The study published in Monday’s online issue of JAMA Pediatrics suggests while 95 per cent of attending physicians, certified registered nurse practitioners, midwives and other health-care workers at Children’s Hospital of Philadelphia who answered an anonymous survey said they believed working while sick puts patients at risk. Eighty-three per cent of these health-care workers admitted to going to work while not feeling well, at least once in the past year.
Newborns and people in hospital for transplants or cancer treatment, as well as individuals in nursing homes are especially vulnerable to infections, such as influenza, spreading in health-care settings.
“Creating a safer and more equitable system of sick leave for health-care workers requires a culture change in many institutions to decrease the stigma — internal and external — associated with [health-care worker] illness,” pediatrician Jeffrey Starke of Baylor College of Medicine in Houston and Dr. Mary Anne Jackson from the infectious diseases division at Children’s Mercy Hospital in Kansas City, Mo. said in a journal editorial.
Dr. Michael Gardam is director of infection prevention and control at Toronto’s University Health Network, where last year, a policy was passed to restrict workers from coming in sick. He has worked in Canada and the U.S., and suspects the findings of the U.S. study would be the same here.
“I’ve had a clinic and I had no choice but to come in because patients were coming to see me from all over the place. What I would do is plunk myself in a room with a mask, with a bottle of alcohol gel and I would have my staff see them, review them with me and I would not be face to face with patients.”
Gardam would like to see hospitals get to the point where if he were working on the transplant unit and had an obvious cold, and he called in sick, then the administration would celebrate his move to avoid putting vulnerable patients at risk. But he recognizes it’ll likely take years to get there.
In his career, he has seen:
“This is a bigger societal issue,” Gardam said. “It’s getting you to realize that it isn’t all about you.”
A fever, chills and sweats are what Gardam watches for when deciding to send employees home.
It’s team-oriented, demanding jobs where people are more inclined to go to work when ill, or exhibit presenteeism, said Gary Johns, a management professor at the John Molson School of Business at Concordia University in Montreal.
“Bosses need to pay attention to both sides of the coin of presenteeism and absenteeism,” Johns said.
While clear and realistic standards on staffing are needed, “our peers are a stronger constraint than any policy,” Johns said.
In John’s review of research into presenteeism, he has found employees were less likely to be inclined to feel pressure to attend work when sick whenever there’s adequate staffing. Since the financial crisis of 2009, he expects a trend away from being absent from work because of sickness because employees feel insecure.