The Society of Critical Care Anesthesiologists

The Accidental Teleworker

Telework, or telecommuting, is an alternative work arrangement where “employees perform tasks elsewhere that are normally done in a primary or central workplace”1. According to the US Bureau of Labor Statistics, more than 25 million people were telecommuting in 2018, and the number of telecommuters increased 115% between 2005 and 20152,3. Workplace social distancing, including telework, has been considered a possible mitigation strategy during influenza pandemics4, and a number of companies and governments have encouraged workers to telecommute5 because of the current COVID-19 pandemic. With the recent, sudden increase in telework during this time, it is worth briefly reviewing the advantages and disadvantages of telework, how teleworkers now may differ from those in the past, and how to make teleworking a more fulfilling experience.

Research examining telework has had conflicting results and been criticized for methodological weaknesses, such as small sample sizes, non-randomization, and self-selection of participants into telework1,6. However, studies generally suggest positive effects for teleworkers, including increased autonomy, schedule flexibility, improved home-work balance, increased productivity, and higher job satisfaction1,7. A number of disadvantages have been identified as well, such as working longer hours, working when sick, blurring of work-home boundaries, social isolation, career stagnation, and resentment from coworkers1,7. While some of telecommuting’s touted advantages, such as increased autonomy and higher job satisfaction, seem fairly consistent across studies, others are less so. For example, are people really more productive, or do they just work longer hours6? Do shorter commutes and staying at home improve work-family balance, or is there a resultant blurring of work-home boundaries leading to increased family conflict and stress?

Notably, people telecommuting due to necessity for social distancing are a different population than those who previously telecommuted. Workers suddenly started teleworking, possibly involuntarily, without time to set up the physical workspace or time structure to do so. An employee and manager may not have had time to work out a telework agreement, which would delineate scheduled check-ins, expectations, and productivity measurements. Current teleworkers may not possess characteristics thought to be associated with better telecommuters, such as a high level of self-motivation, high level of job knowledge and skills, good time management and organizational skills, strong communication skills, and comfort with solitude7. Because of shelter-in-place orders and school closures, parents are contending both with markedly limited access to childcare and homeschooling while also expected to perform their regular job duties. Additionally, the feelings of solitude and stress due to social distancing and apprehension over the COVID-19 pandemic could be amplified by teleworking. All these factors can increase distractibility and decrease productivity, especially when starting a new and unusual work arrangement.

Although there are not yet evidence-based best habits, a myriad of generally congruent practical telework tips can help set up a better practice.

Establishing a Workspace Environment
  • Set up a physical workspace in your home. Ideally, this includes a dedicated area, ergonomically designed, separate from others in the household, and with adequate technological and internet capabilities8,9,10,11,12,13. If you have trouble concentrating because of noise around your home, for example kids playing, then noise cancelling headphones may help you focus 8,10. Having a dedicated workspace helps set mental and physical work-home boundaries and may decrease work-family conflict that arises from telecommuting.
  • Maintain patient confidentiality. As medical providers, we must keep HIPPA compliance in mind when setting up a workspace. If you are performing telehealth visits from home, you should be in a space where patient confidentiality is maintained both in your physical space and through whatever media (e.g., telephone or video) you are using to perform your visit.
  • Set up adequate communication capabilities. If using an internet platform for patient care, your internet capabilities should be robust enough to prevent interruptions that could disrupt visits or impact acute care decisions.
Create a Work Schedule and Routine
  • Build transitions into and out of work. Consider getting dressed9,12,13 every morning, just as you do when commuting to work. Set a routine to signal the end of the day12,13, such as putting away electronic devices8,9,10. Having these routines can both prepare your mind to work and also help it transition back to the home environment, strengthening work and home boundaries.
  • Maintain set work hours 8,10,11,12,13, and schedule breaks12. One disadvantage of telework is the propensity to work longer hours, which can result in overworking.
Communicate with Colleagues
  • Socialize with colleagues. Attend and actively participate in video meetings9,12 with your video camera on8, and also talk to coworkers about their day or weekend like you would at the office13 Social isolation is another disadvantage of teleworking7, and this feeling may be amplified by current social distancing recommendations. Actively increasing face-to-face and social interactions, albeit through the internet, can lessen the feeling of solitude.
  • Overcommunicate10,12,13 with coworkers and supervisors. Career stagnation and coworker resentment have been listed as disadvantages to telework7, possibly because of decreased face-to-face interactions with supervisors and coworkers. However, in the meta-analysis by Gajendran et al1, telecommuting was associated with positive supervisor ratings, possibly because teleworkers knew that employee-supervisor relationships could suffer, so they strategically focused on developing these relationships.
  • Manage expectations around productivity9 for yourself and your coworkers. During this unprecedented time, it is important to set realistic expectations.
People at home
  • Set boundaries with people at home12,13 around your workspace and time to prevent blurring of work-home boundaries.
  • Create a daily schedule for kids, stock up on books or puzzles, and plan virtual playdates9. School closures and unplanned home schooling has added an extra layer of difficulty for parents now working from home. Creating a daily schedule the night before can help integrate kids’ and parents’ schedules and manage expectations for both parties.
Care for yourself
  • Socialize. Organize online social time with friends9,13, or even set up a support group if you need one10. As stated previously, social isolation is a recognized disadvantage of teleworking and can further contribute to feelings of isolation.
  • Go outside if possible10,12. Exercise and visually seeing other people, in a way that follows social distancing guidelines, can help alleviate feelings of isolation and depressed mood.
  • Take sick days. Telecommuters are more likely to work when sick7, another disadvantage of teleworking. Remember to take time to care for yourself when you need it, and allow yourself to rest and recover.
  • Don’t be too hard on yourself. Bear in mind that many people are having a difficult time dealing with the pandemic, and teleworking in an effective way that doesn’t intrude on family boundaries likely takes practice1.

There are disadvantages to telecommuting, but overall studies have suggested positive effects, such as increased autonomy and job satisfaction. Telework is being used as a method of workplace social distancing during the current COVID-19 pandemic. While it may be difficult to abruptly start teleworking, there are strategies that can increase a feeling of productivity and satisfaction, and decrease the sense of isolation.

  1. The Good, the Bad, and the Unknown About Telecommuting: Meta-Analysis of Psychological Mediators and Individual Consequences. Gajendran RS, Harrison DA. 6, 2007, Journal of Applied Psychology, Vol. 92, pp. 1524-1541.
  2. The future of remote work. Greenbaum, Z. 9, Oct 2019, Monitor on Psychology, Vol. 50, p. 54.
  3. US Bureau of Labor Statistics. [Online]
  4. Effectiveness of workplace social distancing measures in reducing influenza transmission: a systemic review. Ahmed F, Zviedrite N, Uzicanin A. 2018, BMC Public Health, Vol. 18, p. 518.
  5. Working from home in the time of covid-19: how to best preserve occupational health? Bouziri H, Smith DRM, Descatha A, Dab W, Jean K. 2020, Occup Environ Med Epub ahead of print.
  6. A review of telework research: findings, new directions, and lessons for the study of modern work. Bailey DE, Kurland NB. 2002, Journal of Organizational Behavior, Vol. 23, pp. 383-400.
  7. Telework and health effects review. Tavares, A I. 2, 2017, International Journal of Healthcare, Vol. 3, pp. 30-36.
  8. Emotional well-being and coping during covid-19. UCSF Dept of Psychiatry. [Online] 2020.
  9. Noguchi, Y. 8 Tips to make working from home work for you. [Online] NPR, Mar 15, 2020.
  10. Robinson, B. 9 Tips to be productive when working at home during covid-19. [Online] Forbes, Mar 14, 2020.
  11. Giurge LM, Bohns VK. 3 Tips to avoid wfh burnout. Harvard Business Review. [Online] Apr 3, 2020.
  12. Duffy, J. 20 Tips for working from home. PC Mag. [Online] Mar 27, 2020.
  13. Borsellino, R. 7 Essential tips for working from home during the coronavirus pandemic. the muse. [Online] 2020.


Karin Sinavsky, MD, MS
San Francisco VA Health Care System
University of California, San Francisco
San Francisco, California