Experiences of Female Racialized Personal Support Workers

Experiences of Female Racialized Personal Support Workers Assignment Help Experiences of Female Racialized Personal Support Workers (PSWs) with Personal Protective Equipment (PPE) Usage during the COVID-19 Epidemic:
The Greater Toronto Area (GTA)
 
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Course title: Major Research Paper (MRP)
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Date: 6th September 2021
 
 
 
 
 
 
 
 
 
 
 
Experiences of Female Racialized Personal Support Workers (PSWs) with Personal Protective Equipment (PPE) Usage during the COVID-19 Epidemic:
The Greater Toronto Area (GTA)
 
Abstract                                       
The COVID-19 pandemic has caused changes in many sectors of the economy, particularly healthcare. Recent research has seen a recorded increase in the demand for PPE for almost all individuals in society (Rowan, 2021). Initially, before the novel virus hit global news, healthcare workers had reasonable access to sufficient PPE. In this situation, the PSWs had sufficient access to PPE because not all PSWs were required to wear gloves, masks, and surgical gowns (UNICEF, 2020). PSWs in particular could wear their medical clothing when attending to two patients or even more because there was no risk of coronavirus transmission. In the current world, almost everyone, whether working in healthcare or not, is wearing masks, leading to increased demand and shortages (Rowan, 2021). PSWs have encountered extraordinary risks during the COVID-19 pandemic compared to other healthcare workers (Achonu and Shwartz, 2020). This is because of the wide variety of clients they serve with limited provision of PPE. In the absence of effective protection, they are at greater risk of contracting the virus. In government provision and prioritization in supplying the PPE, they will consider the healthcare providers before the PSWs. Therefore, they will provide the PPE to hospital health care providers as their first priority. This is because they do not recognize the importance of the PSWs with the required degree of essentialness (Rowan, 2021). To investigate the PPE problem among PSWs, qualitative in-depth interviews were carried out with four racialized female PSWs working in the GTA during the pandemic. The participants reported anxiety caused by the dangers and possibilities of contracting the virus and infecting their families. The findings are a result of a conjunction of understaffing, increased workload, and insufficient PPE. The PSWs feel left out by the government and their employers who have failed to prepare them for the pandemic. In relation to this, the study has analysed the interviews using thematic analysis and has derived themes including psychological distress, inadequate protection, and isolation from friends and families. From the findings, the study makes recommendations meant to address the PSWs’ concerns. This study fills the gap in knowledge for these group of healthcare workers who have been at the margin.
Introduction
The primary goal of this study is to learn more about the problems that racialized female PSWs encounter in terms of their dependence on unavailable personal protective equipment (PPE) during the coronavirus epidemic. I chose to carry out this research in the GTA because of this area’s large population of racialized immigrants. According to Statistics Canada, in 2017, which is the latest data, 51.4% of the Toronto Census Metropolitan Area (CTA) were visible minorities (Statistics Canada, 2017). Limiting the scope of the study to the GTA also reflects my own experience working as a PSW in the area during the current pandemic. During my shifts working as a PSW, I noticed how difficult it could be for some clients to put on PPE, particularly masks. Most of my clients were senior citizens with respiratory problems or suffering from dementia, making the masks particularly uncomfortable. Upon returning home after my shifts, I hesitated to hug my children for fear of spreading the virus to them. There have been times when I was forced to keep away from home for several days after a recorded outbreak occurred at my workplace, out of concern of possibly spreading the virus to my children. I also noticed how friends would stay over six feet away from me when I came across them for fear that I would transmit the virus to them. These experiences placed into sharp focus for me the difficulties of working as a PSW amidst the pandemic. Besides that, narrowing my research to this geographic region allows me to compare my experience with other members of the same location.
On March 11, 2020, a worldwide pandemic proclamation of a new coronavirus epidemic was issued by the World Health Organization (WHO). As the virus spread across Canada, nursing homes were among the places that were hit the hardest. This was because of the unavoidable close contact between the staff and the clients, and inadequate usage of PPE at the early stages of the first wave (Grant and Anderson, 2020). As a result, PSWs who provided direct care to residents were more likely to become infected with the virus. COVID-19 is transferred mainly by respiratory droplets (WHO, 2020; Burke et al., 2020). COVID-19 is airborne, meaning that the virus can quickly spread between two people within a short range of about 1 meter (Feng and Sperry, 2020). When aerosols or droplets that contain the virus are taken in by the nose, eyes, or mouth, the inhaler contracts the virus, thus grouping the virus in the airborn group (WHO, 2020; Burke et al., 2020). At the onset of the pandemic, caution methods like social distancing and PPE wearing were identified as the first lines of defence against the virus. Limited interactions presented by social distancing and curfews act as ways of preventing contact with people and thus reducing contact with infected persons (Singh et al., 2021). The wearing of PPE – masks in particular – was encouraged since this has been proven to limit the inhalation of the carrier droplets, thus limiting the airborne spread of the virus.
PPE helps protect the health care worker and the client from contracting the virus, as PPE acts as a barrier for transmission. Lab coats, hand gloves, face masks and shields, and other protective equipment are examples of PPE (OSHA, 2011). During the COVID-19 pandemic, there has been a recorded rise in demand for PPE (Rowan, 2021). This demand translates to a shortage of equipment to maintain the safety of the clients and the healthcare workers. The rise in demand is caused by the fact that every person is required to have the PPE on. PPE is no longer limited to just medical practitioners but is also required for the general public. The increased number of patients is also a cause of the rise in the demand for the PPE (Roiro, 2020). For PPE to work effectively, health care service providers and caregivers like PSWs should have adequate supply in order to change it frequently enough to be effective. This increased demand has led to PPE shortages in several agencies, forcing the healthcare workers to either buy their own or reuse the available equipment. This situation has resulted in a health challenge to both those receiving care and those providing it, such as PSWs (Singh et al., 2020).
PSWs work in long-term care facilities, retirement homes, and community centres to assist older individuals and those with disabilities with everyday tasks (Kelly and Bourgeault, 2015). A combination of an increase in life expectancy and economic circumstances has led to an increase in the demand for PSWs in Canada. Long-term care and the Ministry of Health state that PSWs make up approximately 100,000 members of Ontario’s health care workforce, with over 34,000 workers providing care in the community and home care settings (WHO, 2020). The COVID-19 pandemic has brought to light the vital role of PSWs in caring for the elderly and vulnerable: PSWs are indeed classified as essential workers. When the SARS-CoV-2 pandemic broke out in early 2020, the PSWs’ already complex duties became much more difficult due to an enormous rise in the number of patients seeking care and a labour shortage. For example, in 2016 only about 3 million people in Canada were aged above 65 years, while this number has seen a 15 % increase in 2021 (Wingfield, 2020). As a result, PSWs must attend to many patients in a limited amount of time.
The economic climate changes how healthcare is delivered and shifts costs from higher to lower-paid workers (Kelly and Bourgeault, 2015; Saari et al., 2017). PSWs therefore face an increased amount of work pressure, leading to burnout. Despite the demanding nature of PSWs’ work, they are arguably the most marginalized group among health care providers, earning the lowest wages (OSCA, 2021). Personal support employees in sectors like community care and homes get a maximum of $19.00 per hour in Ontario (WHO, 2020). There are those clients whose family members are not around to help with the care package who will require maximum attention from the PSWs (WHO, 2020). Considering the amount of work they perform, PSWs are underpaid. This is because some clients require total care ranging from bathing to assistance in feeding, to transfer, to many other duties, meaning the attention such clients are given is almost on a 24-hour basis. Therefore, this shows that the work done by these workers does not equate to the money they are paid in return. By this, it is evident that the pay they get in relation to the work they do for such clients does not add up. The work they do is very demanding and out of the ordinary (Nurse Next Door, 2020).
PSWs in Ontario are predominantly women from racialized backgrounds (Kelly et al., 2015). Centring, honouring, and hearing this group of PSWs is critical in this project because their voices are rarely heard. Hearing from this group of employees highlights the reality that caregivers face concerning Corona virus and the limited PPEs. Through a series of interviews, I investigated the problems, availability, and dependability of PPE for female racialized PSWs working in the GTA during the COVID-19 pandemic. Allowing these PSWs to share their stories and experiences about the reliability and accessibility of PPE is critical to understanding how safe they felt while performing their duties. These workers claim that they gain joy from their work, and state that what keeps them going is the continued satisfaction of helping others achieve their best quality of life, without considering what they have gone through or what they are currently dealing with (Algonquin, 2021). However, there is a clear difference in the lives of Personal Support Workers before and during the pandemic. Times have gotten more challenging for PSWs in general, since they are often struggling at work with the job overloads and combining work with their personal life, friends, and family, while also having their own health at risk. Proper understanding of PSWs’ conditions is essential to enable required inputs that will help make their working conditions better and less risky. Understanding why they keep working amidst the harsh conditions and understanding the harsh conditions’ depths is an essential consideration for the public and the government to impose some changes that would prove crucial to their health and wellbeing.
Research Goals and Questions
My study aims to address the lack of feminist research focused primarily on the experiences of female racialized PSWs in the GTA. My research will address the following questions:
1) What are the experiences of PSWs of using PPE during the pandemic?
2) What challenges have they faced in the use of PPE during the Covid-19 pandemic in regard to reliability and accessibility?
Literature review
The bulk of research on healthcare professionals encounters during the Coronavirus epidemic has been conducted in the United Kingdom (Juan et al., 2020; Moorthy et al. 2020; Wingfield, 2020) and the U.S. (Moorthy et al., 2020, Miller, 202. In Canada, a microscopic study has been done (Rossiter & Godderid, 2020). Given the scarcity of scholarship in this field in Canada, my research adds to the body of knowledge.
Beyond the scarcity of overall research focusing on COVID-19 in Canada, nothing is known about racialized PSWs’ experiences in Canada during the COVID-19 pandemic. Rossiter & Godderid (2020) performed one of the few studies on this issue, which looked at PSWs in the GTA without focusing on race. Doctors, nurses, and other healthcare professionals have been emphasized in most research, while PSWs have not (Hall, 2020; Miller, 2020; Mrklas et al., 2020; Shanafelt et al., 2020). PSWs assist patients with everyday tasks such as washing, dressing, and transport, and therefore have distinct views and confront specific problems that other health care professionals do not always experience. As a result, it is critical to hear their stories. When considering the growing body of knowledge on health care workers concerning the Coronavirus, it is worth noting that the little research that looks at PSWs categorizes them as a homogenous group (Rossiter & Godderid, 2020). Even though the one existing study on PSWs in the GTA mentions challenges that PSWs face, this study focuses on the general population of PSWs. Furthermore, the previous study on PSWs focuses on nursing home customers or residents rather than PSWs. That is, the studies have only concentrated on the problems and experiences of the PSWs’ customers and not on the PSWs themselves (McArthur, 2021).
Another noteworthy finding is that recent research has primarily been performed by medical practitioners and social science academics (Miller, 2020; Shanafelt et al., 2020). Furthermore, no current studies have looked at the problems that healthcare workers confront from a feminist viewpoint. Using a feminist framework, I will examine how race and gender interact to shape how PSWs view their work during the pandemic. I will also pay attention to and honour the voices of female racialized PSWs, who are typically neglected. Individual PSWs will have their voices heard through my interviews, although on a limited scale. This research will emphasize and acknowledge the many realities of this group.
Finally, the bulk of studies have been done using a quantitative approach to research techniques (Miller, 2020; Aronson, 2020). Most health-related studies have relied on survey research methodologies (Miller, 2020; Shanafelt et al., 2020). My study uses a qualitative approach, with semi-structured interviews as the primary method. While quantitative techniques help identify general patterns (Keenan, 2020), this study focuses on gaining a thorough knowledge through first-hand narratives of the female racialized PSWs’ experiences with use of PPE during the COVID-19 pandemic.
Methodology and Research Methods
To better understand the experiences of female racialized PSWs, this study used a qualitative methodological approach. Utilizing a qualitative method, I obtained rich and thorough insights into the PSWs’ lived experiences with PPE usage while working and living in the setting of the present pandemic. I accomplished this research by obtaining and evaluating non-numerical data. Compared to quantitative research, which focuses on numerical data and statistics, qualitative research deals with words, meanings, and analysis. Qualitative research enables the researcher to analyze and explore ideas, occurrences, and experiences in greater depth (Crang, 2016). Qualitative research was more appropriate for my study because this research involves interviews that take a deeper look into the collected data to make a proper analysis of the case studies presented. It is described as a multimedia method that focuses on interpreting and the natural approach of the matter being investigated. Qualitative research enables the interpretation of the information from the interviewees with the exact emotions they give during their responses, most preferably those involved in the research investigations being studied.
The research results are then related to each other according to relativity theory, where the interviewed individuals’ results are related with each other. Similarly, to get an accurate dependable significant change notation, the current experiences are to be related by the previous findings. Therefore, the relative methodology is used to relate the findings in this research after the application of the methods presented for the research (Pauli, 2013).
Compared to other research methods, the qualitative research method is termed a content generator, which gives ease in understanding people’s attitudes and generating the required content and information from the participants (Pauli, 2013). Research like this requires an open-ended process where additions to the initially stipulated questions are possible. Lastly, qualitative research depends on how the interviewees present their words, including the tones they use. Emphasis forms part of the data collection technique.
Purposive sampling, or selective sampling, was used to choose participants for the research. This kind of sampling enables the selection of interviewees who are knowledgeable about a specific issue. The choice of interviewees to engage depended on the interviewer’s judgment to get the best and most knowledgeable interviewees. This depended on specifications like the time she has spent in the particular field (Bullard, 2021). My study’s interviewees are racialized women who worked as PSWs during COVID-19. I used my contacts to locate the participants. They were women from racialized backgrounds (non-whites) with proficiency in English language, 18 year and older, working as PSWs during the COVID-19 pandemic. The PSWs were also chosen from different health sectors to gain a variety of experiences Their selection varied from different agencies within the GTA, and I targeted persons who had worked as a PSW for over three years.
I conducted a semi-structured interview type. Four racialized female PSWs who work in long-term care institutions, hospitals, or community-based settings were interviewed. Each interview lasted around 45 to 60 minutes, according to my estimates. I asked open-ended questions so that interviewees could completely express themselves. Follow-up questions, depending on their replies, were in addition to the planned questions. I also kept in mind that some of the questions might be emotional or sensitive, so interviewees had the option of not answering or taking a break if they were uncomfortable. Because the pandemic is still going on, I did my interviews through Zoom. These interviews were recorded using Zoom, which captures audio and video by default. I recorded with the interviewees’ consent. An ethics application was submitted and approved by McMaster’s Research Ethics Board because I was researching human subjects (Rossiter & Godderid, 2020).
The narratives provided by the PSWs were analysed using thematic analysis to identify themes and patterns in the data (Miller, 2020). Thematic analysis is the best way to analyse the provided data because it is a way researchers find out their required research using people’s views, opinions, knowledge, experiences and values. This means that they put a great consideration on what people think about the topic study they are investigating. Keen concentration was put on their work lives and considerations made on themes that arose during the interviews. The thematic analysis involves the close examination of presented or researched data in qualitative research and identifying common themes-topics and ideas that reappear in the research data. For our case, we will apply the approach to our research and get the commonly repeated response to the provided question to determine the required result.
A combination of qualitative research and thematic analysis techniques proves best because qualitative research involves adequate and deeper understanding of words and their meanings presented by the interviewees. A thematic analysis approach that uses the understood matter systematically to identify standard features and provide answers or required outcomes from a study or research comes out as the best method to collect and analyse the data presented. The questions I presented to the interviewees and glossary are in the appendix of this research.
Ethics and limitations
Because I interviewed four PSWs, their perspectives may not be fully representative. These individuals’ experiences and opinions may differ from those of other PSWs because this kind of work operates in various environments with varied laws and regulations. However, to ensure that I was hearing various viewpoints, my participants came from a range of different healthcare settings, including retirement homes, nursing homes, hospitals, and home health care. I asked detailed questions and follow-up questions throughout the interview to learn more about the interviewees’ problems dealing with PPE. Interviewing four individuals was helpful because interviewing more might have resulted in data repetition so in avoiding the same result that might have led to more time taken in the interviews, I limited my interview to 4 participants. The short timeline I had to conduct these interviews plus the limited page count also contributed a great deal to limit the interview to four members. The PSWs are also a busy group, especially during the pandemic. Therefore, getting them off their schedules to take the interview limited us to a specific number. For all of these reasons, the small pool in this research was just perfect to conduct my study and draw necessary conclusions. The process of setting up interviews and holding the interviews themselves is time-consuming. Devising the questions, organizing the different meetings with the interviewees, and then collecting and analysing the data seemed hectic. The interviews took time, and there were sessions where we were cut short by the set time allotted for performing each interview. Interviewing as a mode of data collection is supposed to be done by experienced personnel. Interviewing calls for the creation of a rapport between the interviewed and the interviewee. For inexperienced personnel, it is not easy to create the required amount of rapport. Creating a rapport depends on how friendly one seems or how one presents himself (or herself) to the interviewees. The first impression is a great determining factor on the levels of rapport created. To build rapport, I led the interview session and listened actively to the interviewees’ answers.
Another potential stumbling block is my prejudice. There is a risk of bias as a researcher with comparable experience to the participants. To counteract this, I was conscious of reflexivity I considered my interviewees’ beliefs and practices during the research process. These biases include friendliness bias resulting from the participants choosing to agree with the moderator or researcher. This limits the research in that agreeing with the participants prevents proper and reliable follow-up questions. At times some answers do not sound authentic, and follow-up is necessary. At other times other participants talk and give incorrect responses to make themselves more liked by the interviewer, jeopardizing honesty This possibility cannot be completely eliminated, but I did my best by urging honesty during the research process. Bias is a combination of either the interviewer or the interviewee. Therefore, these biases might cause limitations to accurate, reliable study results. Starting the interview in a friendly manner, to lighten the mood before going to the jotted questions, is a way of limiting the biases. Starting in a friendly manner made my participants feel relaxed and ready for the session.
Ethical clearance statements
There was assurance of the research being a low risk because it involved four PSW participants who admitted not facing threats to participate. I will not reveal the interviewees’ identities, and they were provided with informed consent before the interview started. I did not ask questions relating to personal life experiences that relate to the mental health of the interviewees because that is an intrusion of privacy. Interviewees were not forced to answer every asked question. If they felt that the asked question was sensitive and emotional, they could skip the question.
Findings
The first finding that stands out from the four interviewees is that they got involved with working as PSWs because of their passion for caring. Only one of the interviewees did not mention caring as one of the factors that made her choose PSW work. Before the pandemic, interviewees described working conditions as just okay. One of them said, “everything was okay with proper or rather adequate PPEs supplies and fairly manageable work.” They added that at the onset of the pandemic, many changes occurred: some of their colleagues resigned and stopped working because of fear (their own or influenced by their family members, still rooted in fear of contracting and transmitting the virus). This reduction in available staffing led to harsh working conditions, exacerbated by bad managementcording to all four of the interviewees, they had to step in and handle more patients than they initially had because there was a reduction in staff members.
Shortage of PPE was evident from all interviewees’ statements. The service providers did not have enough PPE to serve their clients, thus making them end up reusing their PPE. My first interviewee said, “I used one PPE on several clients to save on time during the pandemic period.” This evidenced the improper use of the PPE. Despite this equipment shortage, there was a significant inflow of clients, such that time taken to change to a new PPE kit when transitioning to another client was not available. At some point, one of the interviewees felt like the masks they were being given were not reliable, and they were forced to wear one mask on top of the other because what the agency was providing with them was not the secure N95 ones. “Being that we have worked in the industry for a long time, we know the masks that are quality enough to prevent us from any dangers that may be presented by the virus. The ones we were given they were extra permeable,” said the fourth interviewee.
Another challenge raised by one of the workers was dealing with the clients with their masks. This was because some of the elderly patients are hearing impaired so PSWs need to shout in order to communicate with them effectively, or keep on repeating whatever they say, which will prove to be irritating in the long run. Secondly, many of the elderly need to see and verify that the person taking care of them is someone they know. When PSWs would wear the face mask and shield, the clients could not see their face and would therefore refuse to be cared for by that PSW. Therefore, PSWs were sometimes required to lower their mask to reveal their identity to serve them, putting both parties at risk of the virus. The interviewees formed a consensus when they all agreed that their clients were not wearing masks. Most of the members of the older population have breathing problems. Making them wear masks makes their conditions worse, for they need uninterrupted access to air. Thus, masks would act as a hindrance to their perfect breathing.
The life of a PSW is challenging for all women, but it is more challenging for racialized women. Most older adults do not have tolerance for Women of Colour, making the women frustrated while trying to serve them. On one occasion, as one PSW was going to serve and clean one of her clients, the client met her with a racial response, refusing to be touched by Black hands. The fact that there are unbearable working conditions with insufficient PPE is therefore made more challenging because of racism faced by PSWs. One of the interviewees said that there are days that she would cry before going to work because even with the PPE, she still did not feel safe because of skin colour prejudice. She had a hard time at work not only because of insufficient efficient PPE, but also because of racial judgments. Therefore, the only way they could describe their condition is unbearable, for they had an added trouble on top of their already existing poor conditions.
Most of the long-term care family members within the vicinity of the clients were not perfectly observing the WHO stipulated COVID restrictions. Because of the contagious state of COVID-19, one of the interviewees says that she lost one of her best friends because they disagreed with her continuing to work despite the global COVID condition. For the other interviewees, both their family members and friends did not support what they were doing, stating that it posed a significant health risk to both the PSWs themselves and the family members. Despite the presented risks and advice against their jobs by friends and family, PSWs stuck to working because of the yearning to put food on the table and take care of family. One interviewee said that she had a kid that depended on her work for survival and a sick mother who needed her income to survive. Another said that her passion and love for caring outweighed every negative aspect. One other interviewee explained that there were clients who depended on her to survive, so she felt a sense of responsibility and duty, especially since the clients’ other relatives were locked out by lockdowns. The bond between PSWs and clients is what kept the caregivers going despite the challenges faced in their workplace due to COVID-19.
Analysis and Discussion
I discovered that the most pronounced factor that keeps the PSWs going was the passion for care work, rather than the wages they get from their work. The passion for caring and stepping into the loneliness gap of their clients keeps them going (Catherin, 2017). The workers before COVID-19 had reasonably good working conditions. There were enough PSWs in the various agencies, so no need for as much work to be put onto one worker. PSWs had time to change their PPE because they initially had limited clients. At the onset of the pandemic, there was a relative increase in the number of clients because of induced lockdowns which prevented other family members from interacting with their elderly family members. Similarly, the risk they were subjected to in caring for the elderly prompted a number of them to quit after the pandemic. Their clients did not wear the masks and required PPE so the fear of being exposed to the virus scared them out of a job. This fact also pushed the workers to use a single PPE on multiple patients because of their shortages and the limited time frame to transition between clients.
As a result of the caregivers’ contact with the families and clients, they have a higher chance of contracting the virus (Greene & Gibbson, 2020). Handling many clients translates to close interactions with many individuals in a single day, which translates to increased probabilities of getting infected and transmitting the virus. One of the interviewees said that she had a colleague who contacted the Coronavirus from her work and, in the process, infected her husband with it. This led to her husband’s death, and she had to live with the guilt. The risk factors presented by the inadequate PPE and the increased number of clients per head are what has kept the PSWs’ family members and friends trying to convince the caregivers out of work. This is where the passion as the push to be a PSW comes in. Despite the harsh risky conditions at their job, the passion for doing the work keeps them going.
This passion can be tested when clients’ families try to make sure PSWs as caregivers are safe to provide the services. For example, after introducing the Corona vaccine, the client’s families only allowed caregivers that had been vaccinated. Practically, the caregivers said that vaccination was not an option but was mandatory. The clients’ family members also acted cautiously to the extent that even after vaccination, they could not let the PSWs provide care for their elderly without basic PPE like a mask (Konnyu & Crawshaw, 2021). The PSWs also knew that they were at risk of getting infected without proper PPE. Because their agencies did not provide them with the required surgical masks, they used two of the provided masks to reduce the chances of infection.
PSWs who are Black women face a different challenge in addition to inadequate PPE and their understaffed work environments. Racism has been a significant factor affecting today’s world, and some of the elderly population has the greatest dislike for People of Colour. The rate of racism was worse in the earlier years in the 18th century and as much as the conditions of racialized groups are getting better each year, most elderlies still hold to the ways they viewed people of colour. Therefore, racism appears to be different by generation, the earlier generations being more racist than the current. The PSW women who are racialized are suffering a great deal of racial injustice in their lines of work. It is difficult to have the passion for doing something when you are working in a racist environment, so PSWs need extra motivation to go through and work under the harsh conditions they are subjected to. PSWs are sacrificing a great deal to help the aging population with their day-to-day activities, but the clients kick them back by abuses and prejudice because of skin colour. The work of the PSW involves a lot more than the unsaid, such as the cleaning of their clients, feeding them and other activities that even their own family members run from. They have sacrificed their personal wellbeing to serve their clients but what they receive in return are judgements and abuses in relation to their skin colour.
In a nutshell, the analysis of the data given by the PSWs I interviewed illustrates how crucial their work is and how neglected they are to the extent that they lack the proper equipment to handle the vulnerable people and age groups in their stipulated vicinity. The skin colour factor makes the conditions worse when negative judgment in line with skin colour reigns supreme.
Research implications
Racialized PSW women have in a significant way suffered in the elderly caregiving industry. Their passion for what they do is the blazing factor that keeps them going amidst all the presented dangers and problems, such as unsafe working conditions and lack of family and friends’ support. Despite these challenges, PSWs continue in this line of work because of their passion for the clients they serve and the need to support their families financially. Thus, these women play a significant role in the community because they act as the sole reason why the elderly still exist and are being taken care of – the women handle the most vulnerable members of the community.
PSWs’ troubles with insufficient PPE is a problem that must be addressed, especially since some of the people they support have underlying conditions and cannot even use masks, which is the only essential PPE to protect themselves. Having the PSW experience shortage of PPE or using the wrong mask puts the clients at high risks of contracting the virus. Therefore, observing proper PPE supply for the agencies would help prevent any possible spread of the virus to the elderly and the PSWs offering care to them. The elderly have higher chances of dying when they contact the virus because of underlying medical conditions and poor immunity. Stepping in to prevent this from happening is an excellent step to saving them and acts as a way of caregiving, for it concerns the health of the elderly. One of the reasons why the PSW women need their stated experiences to bring change to the whole caregiving agency is the risk factors presented to a larger community. We need to focus on the risk they pose to themselves, their clients’ families, and friends if they do not have sufficient PPE access. Not addressing the unsafe working conditions of these workers by providing them with the required PPE will result in greater negative outcomes. Family members also should ensure proper sterilization and sanitation techniques when interacting with their elderly relatives. In a significant way they need to observe the Covid-19 guidelines to help prevent infecting their elderly kin.
The government has set programs like The Personal Support Worker Program Standard in Ontario, which offers a path to citizenship to the PSWs or offers them permanent residency; this shows that at least they are being recognized and their work is being appreciated (London H Health Center, 2021). The workers in this program are given places to stay and given citizenship rights. This at least is helpful to the group (Immigration & Refugees and Citizenship Canada, 2020). In addition to that, they are being subjected to multiple pieces of training to enable better performance. Although such training is useful, it does not solve the workers’ major problems. The only factor this program considers majorly is the increase of the PSW workers. Significant attention to PPE availability is not in evidence (Personal Support Workers HQ, 2021).
Conclusion
Practically, PSWs are essential health care providers because they stay in charge of the health of their clients. Studies show that they are known as unregulated healthcare providers (Giosa & Bender, 2015). The PSWs observe vital signs and information about their clients in their homes. They help coach the clients on care plans and assist their colleagues in health care recommendations. They are presented as the basis of the health care services because they guide and provide relevant information to the other interdisciplinary healthcare teams concerning the health and requirements of their clients (Giosa & Bender, 2015).
COVID-19 has been a significant factor that has influenced the world in every aspect, economically, socially, and politically. This has led to an increase in unemployment and has greatly affected socialization. Workplaces have also been hugely affected and conditions have worsened due to many factors. PSWs are a group of individuals whose job can be defined as a calling. Their experiences are not easy, the job itself is not a white-collar desk job but a support role, and what they do with their clients may seem disgusting. The fact that they do it wholeheartedly is an excellent indicator of humanity. All the interviewees have shown that the conditions of their work are not favourable for their mental and physical health. Even though the services they give are given genuinely with passion, their agencies do not return the passion provided by the workers in equal measure. The work overload does not keep them from continuing with what they do. What intrigues me the most is that despite judgements they received from their friends and family, the PSWs I interviewed continued doing the jobs. This group is not well recognized in our societies, yet they take care, in a sensitive way, of our elderly all around the globe. Their experiences are not the best in terms of mental, physical, and social relations. Government agencies need to look into the sacrifices that this group makes. The little that needs to be done is to try to make them safe in their service provisions. The least that should be done for them is providing or making available the required PPE to continue their noble services more securely. In this field the female racialized PSWs are facing a great degree of judgements and mistreatment by people as close as their clients. It is evident that they work their hearts out to enable the elderly to get through their days perfectly, but in return, they are met by racial judgments. It is so disappointing to see that Women of Colour provide care for their clients with no judgment on the white skin colour, while some white clients are so keen to shun the racialized PSWs who are trying to help. This shows how much the caregivers provide the care with great passion despite the harsh treatment on them.
In summary, the workers are exposed to work hazards every day as they handle their clients. By this, what I mean is that they are at risk of being infected easily by the virus. This calls for self-stipulated practices by the worker herself. To protect her health and those of her friends and relatives, governments and agencies need to set measures that will ensure that they are all kept safe. The presented conditions are tough, considering factors like prejudice depending on skin colour, COVID 19 being one of the greatest factors, and lack of family and friend support, but they still stand high to serve their clients. In my view these workers require a lot of support not only from the government but from the greater population at large, especially their clients’ relatives. This would at least make their noble work bearable.
 
 
 
 
 
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Appendix
A: Glossary of terms
Racialized: This is related to making the skin tone a character. By saying racialized immigrants, all we mean are immigrants who are non-white.
PSW: Personal Support Workers. These workers are caregivers that care for people who are either elderly, ill or need help to do daily tasks. They have to make sure the people they take care of are comfortable to enjoy physical and emotional wellbeing. They can either work at clients’ homes when employed by the home care agency or work for long-term care facilities.
PPE: Personal Protective Equipment. This is not oriented only to a single field. PPE is a group of equipment people use to protect themselves in their places of work to address possible hazards. It includes a variety of items of clothing, such as face wear, clothes, and helmets. In our case, we are talking more about medical PPE because PSW is more of a caregiving job description (Taylor, 2013; OSHA facts sheet, 2011-Personal protective Equipment, PPE)
 
B: Interview Questions
1) What brought you to this job as a personal support worker? Can you talk a bit about your
work history leading up to this?
2) Can you describe some details of your experience working with PPE during the Covid-19
pandemic?
3) What are some of the challenges you faced with the use of PPE during the Covid-19
pandemic?
4) What is the age range of the clients you provide care for?
5) Are your clients able to wear PPE during the time of care? If not, how are you affected by
that?
6) Have you ever experienced uncertainty about PPE, if it is sufficiently protective? Can you
describe a specific incident?
7) What are some of the changes you’ve experienced with PPE during the pandemic compared to
regular times before the pandemic?
8)  Is there anything else you think I need to know about your experience with the use of PPE?
 
 
 
 
 
doi: https://doi.org/10.1101/2020.06.12.20129619
 
 
Lastname, F. M. (Year). Title of dissertation/thesis (Publication No.) [Doctoral dissertation/Master’s thesis, Name of Institution Awarding the Degree]. Database or Archive Name.
 
 
 

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