Outten & Golden: Empowering Employees in the Workplace

Posts Tagged ‘caregivers’

Caring for Our Caregivers: Workplace Violence Hearing Highlights Job-Related Assaults for Health Care and Social Service Workers

Friday, March 1st, 2019

Workplace violence is a serious and growing problem for working people in the United States: It causes more than 450 homicides and 28,000 serious injuries each year. Workplace homicide now is responsible for more workplace deaths than equipment, fires and explosions. Two of every three workplace violence injuries are suffered by women.

Health care and social service workers are at greatest risk of violence on the job because of their direct contact with patients and clients. They are five times as likely to suffer a workplace violence injury as workers in other occupations.

Violence against health care and social service workers is foreseeable and preventable but the Trump administration has refused to act. That is why Rep. Joe Courtney (Conn.) introduced legislation last week that would require the federal Occupational Safety and Health Administration (OSHA) to issue a standard to protect these workers. The standard would reduce violence by requiring employers to develop workplace violence prevention programs that identify and control hazards, improve reporting and training, evaluate procedures and strengthen whistlebower protections for those who speak up, which lead to safer staffing levels, improved lighting and better surveillance systems.

Today, the U.S. House of Representatives Committee on Education and Labor, Subcommittee on Workforce Protections, held a hearing to highlight this severe and growing problem and the need for an OSHA standard to protect working people. Patt, an AFT member from Wisconsin, testified about her traumatic experience of assault as a registered nurse. She and her colleagues had tried to speak to management and press for improvements, but their voices were not heard. Then she was attacked by a teenage patient with a history of aggression at a county mental health facility. He kicked her in the throat, collapsing her trachea, requiring intubation and surgery. She suffers severe post-traumatic stress disorder and can no longer work in her dream job as a nurse. It was not a random event, but a predictable scenario that could have been prevented with a clear plan and better-trained staff.

Watch the hearing.

Here are other union members’ experiences of violence on the job that could have been prevented with an enforceable OSHA standard:

Helene: An AFT member and psychiatric nurse in Connecticut for 16 years in an acute care hospital who attempted to hand a patient his pain medication when he punched her in her jaw, knocking her to the floor and breaking her pelvis. Helene was unable to return to work for six and a half months, had to go through rehabilitation and physical therapy, and suffers from post-traumatic stress disorder. This patient had a history of violence, including previously attacking a social worker, but there was no system in place to alert her.

Brandy: A National Nurses United (NNU) member and registered nurse in California for 18 years in general pediatrics who was assigned to a 14-year-old patient with a diagnosis of aggressive behavior. When Brandy entered the patient’s room, the patient had his mother pressed against the closet door with his hands around her neck. Brandy called for security and additional staff assistance. They were able to safely remove the patient’s mother, but the patient threw a chair at Brandy, who was trapped between a wall and a bed. Brandy suffers from tendonitis in her right elbow, which makes it difficult to do simple everyday tasks such as opening jars, typing and hanging bags of fluids at work. Appropriate violence-prevention controls include ensuring that large furniture and other items that can be used as weapons are affixed to the floor in rooms with aggressive patients.

Eric: An AFSCME member and security counselor at a Minnesota hospital who has administered treatment to the mentally ill for nearly a decade. Eric was assigned to monitor a highly assaultive patient who continually attacked his fellow patients. The patient then turned his assaultive behavior on Eric and punched him in the right eye, causing him to instantly lose sight in the impacted eye. Eric managed to restrain the patient until his co-workers arrived to assist. Eric was rushed to the emergency room via ambulance where they discovered he had a blow-out fracture of his orbital bone and a popped sinus. He received 17 stitches, and his eye socket has never fully recovered. The hospital did not have a comprehensive workplace violence prevention program that would have prevented this.

John: A United Steelworkers (USW) member and certified nursing assistant in California for 18 years who tried to change a male veteran’s wet bed when the patient became agitated and attacked John, breaking his arm. He was out of work for four weeks. John didn’t know the patient was prone to violence. At his facility, workplace violence comes from patients, visitors and other employees. There is at least one incident every week, ranging from slapping to breaking arms or punching. After John’s incident, the employer began requiring a note on the patients’ charts when they are prone to agitation or violence. Sometime later, the employer also began using red blankets on the beds to denote a combative patient so all employees would know when they interacted with the patient.

This blog was originally published by the AFL-CIO on February 27, 2019. Reprinted with permission. 

About the Author: Rebecca Reindel is a senior health and safety specialist at the AFL-CIO.

Caring for Workers Who Care for Our Loved Ones

Monday, August 19th, 2013

Michelle ChenFor many seniors, growing older means facing new kinds of stress—such as fragile health, a tight budget on a fixed income, or the travails of living alone.

And for the people who care for the aging, the stress can be just as severe. When her client is going through a rough time, one domestic worker says she lives through every minute of it, too: “Sometimes we stay there for five days…and we don’t know what’s outside…You cannot leave the job.”

Stories like this one, recorded as part of a survey of New York’s care workers, form the invisible pillar of an evolving industry that is making the private home the center of public health, and in the process, reshaping our relationships of family, work, community and social service. Yet the home care workforce, which is driven largely by poor women of color, mirrors inequities embedded in the low-wage economy. At work, caregivers manage the lives of our loved ones while often facing exploitation and abuse, and after a long day of delivering comfort to vulnerable clients, many struggle themselves to cope with ingrained poverty their communities.

To open a conversation about the economics and ethics of caregiving, ALIGN (Alliance for a Greater New York) has partered with the national advocacy campaign Caring Across Generations, along with various community and labor groups, to study New York City’s more than 150,000 home care workers. The surveys and investigations published by ALIGN reveal structural problems in the industry and identify potential for reforms that work for those who give and those who receive care.

In New York, the home care industry is booming as more seniors opt to live at home rather than in institutions. Thousands across the city earn their living by taking care of seniors and people with disabilities. Overall, according to the study, the sector “will be the single biggest driver of employment in the city in the coming years.”

On a typical day in New York, these workers, mostly women of color and immigrants, act as both therapists and companions, managing medications, bathing and feeding, and helping seniors feel dignified even on the days they can’t get out of bed. On top of this, the workers have to negotiate with stressed families about hours and pay–and typically take home low wages that keep them and their families mired in poverty.

And yet it turns out that consumers and providers of care want the same things. ALIGN’ssurveys of New Yorkers, including both caregivers and care “consumers,” show strong concern about decent pay for workers, along with retirement and healthcare benefits. These labor conditions are many cases dictated by insurance companies and Medicaid, not by the families receiving care.

The fact that consumers and caregivers both recognize that labor should be fairly valued “really does challenge this zero-sum notion that good jobs and affordable care can’t coexist,” says ALIGN policy analyst Maya Pinto. “And it suggests that people understand the connection between the quality of care and the quality of jobs.”

The converse is also true: When workers are miserable, it shows up in their work. Nearly 40 percent of people receiving care complained that the quality of services was “fair” to “very poor.”

But from a workers’ standpoint, this is the consequence of a job that treats them poorly. One worker described her situation bluntly: “It is a very difficult job at times because there are patients who think the home care workers are slaves.” Workers reported being subject to verbal and physical abuse, sometimes racial slurs, on the job.

Nonetheless, many care workers feel deep devotion to their job—they just want to their labor to be appreciated and duly compensated. “I do my work well…and the person I care for is very satisfied with my work,” said one worker. “It is very dignified work but it needs to be paid better.”

A priority across all respondent groups was providing appropriate training and monitoring–indicating that workers, contrary to stereotypes, are not instinctively resistant to greater accountability and oversight, and that all stakeholder groups realize the depth and complexity of responsibilities involved in caring for vulnerable seniors.

One area of divergence between consumers and workers was the importance placed on career advancement. The issue was a higher priority for caregivers, especially domestic workers who serve seniors but lack the official credentials of “formal sector” workers—a category that includes certified “home health aides” and “home attendants,” and who are generally employed through an agency. Lacking the formal qualifications associated with specialized, better-paying positions, domestic worker-caregivers (who are disproportionately low-income immigrant women, both documented and undocumented) often remain stuck in the most grueling, precarious jobs.

Some of New York’s privately employed home care workers benefit from a recently enacted domestic workers’ “Bill of Rights” that provides stronger workplace protections and wage standards than does federal labor law. However, domestic workers overall, who include nannies and housekeepers as well as direct caregivers in private households, still suffer from poverty, discrimination and exploitation. According to ALIGN’s survey of caregivers’ household incomes, about nine in 10 domestic workers earn less than $25,000 annually, compared to six in 10 formal sector workers. That is, despite the strides that domestic workers made with the Bill of Rights, in material terms, they still lag behind those employed through agencies or with more formal credentials.

ALIGN recommends several reforms to ensure dignity for both caregivers and people receiving care. More training and certification options–such as programs equipping domestic workers with emergency medical skills–would expand workers’ access to more formal and higher-paying positions and lift up standards for the workforce overall. On a policy-making level, the report calls for a expansion of publicly funded insurance programs so care workers, many of whom cannot afford medical coverage, can safeguard their own health as they care for others.

Since so many families struggle to pay the cost of community-based elder care, especially if they fall outside the income-eligibility bracket for Medicaid, the report recommends a more comprehensive publicly supported insurance program as an alternative to private long-term care plans. Noting that the current rollout of the Affordable Care Act and Medicaid overhaul present an opportunity for fudamental reforms in home care funding, ALIGN suggests creating a broadly accessible long-term care benefit that would be funded through payroll contributions, like Social Security.

The report also highlights why workers need not just laws but organization and collective bargaining power. In recent years, SEIU and the National Domestic Workers Alliance have organized tens of thousands of workers to win fairer contracts for workers and to press for reforms to extend labor protections for care workers. Meanwhile, some workers are changing how care is delivered in their communities by forming their own cooperatives.

ALIGN cites the worker-owned cooperative model as a system that can empower caregivers, by enabling them not only to share in the ownership and profits of the enterprise but also to access training, negotiate better working conditions, and “improve compensation for workers while keeping the cost of care relatively low.” One impressive case study is New York’s Cooperative Home Care Associates, one of the country’s leading cooperatives with about 2,000 workers, half of whom own a part of the business.

Despite the sometimes harsh conditions, Vilma Rozen, a 52 year-old home care worker, remains unshakably devoted to her job and embraces the challenges. “If you want to take care of elderly people, you have to keep your feelings very in touch [with] the person, because the elderly people in some cases are very alone and very depend[ent],” she says. At the same time, she adds, many seniors “suffer so much, because the home-carers, they have a very sad life, very underpaid… They don’t have happiness.” Rozen, a native of Costa Rica, says that if Americans want to place their elders in the care of attentive, dedicated people, “they need to change the system.”

Whether they give or receive care, everyone wants dignity–both seniors and their aides want to look forward to seeing each other every day in a relationship of mutual respect. The labor issues in senior care show the consequences of neglecting shared needs, but also open space for creating a fairer system of care, by making the home a more welcoming workplace.

This article originally appeared on Working in These Times on August 17, 2013.  Re-posted with permission. 

About the Authory: Michelle Chen is a contributing editor at In These Times, a contributor to Working In These Times, and an editor at CultureStrike. She is also a co-producer of Asia Pacific Forum on Pacifica’s WBAI.

Poor, Pregnant, and Fired: Caregiver Discrimination Against Low-Wage Workers

Friday, April 1st, 2011

bornstein_stephanieNew report documents how low-wage workers are discriminated against at work based on their caregiving responsibilities at home

A new report by U.C. Hastings’ Center for WorkLife Law details the extreme measures to which low-wage workers must go to keep a job and care for their children or elderly family members—and the sometimes shocking discrimination they face at work despite these efforts.

The first of its kind to analyze caregiver discrimination lawsuits filed by low-wage workers, the report—Poor, Pregnant, and Fired: Caregiver Discrimination Against Low-Wage Workers—exposes mistreatment at work around caregiving responsibilities.  The powerful cases profiled in the report, which attracted the attention of the National Law Journal, include:

  • employees encouraged to get abortions or asked about their birth control usage, or sexually harassed because of their roles as caregivers;
  • pregnant workers fired on the spot or immediately after announcing their pregnancies, or banned from certain positions no matter what their individual capabilities;
  • workers routinely denied access to their legal rights, especially to family and medical leave;
  • employees being set up to fail, with unreasonable goals or tasks assigned to them, after caregiving responsibilities are discovered;
  • low-wage men who care for children or elderly parents subjected to extreme gender stereotyping at work; and
  • pregnant women of color denied access to accommodations regularly granted to their pregnant co-workers of a different race.

Even in family emergencies, the report shows, low-wage workers are refused the small kinds of workplace flexibility that are commonplace for middle-wage and professional workers.  One retail worker whose case is profiled in the report was fired for insubordination for carrying a water bottle at work—despite a doctor’s note recommending she do so to treat recurring urinary and bladder infections due to her pregnancy.

Ironically, small changes by employers can make a significant difference in keeping experienced employees in their jobs.  They can also prevent costly liability: several lawsuits profiled resulted in large verdicts, including four with recoveries of between $2.3 and $11.65 million, despite the plaintiffs’ (a housekeeper, a shipping dispatcher, a bakery delivery driver, and a hospital maintenance worker) low wages.

“Caregiver discrimination lawsuits brought by low-wage workers document clearly that work-family conflict is not just a professional women’s problem.  In fact, it’s most acute and extreme for low-income families,” said study author Stephanie Bornstein, Deputy Director of the Center for WorkLife Law.  “To help families move out of poverty, we can’t just focus on ‘fixing’ the worker.  We also need to look at how caregiver discrimination in low-wage jobs undercuts economic stability.  Discrimination not only hurts workers and their families; it leads to high turnover and legal liability for employers.”

Another case profiled in the report is that of a pregnant woman who was forced out of her retail sector job onto unpaid leave despite her desire to work as long as possible while pregnant.  Her supervisor had allowed her perform all of her job tasks while avoiding heavy lifting, and she was working successfully.  Yet several weeks later, when her doctor sent a letter to the company’s HR office to cement this arrangement, she was immediately sent home and told that she could not be accommodated—in violation of California law.

A soon-to-be single mother, the woman was “trying to do the best she could for her baby,” and was confused as to why she was being sent home when she wanted to work, said Jamie Dolkas, Staff Attorney at Equal Rights Advocates in San Francisco, who represents the woman.  “As a low-wage worker, she was really disenfranchised….[T]hey didn’t take the time to explain to her what her rights or options were—they just gave her something in writing that essentially said we can’t accommodate you, go home,” explained Dolkas.

The report profiles 50 cases—selected from among hundreds identified by Center for WorkLife Law research—of low-wage workers who experienced discrimination at work based on their efforts to be both a good worker and a good parent or family member.

The Center for WorkLife Law is a nonprofit research and advocacy organization that works with employees, employers, attorneys, unions, and policymakers to fuel social and organizational change around work-life issues.  The Center is part of the University of California, Hastings College of the Law in San Francisco.

About the Author: Stephanie Bornstein is an employment attorney and Deputy Director of WLL. Prior to joining WLL, she worked as a staff attorney at Equal Rights Advocates (ERA), a public interest law center focused on gender discrimination in employment and education. At ERA, Bornstein represented plaintiffs in individual and class action employment matters, specializing in pregnancy discrimination and family and medical leave. She was also among a small group of advocates to help author and enact California’s Paid Family Leave insurance program, the nation’s first comprehensive paid leave law. In addition, Bornstein worked as a legal editor of employment law products at Nolo Press, a leading publisher of legal books for non-lawyers.

New Report: Working Caregivers as a Protected Class?

Tuesday, December 22nd, 2009

Finding a manageable work/life balance is something many of us struggle with a great deal–and the stakes only get higher for Americans who work full-time and have caregiving responsibilities at home. Whether that means taking care of children, a sick partner, or an elderly loved one, holding down an ambitious career while still taking good care of those that depend on you at home can be a daunting challenge.

While I’d like to be able to tell you that employers are universally understanding of their employees that struggle with juggling a full-time job while being a caregiver, we all know this simply isn’t true. As if layoffs due to our ailing economy weren’t bad enough, employers discriminating against employees based on their caregiving responsibilities is on the rise–and it has a name: Family Responsibilities Discrimination (FRD).

Before you stop reading this post because you’re thinking “such a wonky-sounding term can’t possibly affect me,” I beg you to take another few moments and keep on reading. Family Responsibilities Discrimination can occur in any number of unfortunate–but very real–workplace circumstances. Such as….

  • when a new mother is denied a promotion NOT based on her job performance, but because it is assumed she will no longer be as committed to work once baby enters the picture.
  • when a man’s employer refuses him paternity leave because “his wife should do it”
  • when a worker is fired for not meeting work goals while he is on legally protected family and medical leave to take care of a sick parent.

A new report by the Center for WorkLife Law’s Stephanie Bornstein & Robert J. Rathmell provides us with information about additional worker protections under local laws about which most people are not aware–like the ones described above. Take this true situation cited in the report, for example:

In Chicago, a single mother of two who filed a complaint for parental status discrimination under the city’s local ordinance was recently awarded over $300,000 in damages. The woman had been fired from her job as a medical services salesperson after rescheduling a meeting because her daughter was ill.

The report finds that while no federal law and only a few state laws expressly prohibit discrimination against working caregivers, at least 63 local governments in 22 states do. The findings also demonstrate that while the scope of local laws may seem limited, their impact can be pretty significant.

Working caregivers shouldn’t end up unemployed because of their responsibilities at home–but the fact is that they sometimes do. While we may not be able to legislate employer attitudes, we can take responsibility for knowing our rights. Read the report here: “Entitled Caregivers as a Protected Class?: The Growth of State and Local Laws Prohibiting Family Responsibilities Discrimination.”

For more information about each local law collected in the survey, visit www.worklifelaw.org/pubs/LocalFRDLawsDetail.html.

Additional findings of the report can be found after the break.

  • The sizes and types of employers (whether public or private) covered by local FRD laws vary, but most apply to private employers, with some covering businesses as small as those with only one employee.
  • While the vast majority of states have no explicit protections against FRD, laws or regulations in Alaska, Connecticut, New Jersey, and the District of Columbia are the exceptions to the rule.
  • States including Florida, Maryland, Michigan, Oregon, and Pennsylvania have the most protections under local FRD laws, increasing the likelihood that a business or an employee in that state may be covered.

Local governments that have explicitly banned Family Responsibilities Discrimination also include:

• Tucson, Arizona • Atlanta, Georgia • Cook County, Chicago & Champaign, Illinois • Boston, Cambridge & Medford, Massachusetts • St. Paul, Minnesota • Kansas City, Missouri • Tacoma, Washington • Milwaukee, Wisconsin

*This post originally appeared in the SEIU Blog on December 17, 2009. Reprinted with permission from the author.

About the Author: Kate Thomas is a blogger, web producer and new media coordinator at the Service Employees International Union (SEIU), a labor union with 2.1 million members in the healthcare, public and property service sectors. Kate’s passions include the progressive movement, the many wonders of the Internet and her job working for an organization that is helping to improve the lives of workers and fight for meaningful health care and labor law reform. Prior to working at SEIU, Katie worked for the American Medical Student Association (AMSA) as a communications/public relations coordinator and editor of AMSA’s newsletter appearing in The New Physician magazine.

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