Presenteeism, an attendance behavior defined as going to work while our health is not optimal, is a phenomenon more and more recognized and known to impact workers and their organizations negatively. For example, we now know presenteeism generates significant productivity and financial losses and is associated with various health difficulties, such as burnout, depression, anxiety, and chronic pain (more details on the impacts of presenteeism are presented in Part 1 of this article).

The global pandemic has changed the professional reality: most workers are now forced to work from home, organizational restructuring and layoffs are more prevalent, and maintaining a work-life balance is even more challenging. In that context, it may be even more difficult for individuals to take the day off work when they need to – putting them and their organization at higher risk of experiencing the harmful consequences of presenteeism.

The good news is that we know organizations, managers, and workers alike can prevent and intervene to limit the impacts of presenteeism and promote well-being and productivity in the workplace. Here are a few points to consider to help you and others face this reality.

Recommendations for individuals

• One of the best tools we can use to prevent health difficulties associated with presenteeism is to be aware of our signals. Our body typically tells us when we need to slow down and take a break – we just need to respect it more. If you are experiencing difficulties with concentration, motivation, low energy, higher stress levels, and physical aches, it may be time to take some time off work to recharge your battery.

Checking in with yourself to see how you are doing psychologically and physically can help you decide if it could be a good idea to take time for yourself or slow down your work pace. Even taking a half-day for yourself or respecting your work-breaks can have a significant impact.

• Asserting your limits and expressing your needs to your colleagues and managers can also help manage your workload more effectively and help you manage your energy.

• Being present for work can be a positive source of self-accomplishment and social support. Continuing to connect with colleagues and friends, and practicing self-care activities, can help meeting those needs when you are off work.

• At times, we need to adjust our self-imposed ideals and expectations. Life is full of stressors and transitions, so, understandably, we cannot always be present at work or as productive as we want to. We are not robots, and sometimes we need to accept that we have limits and needs.

Recommendations for organizations and managers

• Too often, promoting wellness and productivity clashes instead of being an integrated message within the work culture. However, from a clinical point of view, well-being and productivity go hand in hand. If we proactively respect needs and limits and take concrete actions to maintain a healthy work-life balance, we will be more productive at work and in our personal lives.

Offering sick-days to employees does not seem to be enough. Changing implicit messages that reward being present at work at all costs, training managers on the risks of presenteeism, and recommending concrete behaviors that promote well-being are all avenues that can limit presenteeism and its negative impacts.

• Managers are often in a privileged position to see members of their team struggling with workload, feeling unwell, lacking motivation, etc. Having open discussions regarding a need for taking time off work, reducing or reassigning tasks, and implementing a more reasonable work routine, can help prevent the negative impacts of presenteeism.

• Supervision and management mean many different things, and it also includes modeling. Suppose directors and managers themselves respect their own boundaries, promote well-being and healthy work-life balance, and encourage taking advantage of sick and personal days. In that case, their team members will be even more likely to practice the same behaviors.

Taking time off work is not the only solution to prevent presenteeism. Taking care of ourselves and others and promoting healthy boundaries and a work culture that does not exclusively care about productivity can positively impact employees and organizations alike.

If you recognize a more pronounced difficulty to manage psychological or physical symptoms within yourself or colleagues, starting psychotherapy can also be an option. CFIR’s professionals are here to support individuals and organizations to promote wellness in the workplace.

Dr.Karine Côté, D.Psy., C.Psych. is a psychologist at the Centre for Interpersonal Relationships (CFIR). Dr. Côté provides psychological services to individual adults and couples experiencing a wide range of psychological and relationship difficulties related to mood and anxiety disorders, trauma, eating disorders, sleep disruptions, and interpersonal betrayal. She works from a humanistic approach and integrates therapeutic techniques from gestalt and object relations psychotherapies, emotion-focused therapy (EFT), and cognitive-behavioral therapy (CBT).

For many of us, work represents a significant part of our lives. Not only do we spend half of our time at work, but we also tend to invest personal resources and efforts to accomplish our professional responsibilities, develop meaningful relationships with colleagues, and construct our sense of identity on what we do.

In the past few decades, organizational and management research has focused on the impacts of absenteeism and implement measures to prevent it, such as rewarding satisfactory attendance and reinforcing policies to justify absences. Combined with a social context that values performance and being seen positively by peers, these measures can influence employees’ decisions to go to work or not. In return, another attendance behavior has been a subject of interest more recently: presenteeism. 

Defined as going to work while being sick, presenteeism is now known to be a widespread phenomenon among workers. It is estimated that more than 60% of employees report having worked while their health was not optimal, having different impacts for organizations and their members. 

Impacts of presenteeism for organizations

By reducing employees’ efficiency, presenteeism also generates productivity losses for organizations, which are estimated to be higher than those produced by absenteeism. It is estimated that presenteeism costs, on average, $255 annually per employee of a single organization, and its productivity losses can cost between $150 – $180 billion dollars per year (Goetzel et al., 2004; Hemp, 2004). Some authors argue that organizational culture and policies that promote presence at work can then have the impact of developing presenteeism, and therefore, is very costly.

Impacts of presenteeism for employees

Presenteeism represents a risk factor for workers’ physical and mental health. 

• Going to work while being sick can put others at risk by contributing to the transmission of infectious diseases. 
• This attendance behavior has been associated with different health difficulties, such as burnout, depression, anxiety, and chronic pain.
• Presenteeism is also associated with the worsening of physical and psychological symptoms, and by delaying the recovery process, it can eventually lead to more absences.
• Not respecting our need to stay at home and to take care of our health can also impact our productivity or sense of accomplishment at work, and therefore leading to a diminished sense of work engagement and job satisfaction.

In summary, even though absences from work can hurt an organization, going to work while being ill also can provoke real consequences for both the organization and its employees. It is, therefore, important to recognize signs of suboptimal health and to promote self-care in and outside the workplace. Psychotherapy can be a great place to start to learn how to identify our warning signs, how to assert our needs, and develop acceptance of our limits – and then optimize your health!

Dr. Karine Côté, D.Psy., C.Psych. is a psychologist at the Centre for Interpersonal Relationships (CFIR). Dr. Côté provides psychological services to individual adults and couples experiencing a wide range of psychological and relationship difficulties related to mood and anxiety disorders, trauma, eating disorders, sleep disruptions, and interpersonal betrayal. She works from a humanistic approach and integrates therapeutic techniques from gestalt and object relations psychotherapies, emotion-focused therapy (EFT), and cognitive-behavioral therapy (CBT).

References

Goetzel, R. Z., Long, S. R., Ozminkowski, R. J., Hawkins, K., Wang, S., & Lynch, W. (2004). Health, absence, disability, and presenteeism cost estimates of certain physical and mental health conditions affecting U.S. employers. Journal of Occupational and Environmental Medicine, 46(4), 398-412. https://doi.org/10.1097/01.jom.0000121151.40413.bd

Going to work while being sick – not always the best policy (part 1)Hemp, P. (2004). Presenteeism: At work—But out of it. Harvard Business Review, 82, 49-58. Retrieved on https://hbr.org/2004/10/presenteeism-at-work-but-out-of-it