The uneven consequences of rapid organizational change: COVID-19 and healthcare workers

Abstract

We examine the consequences of rapid organizational change on high and low-status healthcare workers (HCWs) during the COVID-19 pandemic. Drawing on 25 interviews, we found that rapid change can create a sense of social disorder by exacerbating the uncertainty brought on by the pandemic, crystallizing the lack of training to deal with crisis, and upending taken-for-granted roles and responsibilities in health infrastructures. Our work contributes to scholarship at the intersection of organizations, professions, and social studies of medicine. First, we show how organizations that must respond with rapidity, such as during a crisis, sets up workers for failure. Second, hastily made decisions can have monumental consequences in the work lives of HCWs, but with differences based on status. All HCWs had trouble with the rearrangement of tasks and roles. Low status HCWs were more likely to feel the strain of the lack of resources and direct contact with COVID-19 patients. High status HCWs were more likely to experience their autonomy undermined - in the organization and content of their work. In these contexts of rapid change, all HCWs experienced social disorder and a sense of inevitable failure, which obscured how organizations have perpetuated inequalities between high and low status workers.

Keywords: COVID-19; Healthcare; Organizational change; Professions; Social disorder.