Preventing call-ins

Kooky Korky, BSN, RN · Feb 13, 2017

Our facility has a pretty lenient policy, yet I think it weeds out the people who are habitual caller-offers. In a rolling 12-month period, if you have 5, it's a verbal; 8 is a written; 10 is suspension; 11 is termination. Multiple shifts in a row is counted as one absence. After 3, you need to get a doctor's note before returning to work.
You need to enforce it. A lot of managers don't.

This sounds lenient in today's work world.

As for selling back sick time - our place would pay you 1 day for 3 days' of sick leave. I never thought that was a very good deal, especially since we could carry unlimited sick leave on the books.

We were allowed to donate sick leave to a pool and those who had extended illnesses could theoretically receive these donated hours of sick leave. We were not allowed to designate who received our donated hours or ever know that our donations had been awarded. There was some speculation that the hours went to those who were not seriously ill (like with cancer or something serious or even terminal). I never donated, given the above circumstances.

Preventing call-off's - have a lenient, reasonable sick policy, have a great workplace where people are not abused.

mushyrn, BSN, RN · Feb 13, 2017

There is no attack on anyone. (Seriously? LOL.) If you are sick and can't come to work I get it, but this is something that only happens like once a year. And there is a difference between not feeling well and being sick. You might not feel well but you still need to go to work. There are people relying on you. 90+% of call ins are not because somebody is too sick to work anyways. I'm reaching out to a community of nurses to see what their policies and procedures are on call ins. What have they initiated to stop/prevent them, etc. So if you can't/won't answer or just want to post something pointless just move on. If you're truly nurses I don't get why you'd waste not only my time but yours.

I'm sure this attitude on the units does WONDERS for morale. I'd be on indeed.com in a second, bye!

And who who are you to determine how often your employees get sick? Life happens.

OliverElio87, BSN, RN · Feb 13, 2017

Have you spoke to your CNA's? In my hospital the PCT's are extremely overworked (sometimes have 15+ patients in an acute care setting) and only being compensated over minimum wage. On top of that some nurses won't even answer call lights and I just see them on their phones. However, if you have an awesome nurse who is willing to help it makes things run so much better.

So I would say burnout is a big factor. That's why there is such high turnover for pcts at our hospital.

calivianya, BSN, RN · Feb 13, 2017

Enforcing the attendance policy works.

We had blatant abusers of the call in system at my first job, for just the reason you're scared to enforce it - small applicant pool, etc. However, that makes people feel comfortable not showing up whenever they don't feel like showing up.

My current workplace enforces it very thoroughly. Four call ins in a rolling year is a documented oral warning, and seven is termination. However, nobody gets to seven because one documented oral warning makes the employee unable to transfer departments for a year and also ineligible for any raises or bonuses that year, so hardly anyone calls out four times.

A lot of people toe the line and stay right at three call ins, but you better believe they keep track of it and don't call out again until a previous call in falls off. We have a policy that if you stay at least two hours you get credit for being there, so some people will even come in with the flu/norovirus/etc. and stay until 9 PM just so they get credit for coming to work.

Also, being a manager with a sense of humor that makes people actually want to work for you helps.

Here.I.Stand, BSN, RN · Feb 13, 2017

As for how many times per year I personally am legit sick: let's see, this year I had a GI virus 3x, flulike sx once, pneumonia once, and once where I had general malaise which happened to include muscle weakness and a sensation of being sunburnt. (Not all of those resulted in call-offs, as I work part time. Some of those happened on my days off.) And I had a sick child home on a day my husband was unable to stay home (like it or not, my employer has scores of RNs. His only has one CFO, and if he is travelling that day, figure that out) twice. That wasn't an issue of little Johnny having a tummy ache...it was an issue of my tough-as-nails teenaged endurance athlete being so miserable she was CRYING "Mommy please don't leave me." The other was my 3- and 5-yr-olds vomiting. (Actually that could have been for me too, as I had been up q1-2 hrs all night cleaning up said vomit.)

Here's the other thing: I do not consider myself a special snowflake or anything. If any of my colleagues were in a similar situation I want them to take care of themselves or their child.

A couple of times a year I'm usually good for a sinus infection -- read, living in face pain, sometimes for weeks. I do not call in for that because Sudafed, ibuprofen, and APAP takes the edge off.

But only sick once a year? Remember developmental psych class? The notion that I need only be sick once a year borders on what child development experts call "magical thinking." :sarcastic:

amoLucia · Feb 13, 2017

Something I just posted in another thread made me think and although not something NMs have control over or that could be changed easily but I wonder if more places offered PTO instead of sick time if the call offs would be less? Personally I have called out a couple of times in the past decade when I was totally disgusted and planning to quit a job because I wanted to burn through some of my many sick hours but if I could have cashed out when I resigned like with PTO I wouldn't have taken off.

When I worked with Civil Service, it was common for employees to 'cash out' UNUSED sick time and vacation time as they were terminating their positions. Vaca time was usually used as earned, but some folk had MONTHS worth of sick time.

There would be employees who could be dead-on-their-feet with something clearly communicable (respiratory or something GI AEB the # of bathroom trips). One could only hope that said employees were handwashing often! Yet they would come to work with no concern re disease transmission AND then they would piss & moan all day about 'oh, how sick they were'. Well, stay HOME! NOTE: these were NOT clinical hospital/institution workers.

But nooooo. Sick time was usually quite liberal under the union contracts and was cumulative. And it could be banked and 'cashed out' upon exiting. Yes, I understand that this was a union-negotiated benefit that truly was a benefit. And it WAS earned. But it was grossly abused. If I remember, I think Gov Christie or somebody tried to introduce action to curb the abuse. I suspect any legislator would lose union votes or there would be other union resistance.

To read about some of the prohibitive P&P some places have implemented to restrict employee sick time is truly sad. Just another example of employers trying to 'thumb down' nursing. (Don't get me started on my soapbox!)

MrNurse(x2), ADN · Feb 13, 2017

Life lesson #1: sometimes call outs are unavoidable. CNA's are not as fortunate to be able to afford childcare, so unbudgeted childcare d/t child illness results in a call out. Some of us are fortunate enough to have relatives who are stay at home, but that diminishes as income diminishes. Being able to call for help is not always a luxury.

AliNajaCat · Feb 13, 2017

That is definitely most of the problem. I just got a job as a nurse manager at a facility new to me. Our policy is that after so many call ins/write ups it's termination. I'm honestly a little scared that if we fully enforced the policy we would have to fire a good chunk of our staff and being in a smaller, rural town in Iowa we struggle to find applicants.

Well, if the town is that small, they might struggle to find other employment, right? And having "fired for cause, attendance policy" on your reference sheet isn't anything to be proud of no matter who you're working for.

See about giving incentives for good attendance, too. Maybe award an extra vacation day or an extra holiday shift off for no call-outs in six months, won't cost the facility much but might keep people on the straight and narrow.

Ruby Vee, BSN · Feb 13, 2017

OP never came back? Obviously she thinks she knows best how to fix her call in issue. Why bother posting a question when you don't care for answers that aren't your own? I smell troll. This thread should be closed.
Even if the OP was a troll or simply someone with her mind already made up and determined not to consider any alternatives, the thread serves a purpose. Maybe someone else had the same question but didn't get around to posting it, or maybe it makes folks think about how they use their sick time and why. No reason to close a thread just because a troll started it!

AliNajaCat · Feb 13, 2017

I'm with the PTO thing. People plan vacations, and if they see a sick day would take away a day of vacation, they think twice.

OrganizedChaos, LVN · Feb 14, 2017

Only sick once a year?
Haha... Yeah, wouldn't that be nice.
I have a child in daycare. Kids in daycare are incubators of disease. Since the fall, I've probably gotten every single bug he has... literally once a month. Some are just the sniffles and do not meet criteria for calling off. Others have been fevers above 101 and GI issues. Fortunately, I work part-time, so I haven't had to call off that much, but still... And I am a "healthy" person without any medical issues.
You are the reason medical staff come to work sick. Try actually providing coverage for earned sick time instead of pushing people toward unsafe behavior.
Sorry, touchy subject... currently sick and not feeling the greatest.

I couldn't agree with this more. My son is in daycare & I swear every little bug he had I got but I got even sicker than he did. If I was working I would've had to call out due to those illnesses. I swear this has been the worst winter ever in regards to me getting sick. I don't know if there were more bugs or if it's because my immune system isn't as strong because I'm pregnant.

NicuGal, MSN, RN · Feb 14, 2017

I always read these type of threads and it amazes me that people think management can just hire PRNs or more people for coverage. Like the old lady in the commercial says "It doesn't work that way". As an ex manager, I couldn't just take it on to hire more people, that comes from above, and they really aren't going to if the problem is habitual calling in.

Go to your HR manual, read it. Copy the policy, post it all over including the bathroom, email and make sure to have a meeting to talk about it. Then follow it. It is never easy to fire someone, but after a couple, people will sit up and get it.

And don't be defensive, snarky etc. You have to be matter of fact. You aren't there to be their best friend, you have to do what is right for the unit. I always knew which ones were the ones who were really sick and the ines that had a pattern. Stick to your guns.