4 in 10 Health Care Providers Choose to Go to Work While Sick

Although health care providers are instrumental in improving patient outcomes, sometimes they can do more harm than good—just by showing up.

A new study published in the November issue of the Association for Professionals in Infection Control and Epidemiology (APIC)’s journal American Journal of Infection Control (AJIC) reported unsettling news—4 in 10 health care providers are going to work while experiencing symptoms of infectious disease, particularly influenza.

Any individual who shows up to work when exhibiting symptoms of illness runs the risk of spreading whatever bacteria they have to others at their workplace. However, when health care providers choose to show up to work when they are ill, it can have serious repercussions, especially for immunocompromised patients or those suffering from chronic diseases who are staying at their health care facilities.

“A symptomatic health care worker can transmit pathogens directly to others; contaminate shared, high-touch surfaces; and experience impaired judgment based on the severity of their illness,” the study authors write.

So, why do it?

To find out, the investigators in the AJIC study collected data from a total of 1914 health care practitioners—ranging from physicians to pharmacists to assistants or aids from various institutions—throughout 2014 and 2015 as part of a national online survey. Participants self-reported influenza-like illness (ILI), which, according to a press release on the study, was defined as “the combination of a fever and cough or sore throat.” Furthermore, participants shared the reasons behind choosing to go to work despite feeling these symptoms.

Of the 1914 participants surveyed, 414 reported ILI. Of the 414 with ILI, almost half (41.4%) reported working for a median duration of 3 days with these symptoms. The investigators also determined that out of all the different work settings—hospitals, ambulatory care, physician offices, long-term care facilities, other clinical settings—those health care providers working in hospitals “had the highest frequency of working with ILI,” at 49.3%, compared with practitioners working in LTC facilities, who came to work with ILI 28.5% of the time. A total of 67.2% of pharmacists and 63.3% of physicians reporting going to work with ILI, making those 2 professions the worst offenders.

Health care providers reported the following reasons behind their decisions to show up for work despite their symptoms:

• Feeling that s/he could still perform her/his job duties
• Not feeling “bad enough” to stay home
• Feeling as if s/he were not contagious
• Sensing a professional obligation to be present for coworkers
• Difficulty finding a coworker to cover for her/him

In a recent interview with Contagion^®, Matt Linam, MD, MS, assistant professor of Pediatric Infectious Diseases at the University of Arkansas for Medical Sciences, addressed the issue of health care providers working while sick, stating, “Trying to get health care workers to stay home when they’re ill is a big challenge, and I think it’s a challenge for all hospitals,” he said. “There’s this ingrained mentality that ‘we need to work,’ ‘we need to be there.’ There are staffing challenges that are sometimes very real, and in some cases, we’ve actually created a system that penalizes health care workers for staying home. In order to really try to get health care workers to stay home when they’re ill, we really need to be more conscious about the system we’ve created.”

When health care providers choose to go to work, they put everyone at risk of infection, which could have deadly consequences. That’s why 2017 APIC president Linda Greene, RN, MPS, CIC, FAPIC, is calling for tailored strategies pertaining to each occupation and health care facility to remedy the situation. This would include “updating sick-leave policies,” which would help “empower [health care providers] to make healthy choices, not only for themselves but for their co-workers and patients.”

Although flu activity is currently low in the United States according to the Centers for Disease Control and Prevention (CDC), states are already reporting cases and even associated deaths. The best way to avoid illness is to get vaccinated against the virus, which is even more important for health care workers. In addition, the CDC recommends that anyone with ILI wait at least 24 hours after a fever breaks before they return to work.