Excessive Absenteeism in the Nursing Profession

[MasterStreet]

Is excessive absenteeism a problem in your healthcare setting? First of all, let's

discuss my definition of excessive absenteeism. Of course, absenteeism is the absence of a staff member from a scheduled workday. Excessive absenteeism refers to habitual absences or call-outs by an individual staff member. For example, is there a nursing staff member who calls off from work three to four times a month? When you come to work and learn that someone called out, do you automatically know who it is? Some characteristics of excessive absenteeism include multiple callouts a month, patterned callouts, and always leaving early or coming in late.

Causes of Excessive Absenteeism in Nursing

Illnesses are one of the most commonly used excuses for call outs by nursing staff. The illness may pertain to the staff member, a family member or child, and may be related to either a chronic or acute condition. A few examples of chronic conditions are migraines, back pain, or abdominal issues. Some examples of acute conditions are the flu, bronchitis, or strep throat. Other call-out excuses may include problems with transportation, child care issues, or a death in the family. Most of these issues are excusable and there may even be an excuse provided by a physician. Excessive patterns of absenteeism may be present when the excuses get odd, made up, or overused. I have heard nurses use the excuse that their goat is sick and their dog was giving birth. Sometimes callouts occur based on staffing. If your facility displays the staffing pattern for the next day, nursing staff may call out because they know that staffing will remain adequate in their absence or they know that staffing is already short-handed. The lack of disciplinary action for excessive absenteeism may also be a cause. When staff know that they will not be held accountable or that the disciplinary action will be minor, they continue their behavior. Although we all have to call out at times, excessive absenteeism in nursing can have negative effects on the profession.

How Excessive Absenteeism Can Negatively Affect the Work Environment

Excessive absenteeism can have various negative effects on the nursing work environment and the nursing profession in general. We are all aware of the global nursing shortage, problems of excessive absenteeism only exacerbate this problem by decreasing

what may be an already shortened staffing pattern. Other examples of the negative effects of excessive absenteeism include low staff morale, increased workloads, decreased productivity, disruption of routine workflow, job dissatisfaction, and a lower quality of patient care. Let's take a more indepth look at some of these negative effects.

Disruption of routine workflow:

Nursing staff generally have the same patient assignments, hall, or unit. When another staff member calls out, assignments have to be rearranged to supplement for the absent staff member. This can cause a disruption in your usual routine and the continuity of care.

Increased workloads:

When nursing staff is absent this generally means that other staff members will have more patients assigned to their workload.

Decreased productivity:

Nursing staff may have less motivation resulting in a decreased output of work, which can be costly to employers.

Low morale:

Nursing staff become unhappy and dissatisfied with their job and have a negative overall outlook of their work environment.

Job dissatisfaction:

Job dissatisfaction related to staffing issues and call outs is can be directly linked to high turnover rates.

Decreased quality of patient care:

Patient satisfaction, which is one of the most important measurements for the quality of patient care, suffers greatly when nurses have low morale, increased workloads, and decreased productivity.

Solutions to Excessive Call Outs in Nursing

What are some interventions that could help decrease excessive absenteeism in the nursing profession?

1. A firmly set attendance policy
2. Strict and consistent adherence to the attendance policy
3. Verbal counseling
4. Written write-ups
5. Termination

As nurses, we took an oath to provide good, high-quality patient care to the people whom we deliver care to. A nurse should also be professional, punctual, and a team player because it takes every member of the interprofessional healthcare team to deliver good quality patient care. Attendance plays a huge part in this. We must take into account who might be affected in our absence including your team members, patients, your organization as a whole, and the healthcare system in general. Nursing is not just an 8 or 12-hour job, but a career that requires 24-hour accountability, and excessive absenteeism has no place in the nursing profession.

This article is just some of my thoughts on the issue. Is this a problem in your healthcare setting? What interventions would you recommend to resolve the problem?

[amoLucia]

You shouldn't have to call in sick. You should get an allotted amount of short-notice time-off and that is it. I actually get a week of that at my current workplace and I love it, no excuses and no lies. I use it when I am sick, I use it when I need a mental health day, and I use it when I don't feel like wearing pants that day.

It used to be that Civil Service in New Jersey had 3 'Personal Days' per year in an employee's liberal PTO allowance.

You could call in and just declare the day as 'Personal Day' time. No reasons needed to be given and no advance notice was needed. It was intended for use for those unexpected times.

Those days were precious and guarded not to be wasted

[Aunt Slappy]

These articles..... they read like 5 paragraph essays my kids learned to do in junior high.

Excessive absenteeism is caused by crappy staffing decisions by management. Period. Fatigue, burnout, injuries, and even illness mostly stem from these staffing devisions. Stop screwing your floor nurses in the name of the Almighty Dollar and then berating them when their pillow-fluffing scores aren't high enough, and you'll see attendance improve. CNAs/techs too. You people are killing support staff with the patient loads and physical expectations you dump on them.

[traumaRUs, MSN, APRN]

These articles..... they read like 5 paragraph essays my kids learned to do in junior high.

Excessive absenteeism is caused by crappy staffing decisions by management. Period. Fatigue, burnout, injuries, and even illness mostly stem from these staffing devisions. Stop screwing your floor nurses in the name of the Almighty Dollar and then berating them when their pillow-fluffing scores aren't high enough, and you'll see attendance improve. CNAs/techs too. You people are killing support staff with the patient loads and physical expectations you dump on them.

The general purpose of articles is to stimulate discussion and absenteeism is a topic mentioned often on AN.

So - what would be your solution?

[Jedrnurse, BSN, RN]

"We are all aware of the global nursing shortage."

Sigh. The propaganda continues...

[Aunt Slappy]

The general purpose of articles is to stimulate discussion and absenteeism is a topic mentioned often on AN.

So - what would be your solution?

Already told you.

Stop screwing your floor nurses in the name of the Almighty Dollar and then berating them when their pillow-fluffing scores aren't high enough

[MasterStreet, MSN, RN]

These articles..... they read like 5 paragraph essays my kids learned to do in junior high.

Excessive absenteeism is caused by crappy staffing decisions by management. Period. Fatigue, burnout, injuries, and even illness mostly stem from these staffing devisions. Stop screwing your floor nurses in the name of the Almighty Dollar and then berating them when their pillow-fluffing scores aren't high enough, and you'll see attendance improve. CNAs/techs too. You people are killing support staff with the patient loads and physical expectations you dump on them.

Unfortunately, your comment displays another problem in nursing, "no accountability" not to mention your attempt to insult my intelligence. Professional courtesy in nursing also a problem, I must decide which of these issues I should do a 5 paragraph essay on next.

[brandy1017, ASN, RN]

To Masterstreet you sound like one of the pearls and pump brigade who look down on the nurses who do the actual patient care. Your contempt and lack of respect for nurses is dripping in your comments. I imagine if someone is excessively absent as you describe they are smart enough to be using FMLA which legally protects them from the discipline and termination which you obviously favor. I imagine you are one of the leaders who are not hands on, who do not step in to help the team, just berate them and tell them it's their coworker's fault for calling in when you choose to short staff them rather than hire enough staff in the first place or have a contingency plan in place with float pool or agency to cover call offs as you should, as is your responsibility.

I'm so sick and tired of being told as a nurse I'm too important to dare to get sick or need a day off and too important to go home after 12 hours when they mandate us for 16 hours due to short staffing that is the fault of management refusing to hire adequate staff in the first place and not having contingency staff in place to save money. They know they can't keep us past 16 hours and will have to come up with another arrangement so they should be able to do the same in the first place!

I've been a nurse long enough to know that staffing ebbs and flows and there is always some degree of turnover. Management over the years has used many different methods to deal with staffing from mandation to agency, float pool, weekend program or not, travelers at times, nurses from India at times, to bonus and overtime to encourage staff to pick up. They have many options in their tool belt to cover staff shortages. Yet you want to wring your hands and blame the nurses for daring to get sick or having a family emergency. How dare you! Don't you know you are too important to call off for any reason! Like we are school children, such disrespect!

Since the current corporate takeover staffing has been worse than over because management is staffing for "average" census, not for a full census, which leaves half the night shift mandated if we are full! This is utterly ridiculous! Also, they are extremely slow to hire replacements for all the nurses who have left in droves since Wrongway Regional Medical Center took over. The ICU is in shatters, to the point where the tele floor is routinely getting ICU patients as they don't have nurses in the ICU. I recently had a patient with a glucose almost 1,000! Totally unsafe!

There is no reason management can't hire enough nurses and staff with enough nurses to run a hospital and have a contingency in place for call-offs and people off on FLMA. Let's face it, it is a female-dominated job and many women routinely take 3 months off when they have their children so management should have contingency plans in place already. Don't blame the nurses because you are running too lean and mean and too cheap to hire adequate staff and too haughty to step in and take an assignment!

[MasterStreet, MSN, RN]

You sound like one of the pearls and pump brigade who look down on the nurses who do the actual patient care. Your contempt and lack of respect for nurses is dripping in your comments. I imagine if someone is excessively absent as you describe they are smart enough to be using FMLA which legally protects them from discipline and termination which you obviously favor. I imagine you are one of the leaders who are not hands on, who do not step in to help the team, just berate them and tell them it's their coworker's fault for calling in when you choose to short staff them rather than hire enough staff in the first place or have a contingency plan in place with float pool or agency to cover call offs as you should, as is your responsibility. I'm so sick and tired of being told as a nurse I'm too important to dare to get sick or need a day off and too important to go home after 12 hours when they mandate us for 16 hours due to short staffing that is the fault of management refusing to hire adequate staff in the first place and not having contingency staff in place to save money. They know they can't keep us past 16 hours and will have to come up with another arrangement so they should be able to do the same in the first place!

I've been a nurse long enough to know that staffing ebbs and flows and there is always some degree of turnover. Management over the years has used many different methods to deal with staffing from mandation to agency, float pool, weekend program or not, travelers at times, nurses from India at times, to bonus and overtime to encourage staff to pick up. They have many options in their tool belt to cover staff shortages. Yet you want to wring your hands and blame the nurses for daring to get sick or having a family emergency. How dare you! Don't you know you are too important to call off for any reason! Like we are school children, such disrespect!

Since the current corporate takeover staffing has been worse than over because management is staffing for "average" census, not for full census, which leaves half the night shift mandated if we are full! This is utterly ridiculous! Also extremely slow to hire replacements for all the nurses who have left in droves since Wrongway Regional Medical Center took over. The ICU is in shatters, to the point where the tele floor is routinely getting ICU patients as they don't have nurses in the ICU. I recently had a patient with a glucose almost 1,000! Totally unsafe!

There is no reason management can't hire enough nurses and staff enough nurses to run a hospital and have a contigency in place for calloffs and people off on FLMA. Let's face it, it is a female dominated job and many women routinely take 3 months off when they have their children so management should have contingency plans in place already. Don't blame the nurses because you are running too lean and mean and too cheap to hire adequate staff and too haughty to step in and take an assignment!

No actually, I am one of the bedside nurses who provides hands-on patient care who's tired of picking up the slack for nurses who are habitually absent without FMLA. Thank you

[Aunt Slappy]

Unfortunately, your comment displays another problem in nursing, "no accountability" not to mention your attempt to insult my intelligence.

Let's be clear: I insulted your writing ability, not your intelligence. As to accountability, I'd say brandy here addressed that. Pretty sure her post represents both barrels.

You sound like one of the pearls and pump brigade who look down on the nurses who do the actual patient care. Your contempt and lack of respect for nurses is dripping in your comments........

Don't blame the nurses because you are running too lean and mean and too cheap to hire adequate staff and too haughty to step in and take an assignment!

[brandy1017, ASN, RN]

No actually, I am one of the bedside nurses who provides hands-on patient care who's tired of picking up the slack for nurses who are habitually absent without FMLA. Thank you

You are blaming the wrong people for the short staffing. Management has plenty of options they simply have to hire and spend the money. Truth is it is cheaper to short staff, blame the coworker who calls out, keep the budget low, and cash in their bonus at the end of the year! That is the truth!

[Aunt Slappy]

No actually, I am one of the bedside nurses who provides hands-on patient care who's tired of picking up the slack for nurses who are habitually absent without FMLA. Thank you

That's still a management problem. If they gave a crap about attendance, they'd discipline absentee nurses, up to and including termination. I've seen some insane attendance policies and overly punitive will backfire, but people shouldn't be comfortable with just calling off whenever they feel like it. You're never going to change low quality people, you can only run them off and work on hiring higher quality people.

I still maintain, though, that most employees are good ones and want to be so, but chronic short staffing burns people out and they will call out due to not being able to take it anymore.

[rearviewmirror, BSN, RN]

Pfffff! Piece of cake! When there's short staff, make the ADMINISTRATORS run the floor!