So, it started over the weekend and fully revealed itself yesterday—the sore throat, watery eyes, stuffy nose and general tiredness that announce that one has a cold. When I worked clinically, a cold was definitely not considered a good reason for taking a sick day, even though nurses with colds were sick. I actually don’t know what would have been a good enough reason for calling off. In general, call-offs were one of the ultimate sins in nursing and I still feel the stress of that when I’m mildly sick, as I am today.
Also this weekend my daughter Sophia got sick. Or rather, she got more sick than she had been earlier in the week, so I took her to urgent care on Saturday and then back again on Monday. She’s 23 and of course could have taken herself, but I offered because I find it hard to be sick and have to get care on my own. I hoped that having her mom along would help her feel better, even though she’s an adult.
On Saturday she tested negative for Covid, influenza, strep, RSV and mono. The Physician Assistant we saw thought she probably had a virus and told her to skip work, rest, and monitor. She did all that, but on Monday was obviously worse. This necessitated a return trip to urgent care, where the Nurse Practitioner said Sophia had a large pus ball in her throat on the left side. She once again tested negative for all the obvious things, and was diagnosed with tonsillitis. The NP prescribed a strong antibiotic—Augmentin—which, knock on wood, will lead her to feel better soon.
This newsletter is going to be short because I don’t feel good, and that is also its point. Sick people are vulnerable, not at their best, in need of rest and compassion from others. As I navigated Sophia’s illness with her, some of my parents’ ideas about sickness came to mind: my father tended to attribute all illnesses to “nerves” and my mother, who rarely gets sick, never understood why being sick made me feel bad. I’m a nurse. I know those ideas are bunk, and I thought I had put them aside, but there they were, entering my mind and suggesting that my daughter was not sick so much as, um, neurotic and whiny? It’s painful even to write that since it absolutely DOES NOT express how I feel. Plus, being neurotic and whiny does not lead to huge pus balls forming in one’s throat.
As I drove Sophia back to her apartment following the second Urgent Care visit, after she’d been diagnosed with tonsillitis, my parents’ incorrect ideas about illness, and the facts of sickness—germ theory, microbiology, that we have an immune system for a reason—floated around and bounced off each other in my head until, click, click, click, like the pieces of a jigsaw puzzle coming together, I suddenly and fully grasped that sickness is not a figment of one’s imagination, but real.
If anyone feels shocked that I, a nurse who has helped people survive cancer and die of many different causes, would hold and admit to such a retrograde set of sickness-beliefs, that’s the point, too. Americans are so suspicious of illness. Even in the hospital, where the stated mission is to care for sick people, management and other employees often dismissed sickness as malingering.
In Healing I point out that Australia mandates 4 weeks of paid sick leave for all employees. Meanwhile, the United States lags behind all other industrialized countries in terms of offering paid sick leave. Many employees have no paid sick days and don’t even get me started on the evils of employees having to “earn” sick days as a version of paid time off (PTO). Businesses’ sickness-is-malingering sick-leave policies encourage people to come to work sick, lowering productivity and getting other people sick, which further lowers productivity, etc.
An article in Healthline discusses the problems that arise when sick people go to work. It’s a very digestible overview of the issue, though I wish it held management more accountable for not having humane sick leave policies. According to the chart below, 74% of the people they surveyed feel they needed to work sick. That’s 3/4 of the people surveyed. Also, advocating for remote work as an option for ill employees does not give people time to actually be sick.
I really hoped that after Covid, companies would take a more sensible approach to employees needing time off due to illness, that they would understand that NO ONE benefits when sick people come to work. To put it another way, I hoped to see an embrace of sickness and vulnerability as intrinsic to being human, and thus something we need to plan for and respond appropriately to, rather than trying to wish illness away, or punish it, as happens when employers fire employees if they take a couple of sick days, or even one. Alas, Sophia has no paid sick leave and a rule mandates that employees are only allowed three sick days every month.
I took Sophia to Urgent Care to acknowledge that her sickness was serious and required caretaking. I also bought her popsicles and mini frozen pizzas. Her sister Miranda picked up the antibiotic Sophia needed along with yogurt to protect her stomach from the antibiotic’s GI rigors. Today her dad dropped by with more popsicles and Eggo waffles (her throat really hurts!). We all pitched in to make her feel loved and cared for, which won’t get rid of the pus in her throat, but will allow her to rest and lower her stress levels, all of that will help her get better faster, because care and compassion make a difference.
That’s not just my opinion. A 2001 article in The Lancet on the value of empathic clinical care reported: “a Swedish team found that patients with tonsillitis recovered faster and were more satisfied when treated by a friendly practitioner who gave a positive prognosis, encouraged questions, and spent an extra 4 min with them” (emphasis added). OK, Miranda, Arthur and I were not Sophia’s practitioner, but compassionate care, whoever provides it, matters.
To summarize: sickness is real and people, including Americans, get sick. After all, if people didn’t get sick, then health care wouldn’t be a billion dollar business in this country. Wrap your head around that conundrum if you can. In the meantime, generate some compassion for yourself next time you’re sick, or for your co-worker who needs time off to get well. Tender loving care, and time off, are essential for healing.
Bonus:
I was interviewed by MedCityNews about the Nurses’ Strike in New York. Read the article here: Sometimes Striking Is the Only Way Nurses Can Protect Patient Safety, Expert Says.
Good luck navigating the winter months and their accompanying viruses and sicknesses!
And hugs,
Theresa
Theresa: You summarize so well the problem we Americans have of working while sick and then offer reasoned and compassionate policies that might address it. But what really struck me was the fact that, even though you did not feel well and your adult daughter could have taken herself to Urgent Care, you took her, twice. You might say, well, that's just a mom, but I say, in addition to that, "Once a nurse, always a nurse." No wonder they are the most trusted profession in America. Good for you!
Thank you so much for writing this. Of all the stupid assumptions and practices in the US work world, the attitude to sickness is the most enraging. People get sick! That is a normal part of being a living creature! And when people get sick, it is better for everyone if they take the time they need to get better. And I say this as someone who, like your mom, basically never gets sick. But I’m aware that not everyone in the world is just like me!
In Switzerland, there is no limit to sick days. If you’re sick, you stay home. If you’re sick for more than three days, you need to send in a doctor’s note, but everyone living here has a primary-care physician, and they are set up to handle this kind of thing, so it’s no hassle. It would never occur to anyone to force sick people to come in to work.
I hope you and Sophia are totally better very soon!