Q3 Urgent Caring- Kateland Kelly, PA-C: The Write Assistant

My fingers hovered anxiously over the screen, and I closed my eyes tapping the fatal message, “I can’t come in to work today.”

I held my breath, waiting for the inevitable response from my manager or regional manager in our group text before one finally floated through cyberspace, “Is there any chance you can come in later today? If you don’t, we’ll have to close both clinics.”

My eyebrows shot up but before I could respond to the text, another wave of nausea gripped me, and I vomited mucus onto the towel lining my bathroom floor. Her text was filled with subtext: If you don’t show up, no one will get paid and patients will suffer. This is not an uncommon dilemma for medical providers: If we get sick, who looks after our patients? I looked up at the sky, praying for an answer and asked myself what would I tell a patient in a similar situation…How would I counsel them?

I would counsel them to take a sick day, curl up in the bedroom with a hot pad, take their prescribed medication, and hydrate. I would counsel them to enforce boundaries with their employer because sick people can’t heal sick people.

While it is true, I am an Urgent Care/emergency Physician Assistant, I’m also a human, and I live with multiple chronic health conditions. My employer doesn’t need to know the specifics of my health conditions but in America, we often sacrifice our medical privacy for a modicum of understanding. The sad thing is, the chronically ill are rarely understood, and unless we are productive (like a clinician that can rake in high numbers on an outpatient shift), then we are dismissed as “bad employees.”

 The implicit suggestion in the text from my boss suggested I take additional ownership in the clinic for support staff, and that it is my responsibility to keep it staffed no matter what.

Except, it’s not.

Three years ago, I would have literally killed myself working through pain, illness, or injury but things have changed since the pandemic. I value my own body more since realizing I’m only a diagnosis away from death. Sounds dramatic, but when you’ve lived through a few active gunmen, you start to realize what is and isn’t important anymore while on the job.

The concept of quiet quitting has been floating around as the topic du jour but I like to think that calling out sick when you need to is simply being a human. Quiet quitting is defined as, “a response to the burdensome demands of employment. It is often linked to employee burnout and involves deliberate disengagement from work. Employees are performing the absolute least necessary and establishing clear limits rather than quitting their employment,” according to Sociology Plus.

The reason I push back against this concept is because we aren’t products and we aren’t robots; sometimes we need the tincture of time to heal. That shouldn’t be labeled as a deficiency or a withdrawal of any kind, but rather be recognized as a factor in working with other people. Life happens, or at least, that’s the lip service our human resource officers spout whenever they hold a company meeting.  However, as a clinician, tincture of time is one potion we’ve never got enough of. But we can start setting healthy examples for our patients when we start acting in our own best interests.

Let me illuminate just how difficult it is for those of us being choked by white collars to call out sick.

Have you ever considered what happens when your doctor calls out sick? Your physician assistant? Your psychiatrist?

We feel immense guilt even considering a day off.

I pushed through my guilt, and this time and I responded:  “I wouldn’t call out if I didn’t need to; I’m sorry but I can’t come in today.”

I curled up in bed, but not without missing a text and two phone calls from the clinic asking for clarification on various patients. I stared at my phone blinking confused — didn’t I just call out sick?

Even though I called out sick and even though I’m paid hourly, I was still contacted during my sick time to manage other patients. I made a conscious decision to not answer any of the calls as I had already taken some pain medication and once I pull that trigger, I don’t practice medicine. I spent the day praying to the porcelain gods, but I pulled myself through the fog and came to work the next day. Regrettably, I saw fifty-three Urgent Care patients all desperate for someone to listen to them and while I did my best, by the next morning I was up at 5 a.m. vomiting profusely and doubled over with diarrhea.

My period was vengeful.

I texted my manager and regional once more, déjà vu washing over me as I felt like a little bit of a failure, “I can’t believe I’m doing this again and I’m so sorry, but I need to call out sick. I’ve been vomiting since 5:00 a.m. and the diarrhea won’t stop. I can’t come in.”

This time the response was more intimidating, “I hope you feel better but this time we need a doctor’s note.”

Aren’t I the person people come to for a doctor’s note? What the what?

I responded quickly, referencing Connecticut state law which states employers can only ask for a note explaining three consecutive days off of work in a row. I had not called out multiple in a row, but I did realize it was a holiday weekend, Labor Day to be exact. I understood she was suspicious, but I wasn’t trying to score a day down by the lake, I was just trying to get my symptoms under control so I could get off the toilet.

My regional responded, “It’s the weekend.”

So, what? My internal dialogue screamed at myself. The irony of the weekend was not lost on me, but I don’t think she appreciated it considering how chronically short staffed our Urgent Care centers were. I couldn’t help but reflect on the dark origins of Labor Day and how it began after American laborers were tired of being taken advantage of by their employers. Labor Day, at its very core, is a celebration of the achievements and contributions of American laborers. Sadly, there is no rest for the clinically inclined and apparently, I needed an excuse to take the day off even though there was nothing in my contract to suggest that kind of documentation was needed.

I imagined myself as a medical assistant making a fraction of what the clinician makes, and I realized just how scary that text was to a sense of job security.

Staring back at the black mirror I refused to back down: “Is that company policy or law?”

My heart pounded waiting for a response, but the funny thing is, she never responded. I called her bluff.  And I didn’t drag my tired self to go sit in a waiting room where someone would nod, agree with me that I was ill and needed the day off, and write me a performative note wasting their time and mine. What I did was curl back under the covers once my prescriptions kicked in and I realized why I was so upset about the subtext in our conversations about calling out sick:

Are we not adults?

What happened to the sanctity of someone’s word?

I’ve seen support staff, medical assistants and receptionists, blue collar workers that lack the clout to call out, nurse their own illnesses in shame while on shift because the pressure to keep working is so high. When people scorn us saying, “No one wants to work anymore,” I can’t help but laugh, and then cry, when I realize it’s because no one wants to work in these conditions anymore. We deserve better. We deserve to be treated like adults, not children trying to play hooky.

When I call out sick as a clinician, I am doing so because I know my body and I know the risks that I can and can’t safely take. I will never put my patients at risk and now that I know my worth, I won’t continue to put myself at risk.

So, consider this my white coat endorsed professional opinion: If you think you need to take a day off to recover from an illness or injury, take the day off and let the corporate overlords figure out how to staff your absence. That’s their job, after all, not yours, even on Labor Day.