What's wrong with Paid Time Off (PTO) at dialysis centers

[RightSide]

Have you ever seen staff reporting for work at your dialysis center while they're sick with a bad cold or some other infection, risking spreading it to the patients?  (I have at my dialysis center, several times.)

Ever wondered why?  It could be due to how they're paid.

One of the dumber "innovations" in corporate America in the last 20 years has been the Paid Time Off (PTO) bank.   The employee gets one pool of total time off from work, to cover both his sick days and his vacation days.  (Prior to PTO, a worker got a certain amount of sick time and a separate amount of vacation time.)  The theory is that if the worker is healthy and rarely calls in sick, he can use his unused sick days for extra vacation time.

Of course, the converse is also true:  If the worker takes a day off due to illness, that will represent one less day off he could have used for a vacation.  Thus a sick worker has a strong incentive to report for work anyway--even if he's contagious.

http://management.about.com/od/conflictres/a/SickLvPTO1104.htm

The comic strip "Dilbert" once satirized PTO banks.  They're bad enough in any large organization, where it takes only one employee who is sick with the flu to infect the entire workforce there.  But in a hospital setting or a dialysis center or other health care facility, to give the staff an incentive to report for work while they're sick (so they don't lose vacation days) is absolutely insane.

And that's the situation at my dialysis center, where the staff are on a PTO bank.  I've seen staff come to work at the center with bad colds (really bad, sneezing and coughing all over the place).  It's clear that they came to work to maximize the use of their PTO bank for vacation time.

No health care facility should force its workers into PTO banks.

[kellyt]

Who do you complain to?  I mean, above and beyond the dialysis Manager or whatever they're called?  They should be forced to take the day, paid or unpaid.  That is B.S.!  Dialysis patients should not have to deal with that on top of everything else. 

[VintageVera]

My dialysis center has a formal complaint process. You could also speak to the director. And I agree with you on the people showing up with colds. VV

[cariad]

I don't think they should be forced to take time off unpaid. I think this country should provide adequate sick leave.

The CEO at the place where my husband was employed in CA used to try to pressure people to come in when they were sick, and also to abandon family members at home if they were sick. He once threw a fit with my husband for accompanying my younger son and me to the ER when my child was having breathing difficulties. The CEO said that his wife and kids all had strep, and he had left them at home. Coincidence that my older son ended up with strep shortly after this? I have never thought so.

One positive of the swine flu epidemic is that people seem to be more aggressive about confronting people who thoughtlessly expose others to illness. Can't you report nurses and techs to the department of health?

[kellyt]

At the very least they should be working off the floor and away from the patients OR they should have to wear a mask at all times.  Annoying I know, but safety first.   

[brandi1leigh]

At my center, the techs sometimes come in sick but from what I've observed it's less about the PTO bank and more about wanting to accrue hours during the week. Once they hit a certain amount of hours they get overtime pay. So they never want to call in "sick" because then they are not on the clock. Yes, they might get paid for sick leave, but that time doesn't add hours to their check and get them to the magic number of overtime hours to get them the bonus overtime money.

[Bruno]

Here in good old Oz, you get sick days off (I think 5 per year) as well as your annual holidays. Having said that I notice that our nurses often come in when they are sick and I'll tell you the truth, it scares the s**t out of me because they all wear surgical masks. I'm never too sure whether they are going to kill me or maybe rob me. And I wouldn't be able to identify them either...unless of course they said 'Stick'em up".
(or stick'em in?)

[Desert Dancer]

My last two days in-center I had a tech who was hacking up her lungs all over the place, and didn't bother to put/keep on her mask while she was doing so. It scared the crap out of me and reinforced my decision to do home hemo.

I don't know what the PTO situation is at Fresenius but as far as I'm concerned anyone dealing with a sick and immuno-compromised patient population should be turned away at the door and sent home if they are sick. At the very least, they should not be on the floor.

[KICKSTART]

Our nurses over here havent got that excuse, but we have them working with everything from coughs and colds to chest infections! I wish i could take a week off when i feel  on top of D !

[Riki]

I think that the nurses in my province must have a pretty sweet contract, cuz they call in sick all the time, and they get an awful lot of time off for vacation.  More than I ever got when I was working, for sure.  One of my nurses went to the Dominican twice since May, 2 weeks each time.

[BigSky]

Not really a big deal here,  nurses and techs wear masks when they are sick,  now on the other hand its usually the patients here who are catching stuff and bringing it into the unit to "share" with others.

[Phraxis]

Unpaid/paid sick leave is an ongoing challenge in the work place. As an employer, who has an unpaid days off policy, we have solved the problem of "my child is sick so I can't bring them to daycare" (a phenomena that affects female workers far more than their spouses), "I am sick this morning (or still drunk from the night before)", etc by sharing the financial consequences with the worker of their absence. And yes some people "tough it out" but since many of people are commission based, therefore unpaid if not working, peer pressure works quite effectively.

Now as anside with the very public presence of a person with acomprimised immune system, me, the rules are simple. Sick -- stay home out of courtesy, and if that is inadequate you are sent home immediately. Last years H1N1 has changed people's views radically.

Now at the clinic-- having an infectious disease makes you unqualified to work in that environment and you should be sent home also. I like the example of a salad maker at your favorite restaraunt with Hep C -- if they take "precautions" would you eat there? Few healthcare workers volunteer for the first salad.

As for the loss in salary-- switch shifts, etc. It is better then affecting the health of patients.

[kitkatz]

I had a tech coughing near me and I looked up at him and said: "If you are sick, do not be near me, please."  He said: He was choking on his spit.  So okay.  But I do not want sick health workers anywhere near me!

[cariad]

Unpaid/paid sick leave is an ongoing challenge in the work place. As an employer, who has an unpaid days off policy, we have solved the problem of "my child is sick so I can't bring them to daycare" (a phenomena that affects female workers far more than their spouses), "I am sick this morning (or still drunk from the night before)", etc by sharing the financial consequences with the worker of their absence. And yes some people "tough it out" but since many of people are commission based, therefore unpaid if not working, peer pressure works quite effectively.

Now as anside with the very public presence of a person with acomprimised immune system, me, the rules are simple. Sick -- stay home out of courtesy, and if that is inadequate you are sent home immediately. Last years H1N1 has changed people's views radically.

Now at the clinic-- having an infectious disease makes you unqualified to work in that environment and you should be sent home also. I like the example of a salad maker at your favorite restaraunt with Hep C -- if they take "precautions" would you eat there? Few healthcare workers volunteer for the first salad.

As for the loss in salary-- switch shifts, etc. It is better then affecting the health of patients.

Wow! This attitude makes me so angry, I am going to have to take a few deep breaths and come back to this later. I will just start by saying that I am so grateful that I had a transplant before paranoia could ruin the world as we know it. The Myth of the Salad Bar Worker rears its ugly head again! Mothers trying to do best by their children are really liars who should put the health of other children at the school (some of whom might be immunocompromised themselves!) at risk by sending their child off anyway in order to be able to support them financially! What next?