charge nurse tried to make me go to work with allergic reaction

[thanx2mj]

So today I accidentally ate something that had sulfites in it, and I am allergic to them. Luckily, I'm not so bad off that I immediately go into shock, but I had to take a ton of antihistamines, far more than usual, with the blessing of my allergy doctor, to stay out of the hospital. As of right now, I still don't feel well and am displaying mild allergy symptoms.

I called in to work, today was to be my first day by myself as a CNA. While on the phone the charge nurse belittled my decision to stay home because of my allergies and the heartburn that was accompanying them. I was not thrilled that she wanted me to list so many symptoms and even less than thrilled when she belittled my decision and acted put out that I was not coming in.

My previous allergy doctor (I just moved, he is in another state now) ordered me to NOT work when displaying out of control allergy symptoms--even more so when I accidentally consume sulfites or naproxen. My last two employers would not let me work at all with an allergic reaction, no matter how mild (one was a hospital, the other a law firm). They did not want to deal with the liability or the potential of me being taken out on a stretcher to an ER.

I told several family and friends about this and their recommendation was to go to HR to ask how much should be disclosed to my immediate supervisor, since the charge nurse was so rude about it and expected me to come to work while barely able to function.

I am wondering...would going to HR be a good idea, or should I just go to my supervisor? I carry an epi pen in my purse at all times and am supposed to wear a medic alert bracelet that states I am allergic to sulfites and naproxen. I've also been hospitalized twice in the last 6 months for my allergies, so my allergies are no laughing matter, and I really did not appreciate being belittled over them.

I also disclosed to HR that I have serious, potentially life-threatening allergies upon hire. So it is not like HR is unaware.

[nursemike, ASN, RN]

You didn't mention the type of facility where you work. I work acute care in a hospital, and if one of our aides calls off, it's a pretty big bummer, but not the end of the world. In LTC, it could be a lot closer to the end of the world.

I do charge part-time, and I've taken a number of calls. I've called off myself from time to time. I wouldn't belittle anyone, but more than once I've said, "Feel better soon," hung up and thought, "Yeah, right." I do get a bit pushy, any more, with staff, especially nurses, who call off late with non-emergent problems. What I expect, and what I recommend, is that if you think you probably can't work, call off in time that I might be able to replace you. It isn't always possible, and it's rarely convenient. I work nights, so I'm getting call offs for days. If you go to bed feeling awful, but think you might be okay in the morning, it's a big pain to wake up at 0300 or so to decide whether to call off. But doing so is shouldering some of the responsibility for your problem, rather than dumping it all on me at 0500.

Stuff happens. I've gone to bed fine and woke up at 1700 at death's door. Or felt like it, anyway. Allergies don't schedule themselves as well as they might. Generally, making the person calling off feel worse isn't that helpful, although sometimes CNs are pressured to do just that, and I'm not a bit shy about letting you know you've left us in a jam if it sounds like you could have called earlier. A new person, especially, might not realize how they could have mitigated the problem.

I wouldn't want you coming in loaded up on antihistamines. If you fell asleep at work, you could get fired. If you fell asleep on the way to work, you could die. Either way, I still have a staffing problem. But as a healthcare worker, you do have more responsibility than a burger-flipper or a bank president. You need to be very careful to avoid allergens, and not just for your own sake. If there is any way you can manage to schedule your anaphylaxis for a day you're off, that would be the responsible thing to do.

Feel better soon.

[JerseyBSN]

The charge nurse was only concerned with working short not with your health. You were correct to call in, you were correct to stay home. I'm sorry it happened to you on your first day working as a CNA. Life happens. They'll get over it.

[GooeyRN, ADN, BSN, CNA, LPN, RN]

I don't care someone's reason for calling off sick. WHY can't employees be trusted to know if they are too sick to work or not? That is my beef. How does someone REALLY know how someone else feels, or the potential risk they may be? I am assuming we are adults... If you feel you are too sick to work, then you are too sick, period. No one else should be determining whether you are sick or not. What is this, second grade where your mommy decides if you are too sick to go to school or not? You should be able to call in and say "I'm sick. I will not be at work today. I will return to work tomorrow." END OF STORY. Maybe if you are nice, you can throw in what you are sick with. I do not think that is necessary, though. No one should judge (other than your medical doctor) if you are too sick to work or not other than the employee themself. I don't think it is the supervisors/charge nurses whoever answers the phone's business WHAT the employee is sick with. AND it is certainly not appropriate for them to tell you to come in anyway. I think if the employee is contagious, they should know enough to not come back until no longer contagious. WHY can we not trust employees to call off when sick and to not abuse calling off? WHY not trust people until they give you a reason to not call off. Sure, it doesn't look good calling off on your first day. You know that. But you know what? Things happen. Such is life.

oh, and food allergies are no laughing matter. So many people think of itchy watery eyes and a stuffy nose/sore throat, or minor upset tummy/vomiting/diarrhea. That would be a minor reaction, and I really like to think that most people would NEVER consider calling off for such a minor thing. My son has a peanut allergy- and guess what- if HE was exposed to peanuts I would be calling off work, since there would be a good chance of him going into anaphylaxis. It is pretty hard for some people to work when their eyes are swelled shut, are wheezing, and feeling like they can't breathe. I think that warrants a call off IMO. Who really wants to work after mass doses of Benedryl when you feel all foggy and drowsy, even if the symptoms are under control? Would you want someone taking care of you or your loved one like that?

[nursemike, ASN, RN]

My instructors have stressed that an allergic reaction is one that causes anaphylaxis, everything else (like an upset stomach) is an adverse reaction or side effect, not a true allergy.

Is this what you guys have been taught/believe/practice as well?

There's a spectrum of symptoms from sniffles to cardiac arrest/respiratory failure that are true allergic reactions, and my understanding is that any allergic reaction can progress down that chain, so you could, in theory, die of hay fever. Some do seem more apt to do so. A latex allergy, for example, can progress from a rash to the ICU on a vent pretty suddenly. A bee sting might make your arm swell one day, but next time could be lethal. Hay fever usually just makes like unpleasant but I've never heard of anyone dying from it, although a couple of times I might have welcomed death.

But I have listed codeine as a med allergy doing admissions when the reaction was "nausea." Or morphine for "drowsiness." Call me an optimist, I still explain to the patient that that isn't a true allergy, in the forlorn hope that one may eventually believe me.

[TheMoonisMyLantern, ADN, LPN, RN]

Also, when it comes to call outs. Instead of getting angry at the person calling out, get angry at the fact that perhaps if administration had the foresight to either have a PRN float pool or to keep it adequately staffed then call outs wouldn't cause as much stress.

Nurses can do a great job at taking of people, but we often do a lousy job of taking care of ourselves and our own.

[Pepper The Cat, BSN, RN]

WHY can't employees be trusted to know if they are too sick to work or not? That is my beef. How does someone REALLY know how someone else feels, or the potential risk they may be?

Because every place has that nurse that calls in sick every Friday evening. We have one that calls in sick on the Sat and Sun of the long weekend but can work on the Monday that is time and a half pay.

Or you get the person that calls in sick for a day shift but then comes in talking about the party they went to that same night.

If someone who hasn't even started working yet calls in sick, it just raises some flags.

[GooeyRN, ADN, BSN, CNA, LPN, RN]

Because every place has that nurse that calls in sick every Friday evening. We have one that calls in sick on the Sat and Sun of the long weekend but can work on the Monday that is time and a half pay.

Or you get the person that calls in sick for a day shift but then comes in talking about the party they went to that same night.

If someone who hasn't even started working yet calls in sick, it just raises some flags.

So why not make THOSE nurses justify their call off's? Or why not just fire them? There are a ton of new grads out there that would LOVE to be dependable workers. Do we need to treat every nurse like a 2nd grade kid trying to get out of school just b/c there are a few bad eggs? Just get rid of the bad eggs.

[TheMoonisMyLantern, ADN, LPN, RN]

So why not make THOSE nurses justify their call off's? Or why not just fire them? There are a ton of new grads out there that would LOVE to be dependable workers. Do we need to treat every nurse like a 2nd grade kid trying to get out of school just b/c there are a few bad eggs? Just get rid of the bad eggs.

Well said.

[hiddencatRN, BSN, RN]

Because every place has that nurse that calls in sick every Friday evening. We have one that calls in sick on the Sat and Sun of the long weekend but can work on the Monday that is time and a half pay.

Or you get the person that calls in sick for a day shift but then comes in talking about the party they went to that same night.

If someone who hasn't even started working yet calls in sick, it just raises some flags.

Those nurses get fired pretty quickly at my hospital.

[nursemike, ASN, RN]

Also, when it comes to call outs. Instead of getting angry at the person calling out, get angry at the fact that perhaps if administration had the foresight to either have a PRN float pool or to keep it adequately staffed then call outs wouldn't cause as much stress.

Nurses can do a great job at taking of people, but we often do a lousy job of taking care of ourselves and our own.

At my facility, we have to let PRN staff know by 0500 if they won't be needed. We're semi-rural, so if we waited much later, a lot of people would be en route by the time we tried to call. Or census might be down and we're overstaffed, then someone calls off after we've given two others the day off.

I agree that people should be treated like adults. But if three people are calling off with hangovers from the same party, it could just be that treating them like adults means terminating them. I'm not saying that applies to the OP. In fact, in my previous (unlicensed) job, I called off during my probationary period with a fever the doc attributed to "a virus." I knew I was contagious, and I figured I didn't really want a job that would fire me for doing the right thing. Now, as a nurse, I'm older and under a lot more stress, and I find myself yet again on the first step of progressive discipline for absences. As I said, stuff happens. I don't usually get grilled about a reason, I usually volunteer a generic one: sick, Dad's sick, sewer backed up, etc. A lot of the dayshift CNs are friends, so I'm often inclined to share vivid details, especially if it's a GI issue. Because I'm sure they would want to know.

[Jenni811, RN]

Ummm... sometimes you need to... like when exposed to allergens that cause severe rxn. Often the recommendation may be up to 4x what the OTC bottle says. Everyone reacts differently though. 100mg of benadryl doesn't make me sleep. But the FAA won't let a pilot fly a plane on that.

Unless OP was having mental effects from the antihistimne, OP should have gone to work despite feeling crummy. I'd have to be incapacitated/incompetent d/t illness (or contagious) to miss my first day!

Um...wrong!!! there is NO reason you should take "A ton" because "a ton" refers to 2,000 lbs. I dont care if your dying from a peanut allergy, there is NO doctor in there right mind that would prescribe 2,000 lbs worth of antihistamines. And i know she may have been exaggerating a touch, because clearly she didnt take 2,000 lbs (i know that). It's the fact that she needed to exaggerate to get out of work.

Because if someone told me "i took A TON of antihistamiens" then i would probably say don't come to work.

But if someone told me..."I took 2 antihistamines" then i would say "Come to work."

To me, it just sounds like she exaggerated how much she took to get out of work.

[Pepper The Cat, BSN, RN]

Those nurses get fired pretty quickly at my hospital.

We've been told you can't fire someone for being sick. They can monitor it and we do have sick time program - unfortunately, they only monitor the full time people who get paid for sick time. They don't care about the part timers who call in sick and don't get paid.