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The backwards logic of American hospital attendance policies

Okay, you got me. This one is more of a rant based on a couple short stories. For background, the hospital I work at used to accept doctor's notes for calling out sick. So, if I contracted COVID from one of my patients and was so severely ill that I ended up in the ER overnight, the ER doctor could write a note for work explaining why I was not at work. Seems logical, right? I mean, doesn't that just seem like the humane way to treat employees constantly exposed to illness? Well, not according to the administration of most hospitals and, as of this year, even my hospital. You read that right. As of January, the hospital I work at no longer excuses any callouts whatsoever, note or no note. And here's the cherry on top: We also don't have "sick days".


In light of this policy change, which apparently is just catching up to most other big hospitals in the U.S. who have already adopted this policy, we have already heard some absurd stories. I posted about it online and 200+ healthcare workers commented their own stories or thoughts about it, and some of them just sound like blatant lawsuits to me... But before I share some stories, I want to be a little more specific about how the "logic" is so cruelly backwards.


If I get deathly ill and end up in the ER the night before I work day shift, one would feel concerned that if I try to work while sleep deprived and sick, I could make a medical error and cause harm to a patient. I have made an error before one night when I was sleep deprived, and I have taken sleep before work seriously ever since (no one got hurt). Similarly, if I come down with COVID and have a fever, I'm technically not supposed to work. If I tell my boss I have a fever, she would tell me I'm not allowed to come in because it means I'm contagious. But the backwards part is, even though calling out would be just obeying my boss's orders, it would still count against me as a callout. I would still be one step closer to getting fired. So, what do you think I'm going to be tempted to do? Yep, I'm going to be tempted to either not check my temperature on purpose or hide it so I'm not forced to stay home and get punished. So, let's say I decide to not tell my boss I have COVID and a fever and I go into work. I have now put the safety of countless people, including myself, at risk by being there. I could spread it to patients and other staff members, or become sicker myself because I'm not resting and letting my body fight the infection. But remember... If I call-out to avoid all that, I get punished. Wrap your mind around that logic.


People have said this policy benefits hospitals because it results in more patients for them... One could also say it hurts them when a virus runs rampant through the hospital staff. Sick employees are more likely to make mistakes, be less efficient, and go home early, leaving the unit understaffed (if an employee calls out in advance, the unit has the opportunity to be assigned a float nurse).


But that's not all I have to say about it. It isn't just about the backwards logic... It's also about the brutal unfairness and cruelty of it. Life happens to everybody. If I woke up before work to find my newborn child clinging to life so I have to rush him to the hospital, I'm somehow still expected to show up to work or be penalized. If I get in a car accident on the way to work, yes I'm expected to get a taxi to still show up or be penalized, and if I'm injured by the accident and must be hospitalized, yes it still counts against me unless I apply for medical leave, which for me doesn't cover full pay. And honestly, bedside nurses and hospital care staff are almost constantly exposed to diseases and illnesses in patients and their families, oftentimes before we realize they have it. What demon came up with the reasoning that healthcare workers who are not lucky enough to avoid contracting something their entire career ought to be punished if they get sick from a patient no one knew had a contagious illness?


I know you may be thinking, Girl this is common in many careers. Sure, but the main difference to me is lives are at stake when sick nurses care for sick patients. That's why I think this policy is unacceptable especially in hospitals.


Okay story time. The reason I'm worked up about this right now is because I had my own battle with it this past weekend, and I heard about the experience of a float nurse at our hospital. In my case, I was helping care for a patient that was neither on isolation nor suspected of having a contagious illness at the time. I came back the next day to see the same patient then on droplet isolation for a positive flu test. I had been in and out of that room multiple times, touching the same environment and breathing the same air as the patient who unknowingly had flu. The next day, I woke up with flu-like symptoms. I suspected I had gotten sick by that patient and wondered naively if that meant I wouldn't get in trouble if I called out. I explained to my manager I appear to have gotten sick after being exposed to a patient who was not on isolation but now is and asked if it would still be a call-out against me if I cannot work. She said yes, it is. So guess who worked 3 days in a row while becoming progressively sicker? By the third shift, I had gotten significantly worse and, since we were overstaffed and had to send one nurse home anyways, the charge nurse sent me home.


I heard another story about a float nurse who was admitting a patient with known drug abuse history. They asked him to empty his bag to be searched. As he complied, he pulled out a pipe unsteadily, causing a white cloud to go into the nurse's face, which she of course inhaled. After some time passed, she became lightheaded and had some other symptoms so she ended up a patient at the ER for 10+ hours. Ultimately, they concluded she had likely inhaled fentanyl. When she told her manager this, he told her to go home and take the next day off and rest. A few days later, she got an email notifying her of a written warning for callouts.



Moral of the story: Just don't ever get sick if you want to work in a hospital... (kidding ofc)

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