Still struggling in, no matter what?

It's autumn - there are clues. It may still be amazingly sunny but the flu jabs have arrived and I now leave the surgery in the dark. I like autumn; watching the leaves change to burnt sienna and the occasional whiff of bonfire. The cooler months however, do tend to bring a greater tendency to illness and absenteeism, but absenteeism has a less well known sibling who also deserves a mention.

Presenteeism is when people go to work even though they should be at home. The term was coined by psychologist Cary Cooper. Sometimes they may be ill, potentially contagious and not functioning at 100 percent, but they still feel like they should be at work. Presenteeism can also apply to people who work late or come in during their holiday. The cost of presenteeism to both employees and employers, can be significant. Research suggests absenteeism costs employers £8 million a year, but presenteeism costs approximately £15 million, so for economic reasons alone, it deserves recognition.

There are many reasons why people may feel they should go to work when they are ill: senior medics may discourage or penalise juniors for taking sick days, even if juniors are entitled to them. This may make people come into work as an act of future career or references protection. Medics may feel like they have so much work piled on their plates, or so many deadlines, that it is impossible to take time off without making patient care suffer. Some may feel like they must be present at work because there is no one else to replace them while they're away, or they may feel no one can replace them.

Some medics may come into work or stay late when they shouldn't, even if there isn't a whole lot of extra work to do, because they want to be seen as working hard. Some successful cultures actively discourage this, as a truly efficient worker would accomplish all the necessary tasks in normal working time. The more efficient the worker, the less time is required.

There are many hidden 'costs' of presenteeism. In the case of someone coming to work sick, presenteeism could mean that their germs are spread to healthy colleagues. Even if the index case feels well enough to perform their duties, other people may have lower immune systems, catch the illness and become much sicker than the person who gave them the illness.

Even though the ill employee is present at work, they are not functioning at 100 percent, which may have negative consequences for patients and their colleagues. The costs of presenteeism may be associated with lower quality service - for example a greater chance that someone might have a needlestick injury or make an error with medication dosing, because they are not performing as well as usual.

Medics who come into work when they are sick may take longer to recover, meaning that they are functioning at less than 100 percent for a longer time. Those who don't take vacation or who work very long hours can suffer from stress and depression, as they are not having the necessary breaks from work. Presenteeism can also contribute to a negative workplace culture where everyone is either expected to or feels like they have to, be in, no matter what the circumstances. This could lead to low morale and resentment. How many times have you heard colleagues extol their exemplary sickness record?

Don't follow suit - take the time you need, when you need it. When you're ill don't answer emails. Don't work on that referral audit or your appraisal. Switch off your brain, sleep and eat. It's that simple. ONLY when you feel better should you glance at our content updates for this month. Stay well.