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IMPACT OF WORKING CONDITIONS ON EMPLOYEES PERFORMANCE

This paper attempts to analyze how an organization's working conditions affects organizational performance of employees. Companies which foster good working conditions such as consistent communication, heating and lighting issues, manageable workload, work and safety, trust, non discriminatory policies will boost employee’s performance. The study is exploratory is nature and information is collected from secondary sources. The result shows that improvement in working environment helps in improving productivity and efficiency of the employees. Companies should create better workplace for its employees as a result employee will feel motivated and give their optimum efforts

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• Am J Public Health
• v.106(6); Jun 2016

The Role of Labor Unions in Creating Working Conditions That Promote Public Health

All authors contributed to the conceptual development of the study. C. A. Paras and H. Greenwich coordinated data collection. All authors collaborated on study design. J. Hagedorn was the primary author of data analysis and interpretation and drafted the article with significant support from A. Hagopian and H. Greenwich. All authors revised content and approved the final version to be published.

We sought to portray how collective bargaining contracts promote public health, beyond their known effect on individual, family, and community well-being. In November 2014, we created an abstraction tool to identify health-related elements in 16 union contracts from industries in the Pacific Northwest. After enumerating the contract-protected benefits and working conditions, we interviewed union organizers and members to learn how these promoted health. Labor union contracts create higher wage and benefit standards, working hours limits, workplace hazards protections, and other factors. Unions also promote well-being by encouraging democratic participation and a sense of community among workers. Labor union contracts are largely underutilized, but a potentially fertile ground for public health innovation. Public health practitioners and labor unions would benefit by partnering to create sophisticated contracts to address social determinants of health.

Labor unions improve conditions for workers in ways that promote individual, family, and community well-being, yet the relationship between public health and organized labor is not fully developed. 1 Despite historic and current efforts by labor unions to improve conditions for workers, public health institutions have rarely sought out labor as a partner. 2,3

In 2014, American labor union density was at a 99-year low. 4 Low union density has left workers vulnerable to reduced health and safety standards, and has fed the decline in public perception of the value of unions. 5,6 Unions have helped to codify economic equity in the workplace, and the decline of their power is associated with the greatest level of economic inequity in our nation’s history. 5,7–9 The erosion of union density has undermined the role of organized labor as a societal power equalizer. 8

Income is a primary social determinant of health, associated with the living environment and overall well-being of individuals or families. 10–16 Income is higher in union jobs than in nonunion jobs, especially for lower-skilled workers. 5,16–18 Retirement or pension plans create the financial stability to promote health into old age. 19 Union employees are more likely to have a retirement or pension plan and are more likely to participate in a retirement plan sponsored by their employer than employees who are not members of a union. 20,21

Researchers have established a correlation between unionized work and a higher percentage of pay coming in the form of highly valued benefits. 22,23 Unions have historically been involved in creating healthy and safe workplaces, advocating regulations that are monitored and enforced by public health entities such as the Occupational Safety and Health Administration. 3,24

Autonomy and control over one’s life are associated with positive health outcomes, 25–28 and social support in the work environment enhances psychological and physical health. 29,30 Conversely, perceived job insecurity is associated with risk factors for poor health outcomes, contributing to racial and socioeconomic health disparities. 31–35 Unions help members gain control over their scheduling 36,37 and job security, 38 and union membership is associated with increased democratic participation. 39

The American Public Health Association is on record supporting the role of labor unions in promoting healthy working conditions, health and safety programs, health insurance, and democratic participation. 40–42 The decline of union density may undermine public health in the United States, making this a critical time for public health to actively support labor unions.

Previous researchers published in AJPH have highlighted the links between unions, working conditions, and public health, but called for more research to establish the precise mechanism of the relationships. Malinowski et al. proposed the social–ecological model as theoretical framework for connecting public health and labor organizing. 43 Both labor unions and public health organizations intervene in the conditions that make people healthy through individual life choices, and social and community networks, as well as general socioeconomic, cultural, and environmental conditions. Malinowski et al. illustrates the overlapping interests of labor unions and public health and how their lack of coordination has created barriers for both institutions.

One mechanism unions use to promote public health is the union contract. These are legally binding, durable over a designated time, and specific. They are durable because they cannot be unilaterally changed, and contracts that follow often build on the progress of previous negotiations. Even after a contract expires, federal labor law provides a process and momentum for the negotiation of a new one.

We hypothesized that union contracts promote the health status of workers. If true, contracts have untapped potential for public health professionals working to improve the health of individuals and communities.

We designed this cross-sectional, mixed-methods study to identify specific mechanisms that link labor union representation and public health outcomes. Our primary unit of analysis was the negotiated contract between management and labor for a variety of unions in the Puget Sound region of Washington State. We supplemented a textual analysis of the contracts with interviews of union organizers and union members.

In the summer of 2014, we established a partnership between a University of Washington master of public health graduate student (J. H.) and Puget Sound Sage, a nonprofit organization that promotes alignment among labor, environmental, and community interests to “grow communities where all families thrive.” We identified 6 union locals in the region that represented hotel workers, truck drivers, home-care workers, construction workers, child-care workers, office workers, and grocery store workers. Sage held preexisting relationships with these unions, either through representation on Sage’s board or some other form of collaboration, which greatly facilitated our data requests. For each union, we obtained 1 or more labor contracts, for a total of 16 contracts ( Table 1 ).

TABLE 1—

Union Contracts Dated 2010 to 2014 Analyzed for Mechanisms That Advance Health of Employees and Their Families: Pacific Northwest, United States

Note. SEIU = Service Employees International Union; UFCW = United Food and Commercial Workers; UNITE HERE = Union of Needletrades, Industrial, and Textile Employees and Hotel Employees and Restaurant Employees Union. Data for this article came from the 16 union contracts analyzed for their health-related factors, obtained from 5 Puget Sound labor unions in 2014.

Through a comprehensive literature review of the work-related determinants of health, we identified health-related factors that theoretically might be addressed in a labor contract. We then created a spreadsheet abstracting specific language from each contract by each of the theoretical constructs, and, through an iterative process, settled on 12 health factors. For example, we created a cell for “fair and predictable pay increases,” into which the following Service Employees International Union (SEIU) 775 contract language was placed:

Employees who complete advanced training beyond the training required to receive a valid Home Care Aide certification (as set forth in the Training Partnership curriculum) shall be paid an additional twenty-five cents ($0.25) per hour differential to his/her regular hourly wage rate.

After creating the 12 large categories, we further analyzed the contract language in our spreadsheet to generate 34 subcategories ( Table 2 ). We suggest that these 34 factors, taken together, comprise the specific mechanisms by which labor contract language supports public health. We determined whether the indicators were present in each contract (Table A, available as a supplement to the online version of this article at http://www.ajph.org ) and Table 2 reports what proportion of contracts contained language on each of the 34 factors. When “all” contracts have an indicator, this means each of the 16 contracts contains health-protecting language on the topic. “Almost all” refers to 14 or 15 contracts, “most” means 7 to 13 contracts, and “some” refers to 5 or 6 contracts.

TABLE 2—

Factors That Advance Health of Employees Theorized to be Found in Union Contracts, and Their Presence in 16 Union Contracts Dated 2010 to 2014: Pacific Northwest, United States

Note. All = 16 contracts; almost all = 14 or 15 contracts; most = 7 to 13 contracts; some = 5 or 6 contracts. Data for this article came from the 16 union contracts analyzed for their health-related factors, obtained from 5 Puget Sound labor unions in 2014.

To supplement our analysis, we interviewed 1 member from each of the 6 unions covered by a contract in our analysis, as well as 7 union organizers representing those members ( Table 3 ). In 1-hour interviews with union organizers, we explored how contract language is aligned with public health outcomes through questions about their job and the role of the union. We asked workers about the dangers in their job and if or how the union helps to protect them, we asked about safety and health problems and the union’s role in addressing those, and we asked about conflict in the workplace and whether the union helps to resolve issues. We also asked workers to compare any workplaces they had experienced without a union to their current workplace.

TABLE 3—

Interviews Conducted With Union Members and Organizers: Pacific Northwest, United States, 2015

Note. SEIU = Service Employees International Union; UFCW = United Food and Commercial Workers; UNITE HERE = Union of Needletrades, Industrial, and Textile Employees and Hotel Employees and Restaurant Employees Union. Interviews conducted between January and April 2015 with Puget Sound–area labor union staff and industry employees to supplement our understanding of the role of labor union contracts in protecting employee health.

Each union assisted in identifying a covered member for us to interview. Usually, an e-mail was sent to members the organizer thought may be interested in the study. These members were compensated $50 for their 1-hour interviews, with funds provided by Sage. In interviews with members, we asked about the most dangerous or hazardous aspects of their jobs and how the union helps to mitigate those risks, as well as other benefits of being a union member.

There is consistency among contracts negotiated by same union (Table A). Contracts with public sector entities (such as 925.2, Headstart Program; 775.3, State of Washington; and 242.3, Seattle School District) have fewer provisions that contribute to health in their contracts.

Compensation

We created compensation indicators illustrating how the wages of employees are augmented when employers are prohibited from externalizing their costs by having employees pay for work-related travel, training, and materials.

All contracts include minimum wages by employee classifications, including overtime. Higher income and overtime wage gains are built over time. Income is augmented when employers are directed to cover specific work-related expenses. Most contracts compensate employees for the cost of traveling between work sites and the cost (or partial costs) of trainings. Some contracts also provide money for materials, such as United Food and Commercial Workers (UFCW) contract 21.2, which states, “The Employer shall bear the expense of furnishing and laundering aprons, shop coats, and smocks, for all employees under this Agreement.” Other contracts ensure employers will not call in more employees than needed and then send them home; they do this by creating a “show-up pay” provision. Laborers’ contract 242.1 describes this as

Employees reporting for work and not put to work shall receive two hours pay at the regular straight time rate, unless inclement weather conditions prohibits work, or notified not to report at the end of the previous shift or two hours prior to the start of a shift.

One child-care worker explained how union advocacy has increased the supplement provided by the state for the extra challenges posed by caring for low-income children, saying “For family childcare workers, who are often very underpaid for the amount of hours that they work, we have seen over the last 8 years, a 22% increase in our subsidized childcare. That is big!” Another worker from Teamsters Local 117 said, “I know there are guys doing the same job [in nonunion warehouses] making $10 less an hour.”

Predictable and fair increases.

All contracts provide wage increases on the basis of qualifications, duties, and duration of time at the company. Workers can increase their wages by increasing their training or by assuming additional responsibilities, including mentoring peers, accepting clients with higher needs, working less-desirable hours, doing more physically strenuous labor, or taking on leadership roles within a working group. Some contracts require transparency in paycheck calculations, mandating employers to itemize hours, overtime, and sometimes the cumulative number of sick days or holidays used, allowing employees to check the calculations.

An organizer with UFCW (grocery) Local 21 explained, “[employers] see experience as a cost and not a driver of sales.” The organizer explained that without the contracts, employers would not raise wages over time, especially for jobs viewed as requiring fewer technical skills.

Retirement and pension.

Almost all contracts include retirement or pensions. Most of these are set up in the form of trusts, with a collaborative process for management and employees to manage money and benefits. This language usually exists in a separate document referred to by the contract.

A retired member of Laborers Local 242 described how he was able to adjust his hours to make the money he needed, but also be able to retire comfortably because of his savings and pension. He explained, “I retired early. I wanted to do things that I wasn’t able to do when I was younger because I had to support the family.”

We created indicators to track evidence-based factors related to physical and psychological health, including time off and access to health care. 44–46

Paid time off.

Most contracts include the indicators of paid annual leave, paid rest periods, and bereavement leave. The amount of annual leave varies, but usually increases as the employee gains seniority. Paid rest periods are usually defined as short, 15- to 30-minute periods. Bereavement leave to attend a funeral or grieve a loss can be used for specific family members in some contracts, whereas others allow its use for a broader range of relationships.

Health care coverage.

Health insurance is included in all contracts. We did not attempt to distinguish among contracts with regard to affordability, comprehensiveness, or number of dependents covered because health care is managed by trusts, much like retirement or pension benefits.

All of the organizers discussed the benefits of union health coverage. An organizer from UFCW Local 21 explained,

Members have consistently traded wages for health benefits. They have been willing to have slowed wage increases in order to maintain their strong health benefits over and over and over. What I see if I go into a [unionized grocery] I see a much higher percentage of people who have children who rely on their health insurance.

Health and Safety

Most contracts guide how health and safety regulations are communicated to workers, including written and verbal forms.

Health and safety information.

Although most contracts include health and safety information, they are usually not very specific. For example, Teamsters’ contract 117.1, states,

[T]he Company may require the use of safety devices and safeguards and shall adopt and use practices, means, methods, operations and processes which are adequate to render such employment and place of employment safe and shall do all things necessary to protect the life and safety of all employees.

Most contracts also include a provision allowing the union to post and maintain a bulletin board to communicate information to members. Contracts also generally ensure union representative access to the worksite. For example, SEIU contract 925.2 (child-care workers) states,

The designated Stewards or Chief Stewards shall have access to the premises of [Community Development Institute Head Start] to carry out their duties subject to permission being granted in advance.

Training and mentorship.

Almost all contracts explicitly require training. Some contracts include compensation for providing mentorship to encourage more senior employees to provide support to new employees or employees taking on new roles.

One organizer from Laborers Local 242 described how important it is for workers to know how to do their work safely, for themselves, coworkers, workplace clients, and their own families. For example, a hospital demolition crew should know how to contain particulate matter to avoid contaminating patients or bringing it home to expose their children. The organizer said training ensures “If you hire a [union] laborer, you know you’re going to get the best product. We have the safest workforce. We’re the most experienced.”

Promotion of a culture of workplace safety.

Most contracts detail the employer’s responsibility to provide and maintain protective clothing and equipment. Most contracts also protect bringing a safety hazard to the attention of a supervisor. For example, SEIU contract 775.5 states, “the employee will immediately report to their Employer any working condition the employee believes threatens or endangers the health or safety of the employee or client.” Some contracts have a provision allowing workers who return to work after an injury to receive less strenuous work, or “light duty.” Both Laborers’ contracts contain this provision, an important provision for physically demanding work.

Promoting Individual, Family, and Community Well-Being

We analyzed indicators that measure the role of contracts in reinforcing social support in the work environment.

Job protections and security.

All contracts contain specific and detailed grievance procedures, the process of reporting, mediating, and resolving conflicts in the workplace. Almost all contracts confirm the right to have a union representative present during meetings with managers. Some contracts, such as SEIU 775.1, make it the employer’s responsibility to make this known:

In any case where a home care aide is the subject of a written formal warning the Employer will notify the home care aide of the purpose of the meeting and their option to have a local union representative present when the meeting is scheduled.

Most contracts also establish or maintain a labor relations or management committee. Although the language about this committee may differ, the purpose of the group is to create a space in which workers and employers can negotiate problems that arise between negotiations of new contracts.

Almost all contracts contain a commitment to creating a discrimination-free workplace. Most contracts create the opportunity for a worker to take a leave of absence without sacrificing seniority for maternity leave, further education, religious holidays (e.g., Yom Kippur, Easter), military leave (for the employee or spouse), domestic violence, sexual assault, stalking, or union activity.

Fair and predictable scheduling.

Most contracts include a mandatory notice of schedule changes. As UFCW contract 21.1 explains,

The Employer recognizes the desirability of giving his employees as much notice as possible in the planning of their weekly schedules of work and, accordingly, agrees to post a work schedule.

Some contracts specify the amount of notice required for a schedule change. Those that change regularly may require posting the week before. Most contracts also include an amount of time required between shifts or minimum shift length, and how employees can request additional hours.

Democratic participation.

Most contracts provide employees the opportunity to participate in union-sponsored legislative “lobby days,” or to engage in political work while being paid by their employer. As SEIU contract 925.1 explains,

As part of our ongoing campaign to provide the highest possible standard of childcare and engage in an ongoing public campaign to explain the direct relationship between funding and the quality of care, it is in each party’s best interest to provide reasonable opportunity for members of the bargaining unit to participate in these efforts.

Contracts require all union members to pay dues. Some contracts also specify how a union member can contribute to a political action fund, which generates revenue to represent employee interests in the policy arena. One home health worker explained that she is getting more involved in politics and collective bargaining because of union engagement, saying,

I like belonging to a union that believes in me as an individual and as a caregiver. They’re behind us every step of the way. They help us to look at things that otherwise we might not be aware of, like state legislation and contract negotiation.

Public health practitioners have not typically viewed unions as partners in promoting public health, nor have they explored contract negotiations as a way to ensure health protections. We suggest that this is a missed opportunity. Our findings demonstrate that union contract language advances many of the social determinants of health, including income, security, time off, access to health care, workplace safety culture, training and mentorship, predictable scheduling to ensure time with friends and family, democratic participation, and engagement with management. This article provides a provisional framework to explore further the factors that create public health opportunities in union contracts.

We examined selected union contracts in the Pacific Northwest, which may not be generalizable. Our sample included only those unions in a relationship with Puget Sound Sage, perhaps suggesting unique perspectives or priorities. We compared our sampled unions to those in the King County Labor Council, however, and although there were some industries not represented (e.g., aerospace, teachers, assembly line workers), we believe the types of workplaces in our sample are reasonably representative of the landscape of unions in the county. We did not attempt to incorporate the views of the respective employers on these contracts.

The language in the contracts we reviewed included rights won at the bargaining table along with restatements of existing city, state, and federal laws. For example, leave without pay contract provisions match the Washington State Family Leave Act. When union negotiators include these indicators in contracts, they generate awareness of health-promoting regulations and protections. Laws and policies can change, but a union contract can only change if the union agrees to renegotiate the contract or if the contract has expired. Union stewards learn the details about a contract, but cannot be expected to know the full range of laws from a variety of jurisdictions. The contract works to reinforce the knowledge of workers and their representatives. Although it was beyond the scope of our study, contracts must be enforced to actualize their health-related benefits. Effective enforcement mechanisms for contracts are also potentially beneficial to public health officials. 22,27,47

We identified many contract indicators that advance health for more than just employees. Unions generate higher prevailing wages in a community. 7,48 Unions invest in campaigns to raise wages for both union and nonunion workers, such as the $15 hourly wage initiative in SeaTac, Washington. 49,50 A safer environment for home-care and child-care workers creates safer environments for the people they serve. A culture of safety on construction sites ensures that environmental hazards are minimized for people who live nearby. Parents earning a living wage can avoid taking second jobs and use the time to engage in children’s schools or community councils. A healthy and happy workforce is more productive and less likely to leave a job, reducing the cost of turnover and absenteeism for employers. In spite of the many benefits unions confer to workplaces and communities, union membership is now limited to only 1 in 10 American employees. 4

The decline of labor union density is related to both the rise of corporate power and to mistakes made by labor. 1 After a period of radical inclusivity and left-leaning solidarity with broader political movements, unions moved toward racism and red-baiting in the 1950s, undermining their strength. 51 Unions are still working to reduce racial and gender disproportionality within their leadership. 52

Despite historical shortcomings, labor unions (and their contracts) offer an underutilized opportunity for public health innovation. As illustrated by Malinowski et al., public health practitioners often work in the “outer” layers of the social–ecological model, promoting environments that can better shape population health. 43 This is also true of labor unions. Public health practitioners could help unions negotiate more sophisticated contracts to address the social determinants of health. Public health practitioners could also work with policymakers to heighten awareness of how unions might help mitigate the forces that threaten health in the workplace and beyond. Supporting progressive labor union contracts is public health work.

ACKNOWLEDGMENTS

We acknowledge a grant from the University of Washington Harry Bridges Labor Center that made this work possible. Also, thank you to Puget Sound Sage for providing the compensation for labor union members who were interviewed.

HUMAN PARTICIPANT PROTECTION

Ethical approval for the project was provided by the University of Washington institutional review board, approval 48520-EJ.

• Open access
• Published: 16 September 2021

Employment and working conditions of nurses: where and how health inequalities have increased during the COVID-19 pandemic?

• Alba Llop-Gironés   ORCID: orcid.org/0000-0003-0270-3159 1 , 2 , 3 ,
• Ana Vračar 4 ,
• Gisela Llop-Gironés 5 ,
• Joan Benach 1 , 6 , 7 ,
• Livia Angeli-Silva 8 ,
• Lucero Jaimez 9 ,
• Pramila Thapa 10 ,
• Ramesh Bhatta 11 ,
• Santosh Mahindrakar 12 ,
• Sara Bontempo Scavo 13 ,
• Sonia Nar Devi 14 ,
• Susana Barria 15 ,
• Susana Marcos Alonso 16 &
• Mireia Julià 1 , 2 , 3  

Human Resources for Health volume  19 , Article number:  112 ( 2021 ) Cite this article

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Nurses and midwives play a critical role in the provision of care and the optimization of health services resources worldwide, which is particularly relevant during the current COVID-19 pandemic. However, they can only provide quality services if their work environment provides adequate conditions to support them. Today the employment and working conditions of many nurses worldwide are precarious, and the current pandemic has prompted more visibility to the vulnerability to health-damaging factors of nurses’ globally. This desk review explores how employment relations, and employment and working conditions may be negatively affecting the health of nurses in countries such as Brazil, Croatia, India, Ireland, Italy, México, Nepal, Spain, and the United Kingdom.

Nurses’ health is influenced by the broader social, economic, and political system and the redistribution of power relations that creates new policies regarding the labour market and the welfare state. The vulnerability faced by nurses is heightened by gender inequalities, in addition to social class, ethnicity/race (and caste), age and migrant status, that are inequality axes that explain why nurses’ workers, and often their families, are exposed to multiple risks and/or poorer health. Before the COVID-19 pandemic, informalization of nurses’ employment and working conditions were unfair and harmed their health. During COVID-19 pandemic, there is evidence that the employment and working conditions of nurses are associated to poor physical and mental health.

The protection of nurses’ health is paramount. International and national enforceable standards are needed, along with economic and health policies designed to substantially improve employment and working conditions for nurses and work–life balance. More knowledge is needed to understand the pathways and mechanisms on how precariousness might affect nurses’ health and monitor the progress towards nurses’ health equity.

Peer Review reports

Introduction

Nurses and midwives play a critical role in the provision and quality of care and the optimization of health services resources worldwide. This responsibility has turned to be particularly relevant during the current COVID-19 pandemic, where nurses in the public and private sectors are leading COVID-19 care, testing, triage, and management [ 1 ], placing them to a unique position able to deal with vaccination and near-future health challenges. With all, nurses had been one of the most affected collectives by the COVID-19. According to the International Council of Nurses (ICN), millions of nurses have been infected with coronavirus since the start of the pandemic. Cumulative number of reported COVID-19 deaths in nurses in 59 countries was 2262 at the end of 2020 [ 2 ]. However, this number is likely to be underestimated as the actual number of fatalities of health workers is unknown due to the absence of a comprehensive systematic surveillance system. Although great efforts have been made in recent years to build up an international health information system with a key set of indicators focused on achieving an adequate size and skill mix of nursing personnel to attain various population health goals [ 3 ], the last ICN press release reports that standardized and systematic collection of data on infectious and deaths of health workers is not yet happening [ 4 ].

Available data show that prevalence of COVID-19 infections and deaths varied by country and regions. For example, the Americas region accounted for more than 60% of the nurse deaths due to the COVID-19, where Brazil, the USA and Mexico have the highest number of deaths [ 2 ]. Compared to other health workers, professional nurses and nurse aides are disproportionately affected by COVID-19. CDC data, from six states of the US, show that among the total number of SARS-CoV-2 infection, 32.1% were nurse aides and 29.5% were professional nurses, compared to 3.2% of physicians [ 5 ]. Amongst COVID-19-associated hospitalizations in 13 States of the US, professional nurses account for the largest group (35%), followed by nurse aides (15%) compared to physicians (5%) [ 6 ]. These inequalities on COVID-19 infection and deaths by country are due in part to a lack or shortage of personal protective equipment (PPE), where is higher in low-income and middle-income countries (LMICs) [ 7 , 8 ].

Under usual employment and working conditions, health care workers are known to be at risk for depression, stress, anxiety, burnout or insomnia [ 9 ]. COVID-19 pandemic has the potential to significantly impact on mental health of health care workers. A systematic review found a prevalence rate of 23.2% of anxiety, 22.8% of depression and 38.9% of insomnia. Moreover, this systematic review also found gender and occupational differences, where female and nurses had higher rates of affective symptoms [ 10 ].

Nurses and other health care workers can only provide quality services if their work environment provides adequate conditions to support them [ 11 ]. Today, employment and working conditions of many nurses worldwide are precarious [ 12 ], and the current COVID-19 pandemic has prompted more visibility to the vulnerability to health-damaging factors of nurses’ globally. Based on the general framework of employment, work and health of Julià adapted from Benach and Muntaner [ 13 , 14 , 15 ], nurses’ health is influenced by several factors. This conceptual framework shows how labour market and welfare state policies influenced by power relations impact on employment conditions. Thus, labour regulations influence how employment conditions are regulated through the different types of contract. Labour relations are the ones that influence the process of precarious employment conditions. Precarious employment measured through different dimensions is present to a greater or lesser extent in the different employment conditions that, directly or through working conditions or material deprivation, produce an impact on mental health, the self-perceived health and health inequalities. Furthermore, unpaid household and care work also has an influence on health and health inequalities. As for social and family networks, they also have an impact on health, depending on whether they are present or not. Inequality axes like gender, age, social class, ethnicity/race and migrant status are key relational mechanisms of generating inequalities.

The aim of this review is to explore how structural social determinants may be negatively affecting the employment and working conditions, practice, and nurses’ health, also during the COVID-19 pandemic, at the global level.

Methodology

A multidisciplinary team consisting of bedside nurses, activists, union members, and researchers, including nurses’ researchers across nine countries in Asia, Europe and Latin America adopted a collaborative process of critical reflections to guide the understanding of the mechanisms by which nurses’ health is affected, pre-pandemic and during current COVID-19 pandemic.

A desk review was conducted on scientific literature and grey literature, including media, reports, and other relevant resources from various countries including Brazil, Croatia, India, Ireland, Italy, México, Nepal, Spain, and the United Kingdom. We also reported about United States, Australia, and conflict zones such as Palestine, as literature was available. Additional information was sought from Ministries of Health.

Pubmed and google searches were conducted combining the key related terms “nurse”, “employment”, “working conditions”, “health” and “COVID-19” according to the guiding priority areas based on the following topics of the theoretical framework [ 13 , 14 , 15 ]: employment relations in nursing, power hierarchy, and employment and working conditions of nurses. Figure  1 provides a visual description of the adapted theoretical framework of the employment, work and the impact on nurses’ health.

Adapted theoretical framework of the employment, work and the impact on nurses’ health

A total of 77 articles were reviewed, which included 39 research articles, an additional 12 reports, 1 book, 1 thesis, 2 clinical guidance, 2 national official gazette and 20 news articles, as identified by the research team. We based reviews on inputs from the multidisciplinary working group that guided the conceptualization and analysis of the information. Thus, the search was not intended to be exhaustive. We met virtually and discussed by email the emergent findings. Recognizing the importance of the lived experiences, bedside nurses provided a unique contribution to the topic.

Employment and working conditions of nurses

Employment and working conditions before and during the covid-19 pandemic.

Before the COVID-19 pandemic, there has been a marked increase in precarization and/or informalization of nurses’ employment globally that had an impact on working hours and conditions, minimum wage, social protection, and job insecurity. For example, in Mexico during the period 2005–2018 they reported an increase of informalization among the group of nurses analysed in relation to: (a) the percentage of people without a written contract; (b) the percentage of people with incomes lower than two times the minimum wage; (c) the percentage of nurses without social security, and (d) the percentage of nurses without social benefits [ 16 ]. In Catalonia, results of a study show that the highest level of job insecurity occurs among nurse aides and in privately managed nursing homes [ 17 ]. In the growing private sector in India where permanent contracts are rare, nurses were often paid less or just above the minimum wage [ 18 ]. Similar to the case of Australia, where the employment conditions are worse in the private sector which lead to increased mortality in nursing homes [ 19 ]. Also, nurses were already facing structural challenges in many countries as lack of energy and water supply, internet access, enough clean uniforms, appropriate space for breaks, lockers or changing rooms and laundry services, as well as lack of safety, for example during night shifts in isolated areas [ 12 ]. Evidence from countries in South Africa [ 20 ], Kenya, Tanzania and Uganda [ 21 ], Catalonia [ 17 , 22 ], Brazil [ 23 ], Chile [ 24 ], Colombia [ 25 ], Mexico [ 26 , 27 , 28 ], and Thailand [ 29 ] show that employment and working conditions of nurses before this pandemic were already associated to poor physical and mental health, and in some cases leading to fatality outcomes as suicide [ 30 , 31 ]. A particular mention to the nurses working in conflict and war zones. For example, previous to the COVID-19 pandemic, nurses in Palestine reported continuous exposure to traumatic events, and a related feeling of general powerlessness [ 32 ]. As the pandemic spread, these occurrences interlinked with additional problems and continuous blockades, including lack of PPE, guidelines and long working hours [ 33 ].

During COVID-19 pandemic, nurses, as other healthcare workers, have been working longer hours and/or with different shift patterns, and nursing staff has been reassigned from other clinical areas to, for example, ICU [ 34 ], current employment and working conditions of nurses are associated to poor physical and mental in the pandemic context [ 35 , 36 ]. However, differences in employment and working conditions during the pandemic disaggregated by gender, race or the other inequality axes have not yet been studied.

Technical division of nurses’ work

A number of countries have a majority of the nursing workforce composed of nurse aides. This is the case of Brazil [ 37 ], where currently nurse aides account for the biggest number of deaths of COVID-19, more than of professional nurses [ 38 ]. Nursing students, despite traditionally not being considered employees, play a significant role in the health care work during their period of clinical practice and there have been reports of students bullied and breach of working hours agreement, including an enlarged schedule during the night time or weekend hours, as well as a lack of recognition of their work [ 39 , 40 ]. Also, in Denmark there is evidence that immigrant students from Eastern Europe, Iran, Pakistan, Africa or Asia are at significantly higher risk of being bullied in colleges compared to their native counterparts [ 41 ]. In addition, during the pandemic, nursing students of the last year with limited experience in the clinical practice have been sent to the hospitals to work with high-risk patients being underpaid and exposed to big risk-hazards without being qualified to handle such clinical situations [ 42 ]. In Spain, nurses who were in an advanced nursing practice course were reabsorbed as clinical nurses with similar responsibilities but underpaid.

Personal protective equipment

Nurses from different countries reported that the national guidelines and hospital protocols were not well-known among all the nurses working in different settings and sometimes conflicting advice existed, which is in line with current literature [ 35 ]. Nurses reported to work based on their experience and knowledge and perceived confusion about adequate procedures for dressing and undressing with the PPE. Lack of PPE was commonly reported by many health workers globally, also in rural areas and the private health sector [ 43 ]. They had to purchase their own PPE, when available outside the hospital, reuse old PPE and collaborate together to develop alternative tools for protection [ 44 , 45 ]. Furthermore, some units such as maternity wards or primary health care facilities have been considered “low risk settings” despite the possibility of positive cases, which again influenced the accessibility of adequate PPE. A report from the United States shows that primary care physicians are the largest subset of physician deaths [ 46 ], but data on nursing is unavailable. Evidence shows that nurses who do not consider the availability and quality of PPE to be adequate had significantly higher levels of depression, anxiety, and stress [ 35 , 36 , 47 ].

Testing and denial of access to health care

Mass testing of asymptomatic health workers during COVID-19 pandemic has been discussed based on the idea that it might not be necessary in health facilities with protocols for PPE [ 48 , 49 ]. However, one study suggests that weekly screening staff might reduce their contribution to transmission by 25–33% on top of other measures, such as the health workers self-isolation if they develop symptoms [ 50 ]. This is also reinforced by CDC advice to test asymptomatic health workers without known or suspected exposure to SARS-CoV-2 working in nursing homes [ 51 ]. Currently, there are countries that are systematically offering testing to nurses, such as Italy [ 52 ].

There has been less discussion on the determination of payment or insurance coverage of testing or in the case of infection or death of the nurse. For example, in Mexico, a number of nurses have been affected by COVID-19 and they have not had access to testing [ 53 ]. Also, in Nepal most of the private health facilities and hospitals have not insured nurses working in COVID-19 wards, who are at higher risk of being infected with COVID-19 [ 43 , 54 ].

COVID-19 vaccine

Nurses play a key role in the immunization of the population. However, the majority of the countries that have nurses vaccinated are high- or upper-middle-income countries. Frontline workers are considered, globally, a prioritized group but it can be the case that a healthy young person from a high-income country is vaccinated first than a bedside nurse in a low-income country or nurses working in conflict and war zones [ 55 ].

Power hierarchy: inequality axes

Inequality axes such as gender, social class, and ethnicity/race (and caste), in addition to age and migrant status, are key relational mechanisms that explain why nurses’ workers, and often their families, are exposed to multiple risks and/or poorer health [ 13 , 14 ]. This may raise questions as for example who is more exposed during health care related work? Power relations and the social positioning in health systems have traditionally valued medical doctors over nurses, and medical structures over communities [ 56 , 57 ]. This is illustrated by the extraordinary financial compensations provided to healthcare workers exposed during the first wave of the COVID-19 pandemic in some European countries where professional nurses and nurse aides received less, or nothing, compared to their fellow medical doctors. For example, in Catalonia (Spain), compared to medical doctors, professional nurses received 200 euros less, and nurse aides 650 euros less, based on supposed “productivity” criteria [ 58 ]. Another example is the United Kingdom that directly overlooked nurses explicitly saying: “reflecting the vital contributions public sector workers make to our country, these pay rises cover the armed forces, teachers, police officers, the National Crime Agency, prison officers, doctors and dentists, the judiciary, senior civil servants and senior military personnel” [ 59 ]. Also, in India, doctors were given accommodation best-quality hotels near the hospital while nurses stayed in unsanitary dormitories [ 60 ]. Finally, nurses from different countries has reported that the distribution of the PPE has been based on the medical hierarchy rather than the needs of the health workers or the community itself [ 61 ]. This hierarchy has been replicated with the administration of vaccines in countries as UK, Italy and Spain.

Despite nurses being the most trusted health workers in clinical settings, discrimination, stigma and violence against nurses as potential vectors of infection are on the rise during the COVID-19 pandemic, hampering nurses’ physical and mental health [ 34 ]. Health workers in countries like India are being excluded from communities, evicted from their homes and forced to sleep in hospital bathrooms and on floors for fear that they may be carry the coronavirus [ 62 ]. In the city of Rimini in Italy, 70 cars of health workers were damaged overnight outside the hospital [ 63 ]. In Mexico, cases of physical and verbal assaults on health workers, including nurses, have been documented both inside and outside hospital facilities, as well as while making home visits to assess patients, and on their way home [ 64 ].

Nursing workers are predominantly women accounting for 89% of nurses, with variations across world regions; for example, in Africa women represent 76% of the nursing workforce and in South-East Asia 89% [ 12 ]. However, only 25% of health leadership positions globally are held by women or nurses [ 65 ]. Furthermore, although there is no international data on the gender pay gap disaggregated by health workers, there is evidence of a gender pay gap in the health and social work sectors, both in the public and private sector. On average, the gender pay gap amounts to 26% in high-income and 29% in upper-middle-income countries [ 66 ]. In the case of the United States, women nurses earned on average only 91% of what men nurses earned [ 65 ], and we can assume that such a gap exists in other countries as well. The association between the gender pay gap and “family gap” is also significant [ 67 , 68 ]. While for men the salary increases with the number of children, each additional child that women have is associated with a drop in the salary [ 67 ]. Yet, there is a lack of such information based on the study of the nursing conditions.

A predominantly female nursing staff requires a range of work time arrangements, such as extended work shifts, night work, and on-call scheduling. The inappropriate use of these arrangements has been shown to negatively impact the health of nursing personnel [ 69 ]. During COVID-19 pandemic, the burden of nursing workload for women and their “second shift” as key caregivers within their families added additional stress and fear of infecting family or cohabiters [ 35 ].

CDC data from six states of the US suggest that professional nurses, nurse aides, and women are disproportionately affected of COVID-19, despite men being at highest risk of case fatality [ 5 ]. Furthermore, during the first wave of COVID-19 pandemic, there has been a lack of consensus and clear information regarding risks for pregnant women workers exposed to COVID-19 which resulted in hospitalizations and deaths. For example, about 18% of the pregnant women analysed needed hospitalization in 13 states of the United States, 2 (1%) were admitted to the ICU, and 1 (0.5%) required invasive mechanical ventilation [ 6 ], also there are reports of pregnant women deaths [ 70 ].

Ethnicity/race and caste

There are several examples of discrimination as a result of the race, ethnicity and caste. For example, the nursing workforce in countries like the United States is still predominantly White (75%) as a result of privatization of nursing education that creates unequal access to education, and has left many nurses indebted when they finish their studies, putting pressure on them to take available employment regardless its conditions [ 71 ]. Also, colonial legacy and the history of Indian nursing are causes of exploitation and discrimination of Indian women nurses [ 72 ].

During COVID-19 pandemic, studies conducted in the United States show that Black essential workers are at higher risk of infection and death of COVID-19 compared to their White counterparts. It has also been shown that Black workers were nearly three times more likely than White workers to hold support roles in health care, such as nurse aides or orderlies [ 73 ]. Additionally, CDC data from six States of the United States show that American Indian, Asian and Black health workers are at higher risk of case fatality [ 5 ].

Migrant status

Globally, one in eight nurses practises in a country other than the one where they were born or trained [ 34 ]. According to OECD data in 2018, the proportion of migrant nurses accounts for 26% of the nursing workforce in New Zealand, 25% in Switzerland, 18% in Australia or 15% in the United Kingdom [ 74 ]. During this pandemic, international recruiters have increased their direct advertising to try and recruit scarce healthcare staff from low- and lower-middle income countries in Africa, Asia and the Caribbean [ 34 ]. Discrimination and racism at work in terms of lack of job opportunities, poor career progression or a poor learning environment have been identified as the cause of worse health among migrant and minority nurses compared to native-born nurses [ 75 , 76 ].

In some countries in Europe during COVID-19, there are reports of migrant nurses unable to visit relatives in the country of origin because the hospital administration is not allowing paid or unpaid leave. In addition, many nurses who migrated in search of better job opportunities in the UK were held up and were not able to register due to COVID-19 and the lockdown. The Nursing and Midwifery Council enabled temporary registration for migrant nurses who completed competitive skill examinations, but those who had not finished were forced to wait for more than 2–3 months for such registration, which hampered their right to higher wages. In India, the United Nurses Association arranged safe repatriation of nurses stranded in Saudi Arabia.

Countries are failing to evaluate and respond to the impact of COVID-19 on the physical and mental wellbeing of migrant workers [ 77 ] and data on SARS-CoV-2 infection and COVID-19 deaths in migrant nurses is not systematically collected.

Available information from 106 countries indicates that 17% of the nursing workforce are aged 55 years or above [ 12 ]. Regional variations in formally employed workforce are, however, important. For example, in the Eastern Mediterranean Region there are 14 young nurses for every one approaching retirement; in contrast, the Americas this ratio is 1.2:1, and in Europe and Africa it is 1.9:1, indicating a much smaller replacement pool [ 12 ].

Exemptions of COVID work for nurses that are more than 50 years of age were not implemented. Many senior nurses were called to work to fill needed care work and retired nurses are working in the COVID vaccination campaigns [ 78 ]. CDC data from six states of the United States show that professional nurses and nurse aides are disproportionately affected and the group of age over 55 years has a significant probability of case fatality [ 5 ].

Employment relations in nursing

The macro-structural framework encompasses the broader social, economic, and political system that exerts significant power over the distribution of resources in a society, shedding light on the complex health and health care politics, and how the redistribution of power relations creates new policies regarding the labour market and the welfare state, namely labour standards, occupational health and safety regulations, and union protections, among many other things [ 13 , 14 , 79 ].

Unions, civil society, and collective bargaining

Nursing professional associations, educational institutions, nursing regulatory bodies and unions, nursing student and youth groups, grassroots groups, and global campaigns such as “Nursing Now” are valuable contributors to strengthening the role of nursing in healthcare teams to achieve better employment and working conditions for nurses [ 12 ].

Unionization in the health sector varies between regions, welfare state regimes and health workers groups, but regions have a similar trend of higher unionization in the public sector compared to the private one. For example, in Europe, the coverage of collective bargaining is notably higher in the public compared to the private sector. Collective agreement coverage in the private sector is considerably low and is even lower for nurses, for example, in the case of Poland, the coverage is only 5% [ 80 ].

Furthermore, while nursing students were employed as actual workers during the COVID-19 crisis, they were not always covered by the existing labour laws and the coverage of collective bargaining in this sector of workers is unknown. For example, a press release from the Irish Nurses’ and Midwives’ Organisation (INMO) points out that students “do not have the protections provided to employee” [ 42 ]. In Mexico, students have claimed that they are not given adequate PPE and hospitals told them that if they leave work, their scholarship will be withdrawn [ 81 ]. However, in England, the unions reached an agreement with the Nursing and Midwifery Council (NMC) and chief nursing officers across the UK that enables more experienced students to work in the NHS, receive remuneration and that this work counts for their learning [ 82 ]. Less has been explored about the role of universities in allowing, enabling and even possibly encouraging their students to enter high-risk health environments [ 83 ].

The International Labour Organization (ILO) Nursing Personnel Convention, 1977 (No. 149) and the accompanying Recommendation (No. 157) set standards for fair employment conditions for nursing personnel. Yet, to date only 41 countries have ratified the Convention. Also, just 20 countries out of 194 Member States of the WHO have reported measures in place to prevent attacks on health workers [ 12 ].

During COVID-19, countries’ general policies do not address nursing work and needs. For example, the current COVID-19 guidance from Public Health England states that a fluid-resistant surgical face mask is sufficient for non-aerosol-generating procedures [ 84 ]. The administration of specific therapies, like Entonox, is not classified as an aerosol-generating procedure; however, a midwife can spend up to 11 hours in an unventilated room with an asymptomatic woman wearing Entonox with no protection other than a surgical mask. Inadequate PPE has been shown to be a source of infection among healthcare workers [ 8 ].

In addition, the declaration of COVID-19 as an occupational disease has been uneven and several countries have not yet developed this policy [ 85 ].

Government, economy, and political priorities

There is evidence of numerous links between the characteristics of welfare state regimes and the regulation of nurse and nursing professionalization, suggesting that the political context has to be acknowledged and addressed to significantly influence nursing employment and working conditions and health policy [ 86 , 87 ]. In addition, the presence of a Government Chief Nursing Officer (GCNO) position and the existence of a nursing leadership programme to effectively take action in government actions, are associated with a stronger regulation of employment and working conditions for nurses and regulation of nursing education [ 12 ]. However, not all countries have a GCNO, and the rhetoric of the dominant groups (i.e. medical doctors) has traditionally been overrepresented in the decision-making compared to nursing [ 88 ]. It is illustrated again with the COVID taskforce of many countries where the involvement of nurses has been negligible or null in coordinating and supervising the governments’ efforts to monitor, prevent, contain, and mitigate the spread of COVID-19. This is for example the case of India [ 89 ].

Regarding the economic situation, the 2008 economic crisis led to neoliberal austerity measures imposed in many countries that significantly curtail government spending. One of the measures implemented set caps on employment in the public sector which had a significant impact in the precarization of nurses [ 90 ]. For example, in Croatia it resulted in overburdening employed nurses; the inability of newly graduated professional nurses to access employment and, therefore, an increase in migration and a deepening of the serious shortage of nursing personnel [ 91 , 92 ]. Other effects of the economy in the current nursing workforce can be found in Mexico, where prioritization in hiring nurses’ aides instead of professional nurses started as a response to the economic development plans of the 1970s that resulted in policies set by Mexico state [ 93 ]. Several countries in South Asia also followed a similar trajectory [ 94 ]. In addition to the direct effect of the austerity measures, a majority of nurses women were also severely affected by shrinking social protection floors with an impact on childcare and elderly care.

The global dynamics in the economy also plays a role, more visible during the pandemic. For example, the country’s purchasing capacity, the availability of PPE or vaccine production capacities, and the international dispute over scarce health workers.

Discussion and limitations

Nurses’ work is essential in the health system as it has been proved once again during the COVID-19 pandemic. Yet, the pandemic has also exposed historic vulnerabilities faced by many nurses’ workers worldwide which resulted in an unacceptable number of infections and deaths among nurses. The neoliberal austerity measures promote precarization and informalization of nursing work and worsened the vulnerability to health-damaging factors, with many countries still to ratify the ILO Nursing Personnel Convention, 1977 (No. 149) on fair employment conditions. However, the current body of evidence lacks a detailed understanding of the pathways and mechanisms on how precariousness might affect nurses’ health. This might be linked to the current limited capacity of health information systems, and the inability to collect, analyse and monitor precarious employment and the impact in terms of health, wellbeing, and equity.

Collective bargaining through participation in unions and networks has proven to be effective in demanding for fairer employment and working conditions, but such collective organizing and legal rights are still insufficient in many countries. In line with this, COVID-19 pandemic has sparked new solidarity actions by nurses to bring more attention to nurses’ concerns, with calls for post-pandemic international and nationally enforceable standards. Some examples of successful actions to increase the number of nurse-centred and nurse-safe spaces to raise concerns and thus improve nursing working conditions during COVID crisis are reported from countries such as Brazil [ 95 ], India [ 96 , 97 ], or Ireland [ 98 ].

The adapted theoretical framework of employment, work and health provides general guidance and helps in understanding the complex causal relations of employment, work and nurses’ health to guide policies and interventions to achieve greater equity. However, it needs to be tailored to the specific historical processes of each country, region or area, and social dynamics of different labour markets. An example is the wage hierarchies and the regulation of nurse and nursing professionalization [ 99 ]. In addition, this conceptual framework must also be considered with a dynamic perspective of the life cycle.

This study acknowledges that the search strategy used for the identification of studies might lead to exclusion of few relevant studies, although the searches performed have been extensive and it has been complemented with the lived experiences of bedside nurses from countries across Asia, Europe, and Latin America. Also, the study was done entirely virtually, and the team was not able to retrieve information from physical archives.

Box 1 describes the main recommendations based on the findings of the study. General recommendations combining policies at different entry points (power relations, employment, working conditions and ill-health workers) need to be specified and contextualized for each territory, condition, and population. Also, international institutions, governments and political parties, unions, and civil society associations favouring fair employment relations are key actors in implementing effective policies leading to the reduction of employment-related health inequalities.

Box 1. Recommendations

Changes in power relations in nursing which can occur between the main political and economic actors in a society:

Public health policies embedded in broader social and economic development planning and public funding should be developed;

Structural drivers of inequality that push most vulnerable nurses, namely migrant, ethnically diverse, younger and older women, into more precarious and exploitative work should be recognized and act upon by them;

Public financing to support gender equity and the needs of nurses' workers should be directed to increase access to the social protection mechanisms adequately funded and fully operational, notably, kindergartens, homes for the elderly, public transport and public housing;

Further investment in public health systems should include the lift of existing caps on employment in the public sector, prioritization of standard employment of nurses in the public health systems and ensure nurses are paid adequately;

National GCNO and nursing leadership programmes should be developed to promote stronger regulation of nursing education and employment and working conditions for nurses;

The right of nurses to organize and join trade unions should be protected and workplace democracy should be recognized.

Modification of employment and working conditions to reduce vulnerability to health-damaging factors:

Countries should ratify the ILO Nursing Personnel Convention, 1977 (No. 149) and act accordingly;

Nursing education should be accessible, free-of-charge and of good quality;

International mechanisms should be in place to regulate nurses’ migration, such as the WHO Global Code of Practice on the International Recruitment of Health Personnel;

Migration policies that are not discriminatory or punitive and ensure that nurses can access public services adequately should be put in place;

Interventions to reduce the unequal consequences of ill-health and wellbeing:

Universal access to health care including occupational health in primary health care should be provided to nurses, including those informalized;

COVID-19 should be declared as an occupational disease;

National capacity of health information systems and the international interlinkages should be strengthened to collect, analyse and monitor precarious employment and the impact in terms of nurses’ health, wellbeing, and equity.

Nurses’ health is negatively affected by their employment and working conditions which in turn are determined by the power hierarchy and nursing employment relations. Current situation aggravated by the COVID-19 pandemic requires of international and national enforceable standards, along with economic and health policies designed to substantially improve employment and working conditions for nurses and work–life balance, reducing the burden of nurses’ “second shift” within their families. Future research should analyse the pathways and mechanisms on how precariousness might affect nurses’ health and monitor the progress (or not) towards nurses’ health equity over time and evaluate the effects of different interventions between and within countries.

Availability of data and materials

Not applicable.

Liu Q, Luo D, Haase JE, Guo Q, Wang XQ, Liu S, et al. The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study. Lancet Glob Health. 2020;8:e790–8.

Article   PubMed   PubMed Central   Google Scholar  

ICN. COVID-19 Update: Mass trauma experienced by the global nursing workforce. Geneva; 2021. https://www.icn.ch/sites/default/files/inline-files/ICN%20COVID19%20update%20report%20FINAL.pdf .

WHO. National Health Workforce Accounts: implementation guide. Geneva; 2018. https://www.who.int/publications-detail-redirect/national-health-workforce-accounts-implementation-guide .

ICN. ICN confirms 1,500 nurses have died from COVID-19 in 44 countries and estimates that healthcare worker COVID-19 fatalities worldwide could be more than 20,000; 2020. https://www.icn.ch/sites/default/files/inline-files/PR_52_1500%20Nurse%20Deaths_FINAL-3.pdf .

Hughes MM, Groenewold MR, Lessem SE, Xu K, Ussery EN, Wiegand RE, et al. Update: characteristics of health care personnel with COVID-19. MMWR Morb Mortal Wkly Rep. 2020;69:1364–8.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Kambhampati AK. COVID-19–associated hospitalizations among health care personnel—COVID-NET, 13 States, March 1–May 31, 2020. MMWR Morb Mortal Wkly Rep. 2020 (cited 2020 Nov 28);69. https://www.cdc.gov/mmwr/volumes/69/wr/mm6943e3.htm .

Amnesty International. Exposed, silenced, and attacked: failures to protect health and essential workers during the COVID-19 pandemic. London; 2020. https://www.amnesty.org/en/documents/document/?indexNumber=pol40%2f2572%2f2020&language=en .

Nguyen LH, Drew DA, Graham MS, Joshi AD, Guo C-G, Ma W, et al. Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study. Lancet Public Health. 2020;5:e475–83.

Moss M, Good VS, Gozal D, Kleinpell R, Sessler CN. A critical care Societies collaborative statement: burnout syndrome in critical care health-care professionals. A call for action. Am J Respir Crit Care Med. 2016;194:106–13.

Article   PubMed   Google Scholar  

Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. Brain Behav Immun. 2020;88:901–7.

Er F, Sökmen S. Investigation of the working conditions of nurses in public hospitals on the basis of nurse-friendly hospital criteria. Int J Nurs Sci. 2018;5:206–12.

PubMed   PubMed Central   Google Scholar  

WHO. State of the world’s nursing 2020: investing in education, jobs and leadership. 2020. https://www.who.int/publications-detail/nursing-report-2020 .

Julià Pérez M. Precarització de les condicions d’ocupació a la Unió Europea: Precarietat, informalitat, i associació amb la salut (Ph.D. Thesis). TDX (Tesis Doctorals en Xarxa). Universitat Pompeu Fabra; 2016 (cited 2020 Nov 26). http://www.tdx.cat/handle/10803/406084 .

Benach J, Muntaner C. Employment, work and health inequalities: a global perspective. Icaria Editorial; 2014.

Benach J, Muntaner C, Solar O, Santana V, Quinlan M. Employment, work, and health inequalities: a global perspective. Geneva: WHO; 2007. https://www.who.int/social_determinants/resources/articles/emconet_who_report.pdf?ua=1 .

Aristizabal P, Nigenda G, Serván-Mori E. The precarization of the Mexican nursing labor market: a repeated cross-sectional analysis for the period 2005–2018. Hum Resour Health. 2019;17:87.

Fité-Serra AM, Gea-Sánchez M, Alconada-Romero Á, Mateos JT, Blanco-Blanco J, Barallat-Gimeno E, et al. Occupational precariousness of nursing staff in Catalonia’s public and private nursing homes. Int J Environ Res Public Health. 2019;16:4921.

Article   PubMed Central   Google Scholar  

Times of India. Delhi: Nurses make less than your plumber. 2019 Dec 5 (cited 2020 Nov 30); https://timesofindia.indiatimes.com/city/delhi/nurses-make-less-than-your-plumber/articleshow/72374665.cms .

Lappin K. Frontline aged care workers warn WHO Western Pacific about horrific consequence of privately run aged care. 2020 Oct 8 (cited 2020 Nov 30); https://publicservices.international/resources/news/frontline-aged-care-workers-warn-who-western-pacific-about-horrific-consequence-of-privately-run-aged-care?id=11197&lang=en .

Engelbrecht MC, Bester CL, Van Den Berg H, Van Rensburg HCJ. A study of predictors and levels of burnout: the case of professional nurses in primary health care facilities in the free state1. South Afr J Economics. 2008;76:S15-27.

Article   Google Scholar  

van der Doef M, Mbazzi FB, Verhoeven C. Job conditions, job satisfaction, somatic complaints and burnout among East African nurses. J Clin Nurs. 2012;21:1763–75.

Baranda L. Estudi sobre la Salut, estils de vida i condicions de treball de les infermeres i infermers de Catalunya. Fundació Galatea; 2017. http://www.consellinfermeres.cat/wp-content/uploads/Salut-estils-de-vida-i-condicions-de-treball-de-les-Infermeres-i-Infermers-de-Catalunya.pdf .

Cordeiro TMSCE, de Araújo TM. Work ability among primary health care nursing staff, Bahia, Brazil. Rev Salud Publica Bogota. 2018;20:422–9.

Ansoleaga E, Toro CJP, Godoy CL, Stecher A, Blanch JM. Psychophysiological distress among health care professionals working in Chilean public hospitals. Rev Med Chil. 2011;139:1185–91.

Triana-Palencia E, Cárdenas-Cárdenas LM, Juárez-García A, Quiroz-Muysina J, Idrovo AJ. Use of assessment scales, turnover and job strain in nursing staff: a study in a Colombian hospital. J Nurs Manag. 2019;27:42–51.

Juárez-García A. Psychosocial work factors associated to blood pressure and cardiovascular symptoms among Mexican nurses. Salud Publica Mex. 2007;49:109–17.

Zavala MOQ, Klinj TP, Carrillo KLS, Zavala MOQ, Klinj TP, Carrillo KLS. Quality of life in the workplace for nursing staff at public healthcare institutions. Revista Latino-Americana de Enfermagem. Escola de Enfermagem de Ribeirão Preto/Universidade de São Paulo; 2016 (cited 2020 Nov 29);24. http://www.scielo.br/scielo.php?script=sci_abstract&pid=S0104-11692016000100355&lng=en&nrm=iso&tlng=es .

Rodarte-Cuevas L, Araujo-Espino R, Trejo-Ortiz PM, González-Tovar J. Quality of professional life and musculoskeletal disorders in nurses. Enferm Clin. 2016;26:336–43.

Kunaviktikul W, Wichaikhum O, Nantsupawat A, Nantsupawat R, Chontawan R, Klunklin A, et al. Nurses’ extended work hours: patient, nurse and organizational outcomes. Int Nurs Rev. 2015;62:386–93.

Article   CAS   PubMed   Google Scholar  

Davidson JE, Proudfoot J, Lee K, Zisook S. Nurse suicide in the United States: analysis of the Center for disease control 2014 National Violent Death Reporting System dataset. Arch Psychiatr Nurs. 2019;33:16–21.

Davis MA, Cher BAY, Friese CR, Bynum JPW. Association of US nurse and physician occupation with risk of suicide. JAMA Psychiat. 2021. https://doi.org/10.1001/jamapsychiatry.2021.0154 .

Taha AA, Westlake C. Palestinian nurses’ lived experiences working in the occupied West Bank. Int Nurs Rev. 2017;64:83–90.

Maraqa B, Nazzal Z, Zink T. Palestinian health care workers’ stress and stressors during COVID-19 pandemic: a Cross-Sectional Study. J Prim Care Commun Health. 2020;11:2150132720955026.

ICN. COVID-19 and the international supply of nurses; 2020. https://www.icn.ch/system/files/documents/2020-07/COVID19_internationalsupplyofnurses_Report_FINAL.pdf .

Fernandez R, Lord H, Halcomb E, Moxham L, Middleton R, Alananzeh I, et al. Implications for COVID-19: A systematic review of nurses’ experiences of working in acute care hospital settings during a respiratory pandemic. Int J Nurs Stud. 2020;111:103637.

Zhan Y-X, Zhao S-Y, Yuan J, Liu H, Liu Y-F, Gui L-L, et al. Prevalence and influencing factors on fatigue of first-line nurses combating with COVID-19 in China: a descriptive cross-sectional study. Curr Med Sci. 2020;40:625–35.

Machado MH, Filho WA, De Lacerda WF, De Oliveira E, Lemos W, Wermelinger M, et al. Caracteristicas gerais da enfermagem: O perfil sócio demográfico. revenf. 2016;7:9.

Conselho Federal de Enfermagem. COFEN. Observatório da Enfermagem. 2020. http://observatoriodaenfermagem.cofen.gov.br/ .

The University Times. Report finds 60% of Midwifery Students Bullied on Placement, and Breach of Working Hours Agreement. Dublin; 2015 Jun 5 (cited 2020 Nov 26). http://www.universitytimes.ie/2015/06/report-finds-60-of-midwifery-students-bullied-on-placement-and-breach-of-working-hours-agreement/ .

The University Times. Responses to midwifery bullying report set for implementation across health science. 2017. http://www.universitytimes.ie/2017/04/responses-to-midwifery-bullying-report-set-for-implementation-across-health-science/ .

Hogh A, Carneiro IG, Giver H, Rugulies R. Are immigrants in the nursing industry at increased risk of bullying at work? A one-year follow-up study. Scand J Psychol. 2011;52:49–56.

Irish Nurses & Midwives Organisation. “Stop exploiting student nurses and midwives.” Dublin; 2020 Oct 16 (cited 2020 Nov 26); https://www.inmo.ie/Home/Index/217/13640 .

Paudel S, Menge J. Under pressure: health care workers fighting at the frontlines in Nepal. The Friedrich-Ebert-Stiftung; 2020. https://www.fes-asia.org/news/already-under-pressure-health-care-workers-fighting-at-the-frontlines-in-nepal/ .

NYTimes. ‘Health Care Kamikazes’: how Spain’s Workers Are Battling Coronavirus, Unprotected; 2020. https://www.nytimes.com/video/world/europe/100000007051789/coronavirus-ppe-shortage-health-care-workers.html .

ANA. Update on nurses and PPE: survey reveals alarming conditions; 2020. https://www.nursingworld.org/~4a558d/globalassets/covid19/ana-ppe-survey-one-pager---final.pdf .

Gouda D, Singh P, Gouda P, Goudra B. The demography of deaths in healthcare workers—an overview of 1004 reported COVID-19 deaths (Ahead-of-print). American Board of Family Medicine. 2020 (cited 2020 Nov 28). https://www.jabfm.org/sites/default/files/COVID_20-0248.pdf .

Sampaio F, Sequeira C, Teixeira L. Nurses’ mental health during the Covid-19 outbreak: a cross-sectional study. J Occup Environ Med. 2020;62:783–7.

Chow A, Htun HL, Kyaw WM, Lee LT, Ang B. Asymptomatic health-care worker screening during the COVID-19 pandemic. Lancet. 2020;396:1393–4.

Bielicki JA, Duval X, Gobat N, Goossens H, Koopmans M, Tacconelli E, et al. Monitoring approaches for health-care workers during the COVID-19 pandemic. Lancet Infect Dis. 2020;20:e261–7.

Grassly N, Pons Salort M, Parker E, White P, Ainslie K, Baguelin M, et al. Report 16: Role of testing in COVID-19 control. Imperial College London; 2020. http://spiral.imperial.ac.uk/handle/10044/1/78439 .

CDC. Interim Guidance on Testing Healthcare Personnel for SARS-CoV-2. Centers for Disease Control and Prevention. 2020 (cited 2020 Nov 28). https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing-healthcare-personnel.html .

Regione Emilia-Romagna. COVID-19: Modifiche tecniche al percorso di screening sierologico regionale—E-R BUR 214/2020; 2020. https://bur.regione.emilia-romagna.it/dettaglio-inserzione?i=3cb4b669baeb4ba9a32b15b2253a2e82 .

Agren D. Understanding Mexican health worker COVID-19 deaths. Lancet. 2020;396:807.

Manoj P. Frontline health workers in Kapilvastu deprived of risk allowance. The Kathmandu Post. Kathmandu; 2020 (cited 2020 Nov 28); https://kathmandupost.com/province-no-5/2020/09/07/frontline-health-workers-in-kapilvastu-deprived-of-risk-allowance .

Medecins Sans Frontières. Israel and Palestine: the despair of cruel vaccination inequalities; 2021 (cited 2021 Mar 24). https://www.msf.ie/article/israel-and-palestine-despair-cruel-vaccination-inequalities .

Wright EO. Class counts: comparative studies on class analysis. New York (NY): Cambridge University Press; 2000.

Book   Google Scholar  

Nimmon L, Stenfors-Hayes T. The, “Handling” of power in the physician-patient encounter: perceptions from experienced physicians. BMC Med Educ. 2016;16:1.

Boletín Oficial del Estado (BOE). Decreto-ley 24/2020, de 16 de junio, de medidas extraordinarias en materia de personal. https://www.boe.es/boe/dias/2020/08/12/pdfs/BOE-A-2020-9554.pdf .

Government of the United Kingdom. Pay rises for doctors, police and more in the public sector. London; 2020 (cited 2020 Nov 28); https://www.gov.uk/government/news/pay-rises-for-doctors-police-and-more-in-the-public-sector .

Babu NM. Dormitories, hostels and shared bathrooms for nurses on COVID-19 duty. The Hindu. New Delhi; 2020 (cited 2020 Nov 30); https://www.thehindu.com/news/cities/Delhi/dormitories-hostels-and-shared-bathrooms-for-nurses-on-covid-19-duty/article31293511.ece .

The News Minute. From lack of PPE to discrimination: Nurses working in Delhi hospitals on official apathy. 2020 (cited 2020 Nov 30); https://www.thenewsminute.com/article/lack-ppe-discrimination-nurses-working-delhi-hospitals-official-apathy-122969 .

The Guardian. Indian doctors being evicted from homes over coronavirus fears. The Guardian. 2020 Mar 30 (cited 2020 Nov 26); http://www.theguardian.com/world/2020/mar/30/indian-doctors-being-evicted-from-homes-over-coronavirus-fears .

Buscaglia G. Rimini, danneggiate settanta auto. "E’ un attacco a medici e infermieri". il Resto del Carlino. 1603686611000 (cited 2020 Nov 26). https://www.ilrestodelcarlino.it/rimini/cronaca/auto-danneggiate-medici-infermieri-1.5647731 .

Caldera-Villalobos C, Garza-Veloz I, Martínez-Avila N, Delgado-Enciso I, Ortiz-Castro Y, Cabral-Pacheco GA, et al. The Coronavirus Disease (COVID-19) challenge in Mexico: a critical and forced reflection as individuals and society. Front Public Health. 2020;8:337.

WHO. Delivered by women, led by men: A gender and equity analysis of the global health and social workforce; 2019.

ILO. Improving Employment and Working Conditions in Health Services: report for discussion at the Tripartite Meeting on Improving Employment and Working Conditions in Health Services. 2017. https://www.ilo.org/sector/activities/sectoral-meetings/WCMS_548288/lang--en/index.htm .

Budwig M. The fatherhood bonus and the motherhood penalty: parenthood and the gender gap in pay. Third Way NEXT; 2014. https://www.thirdway.org/report/the-fatherhood-bonus-and-the-motherhood-penalty-parenthood-and-the-gender-gap-in-pay .

Newman C, Stilwell B, Rick S, Peterson K. Investing in the power of nurse leadership: what will it take?. IntraHealth International; 2019. https://www.intrahealth.org/resources/investing-power-nurse-leadership-what-will-it-take .

ILO. Decent Working Time for Nursing Personnel: Critical for Worker Well-being and Quality Care. Geneva; 2018. https://www.ilo.org/wcmsp5/groups/public/---ed_dialogue/---sector/documents/publication/wcms_655277.pdf .

The Guardian. Pregnant nurse’s death adds to concern among health workers. the Guardian. 2020 (cited 2020 Nov 26); http://www.theguardian.com/world/2020/apr/15/pregnant-healthcare-workers-pressured-into-covid-19-frontline .

Bleich MR, MacWilliams BR, Schmidt BJ. Advancing diversity through inclusive excellence in nursing education. J Prof Nurs. 2015;31:89–94.

Nair S, Healey M. A profession on the margins: status issues in Indian nursing. Centre for Women’s Development Studies; 2006 (cited 2020 Nov 30); http://archive.nyu.edu/handle/2451/34246 .

Rogers TN, Rogers CR, VanSant-Webb E, Gu LY, Yan B, Qeadan F. Racial disparities in COVID-19 mortality among essential workers in the United States. World Med Health Policy. 2020;12:311–27.

OECD. Health Workforce Migration: Migration of nurses. 2020. https://stats.oecd.org/Index.aspx?DataSetCode=HEALTH_WFMI

Schilgen B, Nienhaus A, Handtke O, Schulz H, Mösko M. Health situation of migrant and minority nurses: a systematic review. PLoS ONE. 2017;12:0179183.

Article   CAS   Google Scholar  

Walani SR. Global migration of internationally educated nurses: experiences of employment discrimination. Int J Afr Nurs Sci. 2015;3:65–70.

Google Scholar  

Liem A, Wang C, Wariyanti Y, Latkin CA, Hall BJ. The neglected health of international migrant workers in the COVID-19 epidemic. Lancet Psychiatry. 2020;7:e20.

Williams G, Maier C, Scarpetti G, de Belvis A, Fattore G, Morsella A, et al. What strategies are countries using to expand health workforce surge capacity during the COVID-19 pandemic? Eurohealth. 2020;26:51–7.

Muntaner C, Chung H, Solar O, Santana V, Castedo A, Benach J, et al. A macro-level model of employment relations and health inequalities. Int J Health Serv. 2010;40:215–21.

Weber T, Nevala A. Employment and industrial relations in the health care sector|Eurofound. Dublin: Eurofound; 2011. https://www.eurofound.europa.eu/publications/report/2011/employment-and-industrial-relations-in-the-health-care-sector .

El Universal. Pasantes de enfermería acusan que son forzados a mantenerse en hospitales. México; 2020. https://www.eluniversal.com.mx/nacion/coronavirus-pasantes-de-enfermeria-acusan-que-son-forzados-mantenerse-en-hospitales .

UNISON National. Unions announce COVID-19 support for nursing students. 2020 (cited 2020 Nov 28). https://www.unison.org.uk/news/2020/03/unions-announce-covid-19-support-nursing-students/ .

Hayter M, Jackson D. Pre-registration undergraduate nurses and the COVID-19 pandemic: students or workers? J Clin Nurs. 2020;29:3115–6.

Public Health England. COVID-19: Infection prevention and control guidance. 2020. https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control .

Sandal A, Yildiz AN. COVID-19 as a recognized work-related disease: the current situation worldwide. Saf Health Work. 2021;12:136–8.

Gunn V, Muntaner C, Villeneuve M, Chung H, Gea-Sanchez M. Nursing professionalization and welfare state policies: a critical review of structural factors influencing the development of nursing and the nursing workforce. Nurs Inq. 2019;26:e12263.

Gunn V, Muntaner C, Ng E, Villeneuve M, Gea-Sanchez M, Chung H. The influence of welfare state factors on nursing professionalization and nursing human resources: a time-series cross-sectional analysis, 2000–2015. J Adv Nurs. 2019;75:2797–810.

Herdman E. The deskilling of registered nurses: the social transformation of nursing work in a New South Wales hospital, 1970–1990. University of Wollongong Thesis Collection 1954–2016. 1992; https://ro.uow.edu.au/theses/1729 .

India Today. Inside PM Modi’s COVID-19 task force. India Today. 2020 (cited 2020 Nov 30). https://www.indiatoday.in/india-today-insight/story/inside-pm-modi-s-covid-19-task-force-1665239-2020-04-09 .

Alameddine M, Baumann A, Laporte A, Deber R. A narrative review on the effect of economic downturns on the nursing labour market: implications for policy and planning. Hum Resour Health. 2012;10:23.

Friganovic A, Režić S, Kurtović B, Vidmanić S, Zelenikova R, Rotim C, et al. Nurses’ perception of implicit nursing care rationing in Croatia—a cross-sectional multicentre study. Journal of Nursing Management. 2020 (cited 2020 Nov 4);n/a. https://doi.org/10.1111/jonm.13002

Butkovič H, Samardzija V, Skazlič I, Čavar I. Nonstandard work in Croatia: challenges and persepctives in selected sectors. Zagreb: Institute for Development and International Relations; 2016.

Squires A, Juarez A. A qualitative study of the work environments of Mexican nurses. Int J Nurs Stud. 2012;49:793–802.

Baru RV. Privatisation of Health services: a South Asian perspective. Economic Political Weekly. 2003;38:4433–7.

Araújo-dos-Santos T, Santos HS, Moraes M de A, Mussi FC, Araújo-dos-Santos T, Santos HS, et al. Nursing Comiittee to Coping with COVID-19 in Bahia. Revista Brasileira de Enfermagem. Associação Brasileira de Enfermagem; 2020 (cited 2020 Nov 26);73. http://www.scielo.br/scielo.php?script=sci_abstract&pid=S0034-71672020001400503&lng=en&nrm=iso&tlng=en .

The Times of India. Careless Mumbai’s Wockhardt Hospital compromised 10 nurses, says union; hospital refutes charges. The Times of India. 2020 (cited 2020 Nov 30). https://timesofindia.indiatimes.com/city/mumbai/careless-mumbais-wockhardt-hospital-compromised-10-nurses-says-union-hospital-refutes-charges/articleshow/74976093.cms .

Barria S. Health unions raise issue of protection for health workers to the Indian National Human Rights Commission. 2020 (cited 2020 Nov 30). https://publicservices.international/resources/news/health-unions-raise-issue-of-protection-for-health-workers-to-the-indian-national-human-rights-commission?id=11116&lang=en .

Irish Nurses & Midwives Organisation. INMO welcomes commitment to graduate jobs. Dublin; 2020 (cited 2020 Nov 26); https://www.inmo.ie/Home/Index/217/13604 .

Sørensen A. Kvindefag i historisk skruetvinge: En analyse af tjenestemandsreformens betydning for hierarkiet i offentlige lønninger fra 1969 til 2019. Copenhagen: Institut for Menneskerettigheder; 2020.

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Llop-Gironés, A., Vračar, A., Llop-Gironés, G. et al. Employment and working conditions of nurses: where and how health inequalities have increased during the COVID-19 pandemic?. Hum Resour Health 19 , 112 (2021). https://doi.org/10.1186/s12960-021-00651-7

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Navigating the academic waters often starts with a working thesis – a preliminary statement guiding your research direction. As the bedrock of your argument, it’s vital to get it right from the outset. Whether you’re a budding researcher or an established academic, our comprehensive guide brimming with thesis Statement examples and pro-tips will illuminate the process of crafting an impactful working thesis. Dive in and set the tone for a compelling research journey!

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Starting your research with a working thesis can guide your exploration and analysis. These provisional statements allow you to focus on different angles and will likely be revised as you dive deeper. The following are 100 working thesis statement examples to kickstart your brainstorming and research.

• “Eating organic foods leads to better health.”
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• “Globalization has reshaped cultural identities worldwide.”
• “Artificial intelligence will redefine the job market in the next decade.”
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• “E-sports will soon rival traditional sports in viewership and revenue.”
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• “Consumer behavior has been largely influenced by social media marketing.”
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• “Renewable energy sources are now more economically viable than fossil fuels.”
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• “Digital currencies will change the dynamics of global trade.”
• “Coral reefs are under imminent threat due to ocean acidification.”
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• “Virtual reality will transform education and training methodologies.”
• “Bioplastics are a potential solution to the plastic waste crisis.”
• “Plant-based diets can significantly reduce carbon footprints.”
• “Mental health should be integrated into school curriculums.”
• “Urban planning needs to prioritize pedestrian-friendly designs.”
• “Modern parenting styles differ significantly from those of the previous generation.”
• “Personalized learning will redefine educational outcomes.”
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• “Intermittent fasting has potential benefits beyond weight loss.”
• “Personalized marketing will reshape consumer behaviors.”
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• “Blockchain technology has applications beyond cryptocurrencies.”
• “Animal-assisted therapies have notable success in various treatments.”
• “The future of print media is in niche and localized publications.”
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• “Modern cinema is increasingly addressing global issues.”
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• “Resilience training should be a component of employee wellness programs.”
• “Local tourism will see a boost in the post-pandemic world.”
• “Public transportation systems need to adapt to post-COVID realities.”
• “Elderly populations are facing increased isolation in the digital age.”
• “Upcycling is becoming a significant trend in the fashion industry.”
• “Holistic education emphasizes more than just academic achievement.”
• “Water scarcity will be a leading global issue in the coming years.”
• “The role of influencers is evolving in the digital marketing landscape.”
• “The circadian rhythm has a profound effect on productivity.”
• “Migratory patterns of animals are being altered by climate change.”
• “Alternative protein sources will dominate future diets.”
• “Nano-technology has the potential to revolutionize medicine.”
• “Cultural appropriation in fashion needs a deeper understanding and sensitivity.”
• “Digital literacy is becoming as essential as traditional literacy.”
• “Robotics in surgery can enhance precision but requires ethical considerations.”
• “The tradition of oral storytelling is being revived through modern platforms.”
• “The notion of work-life balance is evolving with the rise of digital nomadism.”
• “The digital divide can exacerbate educational inequalities.”
• “Biodiversity conservation is crucial for ecosystem stability.”
• “Personal branding is becoming essential in the modern job market.”
• “Ethical consumerism can drive corporate responsibility.”
• “Mindfulness practices can enhance workplace productivity.”
• “The dynamics of international politics are shifting with the rise of regional powers.”
• “Food preservation techniques are evolving with technology.”
• “Historical fiction plays a role in shaping perceptions of the past.”
• “Indigenous knowledge systems can complement modern science.”
• “Commuter culture has significant environmental and health impacts.”
• “Craftsmanship is finding its value in the age of mass production.”
• “The role of museums is evolving to be more interactive and inclusive.”
• “Edutainment platforms are making learning more accessible and enjoyable.”
• “Youth activism is reshaping global policy discussions.”
• “Multi-disciplinary approaches are the future of academic research.”
• “Ecotourism can benefit local communities and conservation efforts.”
• “Freelancing is challenging traditional employment norms.”
• “Nature-based solutions can mitigate urban environmental challenges.”
• “The gaming industry is becoming a leader in technological innovation.”
• “Epigenetics is unlocking the mysteries of gene expression.”
• “Digital archiving is essential for preserving cultural heritages.”
• “Remote and flexible working models can have societal benefits.”
• “Self-care routines are integral to holistic health.”
• “Digital nomad visas are reshaping immigration policies.”
• “Adaptive learning technologies cater to individual student needs.”
• “Eco-friendly packaging is more than just a marketing trend.”
• “Quantum computing holds the key to future tech innovations.”
• “Multi-generational households have socio-economic benefits.”
• “The revival of traditional arts can boost local economies.”
• “Precision agriculture can optimize yields and reduce resource wastage.”
• “Local languages are gaining prominence in digital content creation.”
• “Human-centered design is the future of product innovation.”

Each of these working thesis statements can be further refined based on specific research, perspectives, and findings as one delves deeper into their chosen topic.

Working Thesis Statement Examples for Research Paper

Research papers demand precision, clarity, and a strong foundation. A working thesis statement for such a paper typically suggests a hypothesis or a primary point that will later be validated or disproved through evidence.

• “Genetically modified foods present more benefits than potential harm.”
• “Ocean acidification significantly impacts marine biodiversity.”
• “Quantum computing will revolutionize data encryption methods.”
• “Renewable energy solutions are more cost-effective than conventional fossil fuels.”
• “The gut-brain connection plays a crucial role in mental health.”
• “Childhood vaccinations have no proven links to autism.”
• “Microplastics in water sources influence human health outcomes.”
• “Historical art movements reflect the socio-political events of their times.”
• “AI-driven diagnostic tools can predict diseases more accurately.”
• “The frequency of extreme weather events correlates with global warming.”

Working from Home Thesis Statement Examples

The concept of working from home has grown exponentially in recent years. Thesis statements on this topic can explore the various facets, benefits, challenges, and implications of this trend.

• “Working from home enhances employee productivity levels.”
• “Remote work culture can lead to professional isolation and mental health challenges.”
• “Flexible work schedules cater to global clientele more effectively.”
• “Home-based work can reduce urban traffic congestion.”
• “Technological infrastructure dictates the efficiency of remote work.”
• “Work-life balance can be skewed in a prolonged work-from-home setup.”
• “Virtual collaboration tools are reshaping corporate communication.”
• “Remote work could impact urban real estate demands.”
• “Cybersecurity challenges increase in decentralized work environments.”
• “Training and orientation programs must evolve for remote work success.”

Working Thesis Statement Examples for Argumentative Essay

An argumentative essay thesis statement that takes a strong position, which will then be supported or countered with evidence and arguments.

• “Universities should make attendance optional for students.”
• “Plant-based diets are more environmentally sustainable.”
• “Compulsory military service strengthens national unity.”
• “Social media platforms should be held accountable for user-generated content.”
• “Single-gender schools do not offer educational benefits over co-ed institutions.”
• “Animal testing for cosmetics should be banned globally.”
• “Nuclear energy is essential for a carbon-free future.”
• “Euthanasia should be legalized under strict conditions.”
• “Organic farming can sustain global food demands.”
• “Mandatory voting ensures true democratic representation.”

Working Thesis Statement Examples for Speech

For speeches, a working thesis should be compelling and captivating, giving audiences an idea of what to expect and why they should listen.

• “Space exploration benefits humanity in unforeseen ways.”
• “Digital detox weekends can rejuvenate the mind.”
• “Public libraries remain essential in the digital age.”
• “Sports foster essential life skills beyond physical fitness.”
• “Mental health education should be integrated into school systems.”
• “Consumerism drives ecological degradation.”
• “Local tourism promotes cultural preservation.”
• “Continuous learning is the key to professional success.”
• “Ethical fashion is not a trend but a necessity.”
• “The future of mobility is electric.”

Working Thesis Statement Examples for Essay

Essays can cover a broad spectrum of subjects, and the thesis will set the tone and direction of the content.

• “Urban green spaces contribute to societal well-being.”
• “Bilingualism offers cognitive and cultural advantages.”
• “Digital privacy is a modern-day human right.”
• “Classical literature provides insights into contemporary issues.”
• “Embracing failures can lead to unexpected successes.”
• “Community engagement is pivotal for sustainable development.”
• “Ancient medical practices have relevance in modern treatments.”
• “Creativity thrives under limitations.”
• “Cultural festivals foster global unity.”
• “Technology reshapes human interactions.”

Working Thesis Statement Examples for Technology Topics

In the rapidly evolving world of technology, a thesis statement can pinpoint specific trends, challenges, innovations, or implications.

• “Augmented reality will revolutionize retail experiences.”
• “Blockchain technology extends beyond the realm of finance.”
• “Cybersecurity threats challenge global geopolitical dynamics.”
• “5G technology will redefine connectivity standards.”
• “Machine learning algorithms can perpetuate societal biases.”
• “Quantum encryption may render current security protocols obsolete.”
• “E-waste is the environmental challenge of the digital era.”
• “Telehealth bridges the accessibility gap in medical services.”
• “Smart cities prioritize sustainability and urban well-being.”
• “Bioinformatics accelerates personalized medical treatments.”

Working Thesis Statement Examples for Film Analysis

Analyzing films requires a deep dive into themes, motifs, cinematography, character development, and cultural contexts. A thesis provides a lens through which the film will be reviewed.

• “Hitchcock’s ‘Vertigo’ explores the intricacies of obsession and identity.”
• “Cinematography in ‘Blade Runner 2049’ reflects the dystopian themes of the narrative.”
• “Disney’s ‘Mulan’ navigates the terrain of gender roles and societal expectations.”
• “Satire in ‘Get Out’ addresses racial dynamics in contemporary society.”
• “Sound design in ‘A Quiet Place’ intensifies the narrative’s suspense.”
• “The nonlinear storyline of ‘Pulp Fiction’ challenges traditional narrative structures.”
• “‘The Shape of Water’ delves into themes of love and otherness.”
• “Cultural representations in ‘Coco’ underline the significance of family and traditions.”
• “‘The Revenant’ showcases the rawness of human survival instincts.”
• “Character development in ‘The Godfather’ mirrors societal power dynamics.

How do you start a working thesis statement?

Starting a working thesis statement is about identifying the primary point or argument you wish to convey in your paper. It often begins with understanding your topic, conducting preliminary research, and formulating an initial perspective. Here are the steps to get you started:

• Understand Your Assignment: Read the guidelines provided for your essay or research paper. Understand the requirements and what is expected of you.
• Choose a Specific Topic: A narrow, focused topic helps in forming a more precise thesis.
• Conduct Preliminary Research: Before making your statement, get a general overview of your topic through initial research.
• Ask Questions: Ponder over your topic. For instance, if you’re writing about “climate change,” you might ask, “What are the major contributors to climate change in urban areas?”
• Draft a Provisional Statement: Write down your initial perspective based on your understanding. This doesn’t need to be perfect; it’s just a starting point.

How to Write a Working Thesis Statement? – Step by Step Guide

• Start with a Question: Often, assignments come in the form of questions. For example, “How did the civil rights movement of the 1960s affect racial dynamics in the US?” Your thesis will be the answer to this question.
• Be Specific: Avoid vague words and make sure your statement can’t be interpreted in multiple ways. For instance, instead of saying “Pollution is harmful,” you might say, “Industrial waste contributes significantly to ocean pollution.”
• Stay Relevant: Ensure that your statement aligns with the content of your essay or research.
• State an Argument: A thesis should not be a mere observation. It should present an arguable point which can be supported or opposed.
• One Sentence: Try to condense your statement into one clear sentence. However, if necessary, it can be two sentences.
• Refine and Revise: As you continue your research, keep refining your thesis. It’s called a “working” thesis for a reason – it’s subject to change.
• Seek Feedback: Before finalizing, it’s beneficial to get feedback from peers, instructors, or mentors. They can offer a fresh perspective.

Tips for Writing a Working Thesis Statement

• Keep It Debatable: A good thesis will always have an opposing side. If there’s no counter-argument to your statement, it might be too straightforward or a fact.
• Avoid First-Person Pronouns: Phrases like “I believe” or “I think” make your statement seem more like an opinion than an arguable point.
• Stay Clear of Generic Statements: Avoid clichés and general observations. Make sure your thesis offers a fresh and precise perspective on the topic.
• Position Strategically: Place your thesis statement at the end of the introduction. It acts as a gateway to the rest of your work.
• Ensure It’s Provable: Be sure that you can provide evidence to support your claim. If your statement is based on personal beliefs or values, it might not be suitable as a thesis.
• Use Online Tools: There are online thesis generators that can help you refine your statement. They aren’t foolproof, but they can provide a good starting point.

Remember, a working thesis is called “working” because it can evolve. As you delve deeper into your research or writing, you might find more compelling ways to frame your argument. Always be open to revision – that’s the essence of great academic writing!

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