Excessive Absenteeism in the Nursing Profession - page 3

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... Read More

  1. by   KelRN215
    It is not a problem in my current work environment.

    It was a relatively minor problem when I worked in the hospital but, in my opinion, the policy was extreme. I had a colleague, a great nurse, who was disciplined for excessive call-outs (3 in a rolling 3 month period, she had fewer because she was part time) when they were all for legitimate reasons like having to attend a funeral, an illness in a child and having a concussion. I don't remember the details because it was a long time ago but she was told that she couldn't advance to a level 2 staff nurse because of this. She had been employed by this hospital in some capacity for 17 years and left shortly after this happened.

    When I worked in the hospital, I had the experience a few times where I requested a day off way in advance and was put on the schedule for it anyway. I had no problem calling out for those shifts. I told you 2 months ago I wasn't available this day so now it can be your problem day of for not planning appropriately. Shortly after I gave my notice at my hospital job, my best friend's father died unexpectedly of a heart attack. I was scheduled to work a night shift day of his funeral. I found someone to switch with me but my manager denied the switch for a stupid reason. I had 0 Fs left to give at that point and no qualms in prioritizing my best friend over a job that I was leaving in 3 weeks.

    Since leaving the hospital and switching to M-F positions, the only times I've ever had an unplanned absence were when I got stranded somewhere because of snow in my home state. I got stuck in Miami for 2 days, for example, on my way home from Ecuador because there was a huge blizzard that dropped over 2 feet of snow over 2 days.

    The reason it's not a problem in my current job is because of the incredible flexibility we have. My 4 colleagues and I each have a patient assignment of around 20-25 patients who we have to see once/month. We schedule our patients ourselves and can work from home on days that we don't have any appointments. If I had something contagious, I wouldn't call out. I would reschedule any patients I had on that day since my patients are medically fragile children and a cold can land some of them in the hospital and work from home. Plus since my employer uses a PTO system, I never want to call out. I want those PTO days for vacation, not to sit at home because I feel a little under the weather.
  2. by   Katillac
    Why, why why did I click on this article3? I KNEW it was going to be one of those bad nurses pieces.

    Conspicuously absent from the list of reasons for excessive absenteeism are exhaustion, depression, anxiety, burnout and a host of other conditions caused by the crushing working conditions nurses work under. For the OP, the job has zero relationship to the employees' health. And that list of problems the bad nurses supposedly cause by actually taking the PTO afforded them? ALL caused by managements' failure to staff appropriately to cover the absences the employees are entitled to, not the nurses who actually take the PTO.

    And seriously?
    "Nursing is not just an 8 or 12-hour job, but a career that requires 24-hour accountability."
    I'm sure many employers would love to exploit that commitment on the part of their staff. But too many employers have broken that social contract by requiring nurses do ever more with fewer resources and failing to be accountable themselves. So no, not anymore. Management loves to wail and say, "But what about the paaaaatients?" If they cared about the patients they would put in place conditions that would enable them to hire sufficient coverage for short notice call ins, plus sensible and consistently applied PTO policies.

    My being accountable 24/7 looks like taking care of myself and setting healthy boundaries, including mental health days when I need them. I know it would be more convenient for management if I just work until I collapse at the nurses station and they can then hire another warm body to take my place. But I still have more self respect than that.
  3. by   FolksBtrippin
    Just stop.

    People call out when they are overworked. You have it backwards.

    Hire enough staff. Treat staff well. Give staff the time off that they need.
  4. by   HomeBound
    Quote from Katillac
    Why, why why did I click on this article3? I KNEW it was going to be one of those bad nurses pieces.

    Conspicuously absent from the list of reasons for excessive absenteeism are exhaustion, depression, anxiety, burnout and a host of other conditions caused by the crushing working conditions nurses work under. For the OP, the job has zero relationship to the employees' health. And that list of problems the bad nurses supposedly cause by actually taking the PTO afforded them? ALL caused by managements' failure to staff appropriately to cover the absences the employees are entitled to, not the nurses who actually take the PTO.

    And seriously?
    "Nursing is not just an 8 or 12-hour job, but a career that requires 24-hour accountability."
    I'm sure many employers would love to exploit that commitment on the part of their staff. But too many employers have broken that social contract by requiring nurses do ever more with fewer resources and failing to be accountable themselves. So no, not anymore. Management loves to wail and say, "But what about the paaaaatients?" If they cared about the patients they would put in place conditions that would enable them to hire sufficient coverage for short notice call ins, plus sensible and consistently applied PTO policies.

    My being accountable 24/7 looks like taking care of myself and setting healthy boundaries, including mental health days when I need them. I know it would be more convenient for management if I just work until I collapse at the nurses station and they can then hire another warm body to take my place. But I still have more self respect than that.

    Brava, Katillac!! Much more succinct and razor sharp than I managed with my tirade earlier.

    I am all done with this mantra of these managers with the "you are a nurse 24/7" garbage, the ones who prioritize an employer who would walk over their dying body to make a hot pocket, who criticize the ones who want a BALANCE in their home and work lives.

    I am not a Nurse unless I am being PAID TO BE ONE. If I followed that logic, if I would quit my nursing job and return to SAHM, I am still a Nurse, responsible to the board? UH....NO.

    I understand OPs frustration with perhaps someone on her crew who abuses sick time. I also have left a job over several of the senior nurses taking 2 hour lunches, falsified documentation and management covered up for them, called in routinely just an hour before shift start....and I voted with my feet.

    I think the problem you have right now OP is that your list lays all of the blame on the staff's doorstep, ignoring any reasons why the morale may be so low, while suggesting harsher and harsher punitive measures to FORCE nurses to comply.

    Let's go with that. Let's fire them all. Every single one that steps ONE TOE out of policy. And hey...since you are making the rule that policies must be followed to the letter or else....that means no more slack for 2 hour lunchers who are BFF with you as NM, or Nurse Joe who got a flat tire and had a sick kid and then had the gall to get the flu all in a 3 month period!

    See where this gets you? Heavy handedness is not the solution. Admitting, as I had a NM do when I left one place....that the NMs are FINANCIALLY INCENTIVIZED to sqeak thru with minimal staff and resources, it comes to them at the end of the year as BONUSES.

    This isn't a secret. The problems with understaffing and burnout are directly related to call outs. Either real physical injuries occur or mental health injuries occur. Then it trickles down to patient care. Mistakes that can cost far more than hiring 1 extra nurse or keep PRNs on call.

    I will suggest several solutions.

    1. Make it mandatory that a Nurse Manager must declare if his or her performance is awarded by financial bonuses and if part of that performance involved coming in "under budget".

    2. When a nurse signs a contract and agrees to hours, those hours remain set in stone unless and until renegotiated by nurse and management. No more of this "needs of the department"--- because clearly, admin either forgot deliberately or never experienced the needs of the department from a floor nurse perspective.

    3. When a nurse calls in sick, the manager must make every effort to replace that nurse whether with staff, floats, PRN or local travelers. Not this "hey call the nurse sick line" and leave a message for some faceless clerk, and the nurse manager throws over her shoulder on her way out for the evening "btw...sally is off sick. You have to divide her assignment. Have a great night!"

    If the Nm cannot find a replacement, said NM must stay and take over Charge duties so that Charge can take an assignment. Then deal with the call out nurse the following day in an appropriate manner.

    4. Ensure coverage for lunches and breaks. Make it an offense that a nurse sits at the station eating their dinner or punches out "no lunch". Again, the managers sit all comfy in their back offices with the mental mantra of "i did my time out there. I get to sit down and rest" No. If you expect it of your staff, you should be expected to be able to perform every duty on that unit that you demand from your staff.

    5. Absolutely punish the offenders and abusers. Not arguing against this. But you also have to make this and Equal Opportunity Punishment for others, who NMs may "favor" or even the NMs themselves. You break policy? You go down.
    **i expect the most howling on this last one, because we ALL have made mistakes and forgotten policy and were forgiven. But hey. OP wants to bring back the stocks for having the gall to be tired or sick and being a nurse while human.

    Good management doesn't need harsh punitive measures, is what I am getting at. Increasing the stress and fear level will only accelerate your unit's spiral down into "all traveler" status. BTDT.

    My director who put her butt into scrubs and worked assignments could code pts right along with me, knew exactly where supplies were and never did I question when she asked me to come in...."is this just her short staffing and covering herself?" When this woman asked, I and many others dropped everything and were there for her. She didnt abuse us and she was right there in the trenches. Not armchair quarterbacking.

    She didnt have problems attracting and keeping staff. Another hospital i wanted to get into, but never, ever seemed to have an opening in the unit I wanted...I was told there is a waiting list to get into his department, because he has turned that ED around. Nobody but insiders might be able to transfer someday into his unit.

    Its possible. When NMs aren't paid off to screw their staff over, things improve. When the budget is spent on the ACTUAL needs of the department, instead of hoarding it so the NM can pat herself on the back and cash her fat bonus check...things improve.

    When NMs send out memos that we are using too many glucostrips (someone actually counted them, pulled charts and allotted one strip per ordered POCT and came to the brilliant conclusion that there is no way 200 glucostrips were used on 82 patients. I can't even.), or we will not be receiving our raise collectively because some tech crushed a zoll by accident on a gurney....this is where you get abuse of call outs and quitting at a moments notice, leaving everyone to scramble.

    The NMs and admins can come clean about the budgets and this incentivizing short staffing. If I am wrong, please managers, step in and speak up. The silence and absence of certain individuals on AN who routinely denegrate and flog nurses for daring to call out or prioritize their safety in disasters....where are those managers who looooove to tell us how important they are and how this could never happen in THEIR perfect departments?
  5. by   Leader25
    You're saying :"am a 10 year Registered Nurse with experience in Med/Surg, long-term care, Hospice, and Rehabilitation. I have held multiple leadership positions and recently graduated with a master's degree in nursing education"


    Boy I can see a mile away the team you playing for.
    How much solid experience could you possible have with only in ten years and mostly spent five different units and multiple leadership positions.
    Although I believe "leadership positions" is a glorified word for lazy,do nothing,sit in your office shopping on computer and going to "meetings"where you are fed,hydrated while your staff can not even go to the bathroom.

    And oh yes you mention discipline, most of the ones abusing sick time are your own favorites,your friends.

    Yes and I know about your sick time use policies all arbitrary and the counseling part where you go and tell nurses "dont get sick" like we have any control over family death,flu, pulled muscles,foot problems,diarrhea.
    Let me just stop now.You will never be on the staff side,too busy doing your "termination" of sick people.
    Last edit by Leader25 on Sep 25 : Reason: edit
  6. by   Sparki77
    I too am sick & tired of management's war tactics. Either they forget where they came from or were never in the trenches in the first place.

    To the nurses who see through this facade & posted here, bravo! To the pencil pushers you can kiss my a$$.
  7. by   umbdude
    My first RN job was plagued by call-outs and it's because nurses were overworked. It had a negative impact on other nurses because we had to pick up more patients (there's no forced stay). I was only there for 6 months, but during my last month there, at least 1 RN called out every shift (no joke). I couldn't get out of there quick enough. It's not just RNs, when techs called out, the useless management made us pick up their tasks too.

    I had zero negative feelings toward the nurses who called out. They made it clear that it was due to stress and burn out. I 100% feel them. Sometimes they request the day off well in advance and managers put them on anyway. duh.

    Incompetent management and profit-driven companies are the problem, not nurses.
  8. by   Katillac
    Can I get one of these for Nurses Week, please, or at least an amen?
    beatings-jpg
    Like HomeBound, I have worked for bosses I would have walked through fire for, never mind work an extra shift. But when you have a NM who leaves on a Friday with multiple holes in the schedule for the weekend with a fuill house and knowing the nurses are mandated to stay until replaced - well, that doesn't inspire much motivation.
  9. by   billswife
    Quote from Nurse Beth
    I think employers should offer mental health days for nurses. No blame, and not subject to discipline.
    My husband works for a telephone company, and they have "personal days" with no questions asked.
  10. by   billswife
    Quote from rearviewmirror
    Pfffff! Piece of cake! When there's short staff, make the ADMINISTRATORS run the floor!
    Might be bad for patient outcomes.
  11. by   morelostthanfound
    Quote from Leader25
    You're saying :"am a 10 year Registered Nurse with experience in Med/Surg, long-term care, Hospice, and Rehabilitation. I have held multiple leadership positions and recently graduated with a master's degree in nursing education"


    Boy I can see a mile away the team you playing for.
    How much solid experience could you possible have with only in ten years and mostly spent five different units and multiple leadership positions.
    Although I believe "leadership positions" is a glorified word for lazy,do nothing,sit in your office shopping on computer and going to "meetings"where you are fed,hydrated while your staff can not even go to the bathroom.

    And oh yes you mention discipline, most of the ones abusing sick time are your own favorites,your friends.

    Yes and I know about your sick time use policies all arbitrary and the counseling part where you go and tell nurses "dont get sick" like we have any control over family death,flu, pulled muscles,foot problems,diarrhea.
    Let me just stop now.You will never be on the staff side,too busy doing your "termination" of sick people.
    ^^^^^This is the absolute best post in this thread and no truer words were ever spoken-perfect, major kudos, and a huge thank you from your comrades in the trenches for telling it like it really is. Bravo!!
  12. by   Flatline
    Wow, these articles really do spawn debate. Well done OP!
  13. by   SisterofMary
    Quote from Nurse Beth
    I think employers should offer mental health days for nurses. No blame, and not subject to discipline.
    Nurse Beth...this would be awesome.

    I wish this were the case. However, I feel like, at least in my facility, the nurse that comes in no matter how fatigued, how tired, how sick, is the nurse that is revered and is being a "team player." And the nurse that calls in, "leaving the floor short," is looked at negatively. No one wants to hear at the start of shift that a employee called out. However, sometimes, you do need a break and I wish that could be recognized.

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