Healthcare Workers not Taking Sick Days Despite Patient Risk

Many healthcare workers such as physicians and advanced practice clinicians (APC), registered nurse practitioners, physicians assistants and midwives reported to work while sick, fully realizing that their patients could be at risk according to a small JAMA Pediatrics survey conducted online. Exhausted Adult Female Doctor Touching Her Nape

Working While Sick for Patients to Be Well

The survey found that while most people who took it believed they were putting their patients at risk by working with them, 83.3 percent of the healthcare workers surveyed reported working at least once while they were sick in the past year, and 9.3 percent reported being sick at work at least five times.

Why do they do it?

Even though the healthcare workers surveyed believed they were putting patients at risk when they were sick — especially workers who dealt with neonatal and other immunocompromised patients — they still reported to work. The healthcare workers who took the survey reported symptoms including diarrhea, fever and respiratory symptoms.  The vast majority, 98.7 percent, of physicians and APCs said they reported to work because they did not want to let their colleagues down, 94.9 percent cited staffing concerns, and 92.5 percent said they did not want to let their patients down. Sixty-four percent said they feared being ostracized by their colleagues, and 63.8 percent were concerned about continuity of care.

Putting Everything in Perspective

In a related editorial, Jeffrey R. Starke, M.D., of the Baylor College of Medicine, Houston, and Mary Anne Jackson, M.D., University of Missouri-Kansas City School of Medicine, write: “Creating a safer and more equitable system of sick leave for HCWs [healthcare workers] requires a culture change in many institutions to decrease the stigma — internal and external — associated with HCW illness. Identifying solutions to prioritize patient safety must factor in workplace demands and variability in patient census and emphasize flexibility. … Also essential is clarity from occupational health and infection control departments to identify what constitutes being too sick to work.”

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