Women in health care are at a breaking point — and they’re leaving

In the pandemic, women are abandoning health care jobs, citing burnout and decades of inequities in a system that was never designed to support them.

Julie Conboy Russo had been a nurse for almost 40 years. She didn’t want to leave the field, but she didn’t feel she had a choice.

In November, COVID-19 cases were climbing nationally. Russo, who at the time worked in a long-term care facility in New York, had been lucky. She had never tested positive for the virus or brought it home to her immunocompromised husband. Case counts at her current workplace remained low. 

Then the national surge arrived at her workplace. Within a week, she said, a COVID-19 cluster appeared at the facility. One resident fell ill and died days later. 

Russo was terrified. Earlier that year, in a job at a different nursing facility, she had seen the damage the virus wrought. Working through the pandemic — seeing countless coworkers and patients die — is a memory she cannot shake. She doesn’t know if it will ever fully get better.

“They talk about PTSD — this is a form of it,” she said. 

So when COVID arrived at the facility, she sought clearance to work from home. Her request was denied. Out of options, she resigned under duress, she said, which allowed her to qualify for unemployment. Now, Russo, 60, who had been working toward her doctorate in nursing, is devoting time to her dissertation. She hopes to return to work maybe a year from now, but isn’t sure if she’ll be able to find a job — she worries she is too old to be an attractive candidate. 

“Maybe this is like a sign that this is where I needed to be. I’m healthy, I’m well, my husband is healthy and well,” Russo said. “Maybe this was a way to get away from it.” 

The pandemic posed a Herculean challenge for the women-dominated health care industry, which is the largest single employment sector in America. Thousands of health care workers died. And still more carry immense psychological wounds in an industry where a third of workers say burnout is driving them out. In the past year, countless women — physicians, nurses and care workers — say the coronavirus crisis has driven them to leave the workforce or dramatically scale back their professional commitment. 

Many don’t know if or when they will return. 

Employment data shows that women lost or left more than 1.5 million net health care jobs in April 2020 alone. That represented 12 percent of all jobs held by women in health care. About 6 percent, or 196,000, of the jobs held by men were lost that month. 

Even as jobs have begun to rebound, the recovery has been slower for women: They were still short 480,000 jobs as of this March, the most recent month for which data is available, compared with pre-pandemic levels. Men were short 28,000. 

Industry experts say employment data is the tip of the iceberg. 

Studies of the pandemic’s impact on women in medicine have shown that the past year has disrupted pipelines to leadership positions, tenure tracks, access to networking and collaborations, productivity and publications of academic research. 

Experts worry that the pandemic only exacerbated the myriad ways in which the medical industry limits the professional advancement or equitable treatment of the women workers it relies on. If those problems go unaddressed, they say, the impact could be devastating, robbing women of one of their stablest employment pipelines, and undermining health care quality and outcomes for patients. 

“You’re seeing these workers — they can’t keep working, and many of them are women,” said Bianca Frogner, a health economist at the University of Washington who has studied this workforce. “We’re seeing a culmination that’s leading to this continued downward slope of women not gaining back employment.” Read More