KHMU INFO 2014
Summary Results from Korea Health and Medical Workers Union Members (based on the responses from 18, 263 KHMU members, 2014 year.
(1) Maternity Protection and Pregnant Workers
Average working hours per day: 9.8 hours; night shift pregnant workers: 21.9% of the total night shift pool
A labor force shortage increases the number of hospitals that apply the Nurse-Pregnancy-Order-System (17.4%). The incidence of miscarriages and stillbirths is rising, to 18.7% of all deliveries.
◯ Considering that women make up a large percentage of the labor force in healthcare institutions, healthcare centers—more than any other workplaces—should protect women’s maternity rights. But, in reality, female workers frequently experience violations of their rights by these medical institutions.
◯ Around 21.9% of respondents said that they worked at night during pregnancy, which is actually prohibited by law. Daily working hours of pregnant workers were 9.8 hours on average. Even worse, approximately 18.7% of the surveyed workers reported experiencing a miscarriage or stillbirth, due to an intensive labor and work environment.
◯ Around 17.4% of surveyed nurses are affected by the Nurse-Pregnancy-Order-System policy: 20.2% in public hospitals and 20.7 in private hospitals. The policy is run under the auspices of the department head. If one refuses to follow the policy or happens to become pregnant, she is subject to disadvantages in the work schedule, experiences severe stresses and sometimes ends up moving to another department. Korea is a society suffering from a low birthrate, and it is aging, motivating the government to promote pregnancy. That said, such policies are still run in hospitals, signaling that female healthcare workers work in dire conditions, which hamper them from arranging their own family plans.
◯ At the same time, the survey found that only a small number of workers use childcare leave (14% on average: 17.6% in public hospitals, 12.6% in private hospitals). And their average leave period is 9 months. Among them, around 12.3% said that they had to come back to work earlier than expected after delivery.
◯ The survey result signaled that short staffing causes maternity rights to be violated, driving pregnant workers into dangerous conditions.
◯ Against this backdrop, on September 25, 2014, the Shorter Working Hours during Pregnancy Policy has been implemented in workplaces with 300 workers or more. The policy mandates organizations to shorten pregnant workers’ hours by 2 hours per day. But, it has not become a reality, but is a pie in the sky idea.
◯ It is not only uncomfortable for a pregnant worker to ask for shorter working hours directly from the employer but also distressing for her to transfer her work to colleagues in understaffed workplaces.
◯ We, the KHMU, urge the Ministry of Employment and Labor and the Ministry of Gender Equality and Family to fully investigate healthcare facilities to determine their maternity protections and insure the institutions observe associated laws and increase staffing numbers to guarantee maternity rights.
(2) Working hours and conditions
Working hours increase to 9.8 hours per day, 48.9 hours per week.
Despite the five-day work week, work on Saturday continues to increase.
◯ Healthcare workers are suffering from long working hours, working for 9.8 hours per day and 48.9 hours per week on average. This is an increase from 47.4 hours in 2004 when the five-day work week initially took effect.
◯ As of March 2014, wage workers’ working hours decreased to 42.9 hours from 47.8 hours in March, 2004. In contrast, healthcare workers work even longer than before the shorter day work system was introduced.
◯ Even worse, around 19.6% of total healthcare workers were found to work over 52 hours per week, while employees working such long hours represents 11.3% of total workers and regular workers, 7.7%. For comparison, occupations that demand long work hours include security guard (53 hours), medical record officer (51.6 hours), cook/food service worker (51.2 hours), optician (50.3 hours), administration officer (50.5 hours), driver (50.5 hours) and nurse (49.1 hours).
◯ While working hours are increasing, the average consecutive years of work remain below 10 years. For healthcare workers, nurses were found to work for about 7.5 years in a row on average, while non-nurses, 12.8 years, signaling that nurses tend to work fewer years than other healthcare workers.
◯ The forty hour work week policy applies to the healthcare industry as well. That said, two thirds of healthcare businesses, or 66% of the total, have their workers see outpatients and perform some other jobs on Saturdays.
◯ The number of days of annual leave in the healthcare sector was 17.7 days on average, but the actual days of leave taken by workers was reportedly only 12.3 days. Therefore, unused days of leave averages 5.4 days, which means only 69% of eligible leave is actually used. Furthermore, 64.3% of respondents said that they felt limited in “freely” using annual leave.
◯ Workers rated their level of satisfaction with their job at 45.1 in 2014, signaling that workers feel somewhat unsatisfied as compared to scores of 45 in 2013 and 46 in 2012.
(3) Working Hours and Working Conditions
Around 52.4% of respondents commented that they “experienced medical accidents due to a low staffing level.”
Around 62.2% of surveyed workers also linked their poorer health to a shortage of staff.
Expressing serious concerns about the lack of manpower, KHMU members reported that the workforce is 23% smaller than needed, which means that each workplace is required to hire additional 3.3 workers.
◯ Over two-third of respondents (78.1%) thought that the current staffing number should be increased in their workplace and the shortage of workers has led to a lower quality of medical services and poorer health among workers.
◯ Around 76.9% of surveyed workers reported that a low staffing level worsens the quality of services. In addition, many noted that due to a lack of manpower, they failed to be kind enough to patients; failed to provide necessary medical services (65.2%); experienced medical accidents (52.4%); had to reduce the number of sickbeds or remove them (28.5%); working conditions deteriorated thereby affecting workers’ health (62.2%); workers became more vulnerable to diseases and accidents. This demonstrates that an insufficient number of workers negatively affects the quality of services and patients’ safety.
◯ As the survey aptly demonstrated, long working hours turned out to be the main reason behind dissatisfaction about working conditions, and this problem is a result of the shortage of workers, which is well below even one-half or one-third of OECD’s average.
◯ Over half of all the respondents (54.1%) and surveyed nurses (66.5%) also commented that they are considering changing jobs since the staff shortage issue is quite severe. Among the reasons behind the consideration of job change, the largest number of respondents (38.6%) and nurses (44.1%) noted that jobs are too difficult to continue and the second largest number of respondents (15.9%) and nurses (12.5%) pointed out the low wage level.
(4) Verbal abuse, Violence, Sexual Harassment
Healthcare workers are vulnerable to human rights violations, including verbal abuse, violence and sexual harassment.
Five out of ten healthcare workers experience verbal abuse. Since 55.7% of respondents noted that they were verbally abused by patients, patients represent the major source of abuse.
◯ More and more healthcare workers are experiencing verbal abuse and violence. The survey results found that verbal abuse by patients increased to 55.7% in 2014 from 54.4% in 2013, physical violence jumped to 12.4% in 2014 from 11.7% in 2013, sexual harassment rose to 10.7% in 2014 from 10.1% in 2013.
◯ Patients represented the most frequent assailants, followed by patients’ family members and doctors. Patients’ violent behaviors turned out to be somewhat more frequent in public hospitals than in private hospitals. Meanwhile, private hospitals witness violence, including verbal abuse and sexual harassment more from doctors and supervisors than public hospitals.
◯ The rate of occupations that experience verbal abuse, violence and sexual harassment are as follows: security guard/receptionist/phone operator – 77.4%; nurse – 63.1%; patients’ transfer staff – 51.7%; nurse’s aide – 51.4%
◯ As for sexual harassment by patients, occupational caregivers (24%), nurses (13.4%) and security guards/receptionists/phone operators (13.9%) were found to be more affected than those in other occupations.
◯ Meanwhile, those who received counseling services or relevant education from hospitals after experiencing unpleasant treatment represented only 40.1% of verbally and behaviorally abused victims and 62.9% of sexually harassed victims. Only 33.4% of respondents noted that they were given enough leave by the organization after experiencing unpleasant verbal and behavioral abuse.
◯ A majority of victims (79.8%) reported that they simply endured such verbal and behavioral abuse and sexual harassment; around 15.8% of the verbal and behaviorally abused and 21.8 of the sexually harassed said they asked for help from the trade union or the hospital ombudsman committee; Only 11.8% of victims of verbal and behavioral abuse and 18.7% of sexually harassed victims reported that they took legal action.
◯ Such verbal, behavioral and sexual harassment led to job stresses, which in some cases, resulted in depression. And mental distress made it difficult workers to return to work and eventually led them to move to another job. Hospital workers’ rated how much they are respected by colleagues and supervisors at 51.3 and by patients and their family members at 46.3, which are both rather low.
(5) Emotional Labor, Sleep Disorder, Industrial Safely
Hospital workers rate their jobs as emotionally taxing.
26.6% note “80% of jobs requires emotional endurance.”
◯ The survey results signaled that healthcare work entails more emotional demands than for workers in other industries. According to the survey, around 26.6% of respondents noted that 80% of their jobs require emotional “labor.”
◯ The survey results found that hospital workers hide their negative feeling (70.9%); smile and laugh regardless of their emotional state (67.4%); try to be in a good mood when responding to patients (52.6%).
◯ Along with increasingly intensive labor, the emotional toll has devastated healthcare workers. While working for patients and their families, workers felt determined (39.4%), frustrated (23.8%) and sick and tired (22.6%). Reflective of the situation, around 5 out of 10 respondents (53.2 points on average; 59.1 points among nurses) once or more thought of the question: how long I would be able to continue this job.
◯ As for quality of sleep, “bad” was higher (65.2%) than “good” (34.8%). It takes around 33.7 minutes on average to fall asleep after being in bed, while sleep lasts 6 hours and 12 minutes, on average. In addition, as for the frequency of waking up during sleep, around 58.5% of respondents noted that they experienced it three to four times per week while 25.2% once or twice per week.
◯ Meanwhile, on the correlation between jobs and cancer/disease, around 1139 cases of occupational diseases have occurred since 2000 (6.2% in the rate of disease), and 141 cases of occupational cancer have been reported since 2000 (87 cases among nurses(61.7%), 0.7% in the rate of disease).
◯ With regard to occupational diseases and accidents experienced by respondents and by their colleagues, the most frequent disease was sleep disorder at 29.3% followed by musculoskeletal disease (28.1%) and depression (4.7%) while the most frequent among their colleagues was musculoskeletal disease (38%) followed by sleep disorder (34.8%), infection/tuberculosis (18.4%), industrial injuries (14.5%) and occupational cancer (13.2%).