Guilt Trip: Calling In Sick When You're A Nurse
By Kathleen Colduvell RN, BSN, BA, CBC
We've all been there. Your throat feels like you swallowed a bag of razor blades, your head feels like someone's squeezing the back of your eyeballs, and you're so weak you can barely make the walk to the bathroom.
But the thought of calling in sick, playing 20 questions about your symptoms, and leaving your patients and colleagues short-staffed pushes you out the door and off to work.
And you're not alone. Most nurses and physicians have gone in to work sick. It’s a daily occurrence and a known fact in the healthcare field. But why? Why do nurses risk the health and safety of their patients? Why do nurses put themselves at further risk when they already have a fever, hacking cough, diarrhea, and vomiting?
The Dangers Of Going To Work Sick
Health experts agree that nurses should avoid coming to work while sick, known as presenteeism. Not only does working while sick make nurses less productive, it also poses a significant risk to patients and can cause illness to spread among colleagues and other hospital staff.
Furthermore, nurses working with transplant patients, oncology patients, the neonatal population, and already immunocompromised patients are truly risking the lives of their patients. These patients are potentially more susceptible to illness and may be at greater risk for having diseases transmitted to them.
Studies also support that when nurses come to work sick they do more harm than good. For example, a 2012 study of a Colorado assisted living facility identified the source of a severe respiratory illness outbreak was a nurse working at the facility. The study indicated the healthcare worker had the earliest onset of respiratory symptoms and worked while symptomatic.
The American Nurses Association (ANA) does not have a position statement on the issue of presenteeism; however, they do have a code of ethics, which is relevant to this issue. The ANA’s Code of Ethics for Nurses With Interpretive Statements states in part: “The nurse’s primary commitment is to the patient.” With this in mind, nurses should not be going to work sick in order to protect the health and safety of the patients.
Yet why do so many continue to do so?
Nurses will largely agree that coming to work sick is not safe for themselves and their patients, but overwhelmingly they admit to working with a fever, GI symptoms, and/or respiratory symptoms. Guilt is a motivating factor for some, others are unable to take time off without pay or don’t want to use paid time off (PTO), while some do not have any PTO to use.
The Guilt Trip
A driving force for going in to work sick is leaving the unit short staffed. Inevitably, calling out of work two hours before a shift will leave little time for finding coverage. Knowing that a unit will be unable to find a replacement motivates some nurses to come to work ill. Nurses do not want to burden their co-workers with additional patients and responsibilities because of their absence.
Additionally, when calling in sick to a nurse manager or supervisor, most will explain the staffing needs of the unit to ensure the nurse really needs to call out. Some nurses have admitted to saying they would come in despite their illness in order to maintain stability in the unit.
Sick Call Policies
Most nursing units have policies in place for those nurses that call in sick during a shift. These policies are almost a type of punishment for calling in sick.
Policies may include:
If you call in sick on a weekend shift, you are assigned a makeup weekend at the discretion of the nurse manager and staff schedulers. Calling in sick to this shift may result in reprimanding.
If you call in sick on the last day before or the first day after any vacation time, you forfeit your paid vacation days.
If you call in sick a certain number of times, an attendance review may be held with a manager. Policies generally state that no additional sick calls may be allowed for the remainder of the year.
Other ways nurses and healthcare workers are penalized for calling in sick are:
- Paid sick time is not offered by your healthcare institution.
- Used sick days count against you in evaluations.
- You are required to use vacation days before using any sick time.
- A physician’s note is required for each sick call.
- Too many sick calls in a set time period may result in termination.
Penalizing nurses for calling in sick results in employee dissatisfaction and leads to frustration within the healthcare institution. Some hospitals combine sick time and vacation time into one umbrella title, Paid Time Off (PTO). Nurses then have to decide whether to call in sick and use this time or save it for an upcoming vacation. By combining time, nurses are reluctant to call in sick in order to protect their vacation time.
Despite knowing that calling in sick is detrimental to a unit and oneself, nurses continue to work. There is no easy answer to this dilemma. Nurses must always do what is best for their patients but they also need to consider their own health and welfare. Working while sick can cause a delay in treatment and prolong the illness.