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Fight the Flu & Busted Budgets with Balance

By Jamie Miller posted 02-14-2017 14:58


More than 40 states are reporting flu activity as widespread according to the Centers for Disease Control and Prevention.  With more than 10 years in nursing, and part of that time in public health, these continuous reports on an increase of flu cases during this time of year are no surprise to me.  What does surprise me is that despite constant monitoring from the CDC, more than 80% of clinicians have admitted to working sick at least one time over the course of a year.1

It gets worse. This same study from JAMA Pediatrics found 30% would work with symptoms of diarrhea. Or how about 55% said they would go do their job with significant respiratory symptoms.

I can speak to the mindset of a nurse. We don’t want to appear weak. We don’t want to be a burden to our fellow nurses by giving them extra work. We want to help the team, not hurt them, but anytime anyone goes into work fighting the flu you’re hurting the team in more ways than one. Clinicians aren’t alone. A recent public health survey found that a third of people living in New York City admitted that they go to work with flu-like symptoms even though they know it’s contagious.

It’s not just the coughing or the fever that employers should worry about.  Healthcare systems, or any company for that matter, will feel financial pain without a good policy in place.

There is lost time and productivity.

On average, a worker will miss between 2-3 days from work because of illness. When they return, those same workers said they didn’t resume normal activity until three days after the symptoms started.2  So imagine those employees just hanging around work, not performing their best and possibly spreading the influenza virus to coworkers.

In healthcare, there are resources to prevent transmission which you can even find on Medline University. Many hospitals have a sick policy or documented list of reasons why employees shouldn’t come in. Again, this shouldn’t be something that’s disregarded. There should be a greater effort to utilize it, but other employers might find this helpful for their workforce to wipe away any grey area about when an employee should call in sick.

Your staff suffers.

When the flu spreads throughout the workplace, there’s the chance for increased overtime. Hospitals have the ability to quickly diagnose the illness with products like the Medline Influenza Test, but sometimes that’s overlooked because of the need to get the job done, ultimately impacting a whole slew of people: CNAs, healthcare assistants, secretaries, volunteers and even transporters. At some point, someone has to pick up the slack and extra resources are needed and that costs money.

The CDC suggests a cost of $16.3 billion in lost earnings a year because of the flu.

Change thinking and save money.

There is a solution, but it might be harder than you think. Providing the flu vaccine on-site is one part. The other is a change in the workplace culture. Employers need to get their employees to understand there’s balance when it comes to their job and personal life. A survey of American workers in 2015 found more than half didn’t use all their vacation days.  Those employees said they worried no one else could step in and do their job.   Employees need to understand they can take a step back to focus on their health because when they are happy, researchers in Britain found they are more productive.3

What is your company doing to implement a healthier workforce?




12-14-2017 14:45

As we are approaching into yet another influenza season there have already been some deaths from influenza, 7 of them children.  “While influenza has not quite reached epidemic levels yet, it’s spreading farther and faster than it did at the same time last year, the Centers for Disease Control and Prevention said Friday [12/8/17]” (Fox, 2017).  The best ways to prevent influenza is to be vaccinated, proper hand washing, and to stay home when sick.  At the facility I work for there is a very strict policy in place which requires all employees to receive a flu vaccination by a certain date, unless you provide a medical reasoning singed by a physician or you will be terminated.  For those who are unable to receive the vaccination are required to wear a mask at all times when in public areas and those who have received the vaccination have a card which must be visible on their badge at all times. 

            I agree that employees who are ill should stay home, but often do not.  Many of the reasons are they know their shift is already short staffed, or they have reached their number of unscheduled episodes and will get written up if they do not report to work.  Although my facility has hand wash stations with masks and a sign stating if you have symptoms of a cold or flu, please wear a mask in public areas.  These seem to work best for patients and visitors, but not so much for the employees.  As you stated, nurses (and other health care workers) do not want to appear weak and will not wear them while providing patient care.  By doing this, increases the risk of our patients to become infected.  “At least one earlier study has shown that patients who are exposed to a healthcare worker who is sick are five times more likely to get a healthcare-associated infection” (Lewis, 2017)

            National Institute for Occupational Safety and Health at the Centers for Disease Control and Prevention in Cincinnati, Ohio completed a study of 1914 health care professionals  from 2014-2015.  This study found that 21.6% of the respondents reported having an influenza like illness during the time period and 41.4% continued to work for a median of 3 days.  Facilities need to implement stricter rules on reporting to work sick and a time period the employee must stay home if they are infected with influenza.  In addition, employees need to feel safe in calling in and will not get written up or “sculled by their peers.”

Fox, M. (2017). Flu season is coming early and looking tough. NBC News. Retrieved at:

Lewis, R. (2017) Four in 10 Healthcare Personnel Work While Sick. Medscape. Retrieved at:

06-06-2017 20:20

Unfortunately, the statistic you provided that “more than 80% of clinicians have admitted to working sick at least one time over the course of a year” is not surprising to me. I am a nurse in a high acuity unit of a hospital, and calling in sick seems to have become almost shameful in this profession. As I’m sure you’re aware, nurses are notorious for putting others needs before their own; With the topic of nurse burnout being a consistent discussion within the profession, I can’t help but wonder if part of the burnout problem is self-inflicted? Yes, nurse to patient ratios, mandatory overtime, and other issues within the profession undoubtedly add to the burnout epidemic. However, with startling statistics such as the ones mentioned in your blog post, how can we not begin to wonder if more focus should be towards the implementation of higher standards of care for the SELF? To implement a healthier workforce I agree that a culture change is indeed necessary. Peate (2015) reports that “US hospitals with more stressed-out nurses had noticeably higher infection rates” (p. 133).

I currently practice in the state of Florida, and the Centers for Disease Control and Prevention reports that my state currently does not require hospital employees to be vaccinated against the flu. However, these vaccination rules are usually overridden by institution specific requirements. The implementation of a policy that requires healthcare staff to be vaccinated against the flu is a delicate but necessary discussion.  Field (2009) discusses this issue as a threat to patient safety. There is a fine line between respecting the right of the health care worker to choose their vaccination status and providing the safest level of patient care.

The Healthcare Infection Control Practices Advisory Committee (HICPAC) and the Advisory Committee on Immunization Practices (ACIP) both have recommended that all healthcare workers should be vaccinated annually against the flu (Stewart, 2012). I believe that each state should incorporate this ACIP and HICPAC statement to aid in the development of a policy that requires health care workers to be vaccinated.

Amy Nauman, BSN.

Field, R. I. (2009). Mandatory Vaccination of Health Care Workers: Whose Rights Should Come First? Pharmacy and Therapeutics, 34(11), 615–618.

Peate, I. (2015). Sick, Stressed and Burnt-Out Nurses Are No Good to Anyone. British Journal Of Nursing, 24(3), 133. doi:10.12968/bjon.2015.24.3.133

Stewart, A. M. (2012). Using State Laws to Vaccinate the Health-Care Workforce. Public Health Reports, 127(2), 224–227.

US Department of Health and Human Services (2014). State Immunization Laws for Healthcare 
Workers and Patients. Retrieved from:

06-06-2017 18:32

I agree that it is conserning that even with the CDC reports that come out year after year, there aren't more campaigns to mandate flu vaccinations. I also find in fascinating that 80% of clinicians report working with positive symptoms. The balance between work and personal life is one that carries a different definition for each of us. Employers should encourace the use of personal time and penalize for its nonuse. When your statistics are compared to some of the Department of Labor statistics surrounding the frequent use of FMLA, its alarming how many workers are really saying they just need time to rest and let their system decompress. The DoL estimates that at any given time, 10% of the American work force is out of work on FMLA with the number 1 reason being listed as Personal Sickness. These employer initiatives and the data have to be looked at hand in hand because if vaccinations cannot and likely will not be mandated, its up to the employers to take active stances in supporting their own workforce.