Pharmacists working with flu-like illness

pharmacist sneezes

Pharmacists are the worst culprits when it comes to working while sick, new data suggests

A study published in the American Journal of Infection Control showed that more than 40% of surveyed American health care workers went to work while they were experiencing flu-like symptoms.

By occupation, pharmacists and physicians were the most likely to do so, the researchers found – and by work setting, hospital-based personnel were the most likely to show up for duty with flu-like illness.

The researchers used a national nonprobability Internet panel survey of 1914 health professionals during the 2014-5 flu season, and calculated the frequency of working with self-reported symptoms including fever and cough or sore throat.

A total of 67.2% of pharmacists reported working with flu-like illness, the highest rate among the professions; physicians were next, at 63.2%.

Overall, 414 health professionals surveyed reported flu-like symptoms, and 183 (41.4%) went to work anyway.

“Health care settings are known sites of influenza transmission,” the authors write. “Transmission in health care settings, where there is a higher concentration of elderly persons and individuals with immunosuppression or severe chronic disease, is a major concern.

“Working while ill, or presenteeism, by HCP while experiencing influenza-like illness (ILI) increases the likelihood of influenza transmission to coworkers and patients.

“In hospital settings, inpatients exposed to at least one contagious HCP were more than five times more likely to develop hospital-acquired ILI than inpatients with no documented exposure in the hospital.

“The Centers for Disease Control and Prevention recommend that HCP with ILI not work until they are afebrile for at least 24 hours. Despite this recommendation, HCP often continue to work with ILI.”

Commonly cited reasons for working while ill include:

  • Perceptions of ability to perform work functions,
  • Not feeling bad enough to call in sick, and
  • A sense of professional obligation.

These reflect misconceptions about working while experiencing flu-like symptoms, the authors write.

“Training to change social and cultural norms of HCP, such as the expectation to work unless experiencing severe symptoms among clinicians, might address these misconceptions.”

Accessing sick pay was also a problem for the health workers.

“Unlike HCP in other settings, HCP in long-term care settings who reported working with ILI most commonly cited not being able to afford lost pay,” the authors write. “This reason may be amenable to changes in paid sick leave policy.

“To address the third most common reason cited for working with ILI (‘I did not think I was contagious or could make other people sick’), clinicians can encourage their HCP patients to refrain from working with ILI.

“More than half of HCP who cited this reason for working with ILI had sought medical attention. In addition, employers can remind HCP that influenza is likely transmissible from one day before to 5-7 days after symptom onset.”

The authors acknowledged several limitations to the study, including the fact that an opt-in Internet survey does not constitute a random sample.

In Australia, the recent National Stress and Wellbeing Survey of Pharmacists, Intern Pharmacists and Pharmacy Students saw a number of pharmacists explain why they went to work sick: and in many cases, the problem was employer expectation and staffing issues.

“Can’t have day off when sick until finds someone to replace and also when kids are sick, told to come to work with sick child to work,” one respondent to the survey wrote.

Another, working at a single-pharmacist medical centre pharmacy in a regional area, wrote that “I was unable to enlist the help of a locum today and had to work while suffering from gastro with symptoms of nausea, vomiting, diarrhoea, malaise, fever and tiredness.

“It will be a miracle if no dispensing error was made.”

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