To Work or Not to Work: When Should Nurses Call in Sick?
By Melissa Wirkus Hagstrom, contributor
We all know the feeling: first comes the slight tickling in the back of the throat, next the nose begins to drip, and finally the fatigue sets in. While an approaching illness does little to conceal itself, many working healthcare professionals are left unsure as to when they should be calling in sick for work. How sick is too sick when it comes to caring for patients in a hospital or other medical setting?
There may not be a clear-cut answer to this question, as it depends on a variety of factors including the symptoms and circumstance, said David Kuhar, MD, medical officer and infectious disease specialist with the division of healthcare quality promotions at the Centers for Disease Control and Prevention (CDC).
Yet, Kuhar pointed out, there are a variety of symptoms that nurses should not ignore when they start feeling ill.
“First and foremost, it’s important to notice symptoms that are not normal,” he explained, adding that fevers, a generalized body rash, a cough or a gastrointestinal illness are some signs that it might be a good idea to stay home. “I think there are a wide variety of symptoms that could indicate that you shouldn’t be going to work.”
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Nurses working in the hospital setting should leverage the many resources and contacts available to them to help determine whether it is safe to come into work or not. For example, many employers offer occupational health services that nurses can tap into to discuss their symptoms and decide whether a cough is their baseline asthma flaring up or a contagious cold or infectious disease. Your human resource department or travel nurse agency can also help make sense of sick leave, benefits regulations and other logistics.
Health experts agree that nurses should avoid coming to work while sick, an occurrence that’s been identified as “presenteeism.” Not only does working while sick make you less productive, but it can pose a significant risk to patients and cause illness to spread among colleagues and other hospital staff.
Nurses who work with patients who are immunocompromised, infants, diagnosed with cancer, or have recently undergone an organ transplant should be especially diligent when it comes to staying away from work while sick. These patients can be more susceptible to illness and may be at greater risk for having diseases transmitted to them than most.
“Ultimately or ideally, you don’t want anyone who has a potentially transmissible infectious disease to provide patient care,” Kuhar said. “Sometimes there can be low staffing or other factors, but hopefully, we can shift job responsibilities some days so someone who is sick is not in contact with patients.”
In fact, according to a recent report published in the JAMA Pediatrics, 8 out of 10 doctors and advanced practice clinicians refuse to call in sick to work. Although there are many factors that cause clinicians to care for patients while ill--including insufficient sick leave, fear of consequences for calling in, lack of staff coverage and strict attendance policies--many states and employers have bolstered their sick leave benefits to employees.
As of 2015, a law was passed that entitles every employee who works in California for 30 or more days within a year to paid sick leave.
For nurses who are feeling slightly under the weather but have determined that it is safe to report to the workplace, Kuhar recommends using extra precautions such as ensuring adherence to hand hygiene, implementing “cough etiquette” (i.e., covering your mouth and nose fully while coughing and/or sneezing) and wearing a facemask when going to see patients. These simple safeguards offer an added measure of protection to help avoid the transmission of illness and disease.
“It’s really important that all healthcare workers, not just nurses, are very aware of when they might be ill and that they try to handle that appropriately. If you do think you are ill, make sure you take the measures to ensure that you don’t transmit your infection to one of your patients,” Kuhar concluded.
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