Wednesday, November 16, 2011

Sick Days, Part the Millionth

I'm a PGY3 resident and my one year old baby has her first cold. I'm sick too. She's congested and can't sleep for more than about 30 minutes at a time. At 4AM, I realize that between being very sick and getting zero sleep, I don't know how I'm going to get through a busy clinic that day. I decide to text message the chief resident that I'm sick and won't be in that day, as well as sending an email.

The next morning, I wake up to a furious email from the chief, saying that my text woke her up and now she (also sick) has to cover my clinic after being woken up. I was inconsiderate on not one but two counts. (Had I not woken her up, I'm sure I would have somehow been yelled at for not letting them know soon enough.)

Later that year, I get tracheitis (whatever that is). I can't talk more than a few words. I come to work, but get sent home midday by my attending. I call the new chief to tell him I'm going to stay home the next day. I don't have anything even scheduled and was just supposed to "help out" with extra consults. "Well," he says, "I can dock you for the half day you took off today and a full day tomorrow. But the problem is, you can't take off more than six weeks in a year or else you have to make it up."

"Are you serious?" I'm baffled. "This is my second sick day. Do you have me recorded as taking off more days than that?"

"I'm just warning you."

Eventually, you get the message. Never call in sick. You get trained, like a dog or a seal.

I feel like now I need somebody to tell me when it's appropriate to take a sick day. In the past, before I got "trained," I took sick days when I needed to, sometimes more readily than I should have. Now I've gone too far in the other direction. There's a balance between being responsible about your job and ignoring family/health issues. When I tell someone that my child has a fever of 102 and is throwing up, yet I'm at work, it's almost a little embarrassing. Where are my priorities?

Recently, I had a pretty serious family emergency, and although I came to work, I left early. Unfortunately, I had a meeting in the afternoon where my presence was crucial. When I talked to the attending coordinating the meeting, I explained the situation and he said he'd have to cancel the meeting.

"Oh god, I feel awful about that!" I said. "Maybe I should just go to the meeting."

The attending looked at me like I was out of my mind. "Fizzy, stop it! You're being ridiculous. We'll just reschedule."

I felt grateful but also really ashamed over the decision I almost made.

9 comments:

  1. In my experience, the attitude towards sickness is very dependent on one's program. A friend of mine who is a psychiatry resident gets offers of homemade chicken soup when she calls in sick, while another friend who is a surgical resident gets accused of making it up. The last time the surgical resident got sick, she waited so long to take time off and get help that she ended up in the emergency department getting iv rehydration and antibiotics. The emerg doc actually phoned her senior resident and gave him shit for not sending my friend home from work sooner. It's ridiculous how much grief some programs can give residents about sick days.

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  2. I hear ya Fizzy!! I am a PGY-3 in FM and have a seven month old baby (my first). She brought something nasty home from daycare that my husband and I both caught. I felt TERRIBLE...productive cough, etc...let alone a sick baby. I had a full day planned in my continuity clinic and I called the clinic coordinator the afternoon before and tokd her i was ataying home the next day and she was surprisingly understanding. What WAS surprising was how much grief I received from my patients!! We rescheduled all of them and the majority of them commented on it: "The DOCTOR called in sick?!". Some of them were actually rude about it. It was a rough day but my last patient came in and he said, "My work supervisor couldn't believe that the doctor actually called in sick. But then I told her, 'She's a person too and doctors get sick.'" It made me feel better that he was supportive but also made realize how much people hold us to a double standard. Yes, it's inconvenient for our patients to reschedule but life happens. We get sick, our kids get sick and family issues come up. I would have actually been causing HARM to my patients by going into work coughing all over everyone. I guess I could have worn a mask and scared all of my well-child checks. :)

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  3. I think the amount of sympathy you get depends on how many coverage is available. My chief yelled at me that time b/c she was pissed off that she had to cover my clinic.

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  4. Unfortunately, it seems like some physicians see working when sick as an honorable endeavor. One of the anesthesiologists I work with likes to brag about the time that she had such bad gastroenteritis that she threw up in the operating room and continued to manage the case while she was hooked up to an IV for hydration. That attitude does nothing but put our patients at risk.

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  5. I may not be a medical person, but I sure know the pain of deciding whether to take a sick day, and whether its worth it. My job is to fill in when others are sick, but it backfires on me when I need time off. Its interesting to see the number of drivers who regularly take off for no reason or for just the smallest iota of a problem. There are drivers that I wonder how they still have a job since I'm on their route more than they even come to work on a regular basis.

    I hardly ever take off and have gone to work sick at times... which isn't a good thing since I work with children on a regular basis. I distinctly remember a few times I took off last year and got told I needed a doctors note. Overall my absences for one year is about 3 to 4 days total. So, while I have the sick time, I feel your pain about the "great sick debate"

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  6. During my surgical training I worked a weekend with my lovely surgical supervisor, who saw that I was really ill and unable to stop coughing. On Sunday afternoon he told me that I was too unwell to come to work on Monday and he told me that he would phone the surgeon I was scheduled to assist on Monday and tell him that I was too sick to come to work.

    I knew I was too sick to work, but I went to work anyway. The Monday surgeon said that it was a good thing I turned up, because he'd never met a trainee who was too sick to work. And that if I hadn't turned up he would have pretended it was OK, but that he would have secretly been giving me s*** behind my back.

    Between my viral laryngitis and my work ethic, that was the last day for three weeks that I had functioning vocal cords.

    I learned that I could operate very successfully without talking. The nursing staff were excellent at anticipating my needs and interpreting sign language. My junior staff learned to show great initiative. For three weeks I was relieved of the need to verbally respond to my "Monday boss", which was great. I learned a lot about people during that 3 weeks, and also about myself.

    Another surgical colleague has not been so lucky when she's worked herself into the ground. She's the only person I know who has worked with a ruptured abdominal viscus and ended up in ICU on high dose inotropes.

    Which is about as close to working yourself to death as I think you can get.

    Now that I'm through my training I figure I'm qualified to decide if I'm too sick to work. But equally, now that I get regular sleep and exercise I haven't had a really bad illness (touch wood).

    The attitudes I faced (recently) during training are extremely unhealthy, and I make a special point of sending sick junior staff home. Just like my lovely supervisor tried to do to me (thanks boss!).

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  7. I worked in World Class Big Name Clinic. And I was an "attending" already. Had dental emergency one day at work, and managed to make last appointment of the day with my dentist. Even though I cleared my schedule at the end of the day, it was not enough time. I was running and hour and a half late due to demanding patients that I could not cut short. In order to make my dental appt I had to tell the last two patients I had to leave. That night I logged unto my work computer to find an angry e-mail from office manager. I was blamed for not serving my patients, those last two patients of the day got into fight with staff as they demanded to be seen by ...me. Office manager wrote an angry e-mail about me to executive officer of the Big Clinic, cc'd to my medical director and chief of medical staff. My fault? Having a toochache that day. Somewhere in that one page e-mail was a mention that my medical assistant was upset she had to tell patients I was leaving for medical emergency. She had to deal with angry patients because of me. There were inflammatory quotes from those two paitnets in the e-mail. Sadly, most recently one of them was serviced by me almost on a daily basis with extensive phone calls and frequent visits (patient refused to reschedule appointment with me, because...the issue has already resolved, i.e. patient was already cured). Knowing repercussions and consequences in that work place I did not sleep all night, came to work the next morning with a migraine. Oh, and did I mention I never ever called in sick when working there. And my children were taken care of by live in nannies and my husbund.

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  8. Fizzy, I thought you were an attending.

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  9. wow, some of these stories are really incredible. We need to have a "worst thing thst happened when I tried to call in sick" contest.

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