Nurse Sick Calls: Irresponsible or an S.O.S

One question nurse managers often ask me is, What do I do about the nurse who always calls out sick? or How do I handle frequent sick calls? 

There are a few things to consider when this happens.  And the manager's annoyance at the call outs often tell me a lot about her leadership mindset. I get it. Nurses who do not present for their scheduled shifts impact staffing ratios, the unit budget and workflow.  Now, this would not be such an issue if facilities would stop bare bones staffing practices but that's a separate blog post. I digress. 

Let's look on the positive side: What if the nurse is genuinely sick? We protect the sick and the well and sometimes this means that we need to make judgement calls on ourselves.  Personally, a nurse staying home when she is sick to avoid spreading the illness to patients (who are already ill) and/or co-workers is a sign of good common sense.  If a nurse is unable to perform at her best because she is sick, then she is a danger to the patients and a danger to herself. In that case, home is the safest place for her.

Now, if you notice frequent sick calls: a manager will address the pattern, cite hospital policy and follow the discipline plan for the behavior. But a leader will try to understand why the sick calls are happening. A leader recognizes that nurses have a right to call out sick and sick-calls may be the manifestation of some other issue.  Avoidance is a common coping mechanism used by nurses when they are experiencing personal issues, a toxic work environment, being victimized by bullying or are seeking other employment.  Frequent sick calls are also a sign of severe stress.  Instead of dismissing these calls as irresponsible behavior, investigate to ensure that they are not a cry for help.  

Here's how leaders handle frequent sick calls:

1.  They do not jump to conclusions about anyone's work ethic because they are inconvenienced.  They examine their potential role in the event.  They ask themselves, Am I modeling the behavior that I would like to see?

2.  They pull the assignment records and any other shift records that can help them to identify if a pattern exists. Do the sick calls happen only when certain groups are on assignment together? Are the sick calls more frequent during specific days of the week?  What was the nurse's patient assignment for previous shifts?

3. They think long and hard about the nurse. Is she new? Is she one of my senior nurses? What are her goals? What does she do well? How is her care quality? Was she a good fit/hire? Any recent changes?

Most importantly,

4. They talk to the nurse, face-to-face.  This the opportunity to connect, not chastise.  Demonstrate concern instead of annoyance. Assure the nurse that she has a safe space to be honest.  Be open-minded.  The issue can be anything from a divorce with a nasty custody battle to a substance abuse problem, to bullying/incivility issues.  Educate yourself on employee resources available to help her.  

In my years of nursing, education and coaching, frequent sick calls are seldom signs of irresponsible behavior.  They are usually an S.O.S.  This is a great opportunity to demonstrate the values employees recite to The Joint Commission.  Offering support builds loyalty and increases the likelihood of retention.