Faced with the choice of working while sick or sitting out and not getting paid, most will work while sick. Pros and Cons of Sick Pay Schemes: Testing for Contagious Presenteeism and Shirking Behavior takes a look at the ramifications. Most organizations’ human resource policy is focused on short term goal. It is clearly that way with sick pay. While it might take some logistics wrangling, there generally are duties that can be accomplished at home. It is time to get smart and realize that working sick hurts business as well as the bottom line.
The spread of disease in a facility happens quickly, as noted in Office Germs: Viruses Spread Everywhere in Just Hours, Study Shows. Bacteria and viruses move through the water system, on the air, and are moved around a facility on shoes, hands and clothes. Dr Gerba’s study showing how quickly the bacteriophage MS-2 virus moved throughout and office was enlightening.
How long do nosocomial pathogens persist on inanimate surfaces? A systematic review shows that bugs can remain viable on surfaces for hours, even weeks.
Bugs (viruses, bacteria and fungi) all move through the air. The CDC always talks about droplet precaution. It contends that droplets fall out of the air to a surface within six feet of the patient. MIT showed droplets moving 6-8 meters through the air in Studying the Science of 100 Sneezes. High-speed video shows how far sneezes spread in The snot-spattered experiments that show how far sneezes really spread. Droplet nuclei can remain suspended in air for extended periods, according to ASHRAE.
Focusing on cleaning for health, hand hygiene and sub-micron air filtration is a must for a healthy environment.
Presenteeism is more costly than many might imagine. Health, absence, disability, and presenteeism cost estimates of certain physical and mental health conditions affecting U.S. employers makes an attempt to quantify it actual dollars but notes that standardization of future research is needed before the data can be interpreted more singularly. However, that presenteeism comes with negative health and financial implications is difficult to dispute.
Does our body have natural responses to tell us when we need to isolate from other people? There is a body of thought that believes that indeed is the case. Why Do We Feel Sick When Infected—Can Altruism Play a Role? offers an interesting – albeit debatable – take on the symptoms of illness. Authored by a pair whose chief disciplines are immunology and psychology, it suggests that the more people are genetically related, the more sense it makes that being sick might well be an evolutionary adaption as a means to ensure some of their genes can be passed on. Perhaps not directly but through others with whom they share some genetic ties. They cite a number of symptoms that tend to isolate the sick to support the theory.
As health care costs climb, shrewd companies will develop programs that allow folks to work from home if sick when it’s possible, and perhaps they will allow adequate sick days and encourage workers to use them when ill. Presenteeism can be more costly than absenteeism. When one infection becomes 10, it impacts health, safety and the bottom line.
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.