Recently I have had a series of heavy colds, so heavy in fact that I have had to take time off work – I can’t remember the last time that happened. Mrs Moneo, who is a complete stalwart when it comes to health matters, has also been laid low by a nasty bug. At one stage she could hardly speak, had a racking cough and conjunctivitis all at the same time.
Obviously, being male, I suffered far more than she did. In an attempt to regain our normal good health we thought it would be a good idea to get away for a few days and relax completely, but no sooner had we arrived at our hotel than Mrs Moneo went down with another heavy cold.
As a result of this viral epoch in our lives I became very sensitive about the passing on of these illnesses. At the hotel I found it increasingly annoying at breakfast to see parents letting their children help themselves to the buffet while they clearly had colds.
I watched daily as children helped themselves to the cereals while liberally hacking and coughing over them. One child make pancakes in a machine adjacent to a dish full of fried eggs while coughing openly over them. What causes this blinkered approach to the spreading of disease?
I began to consider how we react as optometrists when we are in a similar position. We all have a responsibility toward our patients and our fellow workers. Is it really fair to go to work with a cold? Of course there are those who take time off work at the drop of a hat.
Any excuse is good enough for them but thankfully they are in the minority. But that does leave a dilemma for the rest of us. Optometrists spend prolonged time with their patients. There will be many reading this who will readily blame a patient for passing their cold to them.
How many times has a patient said to you: “I have a stinking cold and really should not be here”? How many times has your heart sunk at the prospect of getting that cold? But how many times have you considered this from the angle of the patient? Are they happy when you sit next to them or opposite them for 20 to 30 minutes in close proximity coughing and sneezing all over them?
We have a duty of care to protect our patients. Many of our patients will be elderly and, indeed, classified as frail elderly. Many of our patients may well be immune-compromised in some way or another. They may be undergoing chemotherapy, leaving them more susceptible to illness. So what is our reaction at that stage when we develop a contagious cold?
It may be that we fall in to two groups here. It is probably easier to take time off work if we are employed because we are still going to receive our full salary and it is not our responsibility to make up the hole in the practice income that may ensue.
However, the self-employed, especially in practices where they are the sold practitioner, may view things differently. To not be at work might represent a 100% loss of income and therefore they will “bravely struggle into work” claiming that no one understands how hard it is to run your own business and that they cannot afford to take time off work. Laudable, understandable, but responsible?
By going to work there is a high probability that the illness you have will be passed on to others. Those who are frail elderly may well, if they catch this cold, suffer far worse than the original carrier.
As clinicians, we have a duty of care to our patients that we should never forget. That duty of care extends to their full welfare while in the practice. I doubt any of us would go to the toilet at work and then examine a patient straight afterwards without washing our hands.
However, examining patients at the same time as liberally spreading rhinovirus to all corners of the room is probably just as unhygienic.
The next time you have a streaming cold you may think you are being extremely brave dragging yourself to work but you should also consider you patients and reflect upon whether being such a trooper is the professional and responsible stance.
Finally, if you do have children and have taken them away to a hotel at half term for a break, then please, please don’t let them spoil my breakfast by coughing, spluttering and sneezing over it!