Why Healthcare Workers Go to Work Sick

Imagine lying in a hospital bed, recovering from an accident or illness, only to discover that the nurse who greets you in the morning has come to work with some sort of respiratory illness. How would you feel about that? It turns out that such scenarios are not unusual. Despite very clear policies designed to keep sick healthcare workers at home, many workers report to work sick anyway.

If we assume this to be an untenable position, it behooves the healthcare industry to figure out why it occurs and how to prevent it. It is apparent that policies designed to keep sick workers at home are insufficient in and of themselves.

Alarming Study Data

A study published last fall in the Infection Control & Hospital Epidemiology journal shows that healthcare workers report to work while sick quite frequently. The study followed 76 staff members and 105 patients in a long-term care facility in St. Louis.

Researchers asked both staff members and patients to report symptoms of acute respiratory illnesses (ARIs) whenever observed. With every report, researchers analyzed throat and nasal swabs. Study participants were tested one more time at follow-up.

Researchers discovered that 18 of the 76 staff members were diagnosed with an ARI during the five-month study period. More importantly, 16 of them (89%) reported to work while sick. The good news is that there was no correlation drawn between staff members and patients. Researchers found no reason to suspect transmission between them.

It was also noted that the small-scale study was limited in its ability to reach any definitive conclusions about spreading ARIs at work. Yet the fundamental point remains: sick healthcare workers are still reporting to work in large numbers.

Why It Happens

Knowing that a sick healthcare worker still report to work is of little value all by itself. Now we need to know why it happens. Perhaps that should be the next avenue of study. Until then, we are left to speculate.

One possible reason is the fact that healthcare facilities are under very tight staffing restrictions. They compile their weekly schedules with very little wiggle room. Simply put, healthcare staffing is already threadbare. If one person has to call in sick, there isn’t someone waiting in the wings to step up. That means someone else has to put in overtime.

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Another possible cause is pressure from management. Managers and administrators are tasked with getting the job done using minimal staffing levels. Because they are not allowed to – or simply cannot – increase hiring, they are under pressure themselves to make do with less. They turn around and put pressure on workers to show up even when they are sick.

Moving Beyond Mere Policies

Regardless of the reasons, it is clear that healthcare workers are reporting to work sick despite policies in place to prevent it. The lesson here is clear: healthcare facilities must move beyond mere policies if they believe there is a problem here. And of course, that is up for debate.

There are certain highly contagious diseases that are easily spread on casual contact. Healthcare facilities go to great lengths to prevent transmission of such diseases. But ARIs are not only fairly routine, they are not transmitted so easily.

If healthcare workers reporting for work sick is a problem, then it is clear we need new solutions. That much is certain.