 And thanks everybody for joining us here again for another crisis conversation live from my social distancing home office. Today, what we're really wanting to dig into is the lives of frontline healthcare workers. You know, over the last couple of weeks, we've seen so much about the lack of personal protective equipment and a lot of what a lot of frontline workers are facing. As they as they confront this really frightening and potentially deadly disease. And so today I want to kind of take it a little step further and talk about how that's affecting not only work and life, but really use this as an opportunity to ask the question what can we learn what can we learn from this experience. I think we've all been now social distancing long enough that we started these conversations with the idea that we would come together and share stories in our inner isolation and try to understand this kind of this very fast moving pandemic and how it was affecting our work and life. And I think that we can still do that but we're sort of sort of settling into a kind of crazy new normal. And I think now is the time to ask what can we learn and how can we emerge from this better and stronger. And I think that there are some bright spots, things that we can learn, but let me start first with Dennis Dennis it's turnover to you. I'll let you introduce yourself you're a nurse in Chicago. When I when I talked to you and heard your story about sort of what you were experiencing at work and how that was affecting you at home. It's an incredibly powerful story so let me turn it over to you introduce yourself and just tell us sort of a day in the life of Dennis Kosin. Sure. Yeah, I know I've been a registered nurse for about 13 years. Most of the time I've worked at Cook County Hospital in Chicago which is the biggest public health hospital in the area I worked in ER there for about eight years. In the past four years I've been working at Chicago public schools as a school nurse. And then part time I work at Provident Hospital which is down on the south side of Chicago for the last two and a half years I go there one one one day a week. And I think the thing that that I've learned about this. And I've known this ever since I went in, even before but personally highlighted for me the disparity between what it means to become a nurse and then the kind of environments that we're dealing with. We're told that we're when we're in school that we're going to be helping people that we're going to be providing health care, fixing people's health and all the rest of that's true that's 100% true. But there's a gap between what we're able to do and what what's needed and I think this COVID pandemic has really shown a spotlight on that disparity between what's needed so so far and what we have in Chicago is as people may have heard it, which is a lot of cities, while African Americans only make up about 30% of the population there over 70% of the deaths in Chicago and that's really horrifying, but it's also on another level not surprising, because because the way health care is run in this country, where it's basically focused on what makes money, unfortunately, rather than what's needed for people and so I think it's really shown a spotlight on that disparity. You know, we can keep talking sort of about this big picture, you know, the CDC came out with a new report this week about how many frontline health workers are infected. I think the number was 9,000. But again, I don't know how widespread testing is so we don't even know if that's a real number. But you know, of those are about 27 deaths and many of them are white middle aged women sort of the kind of the backbone of the nursing population. Okay, talk to us about what is that like to get your job, you know, you're there to, like you say, give care and care for others. What's that like when you know when the job itself could be very, very dangerous and actually, you know, I'm searching for the right word I don't want to say detrimental but potentially could harm your own health and your own care. Absolutely. Yeah, no, and I myself had an incident when I worked on the afternoon of March 20. I went down to the ER was supposed to only work an eight hour shift ended up being a 16 hour shift because there was so many people so many nurses called in sick we couldn't I stayed over to help out. I had a call a few days later saying I had been exposed to two patients who had tested positive. And this was after I'd already you know gone home that Saturday morning I lived with my wife, and my 12 year old, and upstairs from us are my wife's parents you know they're in their mid 70s. My mother in law has significant health issues. And the worst thing that was going through my mind was like, Oh my God, I've just, you know, brought something home that's horrible unknowingly. It was really, it was really difficult for me. And so, but I'm also on the same hand, I'm relatively fortunate like I have a job that pays living wage we have a house that I could be done in my basement and be there for five, five days while waiting my results. But it just made me think about all the families who don't have those same kind of resources. I mean in the schools, so many of the families that I work with as a nurse, they will have five people in a basement that is one bedroom, and they have a job that doesn't have the sick behind they don't they can't call in sick they can't not send their kids to school when they're sick and so I think about those things as the reasons why this condition has spread so far so fast in this country is because we just don't have basic things that most countries have is like when you're sick, you should go to work when your kids are sick, they should stay home. But if you don't get paid when you're not sick or if you if you are sick, you can't isolate yourself. It's going to spread through your through your conditions in a much sharper way, especially for for poor people and people of color. And you know, you'd also talked about the, you know, the hospital on the south side the ER where you where you work, that that's also closing in the middle of a pandemic which you know you were saying you'd never see that in a wealthier community. So what are you doing, right, are you doing now. I mean, so it was really stunning and the way they did it was really stunning we, I, my wife found out that my year was closing through the newspaper there's a local journal called cream Chicago business. It is, you know, it's it's a business magazine. And it was just odd that the Cook County was saying well we communicated to the people. Providence is located in the south side of Chicago and the Washington Park neighborhood. I don't believe that crane Chicago business the high bear has a very high subscription rate in that area and just I'm just guessing that I don't have data on that. The fact that they would just in two days tell the people tell the nurses Oh by the way your emergency room is closing that would never have happened in a community where like Northwestern Memorial Hospital is located where Illinois Masonic is located those are both much more wealthy well resourced areas Washington Park is not one of those areas. There's there was a study done a couple years ago the difference between life expectancy and Washington Park which is where Providence serves and Hyde Park Hyde Park has University of Chicago is a very well endowed institution I think they're there they've a billion they their life expectancy there is 14 years greater in Hyde Park than Washington Park. So that was just stunning that you would close an ER that serves a community of color in the middle of the pandemic it was stunning to me and they said it was for safety reasons they said that one nurse tested positive show me a hospital anywhere in the country that has not had a health care provider test positive when if they're treating COVID patients it's part of the this part of the picture but none of them I guarantee none. No institution around the world who has a worker test positive has shut down. So in the meantime they basically said the nurses go we're going to send you to other places you can work at Stroger which is their main campus or the Sir Mac which is the hospital that serves a community jail. So I opted to go work at the jail and I was there Easter Sunday. I'm going to be going there again this coming Sunday. So I want to talk with you about that and what that's like, you know because you talked about you're in Illinois and I think the CDC statistics also show like the death rate for African Americans is five times that for for white Americans and so I want to go back and talk to you more about the the prison but at this point, you know I'd love to bring in you as an emergency room doctor in the Washington D.C. area and Lynn when when I was talking to you, you know you'd mentioned Dennis was was was exposed to COVID and you know you isolated in the basement. You're still living with your with your husband and your daughter and you were talking about the sort of the steps that you go to try to protect protect them really and protect yourself can you just sort of walk us through a day in the life of how you like just go to work and come home from work. Sure, I'm happy to do that. Yeah, I in my process has changed quite a bit from how my job was a couple of months ago. In order for me to go to work I generally get dressed I put my cell phone and two plastic bags and I go get in my car and drive into work and one outfit. I change my shoes I put on the second outfit. I put my mask in my, my gear on and then I go into the department. And then while I'm there I change my protective covering multiple times throughout my shift, and then at the end of my shift I wipe everything down my shoes my badge everything. I change again and bag up my clothes, go to my car, change my shoes, drive home. I put that bag in a bag on my porch, and then I grab another. I take my clothes off on my porch so that's now two sets of clothes. I go inside and then I shower and then I come out. And so I definitely think it adds a lot and I don't you know honestly I don't know if that's enough or if that makes any sense at all. But you know I think the thing that struck me is that this is a new disease and it's a disease I've only known for four months as compared to any other disease I've studied in my career. So there's a little bit of science out there but what I know is that we're not sure about the spread of the disease. And because of that I'm trying to be as careful as I can. It's interesting that so even though you're you're still at home you're trying to separate as much as you can from your family can you talk a little bit more about what you're doing and and then what that what that's like but what's the impact now on your family with you kind of being so separate. Yeah sure. Yeah I'm lucky enough that I have a separate area in my home which I know a lot of health care workers do not. And I am in my bare bedroom where I have a bathroom next to me and I've walled that off and I no one else uses it and I stay in there almost all the time I come out for meals. But I'm trying to minimize how much of the air that I breathe out of my oral nasal pharynx goes into my family. You know when you so how old is your is your daughter and sort of what are you know what goes through your mind as you're going through all of this. You know when it comes to her and her care and you know is that hard for you to you know be so separate and is your husband really stepping up or really having to because you're because you don't want to breathe the same air. Yeah yeah I have a toddler and so that's hard you know because she hears you in the house so you know initially we thought maybe I would just stay completely isolated but that that really wasn't possible and I have some colleagues who also have toddlers and they've had to make the difficult decision of do they stay in their homes or do they send their toddlers away to live with their spouses in other states and I would say people have done both things. So it's definitely weird you'll hear her crying and you're like I need to wash my hands and then come out and how many times I want to go in and out and that sort of thing. So what's it what's it been like for your husband you know we had had a crisis conversation a couple weeks ago about how women tend to do about twice the housework and childcare even when they're working full time and that this you know that this coronavirus is really upending a lot of that potentially particularly among health workers where it's like 70% of all nurses are women and you see stories about you know like you'd mentioned a couple people you know nurses are staying at hotels or they're staying completely in different places to stay away from their families, you know kind of what's happening, you know, in your own in your own home with, you know, with your husband sort of not only doing the physical labor but all of that invisible mental labor that that women tend to do when it comes to caregiving and housework. I think it's definitely hard. I, you know, in addition to my clinical work my non clinical work has increased in addition to just, you know, reading about this disease and trying to learn as much as you can. So, because of that, he's trying to work while also watching her and then he processes on orders all the food, make meals, and then he's trying to make sure that she's occupied so coordinating zoom parties or almost virtual babysitting with grandparents on the iPad while you're taking a call at work, and, and all kinds of things like that. So, well thanks so much Lynn, you know you talked about. Next I'd really like to bring Ramon and Ramon is a nurse practitioner in the New York area which is we all know has been one of the just the hardest hit outbreak areas. In Ramon you also have family and you're like one of the, like many of the people that we're talking about you're actually living separate from them. Can you talk a little bit about your own, you know, your own story your own experience and what's happening with your family. Yes, thank you. So, you know, I've been a nurse for about 13 years, an NP for about five. I'm married my wife is about five months pregnant right now. I have a three year old son. I actually, you know, have been working in the outpatient world in the last few years. So when this all started. We started to work from home a little bit. But as soon as you know the work from home days were over. I decided it probably would be best to move out. I mean, having worked in the ER during the times of the H1N1 flu, you know, I realized that it because this was such a new enemy and such a dangerous enemy that, you know, I should just probably move out. We also live with my mother-in-law who's, you know, in her 70s. So luckily, a family friend, you know, was more than happy to give their apartment, you know, for a healthcare worker. So I moved here. And, you know, about one week after moving here, they actually redeployed us to the floors in the hospital to help out. So I worked in COVID units and non-COVID units. And at that time, I had, you know, actually felt very glad that I did move out a week before because, you know, I didn't know that I would be going to a COVID unit initially. And I didn't, I wouldn't know what, I don't know what I would have done if I had to come home from work and that they figure out where to go and what to do, you know. You know, you were, you were saying too when we were kind of talking and getting ready for this podcast that, so your wife is five months pregnant, you've got this young toddler and so she's not able to work because she's in the position that you're right. In a sense, it's a privilege to be able to work from home. I'm very privileged that I can work from home. Many people can't. But then the people who, you know, who are also trying to do childcare on top of that, that's also almost impossible to try to do both at the same time. We last week, we talked to Sarah who basically a single mom because her husband's overseas with two kids and her job just didn't understand why couldn't she keep working and try to take care of a one in a three year old. So it's literally impossible to try to do that. So you were talking about your wife is now taking time off, but that's eating into time that she was hoping to have for maternity leave, which is sort of another huge problem that we have in this country where the only country that also doesn't have a paid maternity leave policy. You know, can you talk a little bit about that and sort of what she's experiencing and all of this with you and you're not, you're not there because you're trying to protect them because you can't help in that situation. What's what's this like for your wife. Yeah, so I mean during all this time of change, our daycare also closed down understandably to help stop the spread of disease. And so my wife who initially did try working from home is unable to because now she has become the only parent in the home and also is the only person taking care of the household, which is terrible to think about. On my end, because I'm kind of powerless to help, but on her end, she's had to take days off and use her pay time off, which you know we were hoping would come in handy during her maternity leave. So it's it is really tough for her and for, you know, our family and you know did the fallout from this will be, you know, months and probably years to come. Well, thank you so much for sharing your story. Dennis, let's go back to you and pick up where we left off you were talking about, you know, so now that you're the ER in the south side of Chicago and this very hard hit area has closed down inexplicably. Now you're going into the into the prison and helping there, which, you know, as we know from reports is I think that at one point was was sort of the most infected highest rate in, you know, in the country. So, yeah, what are you seeing there and what are you what are again what are we learning that we can that we need to do better in the future. I mean, it is impressive to me it's a lot of the things that we're learning are things that are known, in the sense that there are horrible inequalities when it comes to how health care is distributed in this country. And learning about underlying reasons why there are these life expectancy differences like I was saying between Hyde Park and Washington Park you know just one street separates 14 years of life that's just stunning and it should have been a three alarm bell ringing for for years and should have been cared for and so this I think has exacerbated these COVID has exacerbated these underlying conditions so in the jail there's constant issues with short staffing with nursing so some of the people I took care of. Were on the one hand just horribly afraid on three detainees have already died from from Coronavirus that they caught in the jail. There's hundreds of detainees that have it. It's worth remembering that a lot of these people in the jail are not there because they've necessarily be convicted of anything thousands of the people who are there. Are there simply because they're too poor to afford bail they don't they don't have the $500 a month will be $5 million for for people who are for many people in this city to they can't just get out and so they're stuck there. The state ended the death penalty you know in 2011 but it has functionally in some ways been reinstated by not allowing these people who are there so many of them for nonviolent charges just awaiting trial. And the city says well it's too dangerous not not physically of the communities but it's too dangerous to set these people up because they may infect others. And my response that is right now in downtown Chicago there are literally thousands of empty hotel rooms the tourism industry obviously is a huge break right now. So why not put these people who are just awaiting trial who many of them who are there for nonviolent like traffic violations whatever let him stay at the Palmer House let him stay at the Intercontinental having there for two weeks they can do a wellness check on them on a regular basis and then they can go back to their communities. There's certainly solutions that could be put forward for many of these detainees in the jail and I hope that the county starts making the better decisions. Oh man, what an amazing story and you know, I love that thinking big about how we could really try to use this crisis to learn and really do things better emerges a better place a better country. You know at this point I want to move one of the participants and Hoffman posed a question in the chat so and let's bring you up and have you pose the question and then we'll have all the panelists respond. Hi yeah thanks for for prepping me in here my name's and I teach at a community college in the DC area. And many of my students are single mothers, mostly primarily women of color, and many of them are nurses aides working in nursing homes and hospice settings. And at the same time they're also working towards nursing credentials and mothering. So you can imagine how the COVID situation has impacted their lives in these really profound and heartbreaking ways because while they must continue to work. They also are trying to continue to work online towards their credentials and in their college classes, and their, their kiddos are home, also trying to now manage e learning. And so, and at the same time, they're getting sick. One student lost her ex husband this week to Corona, and he is the primary financial resource for the family. I have a question about how can we in higher ed as we're thinking big about, you know, how these different systems articulate and how they can come together how can we in higher education or in training programs address and protect these lower level healthcare workers who who don't yet have the credentials, right and the, all of the different supports and access to help, well they probably have access to healthcare but actually in some case they don't, and disrupt the gendered and racialized class stratified labor pipelines that are going to continue to evenly impact these populations, if they can't get these credentials, right. So, that's my question. So, what suggestions do you have, do you have and how can we think about, you know, higher ed, who is going to be getting actually a tremendous amount of money through the cares act to to funnel some of maybe some of these supports towards those those students. Well let's start with with Dennis. Those are so there's some excellent, excellent and troubling questions and how do we know what we do how do we emerge better with that. You are who are seeing this through the zoom that I'm definitely not the face of what nursing looks like in in the Chicago area by any stretch. I'm a Chinese person I'm identified as male, but most of my coworkers most of them went to nursing school with our people of color women most of the nurses I work with that Chicago public schools are in that demographic. My feeling as far as I don't know if there's a short term solution to to the callers question, but I think the long term solutions have to be examined. I think that nurses come out of school with tens of thousands of dollars in debt that makes no sense to me. If you want to go into investment banking or be, you know, some kind of money maker real estate tycoon. Fine, you got to pay for your own school that makes sense but if you want to go into a field. That's about taking care of people that's about improving people's lives that's about giving back to your communities. Why should you be paying for school? Why should you be coming out of your education? I'm sorry to shout and get excited, but come out of this in in debt that makes absolutely no sense. There should be a preschool for anybody who wants to become a teacher or a nurse social worker. I mean those are just the names off the top of my head, things that actually contribute to society. There should be childcare provided to those people who want to pursue the education so they can be supported. There are other people I went to nursing school with I went to Malcolm X college community college I really appreciate what the, the, the questioner asked about it. That's that's who goes to those schools and they need to be put more resources and there's resources that exist out there. Why is it that Wall Street, these big companies are being given this bailout of millions and billions of dollars, while people who are actually doing work, you know, not getting that same kind of relief we need to examine so many things out of this crisis and I really hope that we are going to fight for the changes that we need. All right, awesome. Lynn or Ramon do you have you have some thoughts. I can speak a little bit sure. One of the things I noticed an emergency medicine is that nurses come and they're very excited and then they often about mid career decide to go and leave and get a nurse practitioner degree or a doctorate in nursing. There's a major drain of these mid career nurses out of the emergency departments and I think if we had a system where we rewarded nurses for being good clinical nurses monetarily, perhaps we wouldn't be pushing them into other fields and the emergency departments and other departments within the hospital could reach the benefits of having those people stay around longer and teach our new learners. Excellent point. You know Ramon what do you have some thoughts. Yeah, I mean, you know something I realized a long time ago that is kind of coming to light now is that you don't see someone walking down the street and scrubs, and think, Oh my God, they're putting their life on the line. You see a police officer firefighter, you know, EMT you may think that. But I think that people are seeing that healthcare workers, you know, are on the front lines and do deal with things in the emergency room that are unknown to them and they're bringing these dangerous home to their families and putting themselves at risk and you know, the people that are training or, you know, parenting during this time, they don't have an easy choice. You have to go to work. You want to go to work, you want to help, you want to be a good parent. And there's there's a very hard balance. I mean, like Linda saying, all the steps she takes I mean that adds hours into your day going to work coming home from work, you know, it's it's really trying and you still don't know if that's enough. Yeah, it's really tough. You know, I see that we're coming down on time and so I did want to add I wanted to go back to Dennis and Lynn and Ramon if you had some thoughts to just, you know, here, here again we have a crisis and it's it's really showing what's fraying what's broken what's near what's what's breaking and in the United States, you know, what, what do we need to do next what's, you know, Dennis, let's start with you you've mentioned a lot of really important systems that are broken right breaking. You know, what do we do, what do we learn out of this and who needs to be in charge of making these changes. I think right now it's clear that that healthcare providers and justifiably so are being held up in the media in public as as as Ramon was saying as as Lynn was saying as these heroes that are going in. But I think that's that's half the story. We have been working conditions that that are would be considered embarrassing in any other country that hasn't a similar economy. And these are chronic disparities that have existed in this country of decades, if not for decades for centuries. And so I feel personally as a health care as a person who participates in providing health care. We need to lift up our voices to not just talk about ourselves as heroes, but talk about the fundamental things that are broken. Why is it they're not sick time for people. Why does there are disparities when it comes to health care. Why are they not why do we have a poor profits health care system. All those things are things that we need to be shutting from the rooftops right now, towards changing things fundamentally. Right, as well as talking about the mass incarceration that you're that you're now facing at the jail. 100%. So, Lynn, you have some final thoughts about what do we learn from this. Sure, I think that emergency medicine needs to be given surge capacity. You know, we always operate with our, our emergency departments at 120% full. And when something like this happens. It's very hard to respond. Yeah. All right, great thoughts. Ramon, the last word goes to you. I mean, I think just like Dennis and Lynn were saying, you know, we are always working at capacity with limited resources. And I think this pandemic has actually brought those to light and I really hope that it can be fixed moving forward. But we do have to, you know, point it out to, you know, everyone and people that can make change to make that happen. Right. And this is this is that we're trying to play our part in that trying to bring these voices to light bring these conversations to light, making sure that workers have a voice making sure that the public really understands how these systems are broken and gets behind the kind of larger policy changes that we need the investments and the, you know, the kind of the larger workplace cultural changes that we need. So what we can do as individuals, you know, how we all need to be understanding and pushing for these kinds of changes. So I want to thank Dennis, Lynn Ramon thank you all so much for being here and sharing your stories. I want to thank all of the participants who have chimed in in the chat and thank you so much for being part of the conversation today. My amazing better life lab team, the amazing new America event staff, David Shulman, an amazing producer thank you so much for helping us put these conversations together. Next week we're going to be talking to Kelly Yoast who is a remote and flexible work strategist. We've been all doing this, you know, many of us for a month what do we, what are we learning what, how is this going to change the future of work and what about the people who can't work remotely. What does this mean for future work systems. So thank you all so much for joining today wash your hands stay safe and we'll see you next week.