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Is it Ok to discipline nurses extra for calling off sick on a holiday?

nurse, nursing, calling off sick holiday, nurse sick Should nurses be penalized extra for calling off sick on a holiday?

What are your thoughts about disciplining nurses extra for calling off sick on or around a holiday? Is it fair? Effective? The right thing to do?

Or is it one of those “we’ve always done it this way” practices that needs re-evaluation?

I worked at a hospital in Southern California that shall remain nameless, but I was put on every weekend because that’s where they needed me. It was annoying. I got legitimately sick. I still looked ill when I returned to work after calling in sick on a weekend where I had a temp of 103.5 and a doctor’s note. I was called into the manager’s office and told I was going to have to work another weekend to make up the one I had called off on. I sat there for a minute then said “but I already work every weekend. When is this supposed to happen?” So they told me they were going to give me a weekend off so I could come in and work it. So very stupid. I did ask if they were listening to themselves and I got a blank stare and “but this is our policy”. I don’t think I was ever scheduled off that weekend so I could do my policy required make-up.            

as seen on social media and reproduced with permission unbelievable as it sounds

Double penalty points for holiday sick calls

Many hospitals and other nursing facilities penalize nurses for calling off sick on a holiday in one way or another. One method is to weight holidays when it comes to the attendance policy.

For example, a nurse who normally gets one point for calling off sick gets two points for calling off sick on a holiday. Some hospitals extend the double penalty point policy to include both the day before and the day after a holiday for a total of three penalty days per holiday. Some facilities write up nurses who call in sick over a weekend, and/or require them to produce a doctor’s note before returning to work.

This policy feels unfair to Ashley, a bright, top-performing nurse on 2 Central. Ashley often works extra shifts, and stays over whenever she is asked. Ashley sprained her ankle snowboarding two days before Christmas (read From Bitter to Blessed: Working Christmas), leaving her unable to work the holiday as scheduled. Her manager apologizes for disciplining her, but says she has to as it’s policy. Ashley leaves her nurse manager’s office feeling angry, vaguely shamed, and troubled.

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Call in sick or work sick?

Take Telemetry nursing assistant Flavio, a student nurse with perfect attendance, who came down with a painful student’s revenge sore throat during his Christmas school break.

He, too, is given double penalty points. Flavio is concerned that this will be a blemish on his record when he applies to his hospital’s new grad program in six months.

Is it legal ?

Employers are free to write their own attendance policies, as long as they don’t discriminate. For example, there’s nothing to stop an employer from writing a policy saying nurses will be disciplined for calling in sick on a full moon. But just because it’s legal doesn’t mean it’s wise.

It backfires

Encourages nurses to work when sick

Many nurses will choose to work rather than incur double penalty points. In addition, there’s a culture of suspicion among fellow co-workers around nurses who call off sick on holidays that nurses are motivated to avoid. Having said that, co-workers can pretty accurately identify who’s faking and who’s not.

Brittany is scheduled to work New Year’s Eve, but she has a full-on, sneezing, nose-dripping, red-eyed, coughing, fulminating cold. She’s also a brand new nurse. Being sick and being new places Brittany in double jeopardy. At some facilities, new employees are terminated for sick calls within the first ninety days of employment, holidays notwithstanding.

Brittany chooses to go to work, and spreads the love (virus) to several co-workers, a couple of patients, and one doctor.

Sick nurses make errors

nurses calling sick, nurse sick calls, discipline for sick calls

Should nurses work when they’re sick?

Ron feels achey, has a low-grade fever, mentally isn’t firing on all cylinders, and, as a result, has the Dumb while working a twelve-hour shift on Christmas night. Having the Dumb results in Ron reviewing an order to turn off a Pronestyl drip but then forgetting to follow through and d/c it.

His patient goes into ventricular fibrillation six hours later (true story).

Policies enforced inconsistently

Sometimes managers enforce policies inconsistently among themselves i.e. the NICU manager doesn’t always enforce the double penalty policy, but the Med Surg manager does.  Often when managers make individual allowances, it’s because the policy itself is flawed and therefore difficult to administer in real life with real nurses.

This is no excuse, however, because the NICU manager has now placed the hospital at risk of being charged with unfair wage and labor practices.

Nothing good can come of Med Surg nurse Jackie finding out that she is subject to discipline up to and including termination, while her best friend and roommate NICU nurse Breanna is not.

Is the rationale rational?

At some point way back when, the authors of these policies had a problem for which they came up with a solution, for which they had a well-intentioned rationale. I wasn’t there, but here’s what they may have been thinking.

Rationale # 1

It’s hard to get anyone to come in on a holiday, therefore employees who call in sick should be penalized extra for the hardship they cause the hospital.

True, it’s hard to get people to volunteer to work holidays. But the nurse who calls in sick on New Year’s Day did nothing different from her vantage point than when she called in equally sick three months ago on a random Monday. The consequences should be the same for the same infraction.

It’s like being issued a speeding ticket for driving ten miles over the speed limit on Tuesday. The speeding ticket costs $100.00.

The same driver, driving the same ten miles over the same speed limit on Monday, is issued a speeding ticket that costs $200.00.

Rationale # 2

The problem is Tiffany, who calls in every payday, most weekends, and each holiday. Therefore, the solution is to write a policy to put an end to this kind of abuse.

Coach/counsel Tiffany. Don’t penalize all staff by writing a blanket policy based on a handful of employees’ pattern absenteeism. Good employees and excellent employees far outnumber the Tiffanys.

In my experience, poor attendance is often an indicator of poor performance. Meaning nurses with poor attendance generally (but not always) have other performance issues. It’s best to deal with problem employees on an individual basis.

In addition, Tiffany’s co-workers want their manager to deal with Tiffany. Not doing so rewards bad behavior, ignores good behavior, and penalizes Tiffany’s co-workers, who have to pick up the slack and work short.

Rationale # 3

If the discipline is severe enough, it will make people think twice and thus extinguish the behavior.

This rarely works. Nurses will continue to call off sick on weekends and holidays because nurses will continue to get sick on weekends and holidays, no matter how severe the discipline. No one chooses to get sick on a holiday or a school break.

Positive reinforcement is more effective than fear.

The employer’s responsibility

  • Ensure safe patient care staffing. This includes having contingency plans for predicted high census, employee benefit time off, and unexpected staffing shortages. Often nurses feel guilty and responsible for patient care staffing when calling in sick, but the guilt is misplaced. Recognize that patient care staffing is the employer’s responsibility, not the employee’s.
  • Avoid asking the nature of the illness when an employee calls off sick. No guilting.
  • Provide employees with a fair and well-thought out attendance policy that is simple to understand, follow, and administer.
  • Hold managers accountable for administering the attendance policy as written.

The employee’s responsibility

  • Call in sick as early as possible before your scheduled shift so staffing can be adjusted.
  • Avoid knowingly coming in sick, only to go home sick a short time later.
  • Take personal responsibility. Know how many occurances/points you have, where you stand in the disciplinary process, and exactly what your employer’s policy says.
  • Educate yourself about Kin Care, which requires employers providing paid sick leave to permit employees to use a portion of the leave to care for certain family members. It further prohibits an employer from taking adverse actions against an employee for using or attempting to use sick leave for kin care. (Kin Care is a California law, check your own state law).
  • Learn about Family and Medical Leave Act (FMLA) and intermittent FMLA which protects your job and maintains your health insurance if you have to be off on for a serious health condition for yourself or certain family members.
  • Maintain a healthy lifestyle.

Change for the better

Old policies should be reviewed regularly as they may reflect outdated ways of thinking from previous management.

If the Friday after Thanksgiving is considered a “holiday” in terms of discipline, then perhaps the Friday after Thanksgiving should be considered a “holiday” in terms of holiday pay as well. If that doesn’t make sense, maybe it’s because the policy itself doesn’t make sense and needs to be revisited.

Use positive reinforcement rather than punitive measures to respectfully manage employees and change behavior. Provide some kind of bonus or appreciation for the wonderful nurse who agrees to come in to work a holiday on short notice.

[Tweet “Avoid sending mixed messages such as “Don’t come to work sick” along with “Don’t call in sick.””]

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Good management policies make happy employees

Mixed message: “Don’t come to work sick.” “Don’t call in sick.”

Assume the best of your staff, and treat nurses like professionals. People rise to the occasion when more is expected of them. You do, right? A double penalty policy assumes that nurses are trying to game the system. That is not the best message to send.

What are your thoughts regarding disciplining nurses extra for calling in sick on holidays?

Do you think that doing away with double penalty policies will result in increased sick calls on holidays?

[Tweet “What is best for patients?”]

Leave a note, I’d love to hear from you!


Nurse Beth

AuthorYour Last Nursing Class: How to Land Your First Nursing Job..and your next!” 

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About Beth Hawkes (146 Articles)
Nice to meet you! I'm a Nursing Professional Development Specialist in acute care, a writer, speaker and career columnist.

10 Comments on Is it Ok to discipline nurses extra for calling off sick on a holiday?

  1. I am truly grateful to the holder of this web page who has shared this impressive post at
    at this time.

  2. Christine Hosea Young // December 16, 2015 at 4:15 pm // Reply

    At my hospital if you bring a note from the ER/Urgent Care or doctor the holiday absence will be excused. I feel if you are sick enough not to come to work then you should be seen by the healthcare professional.

  3. There is one problem that keeps managment from dealing with the “Tiffany’s” as individuals nowadays. Just like preceptors and coworkers, managers are getting caught up in the web of “bullying” accusation. Managers who call problem employees on the carpet due to performance issues are just as at risk of being labeled a bully as the “old nurse” or the precepor with “high expecations”. Therefore the chosen solution is to in effect punish everyone utilizing draconian policies.

  4. Our policy is to work the next holiday/weekend if a scheduled holiday or weekend is missed. This is fair, helps cover the unwanted shifts and avoids the punishment/mixed messages. It does indeed need to be enforced hourse wide and there does need to be some manager discretion. (death in the family on a holiday, really, you cant punish that) Managers know who the abusers are and need to be consitent in disapline. Move those out. Keep the hard workers happy. Nurses are professionals, they do not need punishment but a manager does have to staff safely.

    • Good points, thank you I have wondered how nurses perceive the work the next weekend, sounds like they think it’s fair

      • Working the next weekend is not always feasible for parents who share custody of their children due to a divorce. During the school year, my every other weekends off are the only time (besides an alternating holiday schedule) that I have with two of my children, who attend school in a different state. Forcing me to “make-up” a missed Sat/Sun on my next weekend off forces me to not see my children. If an individual employee is a problem when it comes to calling in on weekends/holidays, address the issue with that employee. Don’t apply a punitive attendance rule to the employees who might call in once every year or two.

        • Sue, I so agree. It is not right to to impose a punishment on nurses, and like you said, with no sensitivity to the consequences. Thank you for commenting

        • I so agree. Treat the problem employee, don’t punish the other 90%

  5. Lorelei here. When I first started reading this post, I was all about the “sick it to them” approach. Yes, doctor’s note, yes double penalty points for calling in on a holiday. But low and behold, as I read on, I realized that nurses get sick 365 days a year, and it is “big brotherish” to demand a doctor’s note. This punitive policy will not correct those who take advantage, it will only demoralize those good workers. Instead take call outs case by case, work with the frequent fliers to correct their behavior, and above all else, work to build an environment that discourages (from many different fronts) frequent call outs.

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