Conversations from Twitter

Kathryn Golab, MLS(ASCP)CM

This past February, the American Journal for Clinical Pathology released the results of a study completed by the ASCP Institute for Science, Technology, and Public Policy about workforce job satisfaction, well-being, and burnout among laboratory professionals. Not surprisingly, the study found that 85.3 percent of survey respondents had experienced burnout because of their job stress, and a majority of those surveyed had a little or a lot of stress because of their job.1 Now the laboratory is in the national spotlight with the latest novel virus outbreak, SARS-CoV-2, about testing turnaround, accuracy, and availability. One has to wonder what kind of stressors this is now putting on an already burned out workforce. Add in wage and hour cuts due to low census, and increased job hazards … this is a recipe for disaster.

“Mental illness among healthcare workers will increase, and we need to anticipate this fourth wave that is approaching after this pandemic subsides.”

On Friday, April 3, I talked with my dad about how work was going for both of us, my concerns about how I was going to make up wages lost due to low census, and when we hoped we could finally sit down for a family dinner again. He posed this question to me: “Do you realize how many in healthcare are going to leave when this is all over? Quit their jobs and get out of healthcare forever because of the stress?” After thinking over this question for a couple of hours, I put out a short thread on my Twitter page (@KgolabMLS). Three days later, it had more than 23,000 likes, and has been seen by more than 1.7 million people.

Along with the number of likes, retweets, and views, it also sparked a number of interesting conversations with people both in and out of healthcare. Conversations about burnout, whether or not it is deemed acceptable for people to walk away because of something like this, and mental illness considerations we need to make now for our frontline providers. These are my observations about what people thought about those in healthcare on the frontlines. I did not look into what the folks did for a living, or whether they lived in the United States or a country with a nationally run healthcare system.

Long-Term Effects

One thing that seemed to be an overwhelming theme was that people had not thought to ask the questions that my dad posed, and now wondered what would happen in the long term. This began to be referred to as the fourth wave.

The first wave is occurring now; the second wave will happen with people who have critical conditions and put off healthcare due to COVID-19 fears; the third wave is the delay of care for patients with chronic health conditions; and the fourth wave is the burnout and loss of healthcare providers due to treatment during the pandemic. This is something that needs to be thought about and prepared for going forward.

Physicians and healthcare providers already have an increased risk of mental health issues and normally do not seek out treatment for these conditions due to stigma in healthcare.2 Now that these frontline providers are participating in what both media and healthcare are referring to as a warzone, the concern for increased anxiety, depression, suicide, and PTSD is high. There was already a study out of Wuhan, China, that showed frontline providers experienced a significant increase in mental health conditions after the first wave of this pandemic in their region.3

Current Conditions

Another common theme discussed was how frontline workers are being treated, and this covered a number of topics. Many people commented on how it is atrocious that our healthcare systems were cutting wages, hours, and benefits during a pandemic. And how many were doing so while still not having enough personal protective equipment (PPE) to keep workers who were treating COVID-19 patients safe. One person responded to these comments in a very pointed way: “This country punishes passionate commitment. Unfortunately, passion only goes so far.”

Did We Sign Up for This?

One topic, however, stuck out the most, and we would not leave it. These comments did not come from healthcare employees. The common theme that came from these comments was that this is something we signed up for, and hard times should not be pushing us out of our jobs, because everyone goes through tough times. A number of people responded to those comments, and I will try to sum up the responses here.

Healthcare workers go into healthcare because they have a passion. They have a passion for helping heal and care for others. But they go into healthcare with the expectation that while they are caring for some of the sickest patients, they will have the equipment they need to do their jobs. They do not go into healthcare to become martyrs. They do not go into healthcare to watch their friends and colleagues get sick and die from a disease that would be prevented by appropriate PPE. Nurses and doctors go through physical and emotional abuse every day on the job, they do not sign up for the mental abuse this crisis would inflict upon them. Some will leave because of it.

While working in the background of healthcare, some of these issues might not be hitting laboratorians as hard as others. But the pressures and stresses get to all of us anyway. Mental illness among healthcare workers will increase, and we need to anticipate this fourth wave that is approaching after this pandemic subsides. A simple question has sparked a bigger discussion. Hopefully, one that will continue about how we can better care for our healthcare providers.


  1. Garcia E, Kundu I, Kelly M, Soles R, Mulder L, Talmon G. The American Society for Clinical Pathology’s Job Satisfaction, Well-Being, and Burnout Survey of Laboratory Professionals. Am J Clin Pathol. 2020;153(4):470-486. doi:10.1093/ajcp/aqaa008
  2. Dutheil F, Aubert C, Pereira B et al. Suicide among physicians and health-care workers: A systematic review and meta-analysis. PLoS ONE. 2019;14(12):e0226361. doi:10.1371/journal.pone.0226361
  3. Lai J, Ma S, Wang Y et al. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020;3(3):e203976.

Kathryn Golab is a Level 2 Technologist at Wisconsin Diagnostic Laboratories and a Second-Year DCLS Student at Rutgers School of Health Professions.