Calling in sick

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Tired said:
I'll defend it.

The arguments for calling in sick basically revolve around two trains of thought:

1) I feel too sick to work. I need to stay home to get better.
2) I'm going to make my patients sick, so I should stay home.

Here's what I say about that:

#1 - Shut up. You work in a hospital, and you know what people who are really sick look like. If you have some diarrhea and have to answer a few pages from the crapper, then do it. If you have the sniffles, I really don't care. I'm not covering your service because you don't feel good. It's internship, we don't feel good every day.

#2 - Has everyone forgotten the difference between a bacterial and viral illness? You have a f-cking cold. A cold. Seen a lot of people die of that lately? Have you admitted a lot of "Rhinovirus Sepsis" lately? And even if it is something a little stronger like influenza, put on a mask. Wow. That was tough.

Basically the best reason not to call in sick is that it makes you look like a p*ssy. And you're not a p*ssy are you?
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Tired said:
I'll defend it.

The arguments for calling in sick basically revolve around two trains of thought:

1) I feel too sick to work. I need to stay home to get better.
2) I'm going to make my patients sick, so I should stay home.

Here's what I say about that:

#1 - Shut up. You work in a hospital, and you know what people who are really sick look like. If you have some diarrhea and have to answer a few pages from the crapper, then do it. If you have the sniffles, I really don't care. I'm not covering your service because you don't feel good. It's internship, we don't feel good every day.

#2 - Has everyone forgotten the difference between a bacterial and viral illness? You have a f-cking cold. A cold. Seen a lot of people die of that lately? Have you admitted a lot of "Rhinovirus Sepsis" lately? And even if it is something a little stronger like influenza, put on a mask. Wow. That was tough.

Basically the best reason not to call in sick is that it makes you look like a p*ssy. And you're not a p*ssy are you?
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Actually I am. [shrugs] I guess that explains it. Are you also one of those guys who thinks that someone "talking s**t" is a good reason to fight them?
 
:laugh:

Sure, we all feel sick in one way or another each day of internship, but there are times when you should call in.

At what point do you draw the line? A pregnant resident, severely sick in the first trimester: stay at home?

A pregnant resident, with some contractions, but a ways off from delivering: stay at home?

A resident who hasnt slept in 40+ hours due to work and constant vomiting/diarrhea: stay at home, or round with patients?

Maybe you were actually joking in your post, but if not, chill out man. There are times to call in sick: we're only human.

Tired said:
I'll defend it.

The arguments for calling in sick basically revolve around two trains of thought:

1) I feel too sick to work. I need to stay home to get better.
2) I'm going to make my patients sick, so I should stay home.

Here's what I say about that:

#1 - Shut up. You work in a hospital, and you know what people who are really sick look like. If you have some diarrhea and have to answer a few pages from the crapper, then do it. If you have the sniffles, I really don't care. I'm not covering your service because you don't feel good. It's internship, we don't feel good every day.

#2 - Has everyone forgotten the difference between a bacterial and viral illness? You have a f-cking cold. A cold. Seen a lot of people die of that lately? Have you admitted a lot of "Rhinovirus Sepsis" lately? And even if it is something a little stronger like influenza, put on a mask. Wow. That was tough.

Basically the best reason not to call in sick is that it makes you look like a p*ssy. And you're not a p*ssy are you?
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Perhaps those in residencies without fear of retribution, a soiled reputation or the dreaded "black mark" feel more comfortable calling in sick?

Because a lot of it depends on the culture of your residency program. In the end, don't many of us stick to the status quo to avoid getting beat down?
 
TRAMD said:
I don't even know what you are affirming but, as always, I enjoy your post.
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You asked if we thought if someone talking **** was a good reason to fight them. :D
 
Everyone keeps saying that pregnancy is the only reason to call in sick. I look down on pregnant women who call in sick. In the wild, animals give birth and then immediately continue with their normal routine. If guys can't call in sick then neither can the ladies. If you can't cut it, get back to the kitchen!
 
I can usually work with a migraine if it hasn't gotten to the "get the gun" stage. Imitrex and Coke, munching a couple saltines usually gets me through, and I have po Zofran if the nausea is really bad. But if it gets too far gone, then that's it--I just can't work. If it gets that bad, then I need stronger meds, and then that takes me out of the loop for working.

Doing rounds with IVF running? Now that's dedication. Or a major guilt complex. I'd worry about feeling so ill that I'd make a mistake and then get sued. I've had supervisors say you can get your license disciplined for making a mistake that harms a pt. if it has been determined you were too ill to be there. (This is nursing, I don't know about docs.)

It is ridiculous that you're demanded to be superhuman. Doctors are just as susceptible to flu, illnesses, injuries as anyone else. A healer can heal others much better when he/she is healthy.

I'm surprised the infection control zealots don't crack down on some of this stuff.

BTW Kimberli, have you noticed a difference in your migraines since you're out in AZ? I think this crappy East Coast air and weather is a huge trigger.

Kimberli Cox said:
I think its ridiculous (as I noted in my earlier post)...but yeah, for some reason we have to be superhuman and work under conditions we would expect others to be home in bed getting rest.

Please do not praise me (if anyone were so inclined)...this behavior was part my upbringing, part fear of retribution from my residency program and partly because I felt like I could continue working without having to screw over my colleagues. That said, my personal feeilngs on the subject perhaps lead me to feel less sympathy for colleagues and patients who I deem as being "whiners" or complaining about minor ailments.
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snoopy brown said:
You asked if we thought if someone talking **** was a good reason to fight them. :D
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Just a small critique . . . perhaps writing "Hells ya b**ch!" would have been more appropriate?
 
Blade28 said:
45 patients for the entire clinic. Usually me, another resident, and an attending. :)
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If you are seeing that many follow-up post-op patinets in such a short time frame then its not worth having them come in at all. Instead you should just hire a nurse to call them at home and ask how they are doing.

NOw for new consults, its a different story. But I dont think you get much out of having follow-ups come in for a 2 minute physical exam 2 minute question period about how their bowels and incision site are doing.
 
Tired said:
I'll defend it.

The arguments for calling in sick basically revolve around two trains of thought:

1) I feel too sick to work. I need to stay home to get better.
2) I'm going to make my patients sick, so I should stay home.

Here's what I say about that:

#1 - Shut up. You work in a hospital, and you know what people who are really sick look like. If you have some diarrhea and have to answer a few pages from the crapper, then do it. If you have the sniffles, I really don't care. I'm not covering your service because you don't feel good. It's internship, we don't feel good every day.

#2 - Has everyone forgotten the difference between a bacterial and viral illness? You have a f-cking cold. A cold. Seen a lot of people die of that lately? Have you admitted a lot of "Rhinovirus Sepsis" lately? And even if it is something a little stronger like influenza, put on a mask. Wow. That was tough.

Basically the best reason not to call in sick is that it makes you look like a p*ssy. And you're not a p*ssy are you?
Click to expand...

wtf.gif


The cocaine addict who dreamed up our inane residency training system couldn't have said it better himself.
 
Doing rounds with an IV, or being so delirious in surgery that you need tylenol to bring your fever down is not being dedicated, it's being ******ed. No patient out there appreciates that, and if the public knew things like that were going on there would be a major ****storm. :thumbdown:
 
fab4fan said:
BTW Kimberli, have you noticed a difference in your migraines since you're out in AZ? I think this crappy East Coast air and weather is a huge trigger.
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Not actually out there yet - starting work in November. I need to change my location info as I'm getting PMs from students asking for advice on Az residencies!:laugh:

TMI warning: but my migraines are almost always menstrually related, so I haven't noticed any environmental differences between home in Cali and out east. My best prophylaxis is to prevent my progesterone from dropping but sometimes I lose track of the date, etc. and wind up paying for it.
 
devildoc2 said:
If you are seeing that many follow-up post-op patinets in such a short time frame then its not worth having them come in at all. Instead you should just hire a nurse to call them at home and ask how they are doing.

NOw for new consults, its a different story. But I dont think you get much out of having follow-ups come in for a 2 minute physical exam 2 minute question period about how their bowels and incision site are doing.
Click to expand...

And many in private practice do do that (ie, don't have routine post-op visits) because you aren't paid for the visit anyway and it takes clinic time away from new paying customers. I've seen it in an academic center as well, which I found curious.

However, in an academic setting there is validity in bringing patients back as I do think residents and students can learn a fair bit by seeing multiple post-op wounds. If you've never seen a normal healing wound or talked to a patient who is progressing normally post-operatively, you don't have as much appreciation for the abnomal post-op course.

In addition, I don't like the concept of not seeing my patients post-op, even if it is only for a few minutes...maybe once I'm a more seasoned attending I can feel comfortable that everything will turn out all right, but until then, I want to see my work.
 
oldbearprofessor said:
Infants with multiple health problems, not just NICU patients, but also those with congenital heart disease among other problems, who could be in a number of hospital locations (including an ER of many hospitals), routinely become extremely sick from RSV and other viral respiratory infections. We have several otherwise stable infants die of RSV in our hospital every year and we've had several influenza deaths. Anyone working with sick infants and children, which could include a wide range of caregivers, not just those covering an NICU, should be concerned. Using a mask is inadequate to protect the children at least as far as our infection control and ID specialists have told us.
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True enough. I wasn't including NICU in my rant, because aside from those you who want to be there, the rest of us avoid the place like the plague anyway.
 
TRAMD said:
Actually I am. [shrugs] I guess that explains it. Are you also one of those guys who thinks that someone "talking s**t" is a good reason to fight them?
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Not normally, no. Are you one of those people who takes internet posts personally?
 
I'll fight all of you right now.
 
Kimberli Cox said:
TMI warning: but my migraines are almost always menstrually related, so I haven't noticed any environmental differences between home in Cali and out east. My best prophylaxis is to prevent my progesterone from dropping but sometimes I lose track of the date, etc. and wind up paying for it.
Click to expand...

Thanks for keeping us updated on your periods.
 
Yet another reason to love Yasmin (skipping the placebo week and going straight to the next pack). More TMI back at you! :laugh:

Kimberli Cox said:
TMI warning: but my migraines are almost always menstrually related, so I haven't noticed any environmental differences between home in Cali and out east. My best prophylaxis is to prevent my progesterone from dropping but sometimes I lose track of the date, etc. and wind up paying for it.
Click to expand...
 
The people who actually feel guilty or debate whether they should call in sick are not the ones who should be concerned. It's the ones who really don't feel bad about calling in sick or dumping on other residents that make life for everyone else difficult. When I was an intern, I was pulled in to cover wards for 2 weeks because someone's grandmother had a syncopal episode and needed a pacemaker. Apparently, no one could drive grandma home because the immediate family except for this intern was at some wedding. So he took 2 weeks off. I took call and covered his service, dictated his notes, etc. etc. And no guilt. No payback. A resident I know tried to take off a couple days for "jury duty" although she is not a citizen and doesn't qualify to sit on a jury. Another resident took off 3 days for an elective surgery when switch day (at which time he would have switched to an outpatient rotation) was only 4 days away. When I was on ICU, my fellow intern just didn't show up to rounds - we got concerned and we even tried calling his home - then he showed up at 10am (pre-rounding started around 5:30am and rounds started at 7am) - his excuse? He said his alarm clock went off, he didn't feel well, and since he had a "hole in his heart repaired as a child" and therefore had a "bad heart", he didn't think it would be good for his heart to get up and come to work. So he went back to sleep and woke back up at 9am and got to work at 10am. He didn't call anyone and we were already done rounding and writing notes on all the patients by the time he showed up. Why people like that are allowed to stay on in residency is puzzling to me. The ironic part is that he wanted to be a cardiologist because of his experience as a child.

Unfortunately, it's the conscientious ones who cover other people to be a "team player" who get screwed. It's kind of like communism - you don't get rewarded for working harder than others, so why do it? Especially if no one calls you out on it.
 
axm397 said:
Unfortunately, it's the conscientious ones who cover other people to be a "team player" who get screwed. It's kind of like communism - you don't get rewarded for working harder than others, so why do it? Especially if no one calls you out on it.
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I love the point you make, I agree 100%.

From a practical standpoint, to answer your question, why do it?

#1 - I will call you out. I might not actually kick your a$$ in the parking lot, but if I went through what axm397 did, I might threaten you, then get face time with my chairman. But it would be worth it. People usually think twice before they screw you a second time, if you threaten them after the first time.

#2 - Although we have dramatically overused the "patient care" argument, it still does have meaning. At least to most of us, I think.
 
Kimberli Cox said:
Thought you would want to know!;)

Besides, I gave the requisite TMI warning...its your fault if you kept reading.
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I heard that if you still have periods as a General Surgeon, it means you aren't working hard enough. :D ;)
 
Llenroc said:
Doing rounds with an IV, or being so delirious in surgery that you need tylenol to bring your fever down is not being dedicated, it's being ******ed. No patient out there appreciates that, and if the public knew things like that were going on there would be a major ****storm. :thumbdown:
Click to expand...

How much do you think a first year resident cares about the patient being happy compared to the PD being happy? Nuff said. This wont change. For this to change you have to change the entire structure of residency.
 
Tired said:
Not normally, no. Are you one of those people who takes internet posts personally?
Click to expand...

Certainly not. I was simply entertained by your enthusiasm for mindless insults as I am similarly entertained by men whom are prone to fighting.
 
Calling in isn't a big deal in our program if it's legit.

Most of us come in and round, and if legitimately sick the chief will send you home/go home but continue to answer your pages or hand it off to someone else willing to take it.

If it's not legit then we would gripe about it. Legit then we understand that it's a solid resident that needs to be home taking care of themselves.
 
axm397 said:
Unfortunately, it's the conscientious ones who cover other people to be a "team player" who get screwed. It's kind of like communism - you don't get rewarded for working harder than others, so why do it?
Click to expand...

Exactly. The medical field is exactly like communism. This will rile everyone up but even being on a team sucks most of the time. It's great if you have a "strong" team and everyone is hard working but that's a total crap-shoot. At least half of the time if not more there is at least one "weak" member that everyone has to carry like dead weight, if not more. I hate teamwork because it's just a euphamism for "do the work of the person who isn't doing their work." You know what sickens me most? You can make it through residency like that. We had some really lazy seniors and they were lazy interns. Then when they became the seniors they would just give their work to the interns, having them see consults and such. And then they'll graduate and be lazy attendings at academic institutions where they'll give their work to the residents. Eff you, medical field, eff you.
 
TRAMD said:
Certainly not. I was simply entertained by your enthusiasm for mindless insults as I am similarly entertained by men whom are prone to fighting.
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I wasn't actually addressing your post in particular, just the general theme of calling in "sick". However, in the future, I will be sure to provide Kleenex prior to posting anything that may make you cry. Now go cuddle up with your chicken soup and think nothing of the service you abandoned.
 
Tired said:
I wasn't actually addressing your post in particular, just the general theme of calling in "sick". However, in the future, I will be sure to provide Kleenex prior to posting anything that may make you cry. Now go cuddle up with your chicken soup and think nothing of the service you abandoned.
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I actually probably could have used some extra Kleenex the past few days. Not because of crying, but it is nice that you were thinking of me. [holds back the tears of joy]
 
With all this arguing you're doing, I'm starting to doubt that girl in your pic is your wife. If she was, you wouldn't be here this much.

TRAMD said:
I actually probably could have used some extra Kleenex the past few days. Not because of crying, but it is nice that you were thinking of me. [holds back the tears of joy]
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Coastie said:
With all this arguing you're doing, I'm starting to doubt that girl in your pic is your wife. If she was, you wouldn't be here this much.
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I like to argue . . . it is a problem.

I also like SDN too much . . . also a problem.

Both annoy her.
 
Miami_med said:
I also have both of these problems, and they also both annoy my wife ;)
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[high fives Miami_med] Annoying my wife is part of what keeps me going.
 
Coastie said:
With all this arguing you're doing, I'm starting to doubt that girl in your pic is your wife. If she was, you wouldn't be here this much.
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My wife is 7 months pregnant (you could see her 7-month belly in that picture before I cut it down) and if you have ever been around a woman in her 3rd trimester . . . it is just best to stay away.
 
Calling in "sick" just because you are hungover or blowing your nose is not excusable. You also jeopardize patient care by not showing up or being late. And you jeopardize the other residents by shirking your job duties. I've noticed that after fellowship match, residents have a much higher percentage of "calling in sick", especially for incidental things like tooth repair, elective surgery, etc.
 
carrigallen said:
Calling in "sick" just because you are hungover or blowing your nose is not excusable. You also jeopardize patient care by not showing up or being late. And you jeopardize the other residents by shirking your job duties. I've noticed that after fellowship match, residents have a much higher percentage of "calling in sick", especially for incidental things like tooth repair, elective surgery, etc.
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Whoa. I can agree that it is wrong to shirk one's duties but let's not use Patient Care as an excuse for working when we are sick. "Patient Care" is a blunt instrument used by The Man to shame residents into accepting being treated like sweatshop labor. It is the last refuge of medical scoundrals when they can't think of a good reason to deprive you of sleep so they can work you for taco-stuffer wages. If Patient Care were so important and couldn't take an occasional absence of a resident from a gigantic patient processing mill...er...I mean from a hospital...then it would be a crime to ever go home and we may as well live in the hospital getting only as much time off as is required for the bare minimum of sleep to stave off psychosis.

They tried to pull that "patient care" bull**** on me when I needed time off to interview (when I switched to Emergency Medicine from the Specialty That Dares Not Speak Its Name). Tried to hold me hostage in way. Suppose you needed a day off to take care of business and weren't sick? Residency is the only job in America where on one hand The Man insists that you are drag on his hospital and more trouble than you are worth but on the other blows a fuse if you need a day off or get sick.
 
carrigallen said:
Calling in "sick" just because you are hungover or blowing your nose is not excusable. You also jeopardize patient care by not showing up or being late. And you jeopardize the other residents by shirking your job duties. I've noticed that after fellowship match, residents have a much higher percentage of "calling in sick", especially for incidental things like tooth repair, elective surgery, etc.
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I agree that calling in "sick" at the last minute for a doctor's appointment or elective procedure which has (or could have) been scheduled weeks in advance is unprofessional and irresponsible. However, I feel that most of us have to ignore our own health care maintenance needs because the residency system seems to operate under the belief that physicians are supermen and women who will never need to take a few hours off for the dentist or a yearly gyn visit. Yes, it is sometimes possible to squeeze needed medical visits into post-call afternoons or semi-annual vacation time...but sometimes I wish that the residency/medical profession culture was more open to the idea that residents who are encouraged to take good care of themselves are more likely to be happier, healthier, and therefore, more productive in the work environment.
 
Panda Bear said:
"Patient Care" is a blunt instrument used by The Man to shame residents into accepting being treated like sweatshop labor. It is the last refuge of medical scoundrals when they can't think of a good reason to deprive you of sleep so they can work you for taco-stuffer wages.
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Nicely put.
 
Panda Bear said:
Whoa. I can agree that it is wrong to shirk one's duties but let's not use Patient Care as an excuse for working when we are sick. "Patient Care" is a blunt instrument used by The Man to shame residents into accepting being treated like sweatshop labor. It is the last refuge of medical scoundrals when they can't think of a good reason to deprive you of sleep so they can work you for taco-stuffer wages. If Patient Care were so important and couldn't take an occasional absence of a resident from a gigantic patient processing mill...er...I mean from a hospital...then it would be a crime to ever go home and we may as well live in the hospital getting only as much time off as is required for the bare minimum of sleep to stave off psychosis.

They tried to pull that "patient care" bull**** on me when I needed time off to interview (when I switched to Emergency Medicine from the Specialty That Dares Not Speak Its Name). Tried to hold me hostage in way. Suppose you needed a day off to take care of business and weren't sick? Residency is the only job in America where on one hand The Man insists that you are drag on his hospital and more trouble than you are worth but on the other blows a fuse if you need a day off or get sick.
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add to that, in post residency life, there are plenty of attendings that don't have residents under them and *gasp* don't see their patients every single day. and *oh no* they handle many patient issues over the phone. and the patients do fine.
 
elwademd said:
add to that, in post residency life, there are plenty of attendings that don't have residents under them and *gasp* don't see their patients every single day. and *oh no* they handle many patient issues over the phone. and the patients do fine.
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There are attendings who don't round on their patients daily? What do their hospital bylaws say about that? My hospitals require it.
 
docB said:
There are attendings who don't round on their patients daily? What do their hospital bylaws say about that? My hospitals require it.
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At my institution, consult patients have to be seen every other day by an attending (though in our department they are seen daily).
 
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