January 14th, 2013
You’re Sick: To Work, or Not to Work?
Harlan M. Krumholz, MD, SM
Our hospital, like many others, is experiencing a surge in patients with influenza-like-illness. According to CDC statistics, this year’s viruses are causing more illness than those in the recent past.
We received a notice yesterday from our hospital that urged healthcare workers to stay at home if they have fever, respiratory symptoms, or diarrhea. As doctors, though, we rarely give in to illness. We know that if we do not work many people will be inconvenienced. We tend to work through illness until we are incapacitated. But is that approach really in the best interests of our patients – especially during an influenza epidemic? I fear that we often act as vectors of illness in our attempt to be responsible about our commitments.
So my questions are: What is your approach? How sick do you need to be to cancel your appointments and obligations and stay home? What do you think would be the ideal approach – and what really happens? And what do you tell the healthcare personnel around you?
3 Responses to “You’re Sick: To Work, or Not to Work?”
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This question is very apropos for me, as I called out today after agonizing about it for a couple of hours. I knew that calling out would mean more work for my colleagues who are seeing the sea of sick patients we have been seeing for the past few weeks. I thought about going in and wearing a mask while seeing patients. But 103 fever plus chills, body aches and a heavy cough convinced me that seeing patients would likely harm more people than help them. I was especially concerned about my frail elderly patients with CHF, COPD, etc. I actually regret going in yesterday when I felt I was coming down with something, as I suspect I “shared the love” unintentionally, either with my co-workers or a patient, despite the good hygiene practices I follow. Finally, I do need to take care of myself and get well; working when sick wouldn’t facilitate that. I figure that one of my colleagues is likely to call out in the next couple of weeks, and I would like to be there to pick up the slack for them, same as they did for me today. The question right now is: what about tomorrow? I will wait until the morning to decide.
Loretta Sernekos just about summed it up. Wow, do you have to hit 103 to think about staying in bed? I’m lucky to have a team that orders sick members to stay at home (working is not an option!!) We all know, as Loretta points out, that this is not a favor, this is a “loan”, as next week someone else can be ill. So the team is happy to pick up the extra work, comforted by the knowledge that when it is their turn, they can stay home without guilt added to injury. As department head, I don’t even get a word in sideways, the team has decided. Wish you all this luck!
There’s a fabled story about a dominant surgeon who looked across the operating table to note that one of his juniors was “off-colour”. His reputed comment was -“My dear boy, you’re jaundiced. Take the afternoon off”.