The Dog Ate My Care Plan…

Just a mom/wife/nursing student extraordinaire trying to make it in the big bad city…

Coming to Work Sick: The CYA Culture

Posted by isntshelovlei on July 31, 2011

I see it everyday in the hospital—staff coming to work with cooties because to not come may be career-suicide.  

There are let’s just say…unwritten policies (and punishments)…when it comes to calling out sick—especially in the hospital environment.

First, now you’re on your managers’/charge nurses’ radar (and not in a good way) because it’s an inconveniece—depending on how much notice you’ve given them they now have to scramble to find someone to fill your slot. Then there’s the fear of being given a write-up for an unexcused or unscheduled absence—which could come back to bite you in the arse during your performance reviews. And now that you’re on management’s proverbial sh*t list you now run of the risk being snubbed, given “harder” assignments or a heavier load than others (and being left to flounder), or other forms of horizontal hostility—even possibly being passed over for promotions and perks.  

So now staff just come to work sick. If you’re sick enough according to managements’ standards (which may mean damn near dying) then they’ll have to send you home. And if management sends you home, you’ll avoid a write-up, be seen as a devoted staff member willing to “take one for the team” coming to work come hell or highwater—plus you’ll still get paid for the day/night. So staff now cover their @sses by putting the ball in managements’ court.

But at what cost? Not only are you not at your best (which can be a recipe for disaster in patient care), but it creates the potential for others to get whatever the hell cootie it is that YOU have! And oftentimes, for whatever reason (*hint, hint* staffing), management may not send you home! They may decide (with the plethora of licensed bodies in a hospital qualified to assess you) that you do in fact “look okay” to stay and work. Big. Fat. Fail. Now what?

This call-out taboo is even brainwashed into nursing students. To call out from clinical is to shoot yourself financially in the foot—students are sometimes threatened with having to personally pay the clinical instructor ($50/hr I have heard quoted) to come in on a non-scheduled clinical day to oversee your make up. As if. Or sometimes they’ll give you an ungodly amount of ridiculous busy work to do to make up the hours. And so students just come to clinical sick hoping they can just make it through the eight- (sometimes twelve-) hour shift. We are breeding the next generation of nurses with cover-your-ass-itis.

I was sick a few months ago. And I don’t get sick often, but I really felt like death warmed over. I went to my primary, who gave me a note stating that I needed to stay home (his exact words were “you shouldn’t be in anyone’s ICU like this”). I called the big cheese to let him know (and way before the two hours notice we’re required to give when we call out—I wanted to give him as much notice as possible to find someone else to come in).  I was told that even though I had a doctor’s note it would still be “an incident.” I stayed home anyway.

Would you???

For more insight on the subject, check out Terri Polick’s post, Presenteeism: Why Nurses Don’t Call Out Sick and @TorontoEmerg‘s How Hospitals Punish Nurses for Being Sick.

7 Responses to “Coming to Work Sick: The CYA Culture”

  1. Christine said

    Pull out that trusty employee handbook and look at the policy for call-outs vs. incidents and what it states for doctor’s notes etc. Just to make sure they have a copy of that and your note come “raise” time. Hey people get sick… it happens even to nurses.

  2. Jess Lower said

    Unfortunately this is SOOOOOO true. I have a child with chronic medical issues and have to miss frequently because of her health and it was DURING A WRITE UP that my manager suggested applying for intermittent FMLA. Ya think ya could have talked to me about that as an option BEFORE I got written up genius? Grrrr. . . I love what I do but the management BS drives me bonkers.

    • isntshelovlei said

      Thanks for your comment–it’s definitely a widespread issue. I understand about needing to maintain certain staffing levels (which are already often inadequate), but this is a safety issue as well.

  3. […] has a rant about going to work sick.  As an employer  in a small practice with little redundancy, having someone out sick  does […]

  4. […] The Dog Ate My Care Plan, Isn’tSheLovlei is taking on Coming to Work Sick: The CYA Culture. (Oh, don’t even get me started!) She links to two more posts on the same topic, one by Terri […]

  5. amanda said

    It is ridiculous that a nurse can’t be sick or call off. I have the same fear that if I call off I will be making my co-workers lives ,for that 8 to 12hr shift, hell. I work on an ortho unit – very demanding and you usually need more than 1 staff member to get a patient out of bed. But, if I am sick , I AM SICK. I refuse to work sick. I have done it, and I will never do it again. If management would staff floors adequately and have float pool staffed adequately then when a staff nurse calls off, it would be covered. It’s very frustrating- nursing is low paid and sometimes not very respected in comparison to the responsibility we carry each day.

  6. Mike said

    While I go to school I work as a tech in a nearby hospital where I’m not able to do clinical so that I can experience the hospital. Really a great place, only major complaint is that they instituted an “incident system” which assigns points for different infractions and sick days. This system is only for ancillary staff such as techs/monitors/hucs so the nurses aren’t involved in this. For each sick day, regardless calling off the approved 4-hours ahead of time, you get 3-points. At 24-pts the person is subject to termination…8 sick days! I’m one of the lucky people that gets sick on avg one time per year or less, but for those that get sick often I’m sure 8 days is an easy amount of days to surpass in a year. Needless to say, many of our ancillary staff either come to work sick or don’t stick around long.

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