More than 36 million hospital stays occur in the U.S. every year, within the 6,120 hospitals that comprise America’s complex healthcare system. 22 million healthcare workers staff these hospitals day and night, providing care for a variety of patients. The San Francisco Bay Area is home to 29 medical facilities, each packed with professionals and patients from diverse backgrounds.
Members of the healthcare industry, including doctors and nurses, provide aid to a range of patients that require medical solutions ranging from antibiotics to complex surgeries. Healthcare workers often need to respond quickly to high-risk situations, all while managing the complex dynamics inside the workplace.
Although hospitals intend to function as cohesive units, internal inconsistencies between the hospital system and staff occasionally arise. Higher levels of leadership that work outside of these hospitals deal directly with decisions including money, scheduling, and other conflicts. As a result, individuals not directly involved in a hospital’s daily operations make these choices, creating gaps between the needs of the hospital and the rules that management enforces.
Stacy Wilcox, a Neonatal Intensive Care Unit (NICU) worker and registered nurse at MarinHealth Medical Center of 27 years, finds that the decisions instituted by the upper levels of the hospital system often do not align with the staff’s needs.
“The hardest part [of working in healthcare] for me is the inefficiency of hospital systems and insurance. I am sometimes shocked by middle management and higher leadership decision-making. These are decisions that go against the bottom line sometimes,” Wilcox said.
Hospital dynamics extend beyond the relationships between workers and management. Inter-hospital collaborations between different departments, such as trauma surgery, intensive care units, and the emergency room, play a sizable role in how each separate hospital functions. This is especially present in the case of the close-working relationship between the labor and delivery department and the NICU.
“In my particular unit, we work closely with labor and delivery nurses, and we are definitely two very different animals. I would say that the dynamic always improves when there is strong and fair leadership. When conditions are good, [meaning] adequate staffing ratios, good support from ancillary departments, adequate rest in between shifts, we do work well together as a team,” Wilcox said.
Kaiser Permanente San Francisco Medical Center registered nurse of 10 years, Katie Barger, has also found that having a close relationship with coworkers can help workers cope with potential job pressure.
“We are [all] well-compensated and recognized for our hard work, which makes the team unit work easier. One of my favorite parts of my job is my coworkers and the camaraderie,” Barger said.
While urgent and heavy caseloads can draw doctors and nurses away from their families, having supportive team members can lighten the workload. Elizabeth Dailey, the former Head of Orthopedic Surgery at MarinHealth Medical Center from 2015-2020, has dealt with the effects of work interruptions in her personal life, along with benefits from her close-knit relationships within the workplace.
“It’s really stressful to take care of people who need things urgently when I’m supposed to be having time with my family. It’s part of the job, but it means sometimes I’m not always fully present in my personal life,” Dailey said. “[But] I have the best teammates and partners in [caring for] my patients, and without my job, [I] would probably never have met so many diverse and amazing people.”
Maintaining a balance between the different priorities of the job can be difficult for healthcare workers. This difficulty includes the challenge of keeping hospitals properly staffed, as many roles and responsibilities need fulfillment.
“Keeping hospitals staffed safely is a huge job. It’s a 24-hours-a-day facility and all the jobs need to get done, even if some employees are sick or otherwise not available. Managers and charge nurses are a huge part of this. We also take hard days fairly personally; we interface with the general public on some of their worst days. That can be emotionally draining,” Dailey said.
Balancing a complicated shift schedule with a large amount of work can be overwhelming. While every day has a designated schedule, it is often subject to change due to high levels of demand. A break does not necessarily mean taking time off to decompress. These “breaks” typically mean that hospital staff are not actively visiting with a patient but still completing other necessary work, resulting in continuous shifts for up to 12.5 hours.
“The rest of [my] day is patient care, rounding with providers at 11 a.m., and hopefully I get lunch in at some point. Our shifts are 12.5 hours, since we take a half-hour break for lunch that isn’t paid,” Wilcox said.
Depending on their medical field, healthcare workers can treat more than 20 patients each day. For Dailey, being a surgeon comes with multiple responsibilities, including charting and documentation, seeing and treating patients in a clinic, and performing surgeries.
“In clinic, I usually see 20 [to] 30 patients a day and usually do three [to] six surgeries on operating days. My typical hours are 12 hours a day and five days a week,” Dailey said. “[There’s a] constant pressure to perform and more documentation tasks [that] take me away from face-to-face patient care.”
The ever-changing structure and demand of the job requires staff to adapt to a high-risk environment. Expectations and pressures put on those within the industry can lead to the development of personal and professional changes.
“I feel like this job has made me a better, well-rounded person. I am most definitely an introvert, and I have had to manage a lot of difficult personalities in a high-risk, high-stakes environment, all while constantly being interrupted,” Wilcox said.
Even though they frequently deal with stressful and overwhelming situations, healthcare workers are also exposed to a more positive side of humanity. Wilcox has found that interacting with individuals of different backgrounds through her work has allowed her to create meaningful relationships and experiences.
“I think some of my deepest memories are from medical missions that I am a part of in the Philippines. We had previously only done surgery on children, but our mission speech therapist insisted that this young gentleman, Neillboy, get his surgery, because he wanted to go to school, and they wouldn’t let him in because his speech was so affected,” Wilcox said. “Fast forward five years, and at our ‘Governors’ dinner, that same boy walked up to the podium, said hello, and said his name was Dr. Neillboy. He came to thank us and spoke for about 20 minutes about how he was becoming a craniofacial surgeon.”
Working in the healthcare industry presents the demands of teamwork, patient care, and personal sacrifice. Understanding these pressures plays a crucial role in gaining insight into both healthcare professionals and the hospitals themselves. Despite these challenges, the experiences and opportunities that healthcare presents deeply resonate with those in the career, offering invaluable insights into humanity.
“Being a surgeon is a vocation, not a job. I’m never not a surgeon, and I think it’s a privilege,” Dailey said.
