It is well-documented that hospitals are the best places acquire infection. Read that back. Hospitals are the best places to acquire infection. How can it be that the places the sick go to get better actually often do the opposite? There’s no single answer, but certainly policy th
at latently encourages doctors and other health care workers to show up sick to avoid shaming don’t help. Nor do sick policies so inappropriate that workers are virtually forced to show up for fear they won’t have a sick day left when a child gets sick and needs their attention at home.
A study in JAMA Pediatrics sheds light on what illnesses physicians and advanced practice clinicians will attempt to work through. It asked 536 hospital workers about how frequently they came to work sick. While nearly all believed working sick put patients at risk, more than 4 out of 5 said they had worked sick at least once in the past year. It’s reasonable to suggest that’s one too many time. It also asked with what ailments they might do so. Almost 80 percent of the 280 doctors said they would work with a cough or runny nose, and 60 percent said they would with congestion and a sore throat. More than 21 percent said they would come to work with a fever, and nearly 8 percent said they would work even if they were vomiting. The responses are alarming. Too often it seems our hospital human resource policies drive our nurses and medical staff to work while sick. With limited time off, they work despite being ill to preserve precious vacation days. What can we do to improve?
Some potential answers can be found in Presenteeism: A Public Health Hazard from the Journal of General Internal Medicine, an article that examines presenteeism, which gets far less attention than the much more discussed absenteeism. The article notes that health care personnel who return to work despite having ongoing symptoms of an infectious disease extend the risks of presenteeism far beyond reduced productivity issues into the realms of patient safety and public health. The article delves into why health care workers go into work despite being ill and suggests some solutions to correct it, listing unrestricted sick pay leave for health care workers as a starting point. It also suggests that any policy that mandates strict back-to-work rules must also ensure adequate staffing and coverage of health care personnel to limit feelings of personal responsibility that encourage presenteeism.
The last thing patients should need to worry about is the very people who ostensibly are there to help might be the ones who leave them in a worse place than where they started. Redundant manpower, less draconian sick policy, developing a solid temporary force and better screening of employees for illness are just a few approaches that might help. We encourage you to leave a comment telling us your stories, your obstacles, where you think the issues lie and how they can be fixed. A healthy dialogue is a beginning to fixing this unhealthy problem. It’s time to put patient safety ahead of the misguided notion that more money can be made by using sick caregivers. There’s too much at stake.