Sick policy vs. reality

Nurses General Nursing

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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.

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.

PM me and tell me where you work so I can apply!!! Because I work for a prominent acute care hospital and nurses work while sick, injured, sleep deprived, and into the late stages of pregnancy. Tell me where you work via PM, if what you say is true... would you mind helping a fellow nurse out and sharing the fortune? Because I would love to not have to work in such sh*tty conditions anymore.

Specializes in Med/surg.

We don't really have a set policy in place, to my knowledge. We don't seem to have any issues with excess absenteeism, though.

The way ours is set up, you earn a set amount of vacation and a set amount of sick time each pay period, and these are housed in separate hour banks. The rate at which you earn vacation is more than sick time is, though. We earn about 7 hours of vacation each pay period....maybe a little more or less. I am not sure of the exact amount. Sick time is earned at about 3 hours a period.

In order to use sick time, you must first have used 2 days of PTO.

I have been there a year and nine months, and i have called off sick twice. So, i have never used any sick time. I have like 6 weeks worth of it right now. It will be good if i or an immediate family member become gravely ill or need surgery.

I do use my vacation whenever i want. If it is slow and i take on call, or sometines if i am getting really burned out, i will schedule myself for less days and take vacation.

I have never got any static for calling off sick, or had them require any proof. Nor have i seen this done with anyone else. We always figure something out and cover it.

In that respect, it is a good place to work, because no one wants anyone there sick. I have worked with sniffles or a minor cough, but i think if i tried to work while extremely ill, i would be encouraged to leave. I have had someone get sick mid shift, and i insisted that they not take patients, and just remain in the break room and answer the phone, until we could get someone else in.

When i was in college, i worked as an aide at a nursing home, and was not allowed to be sick. We had to come in regardless and were threatened that we would be fired if we called off. I went in with the flu and 104 temperature, i was in a daze. We would have girls trying to work and throwing up in the trash cans. It was absolutely ridiculous, i would never allow such a thing now, but i was young and stupid. If we were really sick, we had to wear a face mask like that protected anyone lol.

"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."

Do you mind explaining this? I don't understand the 5 times per month that you referenced. I always thought that each case of intermittent FMLA was personalized, and each had its own parameters?

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

Do you mind explaining this? I don't understand the 5 times per month that you referenced. I always thought that each case of intermittent FMLA was personalized, and each had its own parameters?

I interpreted that to mean, if you have intermittent FMLA for your migraines, but you call out a bunch of times for your kid being sick, your car breaking down, you having diarrhea, your kid's school shutting down for a snow day, etc., then you can still be terminated even with FMLA in place.

The FMLA only protects the absences related to the specified FMLA reason -- everything else is just a regular old absence and has to be counted the same as anyone else's absence.

A point system for sick leave...oh the sad things we do to punish healthcare workers.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
A point system for sick leave...oh the sad things we do to punish healthcare workers.

I've seen it in other industries as well. Do you have other suggestions that are objective and equal across the board?

Specializes in Critical care.

I haven't called out sick before and I've been working at my current place for over a year. From my understanding if you call out twice within a 30 day period you get a point, or something like that. It hasn't been an issue for me so I don't remember the full details. I really haven't been sick, even with a cold or typical sinus infection, in over a year.

I've been contemplating all day whether or not I am sick enough to justify calling out. My answer to myself thus far is no, so I'm planning on going into work in the morning. I have a cold or something similar to that- no fever or GI issues. I don't feel the greatest, my head is a stuffed up mess, and I spent my day off today sleeping, but since I'm not terribly achy I don't feel I'm sick enough and want to save my call out for if I get worse.

Specializes in Med-Surg, NICU.
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.

Problem is with PTO systems, often the hours accrued are less than that of sick /vacation hour system. Example: Hospital A uses PTO system. Hospital B uses sick/vacation system. Hospital A offers 3 weeks PTO while hospital B offers 3 weeks vacation PLUS sick time. If hospital A offered four weeks of PTO, then it would be equal...but it isn't.

The rest of this post isn't worth replying to as I feel this mindset needs to be changed.

Specializes in Heme Onc.
Problem is with PTO systems, often the hours accrued are less than that of sick /vacation hour system. Example: Hospital A uses PTO system. Hospital B uses sick/vacation system. Hospital A offers 3 weeks PTO while hospital B offers 3 weeks vacation PLUS sick time. If hospital A offered four weeks of PTO, then it would be equal...but it isn't.

The rest of this post isn't worth replying to as I feel this mindset needs to be changed.

I personally like the accrual system better. So my accruals are based on how many hours I work and not some arbitrary time frame. If I choose to work 4-5 shifts a week why shouldn't I earn more PTO than my peers who opt only to work 2 or 3?

Unrelated to the quoted post. My big peeve with Sick time v. PTO is that theres a point system or penalty at all. If I have the hours ,why am I being penalized for using them? My hospital system has a ridiculous points program in place as well (My unit director doesn't really enforce it unless a persons call offs are out of hand). In the same breath, our systems policy is that only one week (aka 7 days, but only 3 PTO days) of vacation can be GUARANTEED per year. (We typically get way more than that) So wait. Lets do the math. If my points system only allows me to call off a handful of shifts and they can only guarantee 36 pto hours of vacation, how the hell am I supposed to use the other 100 - 130 hours of PTO I accrue?

Specializes in ED.

There is a lot that can be said against the VA but our leave program rocks. 8 hrs PTO per pay, 4 hrs separate sick leave per pay. 5 full weeks of vacation per year, not counted against your sick time. I think one of the local hospitals came up with a policy of mandating all nurses to have the flu shot with no forgiveness for those who get sick and didn't get one. But if you do get the flu when you also had the shot, you get something like 10 days PTO off which sounds reasonable.

Oh, OK! Thank you for the clarification. I obviously need more sleep! LOL

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

Unrelated to the quoted post. My big peeve with Sick time v. PTO is that theres a point system or penalty at all. If I have the hours ,why am I being penalized for using them?

You're not being penalized for using the PTO, you're being penalized for calling out without advance notice, which puts the rest of the unit in a huge bind.

If you call out without advance notice, you would get the same "point" whether or not you have the PTO to cover your missed hours, or you're taking it unpaid. It's not the PTO use that is the issue; it's the unplanned call-off.

My unit director doesn't really enforce it unless a persons call offs are out of hand)

The problem with that is, how does s/he define "out of hand"? If s/he's not enforcing the policy, how can she prove that she was fair across the board with all staff?

I HAVE to go by the policy. As much as it pains me to give someone a "point" because they had a miscarriage or slipped on ice and broke their wrist, I can't NOT give them a point, and give points to someone else who just called in because their throat was scratchy. Because I have to be fair and follow the rules across the board, or I can be cited for favoritism.

If I'm trying to impose a disciplinary action on someone who calls in sick chronically, I have no leg to stand on if that person says "Hey, how come you didn't give HER a point when she called in sick, but you gave ME one?"

In the same breath, our systems policy is that only one week (aka 7 days, but only 3 PTO days) of vacation can be GUARANTEED per year. (We typically get way more than that) So wait. Lets do the math. If my points system only allows me to call off a handful of shifts and they can only guarantee 36 pto hours of vacation, how the hell am I supposed to use the other 100 - 130 hours of PTO I accrue?

Saying they can only guarantee one week of vacation per year means they can only guarantee ONE consecutive week off. That doesn't mean they won't also allow random days here and there for a birthday, or a doctor appointment, or a long weekend. Plus, you need PTO to cover if you DO get sick. What happens if you get influenza and are out for 10 days, if you don't have that PTO banked? Or what about if your mother dies and you need to fly to Texas for her funeral, and you miss three shifts )that you are allowed take under your facility's bereavement policy)?

^^^^Those incidentals are what that extra 100-130 PTO hours are meant to cover.

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