calling in sick

[Veneficus]

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?

 

[8jimi8]

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.

 

[Genesis]

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.

 

[the_negro_puppy]

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.

 

[jjesusfreak01]

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

 

[Madmedic780]

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.

 

[WolfmanHarris]

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.

 

[Aidey]

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.

 

[systemet]

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.

 

[HotelCo]

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?

 

[systemet]

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.

 

[mgr22]

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.

 

[Epi-do]

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).

 

[lex]

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.

 

[jjesusfreak01]

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)

 

[emt seeking first job]

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

 

[TransportJockey]

The codes are also referred to as Clawson Codes.

 

[DrParasite]

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.

 

[emt seeking first job]

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.

 

[Sasha]

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