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How do I deal with a nurse who has chronic attendance problems and a proven diagnosis of fibromyalgia?


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This employee may eligible for an intermittent FMLA and should be referred to whomever is responsible for managing FMLA. This will protect her job as well as give guidelines for what counts as an absence and what doesn't.

The key to managing an intermittent FMLA is clear documentation stating the reason for the call in. Ideally, you have an attendance policy with guidelines for progressive discipline.

Our policy defines an absence and separates out excused versus unexcused absences. The employees incur points over a consecutive, rolling twelve-month period for absences & tardies. A tardy is 0.5 points, an excused absence is 1 point, and an unexcused absence is 3 points. The employee receives counseling as follows:

  • 3 pts - verbal counseling
  • 6 pts - written counseling 
  • 9 pts - final written counseling
  • 12 pts - termination

-Kim Thompson RN, BSN, Employee Health Supervisor and Kari Nelson, PHR, Operations Manager and Diversity Coordinator at Medical City Hospital in Dallas, Texas