Category: Popular Articles

Question:
At my facility we’re not allowed to call out! Lately there’s been a lot of call outs and even more aides quitting. So we work short all the time. A couple aides have hurt their backs too cause we’re short all the time. Anyway I got the “bug” last week and had a fever, vomiting, and diarrhea. I felt horrible. I couldn’t eat anything; I couldn’t keep anything down. I called work to let them know I would be out for my shift and they put me through to the DON. who told me to come in for work, to report to her prior to clocking in so she could assess whether I was too sick to work. If I didn’t follow this directive, I would be terminated. SO I went to work and the DON took my temp (101.2)- she gave me Tylenol and a couple spoonfuls of Pepto Bismol; she told me report for duty. If I didn’t feel any better in an hour to come back and see her.

Is this legal???

Answer:
Your email tells me your employer is having a hard time with staffing. It appears that the place is going through a downward spiral of problems and management is part of that. When an aide shows up for work, sick with fever and infection, she exposes not only the residents, but her co workers as well.

It’s very likely more than a few will catch the illness. So, it spreads like a fire. As each aide comes down with the bug and misses work, management feels it has to do something to curb what it perceives to be an abuse of attendance policy. Management should be prepared for a staffing crunch knowing a virus is going around. But, this facility’s management is punishing the very people who are out in the battlefields where the germs are located. It’s old fashioned and autocratic.

Instead of being proactive, the DON is being REACTIVE and in a very negative manner. Her actions are telling her staff that she doesn’t trust their judgment on their own bodies health. She is also telling them she has no respect for them. A warm body on the schedule is all that matters, even if that body’s temp is 101.

The Legality of this:
If this is a policy, it must be written as such.

I called a lawyer friend and relayed this scenario and she gave me the following advice: Is the DON a doctor or a Nurse Practitioner?? If not, she is straying from her nurse practice laws. Nurses cannot diagnose illnesses, diseases, disorders and the like. Perhaps she is sending staff to a doctor who is legally licensed to perform a medical assessment. She would be smart to do this. She should NEVER give staff ANY medications without a doctors’ order. She is putting her license on the line by doing so. She knows this. And is counting that you don’t know this.

Legally this practice is not advised for management. They are risking a discrimination lawsuit if this “policy” doesn’t cover ALL employees of this facility- so, when the dietary aide or the cook or the maintenance man calls out, the DON/Management must apply this same requirement towards them. They too must come in, be assessed, and determined if they’re “healthy” enough to work or not. And this would mean doing so 24 hours a day, 7 days a week. Even on holidays and weekends.

What To Do?
If you find yourself too ill to perform the duties of your job, you can and should call out. However, you should also make every attempt to get better or try to reduce your symptoms so you can work. In other words, do take Tylenol/Advil to get the fever down. Immodium will end just about every episode of diarrhea. After this, if you still feel too sick, call out. Make sure you follow the policy- most facilities require 2 or 4 hours notice.

Have your spouse or a friend make the call for you if you’re concerned with being harassed by the DON. Instruct your spouse/friend to take a message but to be firm: You will not be showing up for work. Make sure your reasons are given: Details- fever, vomiting, ect. and the actions you have taken to try to make it better. Then call your doctor and make an appointment. You’ll need to be assessed and diagnosed properly; and the MD will need to write you a note excusing you from work. Often, this note will include actual dates you are not recommended to work.

A doctors note will not protect your job.
We need to know this and not rely upon it. The note does give credibility to you though: You’re putting the effort into seeing the doctor to find out what is wrong and get better; you’re paying money to do in most cases; you want to show your employer you weren’t goofing off, ect.

You can still be terminated unless you’re a member of a union which has rules on this.

I would not wish to continue employment at a facility where this practice occurs. I would leave on my own free will and seek employment at another place with more enlightened management.

Question:
I’ve been working at the nursing home for 3 months now. More than a few of the CNAs working here are long term staff and the nurse depends upon them to get things done. I’m never asked to take on special projects or tasks. I really like this job and want to be part of the team but I believe I’m not offered the chance simply because I’m new. I’ve never called out or been late. I haven’t heard any complaints about my work. Is it too soon to ask the nurse to seek me out for more duties? I don’t think she values me.

Answer:
Good question and not one we hear too often! Many CNAs don’t stay employed long enough at nursing homes to be considered reliable staff. So those that do are indeed a valuable asset to the nurses. You say you’ve worked for this facility for 3 months now; how long have the others been employed? That might give you an idea of what the nurse considers to be “seasoned” staff. And that’s what it comes down to: The nurse knows the other aides well; she knows their skill level and quality of work; she knows when she can push them to do more and when she should NOT push them (but probably has regardless)! To begin, I would ask the nurse if she needs any help with anything at those times you have a free minute. If you hear discussions about a sick resident, offer to check vital signs- no matter who the resident is assigned to. Pick up any slack on the other CNA’s part. Offer to take on more residents to your assignment when necessary. Just show that you can handle the extra workload- AND importantly, get it all done in a timely manner. You don’t need to brag about this. Your work will speak for itself. As you grow in your job, nurses and others will take notice. Never complain! Don’t try to undermine the other aides either. Remember you’re all working as a team. Good Luck!

Question:
I have worked at the same nursing home for 3 years now. Initially the administrator and Nurse Director were a solid team of leaders. Then one day, they were gone! They got fired because of a poorly cited federal survey. That happened in the first three months of my employment. Since then, it’s been nothing but change, change and more change! An administrator is brought in and stays for 6 months and leaves. A nurse director gets hired and lasts maybe 3 to 4 months. More than one director has resigned within their first two weeks. It seems that whoever owns the facility can’t keep a management team in place. The turnover is incredible and there is not a good place to work. I am, the staff with the longest employment. There is no teamwork because people are not together long enough to form a team. Nurses, aides, kitchen workers all come and go through a revolving door that is never closed! SHOULD I STAY at this place?

Answer:
I’m amazed that you have stayed here for 3 years given all the turnover you describe. For that, you probably deserve an award.

I’ve seen situations where nurses and aides feel obligated to continue working for a poorly managed facility because of the residents. They do so in spite of their personal dislike of a facility management team or their low pay and/or poor benefits. While this is admirable, we should really make sure we’re doing the right thing for ourselves.
When it comes to decisions about employment, I always like to make a list of PROs and CONs: side by side. Write down what you like about your current employment.

• Is the facility right in your local area so travel/transportation is not a problem?
• Is the pay good, or so good you hate to give it up?
• Are the benefits top notch? (I suspect not but could be wrong)
• Since there is no management, how to you feel supported at this job?
• Do you work with lots of agency, PRN nurses and aides?
• Do you have any relationships with peers that are worth keeping a job over?

There is something that is keeping you here…you need to seriously look at what that is and decide if it a legitimate reason for you to stay. I get the sense that you want to leave but are not sure you should. I wonder if you’re feeling some guilt about the residents and how staffing patterns effect them.

My advice would be to draw up that list and think it over for a week. You have to know what else is out there for employment. Have you worked for other nursing homes? Do you have friends in other places who are content? Are you willing and able to travel to a facility further away if needed? How about working for an agency? What are the options for you, if you were to leave?

One last thing: Personally, I would find out the name of the person who owns the facility and write them a letter; expressing how the lack of management is effecting this nursing home, it’s residents, the quality of care, etc. YOU have nothing to lose but a lot to gain IF that person really cares.