Many doctors, nurses, midwives and physician assistants come to work sick even though they know it puts patients at risk, a new survey hints.
Many said they don't call in sick because they don't want to let colleagues or patients down by taking a sick day, and they were concerned about finding staff to cover their absence.
At the Children's Hospital of Philadelphia, Julia E. Szymczak and colleagues analyzed survey responses collected last year from 536 doctors and advanced practice clinicians at their institution.
More than 95% believed that working while sick puts patients at risk, but 83% still said they had come to work with symptoms like diarrhea, fever and respiratory complaints during the previous year.
About 9% had worked while sick at least five times over the previous year. Doctors were more likely than nurses or physician assistants to work while sick.
Analyzing their comments, the researchers found that many report extreme difficulty finding coverage when they're sick, and there is a strong cultural norm to come in to work unless extraordinarily ill.
http://www.medscape.com/viewarticle/847547?src=wnl_edit_medn_wir&uac=60196BR&spon=34&impID=758713&faf=1
The practice of working while sick is common among physicians and advanced practice clinicians, even though it puts patient safety at risk.
ReplyDeleteAsk any healthcare manager whether they want their employees to come to work sick, and they'll certainly say they do not. But when a physician who's scheduled to see 20 patients that day calls in sick, or when a nurse approaches his manager to say he's too ill to work and needs to leave early, things can get complicated.
"You don't want anybody coming in sick, but if you don't have that coverage there, what are you going to do?" says Mallory Hatmaker, MSN, CNP, an adult/gerontology certified nurse practitioner with Cleveland Clinic's Employee Wellness and Internal Medicine departments.
What sick clinicians often do is trudge through illness and work anyhow, says a new study published in JAMA Pediatrics.
"You can't tell the person that needs open heart surgery" that you're sick and you'll get to them tomorrow, Hatmaker says.
Researchers at the Children's Hospital of Philadelphia conducted an anonymous survey of 280 attending physicians and 256 advanced practice clinicians. It found that although 95.3% of respondents believed that working while sick put patients at risk, 83.1% admitted to working while sick at least once in the past year.
A smaller number of respondents (9.3%) reported they had worked while sick at least five times. "Sick" symptoms included diarrhea (30% worked with these symptoms), fever (16%), and the acute onset of significant respiratory symptoms (55.6%).
Physicians were more likely than advanced practice clinicians to work with these symptoms.
Survey respondents said they worked sick because they
•Didn't want to let colleagues down (98.7%)
•Had staffing concerns (94.9%)
•Did not want to let patients down (92.5%)
•Feared of being ostracized by colleagues (64%)
•Had concerns about the continuity of patient care (63.8%)
Such responses reveal the complex social, cultural, and even logistical issues that cause physicians and clinicians to come to work when they're sick, the study authors say. There's a "strong cultural norm to come to work unless remarkably ill," the study says. Written responses also showed confusion about what actually constitutes "too sick to work."
http://healthleadersmedia.com/content.cfm?topic=PHY&content_id=318937##
Job stress could make you sick (surprise!)--see http://www.cbsnews.com/news/job-stress-could-make-you-sick-study/
ReplyDeleteFor the first time in her 10 years as a mother, Dr. Lisa Stern is keeping her sick child, Charlie, home from school today. He attended school earlier this week, a pair of sunglasses in one hand and a bucket in the other, after she instructed him to “tough it out” with his migraine headache. It was field day, and he earned a gold metal.
ReplyDeleteHe was then sent to school with weakness and myalgias, but was strong enough to push himself around in his wheelchair. His fever resolved after the ibuprofen Dr. Stern had been giving him around-the-clock for the last several days. The school called later that day when his rash appeared, but his mother reassured the panicked school nurse that it was “just a virus” and that he was not contagious. It was final exams, and the child earned all As.
When Charlie awoke this morning, he experienced several episodes of vomiting and diarrhea. Mother was getting him ready for the bus, when she noticed mucosal hemorrhaging. Given the family’s recent trip to West Africa, she thought perhaps her son should stay home from school, just for today.
Charlie has to stay home alone, though, because Dr. Stern has a clinic full of patients, and needs to make her RVU targets for the month.
http://www.gomerblog.com/2015/07/pediatrician-sick-child/