I Love What I Do and I Love My Patients, but at What Cost?

By Shea Sandish

Shea Sandish, SBA at UPMC Western Psychiatric Hospital

I was hired in 2019 to work in Western Psychiatric Hospital in the Integrated Health and Aging Program — the geriatric program. I didn’t love that unit, but a job is a job. Western Psych lets you pick up shifts on other floors, and as I would pick up shifts, I found that I really like working with adolescents. I would pick up shifts on the child and adolescent unit and people with eating disorders unit a lot.

We have a scheduling system where you can see who needs more staff and you can pick up those shifts. But when you show up, they can end up pulling you somewhere else. So you pick up a shift specifically in order to work on one floor and you get pulled to a different unit. It is especially tough being pulled to the floor where people are experiencing acute symptoms that you weren’t prepared to work with or aren’t comfortable working with. By the way, when we’re hired no one tells us this kind of pulling happens.

As the pandemic escalated, more shifts began to pop up, and I picked up shifts on the eating disorder floor whenever I could. I picked up so many shifts there it got to the point they would just text me when they needed someone. At the beginning of the pandemic I was working 40 hours a week, plus an internship and taking classes full time. In October, a position for SBA opened up on the eating disorder unit, so I switched there. I genuinely enjoy the work and it’s an area I feel that I excel in. I wouldn’t trade the job for anything, because I love what I do and I love my patients.

I like where I am, but we get pulled a lot, especially to units that are chronically understaffed. People who normally work on floors with people who have a developmental disorder or autism spectrum disorder get special training — training you don’t have if you just get pulled there. Some floors are more prone to physical violence against staff, which could be more likely if you get pulled there and you don’t know the patients or how to interact with them. The hospital’s response is to remind us that they offer us a chance to see what other units are like for four hours when we’re first hired. But there is a lot of patient turnover on some of the floors dealing with the most acute issues, so seeing a floor once doesn’t necessarily prepare you to work there months later.

I would pay someone my own money to take a shift for me on the autism spectrum disorder and developmental disorder floor. A big part of doing that work well is getting to know your patients personally and knowing their triggers, knowing how to talk to them. But if you don’t know that, then you don’t know what to do, and getting it wrong can mean escalating a problem. The workers on that unit are incredible and they’re great at what they do, but I’m not trained for that. It’s upsetting that staff from any unit can get pulled to any other unit, because we all want to do our jobs well, but we’re not interchangeable and we’re not necessarily equipped to do any job in the building.

The hospital says it’s ok because we get a one-day crisis training. Okay, it’s better than nothing I guess, but one day is not real training. My training is for patient safety, which on my floor translates into my own safety, and my patients are generally more receptive to talking. On some other floors though, saying: “hey can I talk to you for a second?” is a big no.

In late 2020, people on one unit had contact with COVID. They discharged anyone they were able to, and split the hospital into three zones: red, yellow, and green. Red is for active COVID cases, but not so symptomatic that they have to be transferred to Presby. Yellow is for people exposed to the people in red who haven’t tested positive themselves. Green is for people with no contact and where no one has tested positive.

The thing is, staff can get pulled to a yellow or red unit, then go home to their families and come back and work in green the next day. We have minimum staffing requirements, and that has been strictly adhered to — meaning we usually run at minimum.

UPMC needs to review their COVID protections. We find out from each other if we’re working in a yellow zone. They literally don’t tell us when we come in to work. All we get is a paper mask. Some of our patients respect social distancing, but obviously some cannot. And of course sometimes you need to be getting right up in people’s business to take care of them, and some patients don’t understand we’re in a pandemic or what that means.

And in general they really have to raise the minimum staffing. Having extra staff on the unit, especially on some of the more acute floors, makes you safer and makes you feel more confident. We ask for more staff, but they always say no. So we have to take our own precautions to try and keep ourselves safe.

I leave the bathroom unlocked so that I know I can sprint in there to protect myself and lock myself in if I have to. And that’s advice I was given by other workers. It’s been so bad I’ve had to hide behind a cleaning cart. People have had to go to the emergency department. I’ve been hurt, but luckily not that bad. Like, I’ve needed to go to the chiropractor, not the surgeon. And I’m a short white girl, I guess I don’t look threatening, so patients don’t come at me too much. But our patients can be severely ill and they can cause real harm to staff. It’s not a reflection on the patients, it’s a reflection on how UPMC chooses to fund and staff Western Psych. It all contributes to staff burnout.

UPMC needs to re-evaluate: are they doing even the minimum to keep staff safe? Or is it like, “you work for us, you’re at our mercy.” Why is it some floors are always understaffed, and they’re not hiring? Why are staff quitting over things that easily could have been prevented, and then they don’t fix the problem anyway?

The thing is, UPMC expects employee turnover here. At a certain point, there is no room for promotion unless someone quits, so the path to advancement is people leaving. I’ve been here a year and a half and I don’t have more responsibility than someone who is a first-year in college. A lot of people are students here, and a lot of us leave after getting our degree and look at out-patient or state hospital jobs, somewhere that has safer staffing and where you can be promoted.

It’s sad because I really like my job and I really like working with people with eating disorders, but at what cost? At what point do you say, I need to find someplace where I can be safe and succeed and advance?

For a student position it makes decent money, and they now start everyone at $15, which is great, but cost of living is going up too. If this was my only job I’d be pressed for money (I work a second job at a youth group). And I don’t have a family to care for like some others do. I just don’t want to be in a situation where I have to work 70 hours a week forever in hopes of having a decent lifestyle.

I got involved in organizing over the summer. A colleague asked me if I was interested in unionizing the staff and I was like, hell yeah! I have it relatively good on my unit. I like my work, but I recognize that other units don’t have what we have and I think they should. People are getting hurt and UPMC doesn’t care. If UPMC doesn’t fully cover injuries on the job, and if employees can’t go on disability when they’re hurt, that sucks. Some of these staff members have kids, they get beat up at work and they go home and take care of newborns and they can barely lift their arms, and the hospital doesn’t take care of them.

Honestly, it borders on simply exploiting people. Because they know people will take the jobs we can get in this field. But I don’t agree with exploiting people because they need this job or because they want to take care of people in need, and I don’t think people should have to come to work and be afraid they’re going to end up in the ER. I think we should be taken care of so we can take care of our patients.

We are UPMC hospital workers — these are our stories from the frontlines of the COVID-19 pandemic.