Thursday Mailbag

We've received an avalanche of emails in response to our coverage on this week's show of health care workers who show up for duty despite having communicable diseases like influenza and gastroenteritis. One of the residents we interviewed from McMaster University's Faculty of Medicine told the story of getting H1N1 and being told by the daughter of a patient to stay away!

We've received an avalanche of emails in response to our coverage on this week's show of health care workers who show up for duty despite having communicable diseases like influenza and gastroenteritis.  One of the residents we interviewed from McMaster University's Faculty of Medicine told the story of getting H1N1 and being told by the daughter of a patient to stay away! 

As you heard on the show, residents and nursing students are reluctant to stay off work when sick.  The residents said there's a culture in medicine whereby MDs are expected to show up for work unless incapacitated.  The nurses were better able to than doctors to identify with a need to take care of them so that they could take better care of their patients.  Both nurses and doctors said they feel guilty about making their colleagues work harder in the absence of ill colleagues. 
 
And then, we heard from you.
 
"I am a high school teacher of 16 years and am in contact with hundreds of people, in close proximity on a daily basis.  I remember a few years ago a student who had a horrible sinus infection came to school to get work done.  He asked for help (on the computer) and within a few days I had the horrible sinus infection.   I was off for days at great cost to the system.  I see teachers coming in when they have no right to be there as it is hard to prepare for the day off.  Many teachers feel that they would rather come in sick then prepare for a substitute teacher.  I am always amazed at how stupid our work ethic culture can be. Personally I tell students to stay home when they are sick.  I wish we had guidelines to tell them when to come and when not to.   I now use my sick days as I need them, I have found I use less of them if I do."  From David Trimbee
 
"At the local unit long-term care unit where my mother resided until she died recently, there are signs urging visitors to stay away if they have symptoms of flu or cold.  However, it is the policy of the health authority not to replace care aids that call in sick.  I often noticed staff struggling to work through a shift while plainly ill.  It's a no-win situation that must be addressed at the administrative level."  From:  S. Cooper
 
"Frankly, I listened with a mixture of disbelief and disgust.  There is no doubt the culture needs to change and that the system needs to be designed so as to protect vulnerable patients from coming into contact with irresponsible healthcare providers.  No wonder my children and I always get sick when we have to go to the hospital."  From:  Maryse Nelson.
 
"I was listening to your show the other day, there was someone on talking about how hospital staff often came to work sick, and how there wasn't a good substitution system in place when nurses, for example, call into work sick. There is a good system teachers use for this purpose, which I am sure would be adaptable for replacing hospital staff.  It only makes sense to have such as system, as I am sure that hospital workers are more exposed than most to sickness."  From:  Robin Bellows
 
"My late husband was a doctor. The only time I ever remember him missing work due to illness was when he was in the hospital himself for knee surgery. He worked on days when he was sicker than any patient he saw.  It always seemed to me that on the days he was ill, the patient load was greater than on most other days. The occasion that stands out most clearly in my memory was the day he slid and fell on an icy staircase. I was walking behind him and saw the fall. At home, he had me bind up his chest with rolls and rolls of adhesive tape, and then he went to work. He worked afternoon and evening, and, as I remember, he saw about fifty patients in those two sessions. Of course it later turned out that he had cracked several ribs, but even this did not keep him off work. I can't say all of his patients thought him a hero for going to work when he did not feel well." From:  Janet Garnhum
 
"I think that those caring for the elderly in Personal Care Homes often turn up sick for their shift, or in those first few days, when they have a sore throat, but don't necessarily have a fill blown cold, because there is that feeling of their having cared for those people and that they would know so much more than someone taking over. There also seems to be a bit of a thought amongst some of those people that, hey, these people have had their shots and if they get sick, it might just be a blessing in disguise. That should never be there, but I think that it still is. I wish there were more people to take over on that front so this does not need to happen."  From: Margaret Smith
 
"I had to write to express my revulsion at what I heard from several of your medical (M.D.) guests this morning.  They spoke "with pride" about past occasions when they went to work seriously ill or injured.  I can't imagine how anyone who would so intentionally expose others to illness or injury could ever have understood the first principle of medicine -- "do no harm".   I hope the College of Physicians and Surgeons listens to your program, takes notes, and follows up with disciplinary action where it is so clearly called for."  From Mike Bryan
 
"I worked in a health agency (15 years ago) and almost always went to work when I was sick. There was no extra staff to cover if one of us was off. Clients came from quite a distance for their clinical appointments with our agency so it was very annoying to them to have an appointment cancelled at short notice. Sometimes the clients could not be contacted because they were already in transit to our agency. In addition, the business management did a study of sick time absence and set up a monitoring system whereby, if several absences were identified, the manager was obliged to call the staff person for an interview and an entry was placed in the staff persons file; this despite the fact that staff had a contract which included several paid sick days per year.  There was absolutely no incentive to remain at home when sick.  I sometimes left work early when sick, as soon as I had completed all the work that required my presence. I have no doubt that my germs were spread around."  From:  M. Parkes
 
"This week's broadcast struck a chord with me.  Yes nurses can call in sick. We can have back up sometimes but not always. I used to have extreme anxiety when calling in sick because of the responsibility I felt. I worked on the bone marrow transplant unit and of course the patients were immunocompromised. One staff member told me that the patients were on so many drugs that a little cold from us wouldn't touch them. I often witnessed, and I'm sorry to say this, many doctors who walked through the isolation doors to the unit who did not do the mandatory scrub-up to the elbows that was required. It was if the attitude was that a doctor could not pass on their bugs to the patients. It was difficult to understand. My hands and arms were always chapped and red from the antibacterial scrubs. I didn't sit in judgement over them; I just couldn't understand it.  Please keep this anonymous as it's a small, small world."  From:  Name Withheld
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