Calling in sick, staffing issues

redhead_NURSE98!, ADN, BSN · Sep 24, 2012

I feel like once a month is excessive for 12's....I only work 12 days a month for heaven's sake! But if you're sick you're sick. I am one of those that has to be vomiting or bleeding out the eyeballs to not show up. Different people have different ideas of sick though, if they feel they can't do their job properly I suppose they should stay home.

wooh, BSN, RN · Sep 24, 2012

Gee, working with a bunch of sick people, in a stressful job...

It makes me think about something I learned in my nursing pre-reqs. Something about the immune system?

I'm not a fan of those who come to work sick. Since they're in the nurses station with me, a place that should be "safe," using the phone and computer keyboard that I'm using, touching the doorknob to the med room that I'm using, it's the staff that I catch things from much more often than patients.

I distinctly remember a person being convinced to come to work with strep. Guess who had strep the next week and had to call if for two days to cover the time she'd be contagious? Yep, that was me that had the JOY of strep, the cost of the antibiotics and the doctor visit, and had to burn two days of PTO because a staffing person convinced a nurse to come to work sick.

Now that I've been exposed to everything known to man short of ebola, I rarely get sick. But right now I'm nursing a cold that I'm pretty sure I caught from my husband who's pretty sure he caught it from his coworker.

Thank goodness that coworker didn't call in sick! Otherwise I'd be missing the delightful tooth pain I've got from the sinus pressure. And I've really enjoyed getting almost nothing done this weekend because I'm miserable and trying to kick this thing before my next class.

chevyv, BSN, RN · Sep 24, 2012

Many staff call in sick at my facility because they have tried in the past to get a day off and staffing denied. After so many denials to use personal, vacation, or holiday time, people just started to call in sick. Sometimes staffing just refuses to work with nurses and support staff and this is what happens.

WhereIsMyCallBell · Sep 24, 2012

I worked the short term skilled wing at a LTC faclity for 2.5 years. How I lasted that long I'm not really sure. It had to have been the patients and the experience I was gaining while taking care of them. I'd only been a nurse for just over a year when I took that job on. Some evenings I would be driving home as I swore I was having a stroke probably should not have been driving. That just how stressed I was sometimes by the end of my shift. 24 patients, most were 2,3 days post op like you said. Hospitals, or should I say insurance companies are discharging patients way before they are ready! Us nurses working the skilled wings in LTC are an extension of the care that these patients would have abd SHOULD HAVE still been receiving at the hospital. VERY sick and unstable patients would be admitted to my wing and no, no, no sending them out and back to the hospial heaven forbid (so to speak). Seemed to me the most extensive and complex patients would arrive for admission Oh around 6 or 7 pm on Friday nights, usually at shift change. *come Monday AM I would get questioned as to why I didn't punch out at 7:30 when my shift was over, Another heaven forbid if the nurse coming on had to help finish the admission Arrrggghhh! I stuck it out for as long as I could, got some experience and asta la vista baby!! BTW I called off twice the whole 2 and a half years and haven't been the same since. For a while I was so burnt out, resentful and felt so broken mentally and emotionally. Considering looking for a career doing something other than nursing. Those days when I felt like crap, had an ear infection, bad cold... I should have stayed home. i was so busy taking care of others I forgot about me. The same handful of people, whether they were CNA's, LPN's or RN's called off time and time again. Quite often they would come back the next day with no evidence of being sick enough to call off. That may sound a bit judgemental but was my observation and my assessment skills are very good ha! Ok I think that was way more than my two cents. :arghh:

WhereIsMyCallBell · Sep 24, 2012

Oh and one other thing after a yr. of employment we were paid for one day sick time per YEAR. While all other sick hours were accrued and could be used only after three years of employment. When I left there I had something like 174 sick hours accrued that I could not use, nor get paid for when I left WoW..

PennyWise · Sep 24, 2012

I am a Pittsburg Pirates fan. Not a very good team, but they do their best with what they have. Unfortunately, a culture of losing has taken over the organization. At times, it seems the baseball gods are making it their creed that we never become winners. It doesn't matter how much talent we have on the field, how hard they play, how well the manager manages or if the GM is making the right moves or not. We lose, either way. Only thing that changes is how bad we look while we are losing.

I think LTC has a "culture of burnout" much like my favorite baseball team has a culture of losing. LTC facilities foster an environment that promotes poor moral, burnout and poor coping mechanisms. Some people cope by being married to their jobs and letting their personal lives fall apart. Others turn to drugs and/or alcohol. Some lose their compassion or motivation and stop trying to make things work. The list of symptoms created by the LTC working environment is endless.

Yes, excessive call offs and having to take a "mental day" every single month is one of many coping mechanisms nurses in LTC rely on. This is, of course, assuming the call offs are simply mental days, as you seem to believe they are. When being critical of this behavior though, keep in mind the essential point they teach you in nursing school when you are dealing with an individual who is relying on "Ineffective Coping Mechanisms". That point is: Do not take someones coping mechanism away from them without giving them an adequate replacement. It's a nice way of saying "Don't take away the drug addicts drugs unless you can treat the withdraw."

So, I understand you think the behavior should stop. What do you propose to do about it? How can the environment be changed in such a way that the "mental days" are not so necessary? You made it clear there are many nurses doing it, so I can't help but draw the conclusion that its the system, not the people. This is not a case of nurses being lazy or selfish, as you implied (maybe unintentionally). This is a case of a facility wearing down its staff to the point where they have to take extreme measures to protect themselves.

Even if you worked with each individual nurse and gave them counseling to the point where they could handle the environment as is, it'd have to be an ongoing process. You'd have new nurses coming in who would need counseling, most of the nurses already there would have to continue theirs............

Or, you could change the environment so that it is not so toxic. Sort of take a "Treat the disease, not the symptom" approach. I'm sure the administration of the facility are well aware of the problems and how to fix it, but they don't. [nudges shoulders] I wonder why? I'm willing to guess its because they are not willing to spend the money it would take and they, to put it bluntly, are not interested in being that invested in the patient's care or their employee's well being.

So, the problem continues on, with the symptoms being held in check by attendance policies. Its the cheapest, easiest solution. To sum it all up: The problem is the facility and it's lack of compassion (for both the patients and it's workers), not the nurses who are put in a position of having to take mental days.

allnurses Guide · Sep 24, 2012

How hard does the facility make it to take a PTO day in advance? I am dismayed to find at my current position that taking a day of PTO requires nothing short of a miracle. There is always a claim of being too short staffed to allow it. But we have not hired anyone and the staffing ratios are what they are, all the time.

As long as people aren't allowed to plan ahead for days off they are going to be left with no choice but to use their PTO as call-outs.

joanna73, BSN, RN · Sep 24, 2012

At my facility, we are allowed 1.5 paid sick days per month. Some people take advantage of this, some don't. The work load is heavy, and there is a lack of team work. If management was truly plugged in to staff concerns, the sick calls would decrease.

CT Pixie, BSN, RN · Sep 24, 2012

How hard does the facility make it to take a PTO day in advance? I am dismayed to find at my current position that taking a day of PTO requires nothing short of a miracle. There is always a claim of being too short staffed to allow it. But we have not hired anyone and the staffing ratios are what they are, all the time.
As long as people aren't allowed to plan ahead for days off they are going to be left with no choice but to use their PTO as call-outs.

My first year at my LTC facility I was allowed a week off (not paid as I opted for the no benefits/PTO). I didn't take that week AND I worked extra shifts (even shifts not on 'my' time) and I came in earlier so that the nurse I'd be replacing could leave early for whatever reason and I stayed late to cover for the oncoming nurse (we aren't talking 1/2 an hour we are taking several hours).

Toward the end of my 2nd full year (again, I hadn't taken my week off for this year either and continued to work extra shifts, go in early and stay late) I had requested that I be given a week off vacation (which in actuality was only 2 days as I only work 2 days a week). I made the request FIVE months prior in writing and in person to the person who approved time off/PTO(due to me having made the flight reservations and booked the hotel for me and my family). I was told he would 'try' to get me that time off but couldn't guarentee it! WHAT?! You're getting FIVE MONTHS notice. You better figure it out and get me those TWO days off (and it was a week not even during the busy vacation times nor did the time include a weekend shift). Told him...look...I'm NOT going to be here on XXX days...be that either by YOU giving me that time off or me TAKING it..but either way, know that I will NOT be here.

BrandonLPN, LPN · Sep 24, 2012

I work at a union facility and we have a sick time bank (separate from vacation time). I accrue 4.5 hours of sick time every two weeks. As long as we have the sick time available we can call in. Anything over two consecutive days requires a doctors note. But, if I collected enough sick time in my bank, I could call in once a week for a year and there is absolutely nothing management could do about it. Many nurses do this. My own policy is that I make sure to have about a week worth of sick time in my bank in case of true sickness. Once I get eight hours over this, I call in. So, yes, I do call in about once a month. I feel zero guilt. This is time I have EARNED and am entitled to use however and whenever I want. One of the many advantages to working in a union.

NursesRmofun, ASN, RN · Sep 24, 2012

Working in Nursing seems to be, IMO, very conducive for call ins. There is high stress everyday in most nursing jobs. I think some nurses think it is better to call in than quit. And I guess they are right.

NiteNurse212 · Sep 24, 2012

I work the skilled re-hab side in LTC. I have been there for 8 months. We do 5 eight hour shifts. I work midnights. We get some very sick patients...like others have said, patients who seem too sick to be there. It is stressful and a very heavy work load. I have been sick more since I started working there than ever before. I've had upper respiratory infections, bladder infections (holding that pee!), pink eye, stomach virus, etc... I always wash my hands, and wear gloves into every room I go into. I am saying don't be too quick to judge. Why do most people assume you aren't really sick when you call off? Some people do get sick more often than others. I don't feel comfortable taking care of very sick people when I am ill. Having said that, I have worked when I did not feel well, and probably should not have been there. I hate to leave my facility short-staffed. I have worked and asked someone else to take the more acute patients for me, while I took some that were less vulnerable to illness. It is very easy to point a finger and judge if you are fortunate enough not to get ill very often. When you are in the position of deciding whether or not to go to work sick, risking making patients and co-workers sick, missing a days pay, and having managment angry at you...it's not so easy. I also fear making an error if I am ill and not as sharp-minded as I need to be. It really is a no-win situation.