Preventing call-ins

[Brandi,RN]

How do you (attempt) to prevent call ins at work? It's becoming a real problem where I work (CNAs more than nurses), what is everyone out there doing to prevent that? Attendance bonuses, having to work another shift, etc

[TriciaJ, RN]

Enforcing the attendance policy works.

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.

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They come to work with flu or norovirus? Because of an arbitrary sick leave policy? And the rest of the staff don't drop like flies and really mess up staffing?

[Horseshoe, BSN, RN]

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.

You've just named two of the most contagious illnesses we know of. If healthcare workers are coming in while sick with these viruses, there is something seriously wrong with your sick leave policy. This is flat out dangerous.

[Meriwhen, ASN, BSN, MSN, RN]

Actually enforcing an attendance policy. When people know they can abuse it, they will. My wife is running through this right now with the clinic she runs. the person before her let them do basically whatever they wanted.

I agree. If there are no consequences for excessive call-ins, then people are going to keep doing it.

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.

Enforcing the policy will show staff that you're taking it seriously. And if that doesn't get their attention, perhaps seeing someone let go will convince them that it's serious business.

But don't make the policy too rigid. If you give them X call-ins over the life of their employment, that will only lead to disaster. One of the facilities I worked at would allow X call-ins over a rolling 12-month period, so call-ins that were more than a year ago from the current date wouldn't be counted anymore. This would let people who were truly sick take the time off they needed, but also provided protection against those employees who were abusing the system.

[Feelgood RN]

I didn't read many of these replies but the ones I did about policy is probably the best. If you have staff that are willing to talk to you ask why they think people are calling out. Is it because previous management didn't care or because previous management was terrible? Is it because they are having conflicts on the floor?

If you can't figure out what's going on then go with policy. When I started as manager a few months ago here I went to HR for the policy. I had a staff meeting with the policy and announced that any attendance issues up to that point were null. Some people were angry because obviously there were a few that had always called out. I hadn't been the manager and had no control up to that point so any problems from before I treated as hearsay. I had the staff read the policy and sign they'd read it, we had a short discussion about questions of the policy. I have so far had to enforce policy in write up fashion on 1 person, but overall attendance, from what I've heard, had improved.

It sucks going from floor to management and you still want to be cordial and friendly, but now your job is to run the floor. I've screwed up scheduling already and worked a couple double shifts due to call outs and having no PRN backup...learning as I go. I say keep your head up and go with policy. If people know the policy and you enforce it I've seen they calm down.

[sallyrnrrt, ADN, RN]

Brandi, Brandi, Brandi.....why did you never come back to your post? You actually received a lot of experienced advise...

[kalycat, BSN, RN]

I work on a transplant unit. (Pre and post) I will not endanger my patients by working when legitimately ill.

I work part time and then per diem at other facilities because I tend to get bored and burned out and it tends to make me feel that I need a mental health day. I know myself, and if I'm busy and needed and appreciated, I'm less likely to call out. But I also take steps to keep myself interested and engaged.

I have had norovirus (aka two exits, no waiting) and can't imagine working in that condition. I will mask and take prn meds for respiratory stuff within reason, but I will *not* work with GI issues that result in copious quantities of stool and vomit. Just no. I would really appreciate it if my colleagues didn't either. Computer keyboards, voceras, spectralinks... fomite city. Keep your crap to yourself.

We have a fairly generous policy but we also have a single PTO bank. We use a rolling call in policy as well, and I think it is fair - it is also up to the manager to address issues on a case by case basis so that someone with major medical issues (as alluded to above) isn't improperly sanctioned. That said, people experiencing long term or complex illness are encouraged to make use of other options than last minute PTO.

As others have mentioned, morale seems to have a huge part in contributing to call outs - I see it frequently on other units. My home unit has a strong team with strong leadership that promotes transparent communication, individual ownership and ethics, and a culture of civility. We do not tend to have frequent attendance offenders. This is not true elsewhere.

I will text my manager with a note if I have to call out - no gory details but something along the lines of "I'm really sick and can't make it." I do not share personal information with the staffing office when I make the actual call.

We have a large float pool and PRNs so that seems to keep us from working short because someone is sick. There are always overtime hounds as well. I feel like doing everything possible to prevent staff from growing resentful over someone's absence because the "well" employees have to carry an increased load is a key item in positive unit morale. Having worked places where nurses were quite literally at each others' throats convinced me that unit cohesion and teamwork is often sorely undervalued by leadership.

[RestlessHeart]

So many things seem to influence calling in sick a lot. Where I am, with a mix of Nurse and laypeople, it's usually the nurses who call in...a LOT. But, we've also found that if there is any form of confusion or trouble on the floor the amount of call in escalates something crazy. We actually have one nurse who cannot, for the life of her job come to work every day. I dont believe she has worked a full 40 hour week since she started 5 years ago. She misuses FMLA as much as humanly possible. She works half shifts so she can relax at home, she'll leave work early because she has a cold or "flu" but when she gets home will call FMLA and claims her back is spasming.

She causes a fair amount of dissention in the unit. We're a small department and can scarcely afford to be even further limited like this. With her gone so much the work load gets further divided because we have to absorb most of her work as well as our own. It really brings the rest of the unit down and stress levels climb

[Here.I.Stand, BSN, RN]

You've just named two of the most contagious illnesses we know of. If healthcare workers are coming in while sick with these viruses, there is something seriously wrong with your sick leave policy. This is flat out dangerous.

THAT should be the firable offense, to knowingly work with influenza or norovirus. If that was my child in the hospital bed, I might even get Mama Bear enough to contact the BON -- nurse is working while impaired and a danger to patients. At least a nurse working while drunk can't make my child drunk; not the case with norovirus or the flu.

[TheCommuter, BSN, RN]

She causes a fair amount of dissention in the unit.

Your coworker will continue to cause dissension and acrimony in the unit since someone in leadership has obviously allowed her to get away with her antics.

[SmilingBluEyes]

...............and *poof* the OP is gone.

[Kooky Korky, BSN, RN]

THAT should be the firable offense, to knowingly work with influenza or norovirus. If that was my child in the hospital bed, I might even get Mama Bear enough to contact the BON -- nurse is working while impaired and a danger to patients. At least a nurse working while drunk can't make my child drunk; not the case with norovirus or the flu.

I've heard it all now. Drunk is better than flu or noro.

[roser13, ASN, RN]

I've heard it all now. Drunk is better than flu or noro.

Ridiculous statement. Obviously the poster was simply comparing various definitions of the word "impaired" as used in a report to the BON.