When I worked as a Career Services Representative, one of my former hospitals was seeking externs for their Patient Care Technician (PCT) program.

 I wasn’t that familiar with what a PCT did. (The Pharmacy Tech students were my discipline). Our school taught students to become Medical Assistants (MAs).  So when the hospital felt that the MA students would have a good background for a PCT position, I helped set up a process to choose the best candidates for the externship.

Our MA program was a 7-month program where the student received a grade for each month’s coursework.  To be eligible for this externship, a student had to have completed five months of the course. There were eight MA students who applied for this externship.

Each student was evaluated in the following categories: class grades, attendance, instructor recommendations, and a written essay.  I must admit that I found class grades, instructor recommendations, and a written essay pretty routine criterias for selecting the best candidates.  I was flabbergasted by the attendance.

It should be noted that no student experienced a hospital illness that sidelined them for a while.  In addition, no student experienced a long term condition (ie. Flu, broken bones, malaria) which caused them to be out for a lengthy period as well.  Instead, their sick call days were limited to clusters of 1, 2, or 3 days in a row where the student was not in class.

The average number of sick call days of all the students combined was 32 days. 32 sick call days divided by 5 months averages out to more than 6 sick call days a month.  Furthermore, the student who had the most sick call days had a whopping 56 sick call days. 56 sick call days divided by 5 months averages out to more than 10 sick call days a month.  

I was floored by this information.  I was also baffled by several other issues:

  1. Why would a student sign up for a 7-month course, miss between 32-56+ days, and expect to benefit from the course?
  2. Courses are expensive and non-refundable. Who paid for these courses where the student missed all those days?
  3. How could the students expect to receive a good grade or instructor recommendation after missing all that time?

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In my role as Pharmacy Tech Instructor, I had a meeting with the Dean of Students.

“Angela is questioning her grade,” said the Dean, “You gave her a B, but her grades are all As.”

 “That’s right,” I replied, “ but she missed 7 days out of 20 days this month.  That means she was out 35% of the time. That means she was in class only 65% of the time.”

“So it’s her attendance, that lowered her grade,” said the Dean.

“Yes.  Furthermore, Angela called out 8 days in the first month and 5 days in the second month.” I stated, “ That means she’s been out 20 days in the first three months.”

The Dean of Students nodded.

“If she worked for you and you had to arrange for coverage,” I said, “And she called out 20 times in the first three months…”

“...She wouldn’t be working for me much longer,” stated the Dean.

“That’s right,” I said.

I know it’s not work. It’s school.  But let’s assume if the student had exceptional grades (all As). If an employer heard that a student called out sick and missed a lot of class days, would they want to hire the student?  I wouldn’t think so.


1. Employees Abuse Sick Call

I’ve always had a pet peeve when it comes to sick call.  I know some people are legitimately sick. But there are many sick call abusers.  Here are some of my favorite stories:

A. The One Day Puzzle

As a Pharmacy Manager, whenever a staff member called in sick, they had to speak to either myself or a shift supervisor.

There was one particular pharmacy technician who always seemed healthy the day before he called in sick.   He was fine. His voice sounded normal, his energy level was good, and he had no symptoms.

However, the very next day, he called out sick.  On this day, he sounded awful on the phone. His voice was raspy.  He was coughing. His speech was even slurred. In fact, he could barely utter, “I’m sick.  I’m not coming in today.”

The next day, when he returned to work, he was fine again. As healthy as he could be.

I know whenever I was sick, I felt my symptoms a few days before.  Plus my cold always lingered a few days afterwards. But not for this particular pharmacy technician. He was never absent for more than one day at a time. For him, it was always instant onset, instant cure.  

B. The Holiday Rule

My hospital had a rule that if an employee called out sick the day before or after a holiday, the employee lost the holiday as well as any holiday pay associated with the holiday.

So let’s say the holiday were Thursday and the employee was off for the holiday.  Then the employee had off the weekend that followed. Let’s then assume that the employee was scheduled to work that Friday, and call out sick.  The employee would lose the holiday pay for Thursday. This would prevent someone from getting a four day weekend by calling out sick.

Similarly let’s say the employee had worked on the Thursday holiday and received time and a half pay.  Then the employee had off the weekend that followed. If the employee called out sick on the Friday in between, the employee would lose two things.  They would lose the time and a half for working the Thursday holiday. They would also lose an extra day off for working the holiday.

This was an ironclad rule.  There were no concessions. There was no way around it.  No doctor notes, hospital procedures, or any legitimate sick call could bypass this rule.  This was quite unfair for an employee who needed to call out when they were obviously sick, but couldn’t.

But the rule was put in place to prevent the barrage of call outs that might occur and prevent multi-day sick calls during a holiday period.

C. The Shopping Embarrassment

As a Hospital Pharmacy Manager, I mostly ate lunch at my desk.  I seldom went to the cafeteria and rarely ate out. Instead, I brought my newspaper or book and usually ate lunch in my office.  Except for today.

Today, I needed a card for my anniversary.  The mall was less than a mile from my hospital, so I decided to run out and get a card during my lunch hour.

I was in the mall as I walked to the card store.  I turned the corner and came face-to-face with Rose, one of my pharmacy technicians. We looked at each other for a second or two.  Eventually, I smiled and said “Hi Rose.”

Her reaction was not as friendly. She shrieked. She seemed extremely startled.  Then she turned around, covered her head, and ran quickly down the corridor. I must admit I was baffled by her reaction.

When I got back to the department, I discovered the reason for Rose’s unusual behavior.  Rose had called out sick that day. She had stated that she wasn’t feeling well.

She wasn’t sick. I had caught her shopping in the mall.

D. The Doctor’s Note Mess

My hospital had an Employee Health Department.  It was manned by two nurses (RNs). Their jobs included:

  1. Evaluate and eventually send home employees if they were sick,
  2. Clear employees to return to work after an extended illness, and
  3. Administer yearly employee physicals and routine vaccinations (ie TB tests).

I never saw eye-to-eye with my Employee Health Department.  I never knew exactly why.

Maybe it was a personal conflict with the two nurses.  Or may I thought they were too lenient in sending employees home if they claimed they were sick.  But many times, I was at odds with their decisions.

Nate was a pharmacist.  He had sprained his ankle and had called out sick for three days.  He brought in a doctor’s note, but had to be cleared by Employee Health in order to return to work.

I really wanted Nate to return to work.  We were down one pharmacist due to his sick call.  But something didn’t seem right with his doctor’s note and clearance.  I decided to call the nurse at Employee Health after Nate was cleared.

“I’m calling about Nate,” I stated, “I’m questioning his doctor’s note.”

“What about it?!” exclaimed the nurse.

“Well for one thing, it was written by his brother-in-law,” I said.

“But he is a doctor,” replied the nurse.

“Yes, but Nate had a sprained ankle. I feel that it is outside the realm of this doctor’s specialty,” I replied.

The nurse became agitated, “The doctor is a medical doctor.  Nate’s sprained ankle may be outside his expertise.  However, the doctor is still a physician who is well-trained in medicine.

I decided to lower the boom.  “The doctor is a gynecologist.  First of all, I would question anyone who uses a gynecologist to treat a sprained ankle.  Second of all, a guy would never go to a gynecologist for medical treatment!”

The nurse from Employee Health hung up on me.  As far as Employee Health was concerned, the note was valid and Nate was cleared.

Don’t get me wrong.  I was glad that Nate was back.  But their decision about the acceptance of the note, left a lot to be desired.


2. Employers Discourage Sick Call

I’ve come to the conclusion that most employers do not like it when their employees use their sick time.  Even if it’s for a legitimate reason. Employers will offer a sick time benefit, but will frown upon or change the sick call rules.  This makes it more difficult for the employee to use their sick call days.

A. The Excessive Rate Problem

Remember Angela, the Pharmacy Tech student, who missed twenty days of school in a 3-month period?  She eventually got a job in a chain store pharmacy. She was a Pharmacy Technician. Angela worked 10-hour days with the pharmacist.  She filled prescriptions, answered phones, and worked the back register.

All was going well for Angela for the first three months, then she started calling in sick.  She missed one day last week and two days this week. This really wreaked havoc for the pharmacist, because the store manager would not replace Angela on the days that she called out sick.  Instead, the pharmacist had to work by himself.

When Angela returned to work after the last sick call, the pharmacist yelled at her.  He exclaimed that she couldn’t call in sick all the time! Angela said she would try to improve.

Two weeks later, Angela called out sick again.  The next day the store manager informed her that they were letting her go because of her high sick call rate.

It did not matter that Angela had earned sick call hours and was using them for legitimate reasons.  By calling out four days in four months, it was deemed excessive by the employer

B. The Perfect Attendance Predicament

One of my pharmacists had worked for twelve years in the department.  She was a hard-working employee. She rarely called out sick. She had accumulated over 120 sick call days.  In fact, for several years she had received a perfect attendance award for not calling in sick for that year.

My pharmacist became sick with the flu.  She was sidelined for fifteen days straight.  However, she could not use her earned sick time to cover her illness. Why?  Because the hospital’s policy stated…

“Employees may only use sick time for the first five days of any illness.  After that, disability must be used…”

Even though my pharmacist had sufficient time accumulated, she could not use her sick time.

C. The Merit Increase Dilemma

Human Resources implemented a system which it tied to merit increases.  During an employee’s yearly evaluation, if they called out between 0-6 sick days per calendar year, the employee would receive the full merit increase.

If they called out between 7-10 sick days per calendar year, then ½% would be deducted from their final merit increase.

If they called out 11 days or more, then 1% would be deducted from their final merit increase.

Only Human Resources (and not the department managers) could make any concessions.  And they seldom did.

Employees had earned sufficient sick time, but were penalized for using it.

In closing, consider the following conclusions:

  1. Employers don’t like to put extra staff members on a shift, because it only encourages employees to call out sick.  Employers will schedule “just enough” (or sometimes “not enough”) employees to do the work. Thus, one sick call cripples the department.
  2. There will always be employees who rarely call out sick and therefore accumulate a huge number of sick days over the years.  These employees will never be able to use all their sick days. Therefore, under a “use it or lose it” environment, many of the earned sick days will be left on the table when the employee leaves.
  3. There will always be employees that find a way to abuse sick days.
  4. There will always be employers that find a way to change the rules and discourage employees from taking earned sick days.


The Abused and Discouraged Use of Sick Call and How it Wreaks Havoc in Today’s World
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