As an employer, human resources department, manager, or team leader, dealing with staff sickness and absenteeism is something you will need to manage and properly understand. Having a good understanding of how to encourage ‘Positive Presenteeism’, and to reduce ‘Negative Presenteeism’, and ‘Negative Absenteeism’ can be a very good way to maximize productivity whilst at the same time, looking after your staff. All will be explained below.
What is Presenteeism and Why Does it Occur?
You will likely already be familiar with the term absenteeism, that in essence means to be absent. But what about presenteeism?
Presenteeism is the practice of coming to work despite having an illness or injury, thus reducing productivity.
Presenteeism is something that is actually common in the workplace and for a number of reasons including because of:
1. Job strain
For example, an employee might be worried that the workload will build up in one’s absence and that others will not be able to cover. Likewise, they might be worried about tight deadlines, or because their workload is too big.
2. Over-commitment to work
Some people are just very committed to work and cannot switch off (the so-called workaholics). A number of staff members fit into this category, especially in high-level jobs.
3. Time pressure
Similar to the issue of job strain, there may be deadlines looming or too much to do in too little time.
4. Concern for others or colleagues
Some members of staff do not want their colleagues to suffer by having to cover for them. Whilst this is a very noble trait, it is not necessarily good for you as a company.
5. Pressure from colleagues and managers
Some managers may be too demanding and sometimes colleagues too. It is vital to train managers in dealing with staff sickness (see the Absence Management course) in addition to areas such as Conflict Management and Unconscious Bias.
6. Work culture and ethics
In some workplaces, staff members have the idea that they have to commit 100% all the time, and any time off for sickness is seen as unnecessary weakness.
Also, some professions (such as in the areas of welfare, education, and health) may be more prone to presenteeism due to the nature of the job itself and to the responsibility that the professional feels towards people in their care.
7. Not wanting to accrue sick leave
Some people, who suffer from chronic illnesses, may not want to accrue too much sick leave.
Also, this depends on your sickness policy and how you enforce it. Your sickness policy might be too strict or people might see it as a measure of control.
A sickness policy should not be used in a threatening way as a weapon against absenteeism. If this is the case, employees will feel uncomfortable to admit when they are really ill.
8. Job insecurity
If employees feel that they might lose their job, they might come to work even if they are sick.
Moving Towards Positive Presenteeism & Reducing Absenteeism
This slide below can help you to understand the way in which we should strive for encouraging positive presenteeism and to reduce negative absenteeism.
What Is Positive Presenteeism and Encouraging It
We have discussed what presenteeism is. Let’s now delve deeper into different types of presenteeism and how presenteeism can be either positive or negative.
First of all, presenteeism can be positive.
With positive presenteeism, we refer to situations in which somebody with a health condition, if given the right support, can be present at work and can actually benefit from being at work.
For example, somebody who suffers from a chronic health condition, such as diabetes, can attend work if given support such as being able to take breaks to monitor their blood sugar level or to have a snack.
If a health condition is considered a disability, the law requires an employer to put in place reasonable adjustments (accommodations in the US) to allow an employee to carry out their job.
In any case, though, it is good practice to support an employee if, with small and inexpensive adjustments, they can still come to work.
In some cases, you will need to consult with a health professional or with your occupational health department to see what can be done and if the employee can come to work.
This type of presenteeism needs to be encouraged.
I have included absenteeism in this diagram, to show the relation between presenteeism and absenteeism in more detail.
Here, positive absenteeism is what we referred to, in a post about types of absenteeism, as legitimate absenteeism (either planned or unplanned).
We want employees to stay away from work when they have a legitimate reason to do so and, if they are unwell, if they are too sick to come to work (no matter what type of adjustments you might offer) and/or they have diseases that can be transmitted to their colleagues.
Positive absenteeism is also to be encouraged.
Let’s now look at the negatives.
Negative Presenteeism & Reducing It and Why
Negative presenteeism is when an employee is too ill to be at work.
You want to reduce this type of presenteeism by assessing the situation (with the help of health professionals).
So, if the employee can still work with adequate support, you provide support and move towards positive presenteeism.
On the other hand, if there is no way that the employee should be at work, you need to encourage them to be off (and move towards positive absenteeism).
Finally, let’s look at negative absenteeism.
Negative absenteeism refers to either illegitimate absenteeism, or it can refer to people who have been absent for too long because of a health condition but who could work, with the right support.
So, you want to reduce the number of people who feel they are unable to work but would like to come back, by seeing if you can put in place adjustments to help them come back (so, you move them from negative absenteeism to positive presenteeism).
As for those who engage in illegitimate absenteeism, ideally, you would want to eliminate this type of behavior, either by improving your workplace culture or by using disciplinary procedures as a last resort if you have done everything you can and the absenteeism is just down to the individual.
These cases will hopefully be rare, but they do happen.
When Is It Appropriate to Work When an Employee Is Sick?
As we have seen from the previous discussion, there are several considerations we need to make to decide if it is appropriate for an employee to be present at work when ill.
The first thing you need to consider is the illness manifestation.
Illness manifestation refers to whether the illness is episodic, acute or chronic.
An episodic illness is something that comes and goes periodically, such as an allergy or a migraine.
In this case, the decision will depend on the severity of the symptoms and how these are managed (for instance, with medications that might give side effects such as drowsiness).
The manager and the employee can discuss and agree if any accommodations are needed, such as working from home to avoid driving, or avoiding computer screens during a migraine attack, etc.
An acute illness includes conditions that appear suddenly and with noticeable symptoms and these can include communicable diseases, such as flu.
A decision will depend on the type of job, whether the disease is infectious, if rest is needed to avoid a worsening of the condition, etc.
A chronic illness refers to long-term conditions such as diabetes, arthritis, heart disease, etc. Unless symptom are flaring up, usually people with these conditions can work, provided they are given support such as more breaks, time off for medical appointments and lighter duties if needed.
Nature of the Illness
Another factor to consider is the nature of the illness.
This refers to whether the illness is physical or psychological. People with mental distress tend to not discuss their symptoms and to avoid taking time off, until they are badly affected.
So, managers need to keep an eye out for signs of distress and evaluate each situation on a case by case basis.
Task and Role
The third thing you need to consider is the tasks and the role of the job.
An office worker with a broken leg can still perform his/her duties, while a parking enforcement officer (who needs to stand around and walk a lot) with a sprained ankle will struggle.
Last, you need to consider other variables that vary from case to case and cannot be generalized. For example, you might want to consider transport availability or what types of facilities are available in the workplace.
Dr Paul Symonds
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