# calling in sick



## Veneficus (Feb 27, 2011)

Now most of us have went to work not feeling 100% at some point in time. 

I have seen people come into the FD, EMS station, even the hospital so sick they couldn't function. In the esprit de corps of the trade, we covered for the sickling. 

On a few occasions I was covered for myself. 

But now that 99.8% of my time is in the hospital, I recently began to wonder...

When is coming in sick more of a liability than helpful?

From the perspective of the person, there is the money, the required time for students, the required time for employees, etc. 

From the perspective of the employer, there is the need to rely on people to be there, minimum staffing, etc. 

From the coworkers, a dependable person who won't make them sick and carry their share.

From the patient standpoint, there is the issue of your care provider not making you worse.

So how do you reach this delicate balance? How do you decide when it is time to use some sick time?

Do you have a delicate way to tell a coworker, supervisor, or subordinate  when it is time to just go home?

Do you address their concerns when you do?


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## 8jimi8 (Feb 27, 2011)

I call in when I have a fever or vomiting / diarrhea.

Thankfully those are very rare dis eases for me.  At work last week I started getting a fever.  I put a mask on and finished the shift because we were already down 3 nurses.  Then I called in for the return shift that night.  If someone looks visibly impaired by their illness, i'll tell them to go to the ER or go home.


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## Genesis (Feb 27, 2011)

I've always wondered this myself! Looking forward to reading everyone's opinion. 

My take on it is, especially in EMS, if you have something contagious, it's best to stay home for the health of your partners and the patients. That's preferred...but we all know that it's not always acceptable to call off of work depending on the severity of your illness, of course. A bad cold could be very dangerous to a patient with a comprimised immune system.


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## the_negro_puppy (Feb 27, 2011)

In a prprofessional sense, given that we are working directly with patients if you are feeling unwell and or showing signs of a cold or flu you shouldn't go to work. The last the the immuno-compromised nanna going back to chemo needs is a virus.

However, I am a realist. Calling in sick because of a runny nose or minor ailment isnt practical. I only call in sick if I cant do the job for example, vomiting, diarrhoea, injury that prevents lifting etc. 

Its not a huge issue for us. Our service is state run and anyone who calls in sick generally gets replaced by people on accrued leave/ RDO's who can work extra shifts for double time. Its a good way to make extra dollars particularly in the biggest city with the most staff where inevitably lots of people are away sick at any given time.


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## jjesusfreak01 (Feb 27, 2011)

Tylenol, Delsym, and Sudafed...makes you feel 5x better and you don't look like crap either.


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## Madmedic780 (Feb 27, 2011)

I've been chewed out big time for coming in sick (Congestion, cough that won't quit,etc) but my supervisor gave me a good idea of when to call in sick:

"If the patient looks in better health than you, then you should call in. The last thing we need is for the patient and you to switch roles while in the back".

Fortunately I don't get sick all that often, it's the spring time allergy season that gets me.


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## WolfmanHarris (Feb 27, 2011)

I've been debating this recently in light of the H1N1 pandemic and looking back at SARS in Ontario.

I have a generous helping of sick days as a full time Paramedic with benefits. I have 11 sick days at 100% pay and then short term disability at 75% for an extended period. Our casual compliment of staff, who have no benefits, have no sick days. You can tell staff all you want not to come in sick, but when that's taking money out of their wallet you create an untenable situation for that staff member.

With my benefits I will not come in if I'm febrile, have a new cough or obvious N/V/D. As a casual, fresh out of school, no sick days, no money, I practically dragged myself in. Not responsible maybe, but that's the crux of the problem. You can ask someone to put the interests of the patient first only so far as it doesn't take food off their table.

Thankfully in the worst case scenario (i.e. another SARS) where large numbers of staff are affected with quarantine, it has already been negotiated that in the event of work quarantine (at work, in full PPE for the whole shift), we get double pay.


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## Aidey (Feb 27, 2011)

If it was up to my bosses no one would ever call in sick, but obviously that isn't going to happen. 

I am a little biased because I have both asthma and really bad allergies. During the summer, or if I have been exposed to mold/dust/etc I look like crap. I also tend to develop non-productive nasty sounding coughs that last for weeks. In the back of the ambulance one of the first thing I do is introduce myself and explain that I am not sick I have allergies. So I don't always assume the person who looks like crap is sick. 

That being said, I have gone to work sicker than I should have. It was around the holidays and we were down several medics due to various reasons and they were having a horrible time filling shifts. I just kept a mask in my pocket so I could put it on if we ran into any imunocompromised patients. 

I realize too that even if someone calls in sick every time they get the smallest sniffle they could still expose patients because of the incubation periods for various illnesses. I know I went to work for 3 weeks with a sinus infection before I even knew I had a sinus infection.


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## systemet (Feb 28, 2011)

I don't think people should be at work sick.  I formulated this opinion a few years back when I arrived to a 26C that had just become a 9E, then had more time to think about it a couple of hours later as we were doing a difficult intubation.  All the time wishing I was curled up on my couch watching re-runs with the whiskey in one hand, and the nyquil in the other.

Working as a paramedic / EMT is a difficult enough job when you're healthy sometimes.  Having to make critical decisions when you're not at your best is intrinsically problematic.  Not to mention the risk you're exposing your patients to, whether they're acutely compromised due to major trauma, or whatever's just caused their impending ICU admission, or they're immunocompromised on a more chronic basis from HIV or cancer.  It goes against that "first do no harm" thing that the doctors are fond of   Getting the rest of the shift sick is also no good.

I think that EMS employers don't make the situation any better.  They have to deal with the reality that a certain percentage of employees are going to "game" the sick system to get time off (if that time off is your kids four year old birthday party, I understand entirely!).  So they have to disincentivise calling in sick.  But this results in staff being afraid that they're going to be perceived as "faking" when they call in.  It often results in the "mandatory physician sick note" policies.  The pain-in-the-*** factor of sitting in a medicenter for 3 hours to get the adult version of a note from mummy saying that "little billy won't be at school today because he's sick", often adds to a reluctance to call in.  I think these policies sometimes have a negative effect.

There's also the delicate issue of system funding / structure.  If one person calling in sick is going to result in an ambulance being dropped for the shift due to a lack of casuals / an over-reliance on OT, then there's a system problem there.  If the system is minimally staffed so the loss of one truck results in a bad night becoming a disaster, there's a further problem.

It's one thing to come into a data entry job with a box of cleenex and the Sudofed, I think it's a bad idea to come in sick to an EMS job.  I think there's too much risk for the benefit.


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## HotelCo (Feb 28, 2011)

systemet said:


> I don't think people should be at work sick.  I formulated this opinion a few years back *when I arrived to a 26C that had just become a 9E*, then had more time to think about it a couple of hours later as we were doing a difficult intubation.



What?


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## systemet (Feb 28, 2011)

> > don't think people should be at work sick. I formulated this opinion a few years back when I arrived to a _26C that had just become a 9E_, then had more time to think about it a couple of hours later as we were doing a difficult intubation.
> 
> 
> What?



Sorry... MPDS.  

Call came in as a "sick person" which is the dispatch generic for the caller says the patient is "sick" but can't clarify further.  MPDS is pretty unreliable, but usually a 26-code ends up being a low acuity problem.  It's up there with the ubiquitous 32-B "man down" -- i.e. a caller drove by a bus shelter, saw someone lying in it, figured calling 911 was a good idea.

In contrast a 9-echo is a witnessed cardiac arrest.  So they sent us out of the city to something that seemed minor, that became the patient coding in front of first responders.

While it wasn't that complicated, these things tend to go a little better when you're half-awake and well caffeinated.


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## mgr22 (Feb 28, 2011)

Use of sick time has been a significant issue wherever I've worked, including companies that had nothing to do with EMS. Calling in sick usually inconveniences someone higher up the organizational chart, and can morph into a perception that the sick employee is not conscientious. Of course, that's often way off base. On the other hand, some employees do abuse sick time -- calling in sick when they're not. I guess what's needed is (1) managers that feel committed to their employees; and (2) employees that feel committed to their companies. It's a chicken-and-egg problem; I don't think the requisite unselfishness can be taught.


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## Epi-do (Feb 28, 2011)

Like most others have already mentioned, I tend to only call in when I have a fever or NVD.  Or, when I am so sick I feel like I have been the victim of multiple, consecutive hit-and-runs, such as when I had pneumonia, bronchitis, and a sinus infection simultaneously about a month ago.

There have been times where I have thought about calling in, but decided I just wasn't "that sick" only to get to work and be sent home by the officer.  There have also been times where I was just feeling "off" but went in and then spent most of the day in the bunk room napping in between calls.  It's not ideal, but it really is a catch-22.  If you call in for something minor, then everyone thinks you are playing the system.  If you go in when you are not feeling well, then at least they know you aren't faking it (unless they think you are a really good actor).


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## lex (Feb 28, 2011)

While it depends on just how sick you are, I think a lot of it also depends on where you work and how many people you've got on staff to potentially cover for you.

I fully expect to be torn apart by some of our members for my choices here, but I am sure that I am not alone in my experience. Last winter I was working for a very rural small town service.  There were three of us that worked the rotation to ensure that the trucks were always staffed and one of our staff was away on holidays (Mexico, or some such) which left my partner and I as the only ones left in town to staff the truck that week. I hadn't been feeling great all week, but was definately not feeling unwell enough not to go in and do our regular unit maintanence, etc, until Thursday when I woke up in the middle of the night with a fever of 104 and a cough so bad that it led to coughing up small amounts of blood. Needless to say I gave my partner a call and let her know that I would not be at base in the morning, but when the tones went off later that day it was either she and I, or waiting close to 90 minutes for the next service over to come for our patient. I know dispatch isn't always bang on, but when it was a L/S response for a possible CVA, I isogelled and then masked up myself and ensured that I drove and stayed as far away from the patient as possible. I'm certainly not proud of potentially exposing our patient to whatever I had but sometimes when it is that or nothing, you have to make a choice, and I can honestly say that I would  make the choice again if I had to.


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## jjesusfreak01 (Feb 28, 2011)

HotelCo said:


> What?



Basic Rundown:

A - Shouldn't be an EMS call, but you're being dispatched to it anyways. You will smile and nod as the patient gives you their complaint, and then curse them under your breath after dropping them off at the hospital. This category can include minor "sick" calls, invalid assists, or (as I had the pleasure of doing on my last shift) a blood pressure check.

B - This may or may not be a real EMS call. It has a chance to be a legitimate problem, but even so, no one is about to die. The dispatcher may be able to only understand that it isn't serious, but nothing else.

C - This is a real EMS level call, and someone made the correct decision when calling 911. It could be a fall, a minor medical problem, or the like. It might also end up getting upgraded to a D (delta) level call (though its also possible it might be downgraded to a B (bravo).

D - This is a real emergency, and you need to get there very fast. Strokes, cardiac events, and severe traumatic injuries fall into this category. Sure, it might just be indigestion, but we don't mess around with chest pain.

E - The patient is dead and you are being dispatched to attempt to make them less dead. 


What gets dispatched here (Wake County NC) for each level...

A - Just an ambulance
B - Ambulance and sometimes a fire truck
C & D - Ambulance and almost always a fire truck
E - 2 Ambulances, a fire truck, and closest available supervisor level paramedic (they carry our cold saline)


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## emt seeking first job (Mar 1, 2011)

If your illness affects your ability to do your job, then you should not come to work.


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## TransportJockey (Mar 1, 2011)

The codes are also referred to as Clawson Codes.


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## DrParasite (Mar 4, 2011)

at my job, we can get written up for abusing sick time.  I went full time Aug 2009.  Oct 2009, I caught pneumonia, and was out for 5 days straight.  Dr's note, in the hospital, wasn't out any other days that year.  and I received a counseling notice for abuse of sick time.

Now, I also have worked with a sick partner.  like he was sick with teburcathrax, and I didn't want to catch what he had, but he wouldn't go home.  and my supervisor refused to send him home, despite him being obviously sick.  talk about putting me in an awkward position, since I didn't want to catch what he had.

So if an employee calls out sick, they get written up for abusing sick time, and if they don't call out sick, they infect everyone.  amazing double standard.


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## emt seeking first job (Mar 4, 2011)

DrParasite said:


> and I received a counseling notice for abuse of sick time.
> 
> .



In my old LE job they would do that, I think to build a paper trail. I was out for an operation, hernia, and a few other times actually sick, (next day in with runny nose hacking phlem) and they did that.

Today's model is abuse the rank and file. Nobody organizaes against it since everyone just wants to become management and be the one that does the abusing.


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## Sasha (Mar 4, 2011)

I'm not allowed to call in sick anymore, so I will be coming to work with TB if I have too.


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## frdude1000 (Mar 4, 2011)

We have to find a sub of equal or higher training, but then again I'm a volunteer.


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## nemedic (Mar 5, 2011)

What people should do is if Management's policies basically force you to come in sick, make sure you have nice, long winded conversations with said management as much as possible. After a couple managers getting sick from contact with sick employees, you just might see them lighten up the sick time policy.


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## slb862 (Mar 5, 2011)

I like to call in "dead"...


J/K       :blush:   :unsure:   :wacko:


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## MrBrown (Mar 5, 2011)

Brown is interested to see if you guys get paid sick time; Brown hears its not very common in the US.

We get 5 days paid a year by law but most places give you 10, we get 10.

Oh and for those Clawson people, the fun calls are the "Omega" level calls, basically lower than an A.


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## CAOX3 (Mar 5, 2011)

MrBrown said:


> Brown is interested to see if you guys get paid sick time; Brown hears its not very common in the US.
> 
> We get 5 days paid a year by law but most places give you 10, we get 10.
> 
> Oh and for those Clawson people, the fun calls are the "Omega" level calls, basically lower than an A.



So do you have sick time and vacation time?

We have off time, it combines vacation and sick.  It varies based on step from three weeks to eight weeks.


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## 46Young (Mar 6, 2011)

I'm old school - if I'm vomiting, running a temp over over 101, have diarrhea, or coughing up lung butter, I'll go in. I'll tell my supervisor how I feel, and if they want to send me home, then fine. At my dept, you can call in sick as much as you want, so long as it's at least two hours before start of shift, and you have the time banked. 

There's a lot of sick leave abuse. People want to turn their four day break into six. If they enter a leave request on telestaff and it reads "more than 30," which means more than thirty requested the day off, they're not getting it. They'll take their name off, and just bang in for that day. I suspect many places that make it difficult to use vacation days see employees bang in for days they really need off, ratheer than request it. Some people do so much OT, that they bang in the next day so they can recover. Short timers need to burn their leave, so they'll bang in 3-5 times a month, sometimes more; they'll lose the time otherwise. I can't complain, though. I made an extra 40k last year due to the copious OT, and I didn't even try too hard. There's entirely too much anal glaucoma (you'll figure out what that means)/slick leave/soft leave going on.

In response, the county has run down two BLS buses every day from 1900 to 0700 and is sending the crew to fill OT holes. The county ran down it's one ALS 8 hour bus, and reassigned it's crew. The county is also taking office personnel, and detailing them out on a rotating basis to cover scheduling holes. They'll get a taste of the effects of their many new G.O.'s, SOP's, etc.


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## Aidey (Mar 6, 2011)

46Young said:


> I'm old school - if I'm vomiting, running a temp over over 101, have diarrhea, or coughing up *lung butter*, I'll go in....
> 
> 
> ....*I suspect many places that make it difficult to use vacation days see employees bang in for days they really need off, ratheer than request it.*



I am disturbed to see the term "lung butter" is more common than I thought it was. *gag*


We accrue a certain amount of paid time off per pay period. How much is based on seniority, but it ends up being between 8 shifts and 16 shifts depending on where you fall. Our PTO is our sick and vacation time combined. We can go negative on sick time, but it has to be well documented, with all sorts of Drs notes and what not. 

There is a problem with sick time abuse to a point. The biggest issue is that there are people who call in very frequently which is incredibly annoying as it often results in people being held over or mandatoried to fill the shift. 

We have a rule about how many people can be out on PTO at once. Unfortunately people on LOAs or light duty also fall into that total. The end result is that you can have a vacation planned 6 months in advance, and if a week before you leave someone breaks their leg, your leave can be revoked. And if you call in sick for a day you requested off and your leave was rejected or revoked the company will withhold your pay for that shift until you can prove you were legitimately sick. 

Under ordinary circumstances you only need a sick note if you are gone for 3 or more shifts in a row. 

It does create a bit of a conundrum when trying to plan ahead. If you know you only need 2 days off, it is really tempting to call in sick rather than request the days off, because that way you don't have to worry about your leave being revoked. If your leave gets revoked, you can appeal to the boss to make an exception, but good luck with that.


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## 46Young (Mar 6, 2011)

Sorry about the lung butter. I can't shake my NY crudeness sometimes. 

When our leave gets approved, we print out the telestaff page as proof, have our supervisor sign the proper form to validate the leave, and then make extra copies before filing the originals. That way, if the leave gets mysteriously rescinded by the "computer glitch," we have proof of approved leave, and it's upheld. 

We also have a "no hold/recall" list that we pass around at lineup every morning. If we have travel plans, a doctor's appointment, or a doctor's appointment for our chilldren or spouse (if child care is an issue, or the spouse needs to be driven), then we can be safe from holdovers and recall. If we're working an exchange or OT, and the next day is a scheduled leave day, we can't be held, either.


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## DrParasite (Mar 6, 2011)

MrBrown said:


> Brown is interested to see if you guys get paid sick time; Brown hears its not very common in the US.


I get 8 hours of sick time every pay period.  and 10 hrs of vacation time (assuming you don't take vacation during that pay period of two weeks).  So right now I have 113 sick hours, 40 vacation hours, and 40 personal hours.  

Here is the rub: I can only use vacation time if my schedulers has a per diem to cover my shift.  I can submit guaranteed vacation if no one else has requested it, and those requests are typically filed between Jan 1st and March 1st every years.  So if your family decides to go on vacation in October, and they decide in april, you might not be approved for it, and you won't know if you are approved for it or not until Sept 1st.

Also despite having the 113 sick hours, I can't use them without being charged with abusing sick time (2 sick instances a quarter or 48 hours a year is the limit I think).  

Hospital based EMS systems (where I work) and municipal based systems tend to have significantly better vacation and sick policies than for profit private companies.


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## Shishkabob (Mar 6, 2011)

We get sick time, but I can't use it til may when I'm out of probation. 

My partner was sick 1 week ago, went home early.   I started to feel crappy before I started this 36hr shift, woke up with a really sore throat this morning, went to Walmart and stocked up on cough drops and oral anesthetics, and have been good today, having worked a code and an mvc. 


I hardly ever call in sick, and when I do its because I'm puking and feel dizzy walking.   Heck, I took my nr skills last year sick.


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## WolfmanHarris (Mar 6, 2011)

I went to check my collective agreement to confirm our sick days arrangement, but I already packed it for my pending move (first house).

If I recall correctly we get 11 days at 100% pay per year. We also get a number of days of short-term disability at 75% pay that increases with seniority. The counter to this is the attendance awareness program in which staff are enrolled when their sick time goes over a certain point. The attendance awareness program varies from counseling and support for staff in need of more time off due to prolonged illness or family crisis to progressive discipline for chronic absenteeism.

We also have the standard long term disability benefits through the government that allows extended time off with unemployment benefits for long term injury or illness.

Full time staff who are injured and cannot work on the road, but are still capable of working are placed on modified duty and transferred into HQ on the M-F 0830-1630 schedule. They're assigned to basic admin duties, posted in logistics or fleet and sometimes if enough people are on modified essentially watch paint dry. (Last year their was a bake sale for Haiti organized by our "Mod-Squad." I'm serious.)


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