Sick policy vs. reality

Nurses General Nursing

Published

I'm curious how other institutions handle staff illnesses, particularly colds and the flu.

I work at in an HCA hospital in the OR. According to policy, we are not supposed to work while sick, and they administer flu shots. However...

My HCA facility uses a point system to record absenteeism and tardies. If a person calls in sick 4 hours or less before their shift, 2 points are counted against you. If you go into work but leave within 4 hours of your shift, 1.5 points are counted. If you are late 1 minute - 2 hours, 1 point. No show, 2 points. 7 points and you're fired. Points are erased after 1 year of the incident. Points are 'reviewed' during annual evaluations.

My HCA facility does not have paid sick leave. Employees have to use their PTO, automatically deducted. If the person doesn't have PTO, then they don't get paid. Vacation time can only be awarded if the person has sufficient PTO.

My HCA facility also gives bonuses to employees who do not call in sick for the year, awarded every summer.

So...it's that time of the year where even my manager comes to work sick to preserve their PTO time, possibly get a bonus, and avoid racking up these dreaded points. This policy particularly hurts single parents because they often call in sick for their kids, and end up working sick to minimize their penalty points.

I understand that calling-in is often abused and a fair system is needed. I was wondering what other people have experienced, and what has worked. I also don't know if this point-system is throughout HCA.

BTW, I'm writing this sick. I caught it from either my manager or another sick co-worker.

How much PTO do you get each year? One employer I know of gives only 15 days per year. Another gives 20 days. These both make you take vacation, sick time, and holiday time out of your PTO. When you're used to 3 weeks vacation and about 13 or 14 days per year of sick days, and about 14 holidays per year, in separate banks of time, it is really a shocker to get so much less.

With HCA, just call off sick way before the 4 hour rule takes effect if you are sick enough to call off.

Generally it can be said that sick leave policy is very hypocritical.

ThePrincessBride, MSN, RN, NP

1 Article; 2,594 Posts

Specializes in Med-Surg, NICU.

^^^

"Only" 15 days? My job awards 10 days and that must cover sick and vacation time.

I hope to leave my place of employment for that reason within the next year or so.

My unit allows only five occurrences in a rolling twelve-month period. After eight, you are terminated. No exceptions.

cleback

1,381 Posts

I find the sick call system for healthcare workers particularly broken. I work with ill coworkers all the time. It's for reasons you mentioned-- not wanting to accumulate points on their record and use their PTO. At my organization, full time workers can call in four times a year without penalization. those with kids, though, tend not to want to use them for their own illness but wait until the kids are too ill to go to daycare or school.

Its a jacked system. I'm surprised more patients don't get sick/er from us.

rquinn0111

20 Posts

New, full-time HCA employees get around 7 PTO hours per pay period. So roughly 1 day off per pay period, there are 26 pay periods in a year so, 26 PTO days/year. Part-time earn less PTO hours. More experienced employees (+10 years) get around 10 hours of PTO per pay period. There is a cap as to how much a person can accrue (somewhere in the 400's). Once a person hits that number, they cannot accrue more PTO. They can sell it to another employee of equal status at a fraction of its worth.

Sick time, vacation time, and holiday time are all considered PTO.

Calling in before the 4-hour mark is key, even if it means waking up our manager at 2 am for a 6 am shift. Unfortunately, you better not discover you or your kids are sick within that window.

The people whom I've seen fired due to too many call-ins have all been parents of young children and one pregnant woman.

Specializes in ICU.

We can call in three times with no consequence - the third time is a coaching and counseling, which is a paper that isn't disciplinary action but lets us know that the next one will be a verbal warning. The fourth time is a verbal warning, fifth time is a written, and the sixth time is termination.

Two days in a row count as two days. Greater than two days in a row just counts as two days. But still - having one illness take up 2/3 of the call outs we're allowed in a year is ridiculous.

I have called in exactly twice in two and a half years. Once in 2014 because I had norovirus, and once in October of this year because they put me on a day I couldn't work and I couldn't find anyone to switch with me. I don't want to risk calling out unless it's a dire emergency, just in case I do actually get sick enough to miss two consecutive days in a row. I have gone in with all kinds of viral/bacterial things. I usually wear a mask and frequently bleach down the pod where I'm sitting in addition to frequently washing my hands.

They make us take our PTO if we call out sick, which I think is ridiculous. It's my money, I should be able to choose whether I use PTO or just don't get paid, but that option is not offered. I would rather have my PTO for days I want off.

nutella, MSN, RN

1 Article; 1,509 Posts

New, full-time HCA employees get around 7 PTO hours per pay period. So roughly 1 day off per pay period, there are 26 pay periods in a year so, 26 PTO days/year. Part-time earn less PTO hours. More experienced employees (+10 years) get around 10 hours of PTO per pay period. There is a cap as to how much a person can accrue (somewhere in the 400's). Once a person hits that number, they cannot accrue more PTO. They can sell it to another employee of equal status at a fraction of its worth.

Sick time, vacation time, and holiday time are all considered PTO.

Calling in before the 4-hour mark is key, even if it means waking up our manager at 2 am for a 6 am shift. Unfortunately, you better not discover you or your kids are sick within that window.

The people whom I've seen fired due to too many call-ins have all been parents of young children and one pregnant woman.

I worked at places where they have a separate illness bank, PTO bank for vacation and "days off" and an extended illness bank - typically with this model, you accrue some hours per week for PTO and some for sick time and a small amount for the extended illness bank. However, there were still very strict rules on "calling out" and those rules are usually set by HR with the manager keeping track of it. In one place, people would get called into the office after their second "unplanned call out" to be informed and discussed as 4 "unplanned call outs" per year would lead to a termination of employment.

They also would educate new employees on the fact that they are responsible for child care and child care back -up plans and that winter weather is not an excuse to call out.

I also worked for employers with a different system - one of them has a "combined time bank" which sounds like your model. You accrue more hours per week, which is more compared to the divided model but you have to use your time for everything from illness to vacation and potentially holidays - there is still a separate extended illness bank. Of course this system gives an incentive to people who do not call out sick but it can also mean that people who have a chronic illness use up their time because of illness and not for vacation - with this model I also signed up for short-term disability insurance, which is not that cheap but necessary imo (though there can be stipulations that you cannot use it the first year or similar).

I never encountered your point system though it sounds fair to me as it gives clear guidelines and rules.

Every employer has some rules and if they want to terminate somebody they have to keep track of absences and they have to do that for everybody - not just one person. One way to proof that is to use a system like the one you describe. Once a person is terminated based on evidence - even if they go to a lawyer it will be hard to make a case because they are tracking all employees and do not single out the parents for example.

Having children is a personal choice and if you have children and work, you need to ensure that you have some kind of system in place for times of illness, school vacations, and school closing (especially in winter). Some employers offer some back-up services and have some contract with agencies that you can call "last minute" if your babysitter calls out sick or the daycare is closed or such to get a replacement (for which you have to pay of course but perhaps a contracted better rate).

Here is an important piece of advice for anybody who has a dependent who has a chronic illness / serious illness that does not require a block of time to be taken off but single days because the illness can get acute suddenly or such. Even if you have lets say a child that has chronic illness, you always come to work, now it gets worse and you need to take time off as single days because you child wakes up sick and can't go to daycare/ school/ etc and you may have to take your child to the ER. If you are in a situation like this and you have been with your employer for at least 12 months and work in a benefited position - you need to apply for an intermittent family leave under the FMLA to be protected from getting terminated. If you do not have this in place and you call out - even though with valid concerns - they will terminate you. But if you have a FMLA in place for intermittent leave - you are protected. It is a lot of paperwork and once you are approved you have to report every absence that falls under the FMLA and it gets tracked and the MD who fills out the paper has to estimate what the amount of absences a month is most likely to occur. But - if you adhere to the rules there is nothing they can do about it. Of course, if you call out "sick" for somebody else or yourself 5 times in one month they can still let you go eve though have have a FMLA in place if you do not show for other reasons.

You cannot get it because your child has a cold or such - there are valid reasons and it needs to be approved - typically a chronic or serious illness and you have to re-apply every 12months.

I am a very reliable employee with children (who are now grown up) but when one of my children started to get sicker due to a chronic illness with exacerbation, I applied for an intermittent FMLA to be protected against termination for calling out for this exact reason.

It will also not change that your coworkers, though perhaps feeling sorry for your struggle, may also feel resentment when you call out unplanned a lot. And typically "having children" is seen as a personal choice that does not qualify you for preferred time off during holidays or school vacations...

macawake, MSN

2,141 Posts

We can call in three times with no consequence - the third time is a coaching and counseling, which is a paper that isn't disciplinary action but lets us know that the next one will be a verbal warning. The fourth time is a verbal warning, fifth time is a written, and the sixth time is termination.

Two days in a row count as two days. Greater than two days in a row just counts as two days. But still - having one illness take up 2/3 of the call outs we're allowed in a year is ridiculous.

It is my belief that this type of system encourages or even forces employees to work while sick. This of course means that you risk passing on your infection to both patients and coworkers. That's a flawed system. I feel that it's a system that penalizes someone for becoming sick. Nurses are often in contact with sick and infectious patients (duh! :facepalm:) so it seems ridiculous that a risk you're subjected to at work, can lead to disciplinary actions and even loss of employment.

I'm a Scandinavian nurse and the policy at my hospital (it's the same at any healthcare facility) dictates that in the case of for example a norovirus infection, I not return to work for 48 hours after the last symptom (emesis or diarrhea).

As a Scandinavian I enjoy the protection of a very generous social safety net. In 1938 a law was passed that mandated a minimum of two weeks paid vacation per year for all employees. In 1951 it was changed to three weeks and in 1963; four weeks. The current law is from 1978 and specifies a minimum of five weeks paid vacation per year. Since the law only mentions the minimum an employer can offer more if they want to. I have six weeks paid vacation per year.

Vacation time and sick leave are two separate things. There is no set amount of sick days allowed and you can't get terminated for having "too many" sick days or occasions (unless you have a repeated number of absences and fail to provide a physician's note that shows that you were indeed sick). So if you're seriously ill you can be off sick for the entire year, and still have your job when you return.

We are also allowed to stay at home to care for a sick child if needed. You receive ~80% of your regular pay for a maximum of 120 days per child and year. Again, this is also separate from vacation time and your own sick days.

Of course I realize that this is a very generous system and I appreciate it. To me it's wrong that a nurse can be put in a situation where the choice is to either risk infecting vulnerable patients with for example the norovirus or face disciplinary action, up to and including termination.

klone, MSN, RN

14,790 Posts

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

The people whom I've seen fired due to too many call-ins have all been parents of young children and one pregnant woman.

For pregnant women, they should use FMLA to protect them (if they qualify for it).

In Oregon, there is a law called "Family Sick Leave" where if you're calling in sick for a child illness, it can't count against your "points".

klone, MSN, RN

14,790 Posts

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

My facility also does the point system for unplanned call-offs (including illness). However, they seem a lot more lenient. If you call in sick multiple days in a row, it just counts towards one point (but if you're absent for 3 or more shifts in a row, you need a doctor's note to clear you before you can return to work). 5 points is a verbal, 8 points is a written, 10 points is a suspension, 11 is termination. It goes in a rolling calendar year. If you go 4 pay periods in a row with perfect attendance, one of your points is dropped.

And as I said above, calling out due to a child illness does not count towards points accrued.

We also have a generous leave policy - it's all PTO, but I think nurses start at something like 25 days/year. We also have an extended illness leave bank that people can draw from after at least 3 days out in a row.

LovingLife123

1,592 Posts

My facility also does the point system for unplanned call-offs (including illness). However, they seem a lot more lenient. If you call in sick multiple days in a row, it just counts towards one point (but if you're absent for 3 or more shifts in a row, you need a doctor's note to clear you before you can return to work). 5 points is a verbal, 8 points is a written, 10 points is a suspension, 11 is termination. It goes in a rolling calendar year. If you go 4 pay periods in a row with perfect attendance, one of your points is dropped.

And as I said above, calling out due to a child illness does not count towards points accrued.

We also have a generous leave policy - it's all PTO, but I think nurses start at something like 25 days/year. We also have an extended illness leave bank that people can draw from after at least 3 days out in a row.

I'm on a similar system. We are also paid our holidays in PTO time. If you work the holiday, it's time and a half, plus PTO. If you don't work, you get the straight PTO. I earn 5 hours each pay period in addition for PTO. I earn more the longer time I put in. It actually works out pretty well.

The occurrences are not counted in our review unless we accrue more than the five.

CrunchRN, ADN, RN

4,530 Posts

Specializes in Clinical Research, Outpt Women's Health.

Reality is we all work sick. It is PR BS to say you can succeed and take sick time.

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