Presenteeism: Why Nurses Don’t Call Out Sick » Nursing Jobs Blog – Nurses Insights at Nursing

Presenteeism: Why Nurses Don’t Call Out Sick

February 27th, 2009  |  The Blog

It’s cold and flu season and many of my non-nursing friends are shocked when I tell them that hospitals have unwritten rules about nurses calling into work when they are sick. Sure, nurse recruiters tell new hirers that they can call in sick, but in reality, nothing could be farther from the truth. I’ve actually heard a nursing supervisor refuse to accept a nurse’s callout because there was no one that could take her place on the unit. There are consequences for calling in sick. Nurses that choose to take care of themselves when they are ill face the wrath of their employer when they return to work. Most nurses choose to work when they are sick. This scenario plays out everyday in hospitals and it’s called presenteeism.

How many times have you gone into work feeling like you had to die first before you could start feeling better? I know I have. Why? I’ve had to save my sick time for when my children got sick or for when I was really dying. And then there is the threat of being written up for an unexcused absence. Those come back to haunt nurses at their end of the year evaluation. Annual raises are affected by how many times a nurse calls out sick during the year.

The concept of presenteeism has been around for a long time, but it’s relatively new to the health care arena. According to an article written by Donna J. Middaugh, PhD, RN and published in Dermatology Nursing, April 2007, Presenteeism is the opposite of absenteeism. Nurses report to the nurses station but are functionally absent. Researchers have equated presenteeism to two different employee behaviors. The first group goes to work when they are sick or tired. These employees are not productive because they are suffering from stress, depression, illness, headaches, or other disorders. The second group of employees put in excessive work hours as an expression of commitment or ways of coping with job insecurity. Even though both groups of employees are at work, neither group is working at their peak capacity. This puts them, their co-workers, and patients at risk for illness. In addition, these nurses are at an increase risk of making a medical error.

There are solutions to presenteeism, but it requires cooperation between management and labor. Hospital administrators need to understand how a sick nurse can impact patient care and ultimately the hospital’s bottom line. Nurses need to stand together and tell administrators, “We’re mad as hell and we’re not going to take it anymore.” Yes, I know that sounds like a line out of a movie—because it is—but nurses must understand that they are risking their patients’ health as well as their nursing license when they come into work sick. Remember, one small mistake in calculating a medication dose can kill a patient. Nurses must be alert and at their peak performance when they are work.

Middaugh suggests that nursing managers conduct anonymous job satisfaction and stress surveys of staff, and allow staff members to include details of specific stressors or dissatisfiers and also offer suggestions for improvement. She also suggests that they confer with other mangers, and review human resource policies and benefits that support work/life balance.

Terri Polick
About Terri Polick
Terri Polick has been a nurse for thirty years, and is a published author living in Maryland, just outside of Washington, D.C. She is currently working as a freelance writer, and is a frequent contributor to Nursing Spectrum Magazine. Terri works at a local community hospital as a psychiatric nurse.

9 Responses to “Presenteeism: Why Nurses Don’t Call Out Sick”

  • Super LPN said on March 19th, 2009 at 5:51 pm

    Yes, this is very common where I work. CNAs will call in sick about a toothache or a tummy ache. But the nurses hardly ever do. I’ve seen a nurse bring her sick kid to work with her to keep from getting written up. I’ve called in sick when plantar fascitis hurt so bad I could barely walk, but didn’t worry about it. because I’m a real good nurse. At least that’s what my patients say.
    I don’t think nurses are ever going to be effective at standing up for ourselves without a strong union. I’ve pondered whether we should do this for a little while now…

  • Chad Estes said on April 2nd, 2009 at 12:58 pm

    Presenteeism costs our American industry BILLIONS of dollars each year due to lack of productivity while at work. Back pain and injury is one of the largest contributors to presenteeism. Nurses are especially impacted, due to the fact that they have the HIGHEST incidence of back pain among all positions -even higher than truck drivers! I’m curious as to what is being done about that.

  • Super LPN said on April 3rd, 2009 at 10:54 am

    Ours is a ‘no lift’ facility, which means it has a policy against moving invalids from bed to chair, etc. without a mechanical lift. If a nurse or aide hurts him/herself lifting someone, they can be fired with no protection for medical expenses. If someone hurts a patient that way, it’s considered abuse. I won’t lift ANYONE. And I tell my aides not to.

    I am home sick again. I worked sick three days this week, and have at least 40 hours in 4 days. I am supposed to be working 8 hour days. Too much work, that’s why I’m sick, again…
    A compromised immune system is a bigger risk at our facility for nurses than back injuries.

  • clmm8899 said on July 6th, 2009 at 4:57 am

    Air B Huarache

  • mae said on November 17th, 2009 at 3:43 pm

    I’m in nursing school and I’m not coming back… got all this long way.. but im done. Glad i seen this early but regret not listening to my gut earlier saying “GET OUT”. I’m cutting my losses and going back to school for engineering. Nursing is toxic and sick. I love myself to put up with the horrible abuse(physical,mental and emotional) that comes it it.

  • chichiRN said on October 23rd, 2012 at 3:54 pm

    I had the worst flu in my entire life, I went out from work Thursday morning and woke up at Friday when I really can’t stand because of high fever. I wasn’t able to get a Doc’s appointment until Monday where he made me an excuse not to go to work. According to him either I get worst by tiring myself or I screw one of my patients. I told that to my manager and submitted the excuse to Nursing Dept. I got a loud blame (the implied shame on you cause you didn’t made an appointment earlier, now the unit is going to suffer without you).

    Point of the my drama is: Why is it the nurse’s fault if ever we get sick? Is it the sick nurse’s fault if a hospital can’t find somebody to work and that the unit has to suffer for it?

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