NUR222 Essay: Legal & Ethical Aspects of Presenteeism in Nursing

This essay explores the legal and ethical dimensions of presenteeism within the nursing profession, examining the practice of healthcare workers attending work while unwell. It delves into the implications of presenteeism, including its violation of the Fair Work Act (2009) in Australia, and its ethical ra...Read More

Running head: LEGAL AND ETHICAL ASPECTS OF PRESENTEEISM
LEGAL AND ETHICAL ASPECTS OF PRESENTEEISM
Name of the Student:
Name of the University:
Author’s Note:

1LEGAL AND ETHICAL ASPECTS OF PRESENTEEISM
As stated by Holland and Collins (2018), registered nurses and the midwives are required
to show the highest amount of compassion or dedication towards the care or the treatment
services that they are offer to their patients. Rosen et al. (2018) are of the viewpoint that this
particular aspect is important since the recovery process or for that matter the wellbeing of the
patients greatly depends on this particular aspect of the work of the registered nurses or the
midwives. However, the important issue arises since it had been seen that because of the
problems of workforce shortage, the large number of patients that the healthcare organizations
offer healthcare services to and others, presenteeism had become an integral part of the nursing
profession (McLellan 2017). For instance, many times it had been seen that the nurses are
required to report to their jobs despite being physically or emotionally unwell since their job
roles requires them to attend to the patients. This as a matter of fact is not only in direct violation
of the Fair Work Act (2009) of the Australian government but at the same time unethical as well.
More importantly, it not only reduces the quality of care which is being offered by them to the
patients but also enhances the chances of the other healthcare professionals as well as the
patients infected from the health ailments that the nurses are suffering from. The purpose of this
essay is to discuss the legal and ethical aspects of presenteeism including barriers and enablers to
accessing sick leave.
Wang et al. (2018) are of the viewpoint that presenteeism refers to the situation wherein
the registered nurses or the midwives are required to attend even when they are unwell or for that
matter not completely well to perform their work roles. Adding to this, Sarker et al. (2016) have
noted that an important factor which had substantially contributed towards presenteeism can be
attributed to the Herculean amount of work that the registered nurses or the midwives are
required to perform within the healthcare organizations in the face of the shortage of adequate

2LEGAL AND ETHICAL ASPECTS OF PRESENTEEISM
number of healthcare staff. In addition to this, it is seen that the registered nurses or the
midwives have fixed patients whose medical histories they are familiar with and thus know
exactly the kind of care or treatment that they require (Gustafsson et al. 2019). However, if they
are absent from work it becomes very difficult for the other registered nurses or the midwives
who are filling in for them to administer the required care or treatment since they first need to go
through the medical history of the patients and after that administer the required care or
treatment (Cicolini et al. 2016). More importantly, psychologists have also noted that the process
of presenteeism can also be attributed to the psychological insecurity of the individuals wherein
they feel that if they are absent from work their place within the organization might be taken
away or for that matter they might be replaced (Aboagye et al. 2019). However, regardless of the
reasons for indulging in the process of presenteeism it can be said that the concerned process is
not only derogatory from the legal perspective but also from the ethical perspective as well.
As discussed by Gustafsson et al. (2019), the healthcare sector and the organizations
related to the same just like the other industries of the world are required to take into account the
different governmental policies, regulations, legislations and others not only for the management
of their workers but also for the management of their operations. Nelson, Shaw and Robertson
(2016) are of the viewpoint that the healthcare organizations operational within the nation of
Australia are required to ardently follow the different precepts of the Fair Work Act (2009) of the
Australian government for the adequate management of their human resources. More
importantly, as per the precepts of this particular act, “All full-time employees – except casuals –
are entitled to a minimum of 10 days paid personal leave each year (which includes sick leave
and carer's leave). This is accrued progressively for a full-time employee, and pro-rata for a part-
time” (Legislation.gov.au 2019). Moreover, the Australian government presently had also made

3LEGAL AND ETHICAL ASPECTS OF PRESENTEEISM
it mandatory for the different healthcare organizations of the concerned nation to offer mental
health leaves to the healthcare professionals so as to facilitate their wellbeing or wellness (Rosen
et al. 2018). This is important since the work that the healthcare professionals perform is both
emotionally and physically taxing and thus they are required to have adequate amount of
wellness or wellbeing so as to be able to perform their job roles adequately.
Lui and Johnston (2019) are of the viewpoint that despite the different mandates or for
that matter the stipulations of the Australian government, the precepts of the Fair Work Act and
others are rarely being followed in practical scenarios. In this connection, it needs to be said that
by working when they are actually not well, the healthcare professionals not only disregard the
aspect of patient safety but also jeopardize the safety as well as the security of the patients but
also that of their colleagues as well (Gostin and Wiley 2016). For instance, if the healthcare
professionals are working when they are physically or emotionally not well then the chances of
them making errors or mistakes becomes very high which in turn can even cost the patients their
life itself (Martinsson et al. 2016). More importantly, chances are also high that the healthcare
professionals would unwillingly or for that matter unknowingly transfer the infections or the
health ailments that they are suffering from to the patients or their colleagues (George, Chiba and
Scheepers 2017). Thus, it can be said that the process of presenteeism which is predominant
within the spectrum of the concerned industry is completely contradictory to the above
mentioned legal stipulations of the Australian national government. Thus, it can be said that the
healthcare professionals while working when they are not completely fit are likely to cause more
damage to the health of the patients or their colleagues than good and thereby it is important for
them to take sick leaves rather than attend work. Furthermore, the healthcare organizations also
rather than forcing the healthcare organizations to work when they are sick needs to follow the

4LEGAL AND ETHICAL ASPECTS OF PRESENTEEISM
mandates of the Australian government and offer them sick leaves so as to offer them the
required amount of recuperate.
Nelson, Shaw and Robertson (2016) are of the viewpoint that along with the legal factor
there are ethical considerations as well involved with the process of presenteeism wherein the
healthcare workers work even when they are working. Adding to this, Mach Piera et al. (2018)
have noted that the healthcare workers perform a very novel job and the work that they perform
actually helps in saving the lives of numerous individuals. However, it is not possible for these
individuals to perform their job roles adequately if they themselves are not completely physically
or for matter emotionally fit. More importantly, it is seen that an important concept which is
predominant within the healthcare sector can be attributed to the fact that the healthcare workers
are required to follow the ethical theory of utilitarianism and thereby indulge in the kind of
actions which are likely to cause the maximum amount of benefit to the maximum number of
people (Pawlecki et al. 2018). This in turn had given rise to the idea that the healthcare workers
are required to prioritize the health as well as the wellbeing of the patients even before their
health or wellbeing. However, the thing that the healthcare workers as well as the healthcare
organizations need to understand is the fact that the healthcare workers just like the patients are
human beings and thereby they too fall ill or sick. Furthermore, in order to look after the
treatment needs of the patients or for that matter to offer the best quality treatment services to the
patients, the healthcare workers themselves need to completely fit (McLellan 2017). Thus, it
becomes totally unethical as well as completely unsafe for the healthcare organizations to deny
the healthcare workers sick leaves when they are unwell or unfit and thereby force them to attend
the patients or for that matter to work. This can be explained on the basis of the fact that the
healthcare workers are also workers just like the ones in other professions and thus they should

5LEGAL AND ETHICAL ASPECTS OF PRESENTEEISM
also be entitled to sick leaves and the other benefits or the entitlements as outlined by the
Australian government that are commonly available to the other workers of the concerned nation
(Holland and Collins 2018).
As discussed by Rosen et al. (2018), the process of presenteeism which is predominant
within the healthcare sector cannot be merely pinned down on the management of the healthcare
organizations but can be seen as the resultant effect of a plethora of factors or challenges that the
concerned industry is presently facing. George, Chiba and Scheepers (2017) are of the viewpoint
that an important issue that the healthcare sector had been facing for a very long time now can be
attributed to the challenge of workforce shortage. For instance, it is seen that there is a dearth of
qualified healthcare professionals and the exponential surge in the number of patients who visit
the healthcare organizations for availing healthcare treatment services had aggravated the issue
even further (Wang et al. 2018). The resultant effect of this is that the healthcare workers need to
work long shifts and cannot afford to take a leave since this is likely to add on the workload or
the work pressure of their colleagues. This in turn had given rise to the situation wherein it is
seen that the healthcare organizations either deny sick leaves or for that matter force the
healthcare workers to come to work even when they are sick or unwell. More importantly, the
healthcare workers are required to administer treatment to the individuals who are not well or for
that matter unfit and also it is a common perception that they know everything about health and
health issues (McLellan 2017). Thus, it is seen that many healthcare workers do not feel
comfortable reporting sick since it would raise questions about their knowledge of health or for
that matter very credibility itself. This in turn had also substantially contributed to the trend
wherein it is seen that the healthcare workers work even when they are not completely physically
as well as emotionally fit.

6LEGAL AND ETHICAL ASPECTS OF PRESENTEEISM
The healthcare organizations as well as the healthcare workers need to understand that
the process of presenteeism is not only illegal but at the same unethical as well and thus they
need to take the help of various measures so as to overcome the challenges that had given rise to
presenteeism. For instance, the healthcare organizations need to overcome the issue of workforce
shortage that they are presently by hiring adequate number of healthcare workers or by managing
their existing workforce in such a manner that when a worker is absent it would add to the work
pressure of the other workers or for that matter affect the treatment of the patients. In addition to
these, the healthcare workers themselves need to understand the fact that at the end of day they
themselves are human beings and thus it is very natural for them to fall sick. Thus, when they are
sick they need to take a sick leave since while working when they are sick they are likely to
cause more harm than good.
To conclude, presenteeism is predominant within the healthcare sector and thus it is seen
that the healthcare workers attend work even when they are sick or not well. However, at the
same time it needs to be said that during this condition the healthcare workers not only disregard
the entity of patient safety that they are required to follow but also jeopardize the wellbeing of
both the patients and their colleagues if they work. More importantly, it had been seen that the
Australian government through its different employment mandates had clearly stated that the
healthcare workers just like the other workers of the concerned nation are not only entitled to
sick leaves but also other kinds of perks. Furthermore, the healthcare organizations also need to
understand the fact that forcing the workers to attend to patients while sick is not only risky but
also unethical as well and thereby they should desist from doing so. These aspects of
presenteeism within the healthcare sector become apparent from the above discussion of the
same.

7LEGAL AND ETHICAL ASPECTS OF PRESENTEEISM
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