Counseling Staff Members On Sick Leave

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by k1p1ssk k1p1ssk, BSN, RN Member Nurse

Specializes in pediatrics, school nursing. Has 11 years experience.


I am in a tricky situation - I have a staff person who was recently diagnosed with a stage 3 cancer. She had a major surgery around 3 weeks before the start of school and just had her first round of chemo this past week. Myself and the admin assistant have been frequently reminding her that she needs to take whatever time off she needs, sort of silently encouraging her to independently come to the conclusion that she should take her FMLA and invoke her ST disability insurance.

She was initially optimistic about how chemo would affect her as she basically had no side effects on the first day after, however through the weekend she was in intense pain and she decided to take today and tomorrow off in hopes that she can return on Wednesday. I don't know what her chemo schedule is like yet (I don't know that she knows yet either), and as we all know there are lots of other appointments and treatments etc. that goes along with such a serious diagnosis.

We are very concerned now that if she is to have weekly treatments, she may only get one good day a week, and we really don't want her to feel like she needs to spend it at school. In reality, she may just need to take that day to rest as much as possible to prepare for her next treatment!

Selfishly, it would be a lot easier to know that she won't be here so we can try and hire a long term sub. We love this woman dearly and we just want her to realize that her health should be her priority right now. I have been asked to have a heart to heart with her about it, and I just have never had to counsel someone this way before and feel a little uneasy. Has anyone else been in this position personally or professionally? 

LikeTheDeadSea, BSN, RN

Specializes in School Nursing. Has 6 years experience. 650 Posts

I would be clear that any conversation with her is with your "friend" hat on and not your "employee of same location" hat, since essentially you're being asked to discuss her employment status. Maybe a discussion with her direct administrator and someone from HR who can discuss what going on FMLA/ST really means can help her see what her options are clearer. 

JenTheSchoolRN, BSN, RN

Specializes in School nursing. 3,029 Posts

I'm curious as to why you have to have the heart to heart talk? Is this as a friend? Or as a co-worker?

Due to COVID, the line blurred a bit for staff and me re: health care advice. Because of it, I was becoming the person they asked questions that they needed to ask their PCP and also I entered HR territory, which is murky water indeed. I'm trying to navigate this back (with full support of my admin, who keep telling staff I am not HR, please talk to HR). I'm just urging you to be cautious here on the HR end. If you are approaching this 100% as a friend, great. But with the piece re: it being easier for a sub, that is territory for her direct supervisor and HR. 

k1p1ssk, BSN, RN

Specializes in pediatrics, school nursing. Has 11 years experience. 697 Posts

I would definitely come at it from the friend angle and not the HR angle; she is such a team player and she already feels like she is letting us down, I know she is trying to push through to be as helpful as she can be, but also to try and stick to some semblance of normal. Beyond the cancer diagnosis, she has had an extraordinarily tough year thus far. 



Specializes in NICU, PICU, Transport, L&D, Hospice. Has 43 years experience. 9,457 Posts

If you are going to approach her as a friend do it off work and off work property. Recommending FML and STD shouldn't be offensive.  Maybe she doesn't know that she can take that FML in chunks. 

lifelearningrn, BSN, RN

Specializes in School Nursing. Has 8 years experience. 2,534 Posts

We have an administrator with stage 4 cancer diagnosed toward the end of last school year. She comes to work when she feels up to it. Early on, we might have seen her once a week, this school year she's been coming in almost daily. Maybe not first thing and maybe not the whole day, but she comes most days and does what she can. 

Some people don't want 'lay down' and take it.  If her doctor allows, and she really wants to try and work as much as she can, I wouldn't stand in her way. 

scuba nurse

scuba nurse, BSN, MSN, RN

Specializes in School Nursing, Pediatrics. Has 32 years experience. 622 Posts

As someone who had cancer and underwent chemo, while trying to keep my job as a school nurse, take the cue from her as to what she wants. During this time there is so much uncertainty and you have no control over anything, this might be the one thing she can control, and it may help keep her mind off herself, sometimes just trying to keep things "normal" (like coming to work) is what she might need for her mental health (assuming her doctors have given the OK to work, and she feels up to it). 

k1p1ssk, BSN, RN

Specializes in pediatrics, school nursing. Has 11 years experience. 697 Posts

The administrative assistant; She was in no way asking me to ask our colleague to take FMLA or STD, just to check in and make sure her head was in the right space. I don't think I'm going to speak with her about this unless she approaches me and specifically asks my opinion. I agree that this may be the one thing in life she feels she can control right now.

She texts me updates almost daily and I continue to reiterate that we will be OK without her in the building and that she should take all the time she needs and just let her know that we will support her no matter what. 

Thanks everyone!

CrunchRN, ADN, RN

Specializes in Clinical Research, Outpt Women's Health. Has 25 years experience. 4,447 Posts

I wouldn't touch that conversation with a 10 foot pole unless she opened that door herself and asked your opinion. So many ways it could go wrong and/or be taken wrong.



57 Posts

My brother was diagnosed with stage 4 lung cancer and continued working through all his treatment until 2 months prior to his death.   His bosses' loved him and supported him throughout his illness.  Please, be her friend and support her -  work may be the only normalcy she has at this stage.   If she cannot perform her job, it would be up to management and HR to advise her.    



3 Posts

I worked full time through my treatment for stage 3 cancer, including chemo, surgeries, radiation treatments, more surgeries. I had chemo every three weeks; my treatments were on Wednesdays and was back to work on Mondays. I took FMLA in chunks and never ran out. 

WE ARE ALL DIFFERENT. Some people are knocked flat by cancer treatments and simply must take months off work. Others, like me, do pretty well. Working helped me feel normal and kept my head in my job, not just sitting around at home thinking about cancer. My boss was an absolute prince and supported me in anything I wanted to do. 

Please examine your motives carefully. Do you truly want the best for this nurse or are you really just worried about the smooth running of the unit? Let this employee know you support her decisions and will work with her, no matter what. Don't make her feel like she's being pushed out or you'll be defending yourself in HR.

Edited by WhirlyGirlNurse