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.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Reality is we all work sick. It is PR BS to say you can succeed and take sick time.

That's not the reality everywhere. I'm sorry you work at a place that undervalues you so much.

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! ) so it seems ridiculous that a risk you're subjected to at work, can lead to disciplinary actions and even loss of employment.

Welcome to the culture of nursing in America/Canada... it's one of the many reasons why we struggle and so many eventually quit. You're lucky you have such rational policies where you live, I wish I could speak the language(s) required to work in Nordic countries. If things are as good as you say where you are, I'd be there in a heartbeat. If you don't mind me asking where are you exactly: Sweden, Kingdom of Denmark, Norway, Finland, Iceland?

In Canada, we all work while sick... For the most part, taking a sick day is discouraged and your employment is threatened. So, Nurses who are young, old, pregnant... doesn't matter. You're expected to show up, slap on a mask and work.

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.

The US is notorious for its backwardness in this department and its lack of health care availability for all. I guess Capitalism is the trouble.

I have never heard of even doctors and military personnel getting more than a month vacation. Regular people get maybe 3 and I'm sure many get far less than that.

Specializes in LTC, Rehab.

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.

The thing I hate about policies like that are that they're 'one size fits all' - they don't allow for the reality of 'life happens'. There's a difference between people who are late, or don't show up, or have to leave early, who do it for real, unavoidable reasons, vs. those who make things up, or just don't care. Yet with a rigid point system, it doesn't matter which one of those 'types' you are.

Specializes in Urgent Care, Oncology.

At my last job, we received 5.7 PTO/Sick Days per year. Yep, 5.7 days total. No paid holidays, the only holidays that were observed in the clinic were Thanksgiving and Christmas but again, not paid - just off. This was a huge reason why I left. To conserve our PTO/sick days, we were expected to work out our schedules with each other so we could block time off to not work. That's great when you have co-workers who will work with you, but towards the end of my employment the new hires realized that they could use this to their advantage, and I ended up with an awful schedule despite having seniority and being the only clinic employee that had been there longer than a year. What's funny is I found out one of these people is now having the same issue I'm having, and is miserable too.

Karma, man.

I now get two weeks paid vacation, all government-observed holidays paid off, and 10 days paid sick leave.

Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
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.

What is the problem with combining vacation days and sick days into just PTO?

I guess I don't see the difference between getting two weeks of vacation and one week of sick time versus three weeks of PTO... some people need more than one week of sick time, some people don't need any, but this way EVERYONE gets the same amount of paid time off to use in whatever way they deem necessary for their particular situation.

I get the impression in this thread that people see PTO as being "vacation time" and feel like they should be entitled to "paid sick days" in addition to the PTO. The problem with this line of thinking is that PTO is NOT the same as "vacation time" -- it is Paid Time Off, a combination of Vacation Pay and Holiday Pay and Sick Pay, all thrown into the same bucket to be doled out as the employee sees fit to meet their needs.

Some people shouldn't get more time off just because they are sicker than someone else, or they have kids who get sick (or whose school closes for snowy weather, etc.), or they oversleep more than others, or they get hungover more than others. You use your PTO for whatever you need to use it for, and I'll use my PTO for whatever I need to use it for.

I'm sorry that your kids getting sick means you don't get to take a paid vacation this year, but YOU chose to have kids, so YOU get to deal with the consequences. It's simply not fair for one employee to get several weeks of extra paid time off while another person has to work more for the same amount of pay. Do the work, get the pay. Don't do the work, don't get the pay. Having a child is not a "get out of work for free" card.

And I say all this as a parent myself. While my son was younger, I worked at a different (non-nursing field) job that awarded me the flexibility to work around my son's needs. I also earned less than half what I do now at that job... but it met my family's needs at the time. Now that my son is older and basically independent, I'm working at a job with less flexibility as far as calling in at the last minute, but I'm earning way more money and I'm able to take several vacations per year.

PTO is NOT "vacation time". Change that part of your mindset, and you will stop resenting that your sick time comes out of your PTO hours. Remember, employers in the USA are not REQUIRED to pay you for ANY sick days... be glad that you are working in a career that doesn't make you deal with a smaller paycheck just because your kid caught the sniffles.

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".

That sounds like it could be easily abused - the rule for someone with a sick child. Do you have to have a statement from a pediatrician or do they just believe you if you say a child was ill? Does this extend to grandkids or nieces/nephews if you are the primary "parent" for those kids?

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
That sounds like it could be easily abused - the rule for someone with a sick child. Do you have to have a statement from a pediatrician or do they just believe you if you say a child was ill? Does this extend to grandkids or nieces/nephews if you are the primary "parent" for those kids?

If it's being abused, you can ask for documentation of a doctor's visit. I'm not sure if it counts for grandchildren for which the person is primary caretaker; I haven't delved that far into the law, as I don't have any staff for whom that applies.

Another thread about using your entitled benefits....

If you are sick call out within a reasonable time before your shift.

Where do people get anxiety about this? I always call out if I don't feel good and have never been questioned. Ever.

Welcome to the culture of nursing in America/Canada... it's one of the many reasons why we struggle and so many eventually quit. You're lucky you have such rational policies where you live, I wish I could speak the language(s) required to work in Nordic countries. If things are as good as you say where you are, I'd be there in a heartbeat. If you don't mind me asking where are you exactly: Sweden, Kingdom of Denmark, Norway, Finland, Iceland?

In Canada, we all work while sick... For the most part, taking a sick day is discouraged and your employment is threatened. So, Nurses who are young, old, pregnant... doesn't matter. You're expected to show up, slap on a mask and work.

I also work in Canada, and what you have written does not occur in my world.

People have been sent home for coming in sick.

We can accumulate up to 930 hours of baked sick time. Illnesses stretching beyond three shifts require a doctor's note. Disability is cover d when the sick bank is empty and you are seriously ill.

Four personal leave days are available each year. To cover emergencies like a sick child or household emergency.

Paid vacay is a separate bank, we also have three paid leave days to attend educational events outside of our employer.

Yes, there are some who abuse it. Yes, there are managers who take it as a personal insult when their staff call in. But the insurance companies can investigate disability claims deemed suspicious. Union contracts specifically forbid management from contacting people on sick time. Rules are there for both sides. You need to know them and how to use them.

I remember a few years back when an American nurse was hired, she just couldn't get her head around the difference between sick time and vacation time. Especially when we explained that if you broke your leg skiing and had a note, you went onto sick time and didn't use your vacation hours

Specializes in NICU, PICU, PACU.

We get one point for every hour you call off or are late. At one week of time (i.e. 32 hours etc) you get a written warning. At two weeks worth you get a verbal. After that you get a trip to HR. Now, if you have doctors notes when you go to HR they deduct those points and put you on probation and not fire you. If you call in on a scheduled holiday, or the day off a paid holiday/vacation you get double points. If you have a no call no show it is 5 points and hour until you call the unit.

We accumulate X amount per pay, we can use it for FMLA before vacation. Many of us have over 400 hours in our bank since we are done with sick kids and having babies.

We had the 3 day rule for a while but people would just call off for 3 days son it was one incident.

Yes, we come to work with colds or headaches, fevers keep you home as do GI issues.

Perhaps I gave the wrong impression in this post about having kids and a "get out of work" card.

That's not what I'm saying at all.

I do agree with you in that everyone should be treated equally. It's up to the person to be diligent with their company's policy. Everyone is an adult and as such should automatically set aside days, knowing they tend to get sick x-number of days a year (for me, it's every December, no matter what I do). Parents shouldn't be shocked that every Wednesday-before-Thanksgiving schools are closed and should plan accordingly and early. Responsible adults should know not to drink too much on Sundays or else they will pay for it Monday morning. Perhaps that's assuming too much.

I also agree with what djh123 said, that the 'one size fits all' punishes the honest, hard working person the same as the slacker who knows how to work the system, regardless if they have kids or not.

I also agree that the pregnant woman who got fired should have filed FMLA to protect herself if she really was having difficulty working. I do know she worked there for over 10 years.

My point is: I am curious what other institutions are doing about this dilemma. What I am seeing at my work is that unless you are a patient yourself or have pink eye (in other words, visibly contagious), you are encouraged to work. HR and upper management would disagree, but in reality, this is what is happening. This is especially true if we're understaffed. If it is OK for my manager to work sick, then what leg do I have to stand on to call in for a sniffle? The whole culture is hypocritical.

I admit, I am unfamiliar with the US laws concerning PTO/Vacation time, but from my experience, it is expected to get some time off a year, whether you work in healthcare or not. I guess it is a matter of how much and how it is allocated. I'd like to hear more about this.

I also go back to what djh123 said...'life happens', especially concerning families, and you don't have to be a parent to experience this. A single-digit point system seems to miss that. I do feel for those who have it far worse than I.

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