The pandemic is not the great equalizer: front-line labor and rationing in COVID-19 critical care.

IF 1.3 Q4 RESPIRATORY SYSTEM

Public Health Action Pub Date : 2022-12-21 DOI:10.5588/pha.22.0025

N Navuluri, H S Solomon, C W Hargett, P S Kussin

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引用次数: 0

Abstract

Background: Framed as "the great-equalizer," the COVID-19 pandemic has intensified pressure to adapt critical care labor and resulted in rationing by healthcare workers across the world.

Objective: To critically investigate how hospital intensive care units are critical sites of care labor and examine how rationing highlights key features of healthcare labor and its inequalities.

Methods: A practice-oriented ethnographic study was conducted in a United States academic ICU by a medical anthropologist and medical intensivists with global health expertise. The analysis drew on 57 in-depth interviews and 25 months of participant observation between 2020 and 2021.

Results: Embodied labor constitutes sites and practices of shortage or rationing along three domains: equipment and technology, labor, and emotions and energy. The resulting workers' practices of adaptation and resilience point to a potentially more robust global health labor politics based on seeing rationing as work.

Conclusion: Studies of pandemic rationing practices and critical care labor can disrupt too-simple comparative narratives of Global North/South divides. Further studies and efforts must address the toll of healthcare labor.

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大流行并不是一个伟大的均衡器:一线劳动力和COVID-19重症监护的配给。

背景:COVID-19大流行被称为“伟大的均衡器”，加大了调整重症监护劳动力的压力，并导致世界各地的卫生保健工作者实行配给。目的:批判性地调查医院重症监护病房如何成为护理劳动的关键场所，并检查配给如何突出医疗劳动的关键特征及其不平等。方法:由一名医学人类学家和具有全球卫生专业知识的医学重症监护医师在美国的一个学术ICU进行了一项以实践为导向的民族志研究。该分析在2020年至2021年期间进行了57次深度访谈和25个月的参与者观察。结果:具身劳动构成了三个领域短缺或配给的场所和实践:设备和技术，劳动力，情感和能量。由此产生的工人适应和恢复能力的实践表明，在将定量配给视为工作的基础上，全球卫生劳工政治可能会更加强大。结论:对流行病配给做法和重症监护劳动的研究可以打破过于简单的全球南北划分的比较叙述。进一步的研究和努力必须解决医疗保健劳动力的损失。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Public Health Action RESPIRATORY SYSTEM-

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期刊介绍： Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.