Sick leave in the emergency department: Staff attitudes and the impact of job designation and psychosocial work conditions

Aim: To examine patterns of, and attitudes to, sick leave taken by ED and other hospital staff and to compare ED doctor and nurse psychosocial work conditions. Methods: This was an observational study in a tertiary referral ED. An audit of sick leave taken over a 2-year period (2007-2008) by all ED, general medicine (GM) and pharmacy pay groups was undertaken. This was followed by a cross-sectional survey of ED staff. It evaluated attitudes towards sick leave and used the Karasek's Job Content Questionnaire to assess psychosocial work conditions. Results: Overall, sick leave taken by the various staff groups differed significantly (P < 0.01). The ED and GM nurse rates (6.0% and 5.9%, respectively) were approximately twice that of pharmacists (3.3%) and ED allied health staff (3.1%) and more than three times that of all doctor groups (range 1.3-1.9%). ED registrars and nurses tended to take more leave on Monday/Tuesday and Thursday/Friday, respectively. These groups also tended to take more leave in winter/early summer and autumn/spring, respectively. In total, 147 (93.0%, 95% CI 87.6-96.0) ED staff rarely/never took sick leave without being sick. However, 15 (9.5%, 95% CI 5.6-15.5) often/very often took sick leave because of work stress. Compared with ED nurses, ED doctors had significantly more job insecurity and supervisor support but less psychological job demand (P < 0.05). Conclusions: Emergency department staff generally report healthy psychosocial work conditions. However, the high rate of ED nurse sick leave might be related to their considerable psychological job demand and perceived lack of supervisor support.