Nurse Fired After Staying Home Sick: Time to Change Policies?

Troy Brown, RN

February 09, 2018

Hospitals should not punish nurses for staying home when they are ill, says a nurse who was fired for calling in sick when she had influenza. She is speaking out because she wants to see punitive policies such as the one at her former hospital changed.

Theresa Puckett, PhD, RN, told Medscape Medical News she worked on inpatient psychiatric units at University Hospitals in Richmond Heights, Ohio, until recently. Although she received an influenza vaccine, she became ill with influenza shortly after Christmas. She was sick at home for 2 days with chills, achiness, and generally "feeling miserable," so she went to an urgent care clinic.

While there, she became nauseated and felt like she was going to pass out. She was diagnosed with influenza and given oseltamivir. The physician wrote her a note and she missed 2 days of work covered by that note.

Dr Theresa Puckett (Courtesy of Dr Puckett )

Dr Puckett said she felt guilty that she was missing work and leaving her fellow nurses short-staffed, so when she was scheduled to work several days later she went in although she was feeling only marginally better. At work, she was "having horrible coughing fits" and her charge nurse encouraged her to leave early, after she'd given her bedtime medications. She was reluctant to do so but did leave around 9:30 PM.

She was scheduled to work 2 days later and again went to work even though she was still ill. She no longer had the chills and achiness but was still coughing a great deal, felt dizzy, and now had a runny nose, so she went to a nurse practitioner the next day. She was diagnosed with a sinus infection and given a prescription for an antibiotic along with another note to be off work. After the second absence, her nurse manager told her she was being terminated.

Dr Puckett had been employed as a "prn" nurse, filling in staffing gaps not covered by regular staff nurses. She said that until this episode she had received excellent performance evaluations and had no absences during 2017 until late December. Dr Puckett is a nursing instructor at another institution and has written chapters in two nursing textbooks.

She said that although the hospital's attendance policy for "prn" staff states that staff "may be" terminated after two unexcused absences during a 60-day period, she was shocked when it happened. Her absences were considered two separate occurrences because she had returned to work between them.

Excused absences include approved leaves of absence, workplace illnesses or injuries, scheduled paid time off such as vacation time or doctors' appointments, and bereavement leave or jury duty.

"Many factors contribute to any decisions about an individual’s employment status at University Hospitals. We care deeply about our employees, their wellbeing, and providing them with a work experience that is supportive and fulfilling," Mike Ferrari, senior media relations strategist, University Hospitals, told Medscape Medical News.

"As a health system, we know how important it is for employees to get care when they are ill and to not expose and spread their illness to others. Our managers partner daily with our employees on their attendance and time off," he said.

"University Hospitals values our nurses and all of our employees for the dedicated, compassionate care they provide that distinguishes our health system. We strive to make UH the health system our nurses choose over all others and trust with their careers," Ferrari added.

Dr Puckett said she initially contacted her local news station because as a nursing instructor she tells her students to stay home when they are ill, and she believes hospital policies such as this one need to be changed.

"If someone is sick with a contagious disease, I don't think they should be punished for making the decision to stay home when the doctor is saying, 'You need to stay home,'" Dr Puckett told Medscape Medical News.

Nursing Care Suffers When Nurses Go to Work Sick

The issue is not only one of infection control but also of patient safety, Dr Puckett explained. "If you're sick you're maybe not making the best decisions," she said.

Brian Burger, MSN, RN, president, Ohio Nurses Association, agreed. He told Medscape Medical News that when a nurse is sick at work they risk making mistakes such as medication errors, which "can come back on them as well."

As a nurse leader, Dr Puckett said she feels an obligation to speak out about this issue. She first went to her local television news station and although she could have remained anonymous she felt this problem is too important not to go on the record. "I didn't go to school for 15 years, through all of my degrees, to hide from problems," she said.

"This is a problem that's in our nursing culture and in many hospital policies across the country. It could be any other person in many different facilities," she added.

Dr Puckett has seen many comments about her situation on social media, most of which are from nurses with similar experiences or those who know others who have had such experiences.

Nurses Look Out for Patients, Hospitals Should Look Out for Nurses

Burger said that nurses are always looking out for their patients and they expect hospitals to look out for them as well. When a nurse calls in sick because of the flu they are protecting the hospital as well as patients by not exposing their colleagues to infection, he said.

"As a nurse, we are always looking out for our patients, and we…expect hospitals to look out for us. If we're calling off because of the flu…realistically, we're protecting the hospital as well as the patients," Burger explained.

He said he knows of one unionized hospital that requires nurses to get an influenza vaccine and has agreed not to take corrective action against nurses who call in sick with influenza if they have received the vaccine.

Burger said other healthcare professionals such as physicians, nursing assistants, and unit secretaries deal with similar issues.

"We all need to work together to find a solution that best helps the patients and everybody that takes care of them," Burger said.

"We need to encourage all hospitals to review their policies and make sure that they don't reprimand nurses for contracting illnesses that we have no control of," Burger added.

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