---
title: Who’s the last man/women (girl) standing!
description: Who’s the last man/women (girl) standing!
---

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## Who’s the last man/women (girl) standing!

<http://static1.squarespace.com/static/595689fc9de4bbc892200518/t/59568aca5fd63b5f29287714/1498845257805//img.jpg.com/static/595689fc9de4bbc892200518/t/59568aca5fd63b5f29287715/1498843850005/1000w/>

If you’ve followed the "Talk Clean To Me" blog  
 for a while, you’ll know that sharing others misfortunes for the sake of  
 getting my point across is not something new.   
 Take the [#FF – Micro Blog’s Viral Misfortunes ](http://talkcleantome.blogspot.ca/2013/11/ff-micro-blogs-viral-misfortunes.html) blog from November 2013 as  
 an example, outlining a Norovirus outbreak within his family.  This past week I had the “fortune” or  
 “misfortune” to have lived through some sort of outbreak that spread through 5  
 of 6 people at my cottage.  The line  
 listing looks something like this:

Wednesday July 1/15, Male aged 6.5, vomiting

Saturday July 4/15, Female aged 44, vomiting

Sunday July 5/15, Male aged 45, pooping

Monday July 6/15, Female aged 43, pooping

Tuesday July 7/15, Male aged 10, vomiting

Wednesday July 8/15, Female aged 7 strutting around the  
 cottage bragging that she was the only healthy one (picture to prove it)

As someone in the “know”, perhaps I should have called my  
 friend and had her postpone her arrival...when I came down sick on  
 Saturday.  But she’s my best friend.  I wanted to see her and spend some time with  
 her and her kids....I was hoping that by disinfecting everything and washing my  
 hands like crazy I could stem the outbreak, but I knew I was putting my friend  
 and her kids at risk.....

So why then do doctors, clinicians and nurses routinely  
 work when sick and put their patients at risk? Well, an editorial in [JAMA Pediatrics](http://archpedi.jamanetwork.com/article.aspx?articleid=2344548) focused on just that.  For  
 centuries,* Primum Non Nocere *(first do no harm) has been the guiding principle  
 for healthcare workers which one would assume also means they should not spread  
 infections by working while sick.  As the  
 editorial goes to describe, a survey of healthcare workers  was conducted looking at the role of  
 presenteeism and what the key reasons were for going to work while sick (and  
 infectious). 

The top reasons for working while sick included; concern  
 over who would fill in for them, concern that their patients could not get by  
 without them and a widespread belief that if they stayed home because of a cold  
 or flu they would be perceived as being weak or unprofessional.  Of the 280 healthcare workers who competed  
 the survey 83% positively responded to working while sick at least once in the  
 past year even though 95% stated that working while sick put their patients and  
 colleagues at risk.  That rationale for  
 working while sick was the belief of an unspoken understanding that you should  
 be on your deathbed if you are calling in sick.   
 It was easier and less stressful coming into work than feeling they were  
 letting their colleagues and patients down.   
 When asked about what symptoms they would come to work with 55% would  
 work or have worked with symptoms such as a cough, congestion or sore throat  
 and 30% said they would work with diarrhea!

The co-authors in reviewing the reasons for showing up  
 while sick cited that there were systemic, logistic and cultural factors  
 involved which created a climate where staff felt they had to work when  
 sick.  With streamlining, budget cuts and  
 the need to balance the books, hospitals have become a place where everyone is  
 expected to work at peak capacity all the time and with a lean staff this means  
 less redundancy and less flexibility to find a replacement to cover sick  
 time.  The result being a culture where  
 those who know they should not work while sick and know that by working sick  
 they are putting their patients at risk come into work anyways. 

Changing a culture of a facility and changing the beliefs  
 and norms of staff is no small feat.    
 But in the day and age where hospitals are under scrutiny by the public  
 for infection prevention rates....perhaps it’s time to invest in developing a  
 culture where when sick staff know “we’ve got your back”.  Stay home and get well because it’s better  
 for all of us.  The alternative of course  
 could be that the staff member with diarrhea in fact has C. diff....because we  
 just never know when or how the next outbreak is going to start!

To my friend....sorry that you lost a day of your  
 vacation being sick!

*Bugging Off!*

Nicole

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