Hospital housekeeping staff are the forgotten COVID-19 front line
Hospital housekeeping staff take on similar levels of risk as other front-line health-care workers, but seldom receive the same level of community praise for their work.
Environmental services staff, the people who ensure hospitals are clean environments for healing, are right there in COVID units. They work alongside doctors and nurses in the messy, difficult and volatile moments of combating disease and injury, and are a key component of health care.
When I first approached University Medical Center to interview “hospital janitors,” their representative Ryan Mielke was quick to let me know that janitor is not the preferred nomenclature for hospital housekeeping staff members. Mielke clarified that the role of hospital housekeeping entails far more than what a layperson would typically associate with the term “janitor.”
“Our environmental services team must know all methods of sanitizing, control of infection, (and) are necessary to the continuum of care that can save lives. If their job isn’t on point, a surgery could be at risk of not taking place; from ensuring an operating room is ready, to assisting others with the immediate support in the service to each patient,” Mielke said. “Their job affects the health of sick patients. That is why we ensure so much goes into their training and awareness of new guidelines by the CDC.”
Housekeeping workers make personal sacrifices to promote safety
Claudia Lemus, a 53-year-old El Pasoan, is the matriarch of a large family. She has five children and 14 grandchildren. Claudia loves spending time with her grandkids: taking them to the park, cooking for them, and simply being together.
But Claudia hasn’t been able to visit her grandkids for several months as a safety precaution, because she is also a member of the housekeeping staff in the emergency room at Providence Memorial Hospital.
“I want to go see my grandkids and my family, and I don’t go because I don’t want to pass (COVID-19) to my family, you know? It’s hard, where I can’t go and be with my family. It’s a lot,” Lemus said.
Ana Landa, a 25-year-old environmental services worker at Las Palmas Medical Center, has two young children at home, and has said it’s been difficult to maintain distance from her kids when she gets home from work.
“Once I get (home) I shower. And I don’t say hi to anyone until I’m done, until I get out of the shower. The hardest part is trying to make sure that once I come through the door — my little one is someone who, once I get home he comes and wants to hug me, you know? It’s a little bit hard to ignore them and go straight to the restroom,” Landa said.
For Patricia Priego, it’s important to set a good example for her family members. Priego, a 58-year-old environmental services worker at University Medical Center, hasn’t seen her extended family for three months. She told El Paso Matters that keeping her distance from her family is a way for her to protect them.
“My husband is diabetic. He has other medical problems in his heart, he’s had three surgeries, and so it’s my responsibility to be very careful. It’s a stress, but I have faith that God will help me, (and) that everything will be OK. But also I have to take care and do the best I can,” Priego said.
COVID-19 has dramatically altered hospital housekeeping
Major hospitals in El Paso report significant changes to safety and personal protective protocol that affect environmental services staff as a result of the COVID-19 pandemic.
“We ramped up the cleaning of all high touch areas of the hospital. We have foggings at night to disinfect our tents, our nurses’ stations, our doctor patient areas, everywhere there’s any chance that something may live on a surface, we’re making sure that we’re ramping up on the amount of times we disinfect those areas,” said Clair Ellis, director of environmental services at UMC. “Because also we want to protect all of our coworkers, our peers. We all need to be here, we’re all part of a team, and if we didn’t take care of each other then how would we take care of our patients?”
Landa said at Las Palmas environmental services workers now rotate between who works in COVID-19 units and who does not.
“Before, they had me in the ER, and I would go every day and clean the rooms, that was pretty much it. Now they have us wear a mask while we are in the hospital. From when we go in until we get out of work. And they’re rotating us with the area, moving everyone around. That way it’s better for everyone to be in each area. (The) ER is a little more exposed, and now it’s not just me, it’s everyone, so it’s more fair,” Landa said.
UMC has also begun rotating environmental services workers between non-COVID and COVID units of the hospital. Celeste Chavez, environmental services manager for UMC, said it’s more fair and less stressful for workers this way.
“It’s good to rotate everybody and give everybody a chance to have a break. And then I think they understand each other and what they’re going through, because they’re all going through it,” Chavez said.
Housekeeping staff don and doff equivalent levels of personal protective equipment to nurses and doctors when entering and exiting COVID patient rooms, some hospital staff report. A representative from Las Palmas del Sol stated that “environmental services staff who work in areas with COVID-positive patients are provided the same level of PPE that our nurses and physicians receive (including face shields, shoe covers, masks, etc.).”
Lucia Alvarado, 53, a housekeeping worker at Del Sol, described the process of donning PPE to enter a COVID unit.
“We have our uniform on, but then we have to put on the gown, the thing for the eyes, a head covering and then I have my mask that they give me here at the hospital, but they give us another one and then over that I put on the plastic cover and double gloves. The masks they give us in the ER are different — they give us N95 when the patient has been confirmed (to have COVID-19), or if they suspect it,” Alvarado said.
PPE protocol varies somewhat from hospital to hospital, and has changed throughout the course of the pandemic. As safety protocol changes are implemented, ongoing communication among environmental services staff is critical, said Chavez of UMC.
“It’s very important that we disseminate (new) information to our team,” Chavez said. Daily bilingual “huddles” to discuss new protocols help all environmental services staff to be on the same page.
Public accolades of medical workers often leave out housekeeping
Some housekeeping staff lament that the general public doesn’t realize all the work that is done by environmental services staff to keep the hospital operating smoothly.
“If you see the news or a commercial, they say ‘We want to thank the doctors, the nurses, the techs,’ but nobody mentions us. Like we’re nothing,” Lemus of Providence said. “Nobody says, ‘the housekeeping is very important in the hospital.’ I always keep everything clean and safe for wherever patients go. The front line is everybody that works in the hospital. Not only the doctors, not only the nurses, not only the techs. It’s everybody.”
Priego at UMC said she wished more people knew what it’s like for housekeeping staff, to better understand the intensity and importance of the work. “We see patients who are suffering. The way it is cannot be grasped unless you see it here in the hospital,” she said.
Chavez recalled how important housekeeping was at UMC in the aftermath of the Aug. 3 mass shooting.
“Typically (environmental services has) one person in trauma, one person in ER, one person in OR. I think that day (the environmental services supervisor) already had about 12 housekeepers in trauma, four in the OR, three in the main ER. I’m telling you, I was there within 10 minutes of that call. She had already stocked up all the linens, to make sure that people were able to change into scrubs that had to pick up all the blood and things that were happening. I cannot tell you how key we were that day, to getting it all done. I say we but really it was our team, they did all the hard work,” Chavez said.
Cover photo: Patricia Priego, environmental services associate at University Medical Center, puts on gloves as she prepares to demonstrate the process for cleaning the rooms of COVID-19 patients. (Corrie Boudreaux/El Paso Matters)