Presenteeism in the Radiology Department

Although presenteeism is a topic that is not widely discussed, itis looming as the department’s next safety risk. I certainly have given this topic more attention in my department.  Presenteeism is the practice of employees coming to work sick. Employees are there, but not doing much because they do not feel well and are often distracted. The employee is not operating to their usual level of productivity. The total cost of presenteeism to U.S. employers has been increasing, with estimates for current losses ranging from $150 to $250 billion annually.   

Unfortunately, the highest rates of presenteeism are typically seen in health care in which employees work with people vulnerable to illness, and there is the potential to compromise patient safety. It has been estimated that as many as 80% of physicians go to work sick, and nurses who go to work sick are more likely to admit to higher rates of medication errors and a greater number of patient falls. Sick employees are not as alert mentally and their reaction times are slower. Just think of the instances you have had a severe cold. Were you as sharp mentally or quick in your movement? In addition, sick employees are putting the rest of the staff at risk for illness. Earlier this year, I had an employee come in sick on the weekend and consequently infected two other employees they worked with. The result was staffing issues the following week.

Without question, today’s workplace  emphasizes being “lean and mean,” which often results in employees coming to work sick.  What are the main reasons for employees coming to the radiology workplace sick?

• Cannot afford to take the day off

• More work to do when they return

• Concern about job security

• Burdening their co-workers with a heavier workload

• Missing work deadlines

• Saving sick leave to deal with their children’s health issues

To change the culture of presenteeism, radiology leaders must do the following:[[{"type":"media","view_mode":"media_crop","fid":"50140","attributes":{"alt":"Sick","class":"media-image media-image-right","id":"media_crop_8753624356356","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"6101","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 215px; width: 170px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":"©Pretty Vectors/Shutterstock.com","typeof":"foaf:Image"}}]]

• Must recognize that presenteeism is a problem in workplace.

• Send employees home! As basic as it seems, many leaders are reluctant to do this.

• Foster a culture that discourages workers from coming to work sick. Explain to them the effect of their illness on patient care, safety and outcomes.

• Evaluate absenteeism policies and their strength of disciplinary action. These policies create incentives for people to come to work sick. Remove the aggressiveness of these policies and move to more trust.

Presenteeism and absenteeism have been described as simulating an iceberg, absenteeism is the top of the iceberg because it’s visible. You know when people are not at work.  Presenteeism is the part of the iceberg silently lurking below the water, it is not always apparent and you cannot evaluate how much an illness is affecting an employee’s performance.

Presenteeism is an issue that has not been given much thought, yet can have significant effects on operations and patient safety. I have made an effort to be familiar with this topic and I have changed my outlook towards employees coming to work sick. I now encourage staff to stay home when sick and send them home if they inform me they are not feeling well.  Matter of fact, last week I sent an employee home sick immediately after having an employee calling in sick. Both of these employees did MRI. The move left me without MRI services for the morning, however, I knew there was no risk lurking below the water.