Coming to Work Sick: The CYA Culture

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.

Pet Peeve: Cafeteria Cooties

Now that the semester’s over, it gives me a little more time to catch up on my blogging. 🙂

So, without further ado…something that I have noticed in the past month or so that really bugs me is surgical gowns/dress in the hospital cafeteria. I mean full garb—right down to the caps and shoe covers. What is up with that? Take that nonsense off before you go to your breakfast/lunch/dinner break. I can’t think of one reason why you would need or want to have that stuff on when you’re about to eat. If you just came from a procedure I’m sure that you don’t want any inconspicuous gunk migrating from your immaculate (I’m sure) gown onto your nicoise salad, and if you’re on your way to surgery I’m sure that your patient doesn’t want shredded lettuce falling from your sleeve into their open wound.

The whole point of surgical gowns is to reduce/eliminate the transfer of bacteria. Do you know how much bacteria one comes into contact with in a cafeteria? The reusable trays, the handles on the refrigerator cases, the exchange of money, the tables, hell even the food itself if it’s not cooked to the proper temperature…Not to mention all of the other sick people in there. Sheesh.

I know that in the health care we are forced to find creative ways to do more with less time (and I also understand that people gotta eat), but I don’t think salmon with a side of soiled linen is a viable solution.