Nurses Are Talking About: Why They Go to Work Sick

Laura A. Stokowski, RN, MS


September 23, 2015

In This Article

Sick of Going to Work Sick

Imagine this scenario. You are an experienced, professional registered nurse who works the night shift in the coronary care unit. Every night, the hospital, the physicians, and everyone else depend on your acute assessment skills and your sound professional judgment to monitor very sick patients, detect the status changes that might precede deterioration, and take steps to ensure that your patients do not come to harm. Today, at 4:00 pm, you wake up with a sore throat, fever, and malaise. You call your supervisor and say that you are sick and cannot work tonight. The response? "You will need a doctor's note, or you won't be paid."

Seriously? The health and fate of scores of sick patients are regularly placed in your hands, but you are incapable of determining whether you are too sick to go to work? It would be comical if it wasn't such a serious and frequent problem. Every shift, every day of the year, nurses and physicians are compelled, through fear, guilt, or intimidation, to go to work when they are sick (known as "presenteeism"). And although healthcare employers profess to decry presenteeism, their policies and responses when employees call in sick suggest otherwise.

The news report "Many Docs Come to Work Sick: Survey", described a survey that found that many doctors, nurses, midwives, and physician assistants routinely go to work sick primarily because there is no coverage, and they don't want to abandon their colleagues or patients. More than 95% believed that working while sick puts patients at risk, but 83% still said they had gone to work with such symptoms as diarrhea, fever, and respiratory complaints during the previous year. Doctors were more likely than nurses or physician assistants to work while sick. Many expressed a strong cultural norm to go to work unless extraordinarily ill. This report provoked a swift and strong reaction from Medscape readers, beginning with the nurse (at work, sick) who found the news timely:

I am the first to say "shame on me" for coming to work today. I am so sick that I cannot stop coughing. Why am I here? We have an "attendance management program." If I am sick "too often," I will automatically be enrolled in this program to help "manage my sick time." My horribly inappropriate reasons for being absent earlier this year were chicken pox and whiplash following an accident. I guess I am just another nurse trying to "suck it up" today, and infecting my fellow nurses, to avoid disciplinary measures. My boss can clearly see and hear how sick I am yet has not offered to send me home.


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