Nurse, we insist you come to work sick. For the good of the patients.

By March 24, 2016Advocacy, Nursing

This actually happened today:

Mini rant: I’ve got influenza A. My boss asked if I was still coming to work tomorrow. I was sent home yesterday after an hour, came home and slept all day and all night. Went to urgent care, they took one look at me and sent me to the ER where I received IV hydration and 2 breathing treatments, plus meds for my pleuritic pain. I texted my boss and let him know what was going on. He goes “we really need you to come in tomorrow because 3 people are out on vacation“. So, I guess I’m going in tomorrow, flu and all.

Yes, you read that correctly. She required medical intervention including IV hydration and nebulizer treatments.  sicknursetemp

The supervisor in a healthcare environment told a nurse to come to work anyway, and expose her patients to Influenza A.  These patients could be immunocompromised, frail elderly, vulnerable children, or pregnant women.  Perhaps the strain is one not covered by the flu vaccine, and contagious to literally everyone.  Either way, we are not at our best when we are ill.  Patient care will suffer.  You may make a medication error because of confusion secondary to hyperthermia.  And all that.

Every single day, nurses are strongly ‘encouraged’ through guilt, restrictive attendance policies, and frank threats to come to work sick.  This phenomenon is known as presenteeism.  Great article here.  I work for the federal government now, and get 12.5 days per year of sick time. When I worked in the private sector, I could have been written up for five absences in a year. We work in an environment which pretty well guarantees that we will be constantly exposed to nasty viruses, and missing five days out of 365 is considered serious enough for disciplinary action.  Even if you pick up 2 shifts a week; Because helping out your understaffed department is never taken into consideration when you get a few absences. For that matter, with many employers if you call in sick on a Monday, drag yourself into work on Tuesday, and are just too sick to work on Wednesday, you are charged two ‘absences’ when you would have been charged one if you stayed home for three days in a row.  

Because, healthcare organizations make total sense.

I am going to present this to you, again.  I am not going to stop saying it either.flu

You, Nurse are not responsible for the failure of your organization to develop and implement a staffing plan for dangerously short-staffed periods.  They can pay agency staff, period.  Your employer demanding that you expose vulnerable patients to your plague is inappropriate and an extremely poor business practice. 

You are not abandoning and/or neglecting your patients because you have the flu.  You are a patient today.  You drive a regular car and live in a regular house.  You are not driving a Maserati and vacationing in Monaco.  That is because you do not own the place.  The people who own the place are responsible for the staffing level, and having a plan to staff the facility if absences happen.  Also, perhaps they should not have approved vacation for three people during the same week. As the old saying goes, “Poor planning on your part does not constitute an automatic emergency on my part”.

Stand together, direct patient care staff.  We have to make these companies responsible for their own business, their own staffing, and their own conscience.  

Here is a handout from the CDC to give to your employer the next time they tell you to come to work with the flu.






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Author Janie Garner

More posts by Janie Garner

Join the discussion 9 Comments

  • Richard Harman says:

    Stay Home tomorrow, and get well soon! I loved this article. Coincidentally my employer scheduled me to work tomorrow (the first of what was already scheduled to be three days off – and sorely needed – to finish recovering from an acute bout of venous stasis with cellulitis of my LLE that’s been being treated with antibiotics, elevation, ice, Ted hose and as much rest as possible), because of “unavoidable” short staffing. So, knowing I needed the time off to effectively recover was outweighed by their need to fill the schedule. I respectfully declined and begged them to arrange for another person to work. I’ll be staying home tomorrow too. And the next two days as well – so I can be that much closer to 100% on Monday.

  • Sarah Mott says:

    For a short time, I worked for a facility that would write you up if you called out on a weekend, I guess, because we should know when and plan when we are going to get sick. Unacceptable!

  • Mica Harris says:

    Did you know that after a stem cell transplant, patients need to be re-immunized? This includes all immunizations that are required from birth. So when you do not immunize your children, people like my mother are at risk for serious health issues.

    This is one example of patients affected by nurses and healthcare workers who come to work sick. This infuriates me! Great blog, Janie.

  • Scott Nations says:

    yes last year I missed many days due to illness I really believe was stress induced from a poor and way understaffed work environment, I also had a broken wrist and needed six weeks off because they would not let me work while in a cast although I begged – I had to use FMLA – and that got used up I was told by the director that my FMLA was use up and found out later that was not true so I failed to get my DR to fill out then myriad of forms thinking it not applicable , so I ended up being written up and my punishment is “if a miss one more day in one whole year – yes year even if my absence drop off on a rolling calendar and I have zero – so I have to come to work sick and have several times – the stress of this is hard to explain – I am 55 – what if I have chest pain at work – I get fired – what if my 8 y/o son gets hurt or sick and needs me I have to make a choice my job or my son – such a horrible policy – this is a huge Health Care Corporation-

  • Sundi says:

    I thought this only happened where I work. I was forced to come to work with CIDP (chronic guillain barre) that I contracted after a Tdap shot that they forced me to get when I was exposed to a patient with pertussis even though I had a Tdap a few years prior. My boss knew that I had to be off every 3rd Friday for IVIG infusions, but often failed to cover my shift. It got to the point where the doctor I work for was taking vacation days on my infusion days just so I could get them off. There were a couple of times when I tried to call in and she told me there was no coverage and then during the workday, I would pass out from autonomic dysfunction and then she would be mad at me when she had to send me home. I could not win and the real kicker is, she NEVER turned it in to Worker’s Comp and I got stuck with all those bills. IVIG infusions are about $10,000 each and I had 15 of them. She has made me work through kidney stones & gallbladder attacks. Earlier this month, I worked 2 weeks straight while wearing sunglasses because I had an intractable migraine due to a high SED. When patients asked, I told them the truth…”my boss made me come in and no she doesn’t care that I am vomiting…”. Ironically enough, I went to work this past Monday with an arm splint and sling and after an hour, she sent me home and told me I couldn’t come back until Ortho released me. It’s crazy that I can’t get a couple days off to nurse a cold (which flares up the CIDP), but bruising my ulnar & median nerves in my dominant arm got me a week off. I hope you feel better soon!

  • RehabRN says:

    You work for the feds? Have you served your probation? If so, and you want to prove a point, when you are sick, stay home.

    Not a whole lot can be done if you have proof and are truly sick. Any issues from management warrants a visit to the union rep. Been there done that–came in ill and presented to work. Wore masks as much as I could. Called off sick the second I was febrile. If it cleared, I returned, if not, I stayed home.

    Bosses are paid to staff the unit and as nurses, aren’t supposed to willingly expose patients to staff who they know are sick. Just a little ethical conundrum here to remind them.

    Best of luck and hope you feel better soon.

  • Laura says:

    In the hospital I work at we are ALLOWD 3 sick days a year. Thank you for this article. I will be encouraging co workers to read it.

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