Tuesday, February 19, 2008

doctors don't get sick days

So as many of you know, the flu season started with a vengeanance this year. And unfortunately for those of us who got our flu shots, the predictions were grossly off target.

So while I have worked in many a place where folks constantly push the envelope of coming in to work while ill, the era of the coughing coworker is ancient history. The sick policy is now so strict that if you cough while taking a sip of water, folks are starting to raise eyebrows. God help you if you suffer from allergies or frequent sinus infections, because if you do, you must see the occupational health RN and be the recipient of a nasal wash. Which, by the way...takes about 1.5 days to get resulted; which means you are subsequently BANNED for the interim.

At first, when the madness started everyone had to wear gloves with ANY patient contact whatsoever. Even if body fluids weren't involved. Even if you were a receptionist who occasionally handed papers back and forth with the patient but spent the majority of the time typing and on the phone.

Craziness. And questionably effective. Evidence-based practice my arse.

While I at first was somewhat sympathetic with these extra precautions having worked with hoarse-voiced, narrowly suppressed coughing nurses in the past, the love-all let's glove-all approach initially resembled insanity from a bad movie. Luckily it was short-lived. But then it gave birth to a new phenomenon--a very strict sick policy. This includes daily staff self-assessment (exemplified by a dated sticker that must be plastered across your physical person in an OBVIOUS location) in addition to surveying each and every person--man, woman, child, and service animal-- entering the clinic.

Now this is a measure I can definitely support. Unfortunately it hasn't been without its consequences in terms of staffing. I don't think anyone could have possibly imagined the huge staffing impact this would have. In several instances, things have been kept at a barely functional level. And the temporary staff hired to help out with the anticipation of the impact of flu season is predictably under-trained.

So while patient have been quite understanding and appreciative of this vigilance, those of the staff who miraculously manage to avoid being ill (such as myself) have been trudging along, occasionally contemplating the merits of taking a 'mental health day'. =)
Exampled of creepy-crawlies occasionally found within hospital rooms

One of the things docs are (with a few exceptions) notorious about is foregoing, ignoring, or being completely oblivious to (? which is it?) infection control policies. Over 4 years of inpatient nursing, I have repeatedly seen troupes of residents and attendings march into MRSA positive or otherwise rooms sans hand hygeine, gowns...and I highly doubt that any of the necessary precautions continues to take place behind closed doors. There is a near certainty that the patient was physically examined in some way-probably by the one poor sucker of a resident who didn't even bother to put an isolation gown on properly while brushing against a bed full of microscopic creepy crawlies. And if I happened to be in the room at the time, gentle reminders or outright protests were voiced.

So now the flip side of all of this is the sick policy is...would you believe it, applies to physicians as well! Their noses must be washed, the results must be known, and they must be symptom-free before entering the clinic! Just imagine--the same rules for the person who does scheduling and is limited to short, non-medical in-person interactions also applies to the person who spends at least 30 minutes with a patient in an enclosed space aka the doc. Oh the brilliance of universal policies.

With only a few exceptions, the patients aren't buying it. And the docs aren't either. I've seen a surprising number of interesting tactics on behalf of clever MDs to circumvent the clutches of the infection control nurses. For a few days now while the doc has been banned, I've managed to turf as many non-urgent issues as possible and defer to other providers. But quite a few patients are more than less appreciative of what they see as these so-called measures to protect their health.

Short of dunking a thermometer in ice water concealed in a coat pocket while the nurse ain't looking, sending in a body double, or inventing a self-hologram I don't put much past this determined doc.

So let's sum it up...doc's voice sounds like a frog, face looks chalky, and there's a rumor that the one MA who can always sweet-talk the doc got an actual temperature on that was definitely not normal.

Who the heck does he think he's kidding? (and hopefully not...ahem, killing?)


deanna said...

Wow! That's pretty serious. I've been walking around with cold/flu symptoms for more than a week now but "lucky" for me it's not bad enough to get me out of work.

Here's to hoping you keep avoiding it!

Jen said...

A strict sick policy is good, but for some reason, patients think healthcare providers shouldn't/don't get sick and are less than understanding. Here's hoping you avoid the bugs!