Due to the stay-at-home order a lot of them were scared to come to the emergency room thinking that they would get coronavirus.”

As the patient flow slowed to a trickle and the anticipated surge never materialized, the economic impact of the early pandemic started to take a toll on the company she worked for, and like  so many other US businesses, they were left in a tough position – losing money and needing to lay off staff. This felt inconceivable, something she believes no one could have ever predicted. Especially with the highly publicized need of medical support across the country dominating the news cycles.

“At the end of April 2020, we had an all staff meeting and were told our contracts are no longer being honored and we were then cut to approximately 75 hours [from 170 before] for the month for an indefinite length of time… I never thought in a million years my job as a physician assistant in an emergency room would be jeopardized especially during a pandemic of all things .”

Though grateful to still have her job in some capacity (and the critical health insurance that came with it), she was put in a position where she was unable to pay her basic bills, leading her to look for a new job. But even there, she found that the problem went beyond just her own hospital.

“I have since applied for more than 30 jobs including Physician Assistant jobs out of state and have found more places are on a hiring freeze than not.”

This situation left her perplexed – how could there be underemployment of medical workers right now? During a pandemic? And worse still, she wasn’t making enough money to sustain her life, all the while putting it at considerable risk.

“I do not understand what sense they are using in furloughing or laying off the very people who are supposed to be caring for those patients who contract COVID-19… I know myself personally am working so infrequently but still often enough to be possibly be exposed at work and therefore have stayed away from everyone in my life to avoid the slight chance of spreading COVID-19 to the ones I love.”

As time moved forward through the summer and cases went down, patients started to return to the ER in higher numbers. However, despite this, her company and hospital have not increased staffing needs to the levels she feels is necessary for her to do her day-to-day job well. This is causing negative impacts on the care patients are receiving, as well as the mental health of the healthcare workers themselves.

“This is not only dangerous for patients seeking medical attention at the emergency room but also is making our lives as healthcare providers that much harder. It is causing chaos some days in the emergency department and making medical providers not want to come to work. With our hours being cut and the huge cut in staffing, the days we do work are sometimes not very pleasant.”

In some cases, the stress is enough to drive healthcare workers out completely. They’re approaching this global level fight and don’t feel they’re being supported by the medical system in the US. Eventually this takes a toll.

“Just recently a handful of the nurses who work on the COVID floors have become overwhelmed and just up and quit after their shift one day.  They are overwhelmed by the amount of work and working with COVID patients in general and are quitting their jobs with no notice.”

The only solution in her mind is a simple one – properly staff all hospitals to accommodate the needs as they fluctuate, especially as we go into the winter months, and as COVID cases continue to rise across the country. Otherwise, we’ll find ourselves in the same situation as in March and April, with hospitals overrun and no one to help.

“At some point, it is going to get to a tipping point where they need to increase staffing again. I would say they do need to now but they have not so far, so the hospital is going to get overrun, workers are going to be overworked. They are going to have to find the balance.”

There is a long-standing battle in the US between private vs public health care and the pros and cons of each. This situation demonstrates one of the downstream implications of a for-profit health servicing – even in a high-need situation like the world is currently experiencing, the human resources needed cannot be maintained, unless the work continues to generate revenue for the servicing companies.

In this case, it may come at the cost of the loss of over-worked and over-stressed medical staff during the coming months.