The rise of on-demand work during COVID
Registered nurse and uPaged founder Zara Lord reflects on the rise of on-demand work during this pandemic.
There’s a certain irony in that 2020 was designated as the “International Year of the Nurse and the Midwife,” to honour the 200th anniversary of Florence Nightingale’s birth. Its aim – to celebrate the work of nurses and midwives; to highlight the challenging conditions they often face, and to advocate for increased investment in the nursing and midwifery workforce – has most certainly been achieved with the unwelcome arrival of COVID.
Celebrating the work of nurses and midwives – Is public reward and recognition enough?
The outstanding efforts of nurses throughout Australia during COVID has been repeatedly recognised and rewarded through the incredible generosity of the general public, from the heartwarming acts of kindness such as those found in the nationwide ‘Adopt A Healthcare Worker’ movement and the many organisations offering free support and deep discounts for frontline workers, to the not-for-profit groups and individuals relentlessly sewing spare scrubs as well as washing and shoe bags, or the entrepreneurial school children using 3D printers to make mask expanders to relieve some of the pressure of wearing PPE all day.
There is a growing number of nurses who’ve taken stock during COVID and either reassessed their careers or accelerated plans for a change in direction. As ‘deskless’ workers who seldom have the opportunity to work at home because the very nature of providing healthcare means interacting with the public, nurses are more vulnerable to illness, and in the midst of the pandemic, not every nurse is in a position to, nor wants to be frontline.
The challenging conditions we work in have certainly been highlighted, thanks to COVID. If nurses weren’t stressed pre-pandemic, COVID has certainly triggered many, while others have thrived during the crisis. COVID has enabled many to become increasingly vocal about what causes them the most stress – and we are increasingly being heard.
Has COVID pushed nurses over the edge?
Almost every nurse we speak to through uPaged worries about the risk of exposure to and infection of coronavirus, the lack of access to PPE, and many discuss the heightened mental health risks. Post-traumatic stress disorder linked to fear of aggressive patients, increased generalised anxiety, and concerns regarding lack of access to personal protective equipment (PPE) is very real and presenting in many nurses.
Pre-pandemic, many nurses we spoke to worried about lack of flexibility that their work affords them – the very flexibility that has been offered to many other professions as a result of the pandemic. It’s this lack of flexibility that was reflected in a US study in April this year that showed that deskless workers would choose having a flexible work schedule over making more money. It’s no secret that inflexible schedules create work-life imbalance, and nurses will be the first to say that these imbalances have caused them to miss out on sleep, meals, social events, holiday celebrations, and personal time, amongst a myriad of things that non-shift workers and those bound to regular business hours take for granted.
Gen Zers and Millennials have already been flagged as those more likely to burn out, because contrary to popular belief, they tend to prioritise work over health and personal time. We’re seeing this reflected in the number of nurses turning to uPaged while they voluntarily take time away from full-time shift work, or because they’ve lost their regular shifts as a result of COVID.
As 5th Year Emergency Department RN, Amelia explained to me “COVID has been my tipping point. Exhausted after a day where we had 500 presentations in ED – 200 more than usual – in the early months of the pandemic, I just realised that I had had enough. I was burnt out and needed a break. I’ve now had that and I’m gently easing myself back into work, being very selective about where and when I work, and so far, it’s working. For once I feel in control, I’m getting paid what I feel is fair, and I’m getting offered (and choosing) opportunities without the stress of thinking I might get cancelled at the last minute. I’m not ready to return to hospital nursing on a permanent basis yet, but I’m sure I will at some point so I can maintain my clinical skills and get some career development.”
Amelia has been one of the lucky ones that have benefitted from picking up ad hoc shifts that offer some diversity – with work options ranging from theatres and wards where the hospital has been willing to train contingent workforce, to telehealth and COVID testing clinics. Like many other nurses, she’s been given access to career options not previously considered, and the breathing space she needs while she assesses her long-term career options.
For others who have been unable to secure work during the pandemic, work through uPaged and other options offering on-demand work has provided a desperately needed financial life-line and given those nurses a sense of control and choice over their nursing careers in a way that they haven’t been afforded elsewhere to date.
Some of the worst hit career-wise by COVID have been nursing students and new graduates. Conversely, some of these students and new grads have been able to work on the frontline, in facilities that would have once never been given access to without at least one year of post-graduate experience. The feedback we’re receiving is that the work has been an incredible opportunity, a chance to prove their resilience, rise to the challenge and show their ability to hit the ground running. And they’ve done incredibly well according to more experienced colleagues, and the facilities that have employed them have been very impressed.
Likewise too have these very early career nurses. They’ve gone on to use the uPaged platform to document their unexpected work experience, and start building up their online career portfolios. Many see this as their passport to future work – a headstart on their peers of sorts. And it probably couldn’t be more timely.
Where does this shift leave nursing?
The final aim of the Year of the Nurse and Midwife – to advocate for increased investment in the nursing and midwifery workforce – has also been realised in some ways, but a lot more will need to be done to manage fallout from COVID. According to the World Health Organisation, the world needs 9 million more nurses and midwives if it is to achieve universal health coverage by 2030. In pre-COVID Australia, for some years now the shortfall was predicted to be 85,000 by 2025, rising to 123,000 in 2030.
What these figures will revise to post-pandemic is yet to be seen, and as COVID’s second wave wreaks havoc across some of our States, the long-term impact that its trail of destruction will leave on the nursing workforce is yet to be uncovered.
Early indicators from nurses that uPaged has been in contact with suggest that many of us will continue to review what we want from our careers, the sort of work we’re willing to do, and where we’ll draw the line on what we’re prepared to do. And the flexibility offered through uPaged serves these nurses well.
The pandemic has certainly proven our value as nurses. Perhaps it’s time for nurses to be given more flexible work options, and be more supported in their choices to work casually. Perhaps it’s time for student nurses to be given opportunities to train in and thrive in more challenging nursing environments while studying like nurses did in previous years, and maybe it’s time for early career nurses to be given opportunities to work in their fields of choice without the fear of missing out on a coveted post-grad year? Perhaps now in the Year of the Nurse, it’s the time for us to permanently change the way we choose to work? And maybe now if the time for us to be compensated at a rate that equates to the value we provide?
Zara Lord is an 8th Year RN, ICU nurse and founder of uPaged, Australia’s first and only nursing workforce marketplace, directly connecting nurses and hospitals to fill casual shifts. uPaged also provides a platform for nurses to store, record and showcase their skills and experience – an online resume for life – supporting workforce mobility and flexibility.