A Hospital Is No Place For A Sick Person

 

 

# 3775

 

 

 

One of the more surprising things to come out of last week’s CIDRAP summit in Minneapolis was the group polling that indicated that Hospitals were among the least likely to make it easy for employees to stay home if they were sick.

 

Of course, I remember from my own days as a paramedic, that you had better be on death’s door before you could even consider calling in sick.   EMT’s and paramedics were a scarce resource, and since everyone was working at least a 56-hour-week . . .  trying to find someone to fill a shift was a major hassle.

 

So we worked with colds, with the flu, with aching backs, and Lord knows what else  . . . because the system required it.  And there were real (unwritten) punitive downsides to calling in sick. 

 

Of course, this was nearly 30 years ago.   One hopes that things have changed a bit in 3 decades.

 

But from what I heard at the CIDRAP Summit, and from what I hear nearly every week in emails and conversations with HCW’s (Health Care Workers), HR (Human Resources) departments in hospitals are very slow to make any changes to their policies, even in the face of a pandemic.

 

Of course, Hospitals will say they want sick employees to stay home . . . but their HR policies often run counter to that claim.

 

Sick leave for HCWs often comes out of an accrued PTO (Paid Time Off) account which combines vacation, holiday, and sick time off.  Workers accrue hours based on shifts worked, and their seniority.

 

Employees who haven’t sufficient hours `banked’ (or part-time workers who aren’t usually enrolled in PTO plans), must take unpaid leave if they fall ill.  

 

Those that do have banked time, must `burn’ vacation days even though they may have contracted the swine flu `in the line of duty’.

 

Either way, it is a decided disincentive to stay home if you are ill.

 

Live polling of the attendees at the CIDRAP conference indicated that industries other than Health Care, such as manufacturing, were more likely to give employees paid time off for the flu and for taking care of sick family members.  

 

Working sick is a bad idea in any workplace.

 

It exposes co-workers to the virus – who then can take it home to their families. It can also cause waves of absenteeism that can cripple a workplace.

 

But in the health care field, working sick can do much more damage. 

 

Infected HCWs can pass the virus on to their patients, who are often compromised and frail.   Sick HCWs are also impaired and more likely to make errors in judgment, which can endanger patients, and expose their facilities to liability. 

 

I’ve had HCWs tell me that when they try to call in sick they are sometimes urged to work `half a shift’, until a replacement can be found.   A reckless, but apparently common practice.

 

Many hospitals have `streamlined’ their operations to the point that they don’t have any `depth on the bench’.  There is also considerable peer pressure to work, even if you are sick, because if you don’t show up, someone else will have to do your job.

 

If any industry should be leading by example here, it should be the health care industry.

 

But the evidence suggests otherwise.

 

For more perspective – this time from a nurse with 30 years experience (Terri Polick) – I’d call your attention to this blog which appeared on the Nursingjobs.org website.   

 

Follow the link to read it in its entirety.  You’ll note, this was written BEFORE the pandemic virus emerged.

 

Presenteeism: Why Nurses Don’t Call Out Sick

 

February 27th, 2009  |  The Blog

It’s cold and flu season and many of my non-nursing friends are shocked when I tell them that hospitals have unwritten rules about nurses calling into work when they are sick. Sure, nurse recruiters tell new hirers that they can call in sick, but in reality, nothing could be farther from the truth. I’ve actually heard a nursing supervisor refuse to accept a nurse’s callout because there was no one that could take her place on the unit. There are consequences for calling in sick. Nurses that choose to take care of themselves when they are ill face the wrath of their employer when they return to work. Most nurses choose to work when they are sick. This scenario plays out everyday in hospitals and it’s called presenteeism.

(Continue . . .)

 

And yesterday, Crof over at Crofsblog posted an article – also on Presenteeism – which indicates that 1/3rd of American workers feel pressured to work when sick.

The curse of "presenteeism"

Via the Vancouver Sun, a good opinion piece by Craig McInnes on the unsanitary aspects of a good work ethic: H1N1: Those keeners may be the death of us. Excerpt:

A survey of American workers by the U.S. based National Foundation for Infectious Diseases a couple of years ago found that about a third of employees felt pressured to go to work despite being sick.

 

None of this bodes well for containing the spread of the H1N1 flu, which is now well-established in British Columbia. It may be that slackers and hypochondriacs are the heroes in the battle against this global pandemic. 

 

 

Whether it is due to punitive or restrictive corporate policies, financial necessity, peer pressure, or an overactive work ethic . . .  Health Care Workers are going to find themselves torn between doing the right thing and staying home when sick, and and caving into the myriad pressures and going in to work.

 

While there is no law or regulation to force them, hospitals have a moral duty . . .to their employees, to their patients, and to the community in which they operate . . . to make it easier for all employees (part time or full time) to take sick leave during this pandemic.

 

And if that isn’t enough justification, hospitals need to consider the liability angle as well.    Sick employees are more likely to make errors . . . and medical errors can be very costly.

 

While a liberal paid sick leave policy may cost some money in the short run, doing anything less is likely to end up being penny wise and pound foolish.