Should You See a Doctor and Take Leave from Work as a Nurse in a Cancer Clinic?
Yes, you should absolutely see a doctor and strongly consider taking sick leave from work, especially given your role as a nurse caring for immunocompromised cancer patients.
Critical Considerations for Healthcare Workers in Oncology Settings
Immediate Action Required
Healthcare workers with symptomatic infections pose a direct transmission risk to cancer patients and must be excluded from patient care. 1 The guidelines are unequivocal on this point:
HCWs who are currently symptomatic with infections transmissible by air, droplet, and direct contact (including upper respiratory tract infections, infectious gastroenteritis, HSV lesions, or VZV infection) should not engage in patient care or visit patients. 1
Where a risk assessment has indicated that an HCW's infection poses a risk to patients, the HCW should be excluded from work until 24 hours of appropriate treatment and resolution of symptoms has occurred. 1
Why This Matters for Cancer Patients
Your patients are at exceptionally high risk:
Cancer patients, particularly those with neutropenia, severe immunosuppression, or lymphopenia, are at significantly higher risk for severe complications from infections. 1
Severely immunosuppressed patients generally have a higher risk of developing complications in community-acquired respiratory virus (CARV) infections. 1
Cancer patients generally shed respiratory viruses longer than immunocompetent people, increasing the risk of nosocomial transmission. 1
The Decision-Making Process
Step 1: Immediate Self-Assessment
- Do you have ANY symptoms of infection (fever, cough, sore throat, gastrointestinal symptoms, skin lesions)? 1
- If YES → Contact your occupational health service or line manager immediately and do not report to work 1
Step 2: Medical Evaluation
- See your physician for proper diagnosis and treatment 1
- Obtain documentation of your illness and fitness to return to work 1
- Discuss the specific infectious risk to your immunocompromised patients 1
Step 3: Work Exclusion Period
- Remain off work until at least 24 hours after starting appropriate treatment AND complete resolution of symptoms 1
- Do not return to work while still symptomatic, even if you feel you can "work through it" 2
Common Pitfalls to Avoid
The "Hazardous Hero" Phenomenon
Physicians and nurses frequently work while ill, which is particularly dangerous in oncology settings. 3, 2 Research shows:
- More than 80% of healthcare professionals have "worked through" illness, citing cultural and organizational factors 3
- Over half of physicians in one study worked while having an infectious disease 2
- This behavior might be harmful to the physicians themselves as well as to their patients and staff members 2
Barriers You May Face
Common reasons healthcare workers avoid sick leave include: 3
- Difficulty arranging cover for patient care
- Cultural attitudes about their own health
- Organizational pressure
- Guilt about burdening colleagues
However, these concerns must be secondary to patient safety when caring for immunocompromised individuals. 1
Specific Infection Control Requirements
Vaccination Status
- Ensure you are up-to-date on all recommended vaccinations (annual influenza, measles, mumps, rubella, varicella) 1
- This is a baseline requirement for working with cancer patients 1
Work Exclusion Policies
- Your workplace should have clear work exclusion policies that encourage HCWs to report their illnesses or exposures 1
- These policies exist specifically to protect vulnerable patient populations 1
Bottom Line
The risk-benefit calculation is clear: the potential harm to your immunocompromised cancer patients from exposure to your infection far outweighs any inconvenience from your absence. 1 Your professional responsibility is to:
- Contact occupational health or your supervisor immediately 1
- See your physician for evaluation and treatment 1
- Remain off work until 24 hours after treatment initiation AND complete symptom resolution 1
- Obtain medical clearance before returning to patient care 1
Working while symptomatic in an oncology setting is not dedication—it is a patient safety risk that violates fundamental infection control principles. 1