We have been having problems with a couple nurses on our unit lately. This is not a direct patient care problem, but an indirect patient care issue and morale problem. Apparently at some point there has been some attendance allowance made through FMLA for these nurses due to chronic health problems. Both nurses are highly litigious. In a nutshell, we are seeing patterns of poor attendance on assigned weekends which are then ascribed to chronic health problems.
As an example, in one situation there has been, out of 12 weekend days assigned, 7 absences. However, during the same time period 1-2 weekday absences.
My question boils down to this. What, if any, actions/documentation is required in this circumstance on the part of the nurse mgr who is attempting to counsel this employee? There are conflicting reports that somehow these nurses are exempt from the normal discipline process?? Any help/tips on this situation would be greatly appreciated!
Not a Manager, myself, at this time. I have been in the past.
A few years ago, this was a MAJOR issue not just on our floor, but the whole Hospital.
Management proceeded to make a new policy--- if you call in on a weekend day--you must make it up on your next weekend off; Therefore--we have everyother weekend off-- if you call in on Sat. then y ou work the next Sat ( which would have been your Sat. off). Now, since the schedule is all ready made, you are an extra person & therefore, you are bound to float.
It worked--we have very few call in's on weekends.
We have had a few people who used to Family Leave in the manner you described, but it has generally been used responsibly--ie, one RN used it for when she had to take her terminally ill DH for chemo rx;s & such.
This is about all I can say.
I know some of these people are difficult to work with
Mary Ann
This also worked well in my past floor experience. The extra weekend day was not an extra work day but they forfeited a weekday for a weekend day.
I will speak to this s someone who does have FMLA in place for intermittant use. When I used ortho-evra patch, I would get terrible cyclical headaches. What I mean by cyclical is that every months a day or two before when my hormones would drop, I would get debilitating migraines. I was treating the migraines with OTC meds that I was unknowingly allergic to, in order to stay at work. I didn't have FMLA in place at the time, and saw all of the abscences that I occured over the year. I was shocked, and really realized how cyclical my absences were. To someone that didn't know me or if my boss forgot what those absences were, it looked as though I called in every month, though that wasn't usually the case. Sometimes you have to give a person the benefit of the doubt. I knew another person who had it with their Bipolar disorder. She was absent a lot when they were adjusting medications or if she just decided not to take them.
I honestly have no problem with FMLA in most cases - it is used responsibly and is there for a good reason.
However, there is always that 5% that abuse the privilege. Call me cynical, but missing 60% of your scheduled weekends over a 3 month span when the same people miss perhaps 5% of their scheduled week day shifts is a red flag IMO.
Would you like to work on a unit where this occurred and your weekend was continually short because someone else was doing this? How would you react when that person shows up on Monday morning with obvious sunburn?
You raised a point about a bipolar/mentally ill pt that doesn't take their medications. Frankly, at that juncture they are not meeting their duty to comply with their treatment plan, which could be confirmed (depending on the meds used) by a simple blood level.
(So, I'm wondering (for example) if an employee that has chronic asthma and is a smoker may be negating their plan of care if they continue to smoke while they have asthma and attempt to claim intermittent FMLA? An interesting legal idea, anyway.)
That's going to open a whole can of worms.
Would you like to work on a unit where this occurred and your weekend was continually short because someone else was doing this? How would you react when that person shows up on Monday morning with obvious sunburn?
No one would want to work in a place when they think abuse of FMLA is occuring. The problem is "Is it really occurring?" You need to have proof. Just because someone is has a chronic illness, doesn't mean they can't lay around in a lawnchair in their backyard. Also don't forget some meds react with sunlight and cause a sunburn with low exposure.
You raised a point about a bipolar/mentally ill pt that doesn't take their medications. Frankly, at that juncture they are not meeting their duty to comply with their treatment plan, which could be confirmed (depending on the meds used) by a simple blood level.
That to me raises a different point. I would have a serious concern about someone who is bipolar (who is NOT taking her meds) caring for patients (giving meds etc). I do think there would be a lot legal probs with requiring drug tests to prove they are taking the meds since there might be a whole lot they are on and how do you prove they are working? It can take a whole lot of trial and error to get the right ones. (I am speaking from personal family history here.)
(So, I'm wondering (for example) if an employee that has chronic asthma and is a smoker may be negating their plan of care if they continue to smoke while they have asthma and attempt to claim intermittent FMLA? An interesting legal idea, anyway.)
That's going to open a whole can of worms.
You raised a point about a bipolar/mentally ill pt that doesn't take their medications. Frankly, at that juncture they are not meeting their duty to comply with their treatment plan, which could be confirmed (depending on the meds used) by a simple blood level.
These are both interesting hypothetical situations. As I stated before, I don't believe that the employer has the right to examine the employee's medical records regarding treatment for the condition related to FML, but I do believe that the employer has some right to know the employee's condition and progress toward returning to work. When an employee is claiming FML to take time away from work, and then not complying with the treatment plan set forth by his/her own health care provider, I have a problem with that. FML is intended to protect the jobs of those who are attempting to resolve (or help immediate family members to resolve) significant health issues. Why should the employer have to hold a job for someone who is non-compliant in resolving those issues?
Like all legal protections, FMLA places both rights and RESPONSIBILITIES upon the worker. If the worker does not meet those responsibilities, s/he has no right to expect a job to be held.
These are both interesting hypothetical situations. As I stated before, I don't believe that the employer has the right to examine the employee's medical records regarding treatment for the condition related to FML, but I do believe that the employer has some right to know the employee's condition and progress toward returning to work. When an employee is claiming FML to take time away from work, and then not complying with the treatment plan set forth by his/her own health care provider, I have a problem with that. FML is intended to protect the jobs of those who are attempting to resolve (or help immediate family members to resolve) significant health issues. Why should the employer have to hold a job for someone who is non-compliant in resolving those issues?
Like all legal protections, FMLA places both rights and RESPONSIBILITIES upon the worker. If the worker does not meet those responsibilities, s/he has no right to expect a job to be held.
I agree totally, and I hope it does't sound like I don't. I DO agree that the employee has responsibilities in handling their own situation.
I also believe that there should be a specific legal course that is followed in all situations rather than in a few in which abuse of the situation is suspected by some individuals. I would think that both FMLA and the employer should have a legal and ethical way of handling cases of suspected abuse rather than it falling on the shoulders on one nurse manager to figure out. I have a feeling the real issue now is how do you deal with employee morale when other employees use the intermittent leave (which may not seem appropriate from the outside.)
I agree that this sounds like an overt abuse of FMLA.
It is perfectly acceptable to take FMLA days intermittantly, however, the hospital can impose certain limitations on how it is done. Most intermittant days are scheduled IN ADVANCE for appointments, scheduled days of rest, etc. If a day off is needed for an unanticipated sick day RELATED TO THE CONDITION FOR WHICH FMLA HAS BEEN GRANTED, the employer can insist on a doctor's note. If the employee is ill due to a condition unrelated to FMLA, then it is NOT APPROPRIATE to use FMLA time to cover that call-out.
I strongly encourage your manager to get a handle on this situation. Failure to do so will hurt the morale of the other emloyees and lead to increased abuse of sick time.
No flaming, I agree with what you said, but how can you legally ask if it is related to FMLA reasons, and what would keep the person from lying about it?
Edit- never mind, I spoke to soon. You answered my question in a later post.
Ordinarily, when an employee calls out sick, I do not believe it is proper or appropriate to ask why s/he is calling out. But when an employee is calling out sick and wants that sick time to be "protected" by FMLA, s/he has the responsibility to provide the information necessary for the employer to determine the appropriateness of the request.
For example, say you are granted intermittant FMLA time for the management of chronic back pain. If you call in sick and request FMLA time, I need to know the reason for your call-out. If it is back-pain related, then FMLA protection is appropriate. If it is because you have strep throat, FMLA protection is not warranted, and you should be "charged" a regular sick day. Providing this information is the responsibility of the employee who is using FMLA.
There is always the possibility that an employe will lie about the reason for a sick call, and say it is FMLA related when it is not. If an employee develops a pattern of questionable sick calls, it becomes the duty of management to verify them, either by requiring a doctor's note, or by requiring the employee to be seen in Occupational Health. I am quite certain that most institutions' policies regarding FMLA allow for these checks to take place.
subee, MSN, CRNA
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This also worked well in my past floor experience. The extra weekend day was not an extra work day but they forfeited a weekday for a weekend day.