Ask-an-Author – Volunteers, Risk Management and the Swine Flu
As promised, here is the first in a series of questions submitted by our readers and answered by volunteerism and risk management expert Linda Graff. Thanks to everyone who submitted a question; come back soon for the next installment of Linda’s good advice.
The Question:
With the anticipated increase in problems with swine flu expected over the winter, most hospitals in Scotland are considering how they can involve more volunteers to free up medical staff and to allow people to help others in a time of potential crisis. With the experience of SARS in Canada, what would you advise to help manage the risk for front line and other volunteers?
Linda’s Answer:
This is a really interesting question that probably has wide applicability as so many communities and organizations brace for the potentially disruptive effects of the H1N1 virus world wide.
There are two aspects of this question I’ll pick up on.
The first has to do with the division of labour between paid and unpaid staff.
Normally I think it best not to assign the same work to paid and unpaid staff. While legislation and legal precedents vary by jurisdiction and, obviously, by country, one risks things like attracting the applicability of labour law and/or labour standards where they otherwise would not apply when volunteers do the same work as paid staff, and open the possibility of suits by volunteers for back wages where they have been doing materially the same work as paid staff. Additionally, volunteers can feel resentment at not being paid, and staff can feel threatened that volunteers will replace them.
The question becomes more complex when, for legitimate reasons (e.g., dramatic increase in demand for service – emergency, disasters, etc.; loss of funding) the involvement of volunteers is critical to service provision. In such cases organizations need to think through both the immediate issues of mission attainment as well as the down-the-road fall out, such as dealing with potential resentment from paid staff or other damage to ongoing volunteer/paid staff relations.
While I remain certain that volunteers should never be engaged in a way that displaces paid staff, I am less hard-lined about whether volunteers might be engaged to replace paid staff who are no longer in place – for a variety of reasons (but usually the loss of funding). As the nature and organization of work changes over time, I can no longer support the notion that volunteers can not be asked to perform work that at some point in the past was done by paid staff. We have seen many transitions in the organization of work and I do not think that duties that have been at some point in the domain of paid staff can never be reassigned to volunteers – as long as doing so does not jeopardize the livelihood of the paid staff in question. This is particularly so in nonprofits where the realignment of duties leads to better service or greater mission accomplishment. This begs the question of managing relationships with organized labour, unions, and paid staff in general, an important matter that goes beyond what I can tackle here.
The second aspect of your question has to do with the ethics of risk, a matter that has troubled me since the very example you cite – the SARS crisis in Canada a few years back.
I know of several hospitals and long-term care facilities in Toronto (and probably elsewhere) which asked volunteers to staff the screening desks during the SARS crisis. Elective procedures were cancelled, unessential staff were sent home, and most facilities also cancelled all volunteer involvement. They closed all entrances but one and all persons entering were required to be “screened”. That is, they were asked if they had a cough, a fever, had been to Asia recently, etc. etc.
In the midst of this most threatening and frightening public health crisis in living memory, facilities asked volunteers to undertake what might, arguably, have been one of the riskiest roles. Asking volunteers to undertake very risky work is one thing, and of course I anticipate readers saying, but Linda, we do that all the time. Look at volunteer firefighters, disaster response volunteers, and so on. And I acknowledge such roles. The problem I had with the SARS situation was that at least one hospital prepared a special waiver that they asked their screening desk volunteers to sign which absolved the facility of any and all liability connected to illness of or harm to the volunteer arising from their screening desk work.
So not only were those facilities prepared to expose volunteers to extremely high risk (for no pay, in a society which often not only pays for work, but pays more for dangerous or demanding work), but were prepared to abandon those very volunteers at the earliest possible opportunity if they suffered loss or harm from their volunteer roles. I also note, in this province, we do not provide worker’s compensation for volunteers, nor do most organization offer any kind of health insurance benefits to volunteers for injuries they might suffer on the (unpaid) job.
I think there should be some limits to the degree of risk we will expose volunteers to, even when volunteers themselves might be willing to undertake the work. And when we do expose volunteers to higher risks, I believe we should be prepared to offer them health care coverage for on-the-job injuries they might sustain.
Finally, in principle, I think there is good basis for planning to engage volunteers in extended roles as part of disaster planning. We have endless precedents – volunteers sandbagging communities in times of flood, and pandemic plans to, for example, engage citizen volunteers as grave diggers in anticipation of city employees being unavailable to fulfill such critical roles.
When exceptional plans are prepared, it is important to consider the ethics of risk, the conditions that would need to be in place to trigger implementation, and some thoughtful plans for returning to “normal” when the emergency subsides. These kinds of considerations should be a part of the overall plan and have the force of policy.
, which is in its 25th anniversary edition, and 
, as a reminder to be present in and appreciate each moment – the accomplishments of the volunteers we lead are truly amazing, but it’s easy to get too preoccupied to see that.
