Do You Ever NOT Take A Doctors Note?

[DanceMom]

To allow a child back into daycare? I have one girl out with a fever over 100 and vomitting..and I get the " I have a doctors note that she can return to daycare" oh really ? No she cannot until she is fever free and vomit free for 24 hours..

These doctors just writing notes for the hell of it? I cant believe a doctor would allow a child back into daycare with a fever and vomitting.

[kpa0627]

I'm so glad you asked this question. I just ran into this problem today. I had a child who was not himself on Monday. No fevers or anything but just laid around ALL day..... very unlike him. He came in Tuesday and was acting the same but once again no fevers. Then all of a sudden just started puking EVERYWHERE at 9:30 am. I called mom and she came and got him and took him to doctor yesterday afternoon. Called me at 5:00pm last night and said well doctor said it's just a cold so he can come back to daycare. I told her he either needs to be vomit free for 24 hours (so 9:30am tomorrow drop off) or there needs to be a note from doctor. Sure enough she came with a doctors note in hand at 7am this morning. I'm not a doctor but really why would they say it's okay for a child to return to daycare/school the very next day after vomiting EVERYWHERE!! Ugh it's so frustrating!

[bgmeyers]

My policies trump a doctors. I don't care if you have a note. The only thing I want a note for is something like an unexplained rash. Note must say child is not contagious. Even then, if child is uncomfortable and I can't reasonably take care of them and the rest of the group, they belong at home.

[Lilbutterflie]

Yes, these are YOUR daycare policies that she needs to follow, not the doctor's. Doctor's notes are only for the instances where there is a communicable disease (strep, flu, chicken pox, etc...) and the doctor is saying when the child can return to daycare. But if a doctor's note is overriding your policy, like coming back to daycare while still having fever or vomitting, do NOT accept it! I agree, that's just ridiculous that a doctor would put their own name on the line when a child is still ill and contagious. I wonder if maybe it was just a phone call to the nurse and the doctor did not get the whole story?

I used to watch a baby, and the mom questioned every single policy I had, especially the illness policy. Well, she got the doctor to write a note for his fever (which was 100.4), saying that it was just teething. And, she got a doctors note when he had bright GREEN mucus flowing out of his nose for the second day in a row (which is in my illness policy to be sent home for), saying that "kids are just snotty" and that green discharge in this case did not mean a serious infection. UGH. I learned my lesson then NOT to accept a doctor's note if it overrides my policies. The doctor's objective is for the one child to get well, not always to keep the other children and yourself from getting sick. YOU have to protect the other children in your care from illness as much as possible, so you have to stick with your policies!

Sorry for the rant, this just brought up so much frustration that I had with the precious DCM!!!

[marniewon]

Originally Posted by kpa0627

I'm so glad you asked this question. I just ran into this problem today. I had a child who was not himself on Monday. No fevers or anything but just laid around ALL day..... very unlike him. He came in Tuesday and was acting the same but once again no fevers. Then all of a sudden just started puking EVERYWHERE at 9:30 am. I called mom and she came and got him and took him to doctor yesterday afternoon. Called me at 5:00pm last night and said well doctor said it's just a cold so he can come back to daycare. I told her he either needs to be vomit free for 24 hours (so 9:30am tomorrow drop off) or there needs to be a note from doctor. Sure enough she came with a doctors note in hand at 7am this morning. I'm not a doctor but really why would they say it's okay for a child to return to daycare/school the very next day after vomiting EVERYWHERE!! Ugh it's so frustrating!

Did you take him this morning? After you told her not before 9:30am and she still brought him at 7?

[countrymom]

I think we all need to rewrite the illness policy. It should be something like, if your child is vomiting/diarrhea or blah blah, they must be symptom free for 24 hours (and no masking the illness with medication) a dr's note is only required if the child has a unexplained rash or has been out sick for very long periods of time.

[DanceMom]

Originally Posted by countrymom

I think we all need to rewrite the illness policy. It should be something like, if your child is vomiting/diarrhea or blah blah, they must be symptom free for 24 hours (and no masking the illness with medication) a dr's note is only required if the child has a unexplained rash or has been out sick for very long periods of time.

I agree..Im going to add something to mine and send it out with a note.

bad thing too with this lady is she isnt even working..shes on mat leave ( last 2 weeks of it ).

[kpa0627]

Originally Posted by marniewon

Did you take him this morning? After you told her not before 9:30am and she still brought him at 7?

Yes, I did take him at 7am this morning because she brought the doctors note in. IF there would have been no note I would have told her it had not been 24 hours. My policy states either 24 hours or a doctors note saying whatever it is isn't contagious. So, honestly she followed the rules. I just don't understand the doctor's part on this. I'm calling to ask them why they think it's okay for a child to come to daycare after vomiting.

[Lilbutterflie]

Originally Posted by kpa0627

I just don't understand the doctor's part on this. I'm calling to ask them why they think it's okay for a child to come to daycare after vomiting.

Good for you! That's what I would do too! I have a feeling maybe he was told a story like he vomited after eating something that usually upsets his stomach, and leaving out the fever part. Hmmmm. Let us know what they say!

[Live and Learn]

I don't get into the whole doc note thing with parents.
MY HOME MY POLICIES
My policy trumps a doc's note basically. If I feel he is too sick to be here he isn't. I am not afraid to tell a parent "if you have a doc's note then the doc is more than welcome to watch junior for the day. As you know my policy is 24 hours without meds fever, diarrhea, and vomit free. That is what I go by." I have only had to say this to one parent in six years but I will again if I need to!! I provide care for a prominent doc in our area and have for years and his kids have never been pawned off on me with a doc's note. Why? He respects me.
My policy also says that a child cannot attend if they are not well enough to participate in the normal daily activities. if he is so sick that he cannot participate I would call parent at work and present her with a copy of your sick policy highlighted.
Also I don't do the whole it is ok to come after 9:30 thing.....if they are sent home anytime on Tuesday for vomiting then the earliest they can come back here is Thursday.
That is just how I roll. On the whole we are a pretty healthy bunch because I am so strict with my sick policy.
Good Luck!!

[kendallina]

Originally Posted by bgmeyers

My policies trump a doctors. I don't care if you have a note. The only thing I want a note for is something like an unexplained rash. Note must say child is not contagious. Even then, if child is uncomfortable and I can't reasonably take care of them and the rest of the group, they belong at home.

Yup, this is me too.

[kpa0627]

Originally Posted by Lilbutterflie

Good for you! That's what I would do too! I have a feeling maybe he was told a story like he vomited after eating something that usually upsets his stomach, and leaving out the fever part. Hmmmm. Let us know what they say!

So, I didn't end up having to call the doctor after all. Once again he threw up everywhere while here so I called mom and told her she had to come pick him up. She came shortly after and got him and said she'd be calling the doctor again. I will not be allowing the child to come tomorrow (even if she does throw a fit). I learned my lesson and should have followed my gut feeling.

[Live and Learn]

***warning***snarky***alert***
it would be tempting to ask mom is the doc would be paying the carpet cleaning bill or would she be paying the carpet cleaning bill.....I think Stanley steamer charges about $99 for one area....
Seriously though...feel free to let it slip that after her child threw up twice you will have to schedule a professional carpet cleaner to take care of the mess.......gross!

[misol]

Originally Posted by kpa0627

So, I didn't end up having to call the doctor after all. Once again he threw up everywhere while here so I called mom and told her she had to come pick him up. She came shortly after and got him and said she'd be calling the doctor again. I will not be allowing the child to come tomorrow (even if she does throw a fit). I learned my lesson and should have followed my gut feeling.

Ugh!!! Had a feeling that was going to happen to you. I'm so sorry you had to spend another day cleaning up vomit. I would call the doctor anyway just to see what they say. And I would call again tomorrow to make sure she called back!

When she returns to care you should tell her that you will no longer accept dr.'s notes from her for fever/vomiting/diarhea and and that from now on YOU will be the one that determines when he can return. You should keep him out until Monday.

[marniewon]

Originally Posted by kpa0627

So, I didn't end up having to call the doctor after all. Once again he threw up everywhere while here so I called mom and told her she had to come pick him up. She came shortly after and got him and said she'd be calling the doctor again. I will not be allowing the child to come tomorrow (even if she does throw a fit). I learned my lesson and should have followed my gut feeling.

Like someone else said, I would still call the doctor just to see what he/she said about it. Question: I've never had to do this, but I've seen several people talk about calling the doctor regarding a dck. Will the doctor actually give out info about their patients? I thought there was some sort of privacy law about that.

Sorry you had to deal with that again! Sometimes we are just too nice/giving for our own good, aren't we..? Good thing we learn fast!

[nannyde]

Originally Posted by kpa0627

I'm so glad you asked this question. I just ran into this problem today. I had a child who was not himself on Monday. No fevers or anything but just laid around ALL day..... very unlike him. He came in Tuesday and was acting the same but once again no fevers. Then all of a sudden just started puking EVERYWHERE at 9:30 am. I called mom and she came and got him and took him to doctor yesterday afternoon. Called me at 5:00pm last night and said well doctor said it's just a cold so he can come back to daycare. I told her he either needs to be vomit free for 24 hours (so 9:30am tomorrow drop off) or there needs to be a note from doctor. Sure enough she came with a doctors note in hand at 7am this morning. I'm not a doctor but really why would they say it's okay for a child to return to daycare/school the very next day after vomiting EVERYWHERE!! Ugh it's so frustrating!

I'm not a doctor but really why would they say it's okay for a child to return to daycare/school the very next day after vomiting EVERYWHERE!!

She told him he threw up from coughing.

[jen]

Originally Posted by nannyde

I'm not a doctor but really why would they say it's okay for a child to return to daycare/school the very next day after vomiting EVERYWHERE!!

She told him he threw up from coughing.

Yep, I bet you're right!

[nannyde]

I don't accept return to day care notes.

The Dr's notes are only to give a diagnosis.

I understand that the Dr. can't know the population of children the sick child is returning to. He can't know if the other children have been in the home during incubation times or if there is a new child in the day care. They don't know if you have an immunocomprimised child or a special need child in your home. They don't know your health status or your childrens health.

It's impossible for a Dr. to know if it's okay for a kid to return to care. I won't put that on them nor will I allow them to make such an important decision for me.

Just the facts Mam and I'll take it from there.

[Lianne]

I've never once asked for or received a doctor's note for a daycare child. I'm fairly flexible with my illness policy though and work with the parents to determine whether the child is well enough to come for the day or not. I've never had a parent lie to me about giving their child medication, they simply tell me they've done so. Personally, I don't want to exclude children from my care for being sick. I want the parent to be able to go to work so that I can continue to work. If a parent continually has to take time off because of a runny nose or persistent coughing, etc., eventually their job could be in jeopardy. If their job is in jeopardy then so is mine. It's usually my clients who decide their child is too ill to come for the day and since it's rare that they have to miss work because of a sick child, they don't mind when they have to do so.

[nannyde]

Originally Posted by Lianne

I've never once asked for or received a doctor's note for a daycare child. I'm fairly flexible with my illness policy though and work with the parents to determine whether the child is well enough to come for the day or not. I've never had a parent lie to me about giving their child medication, they simply tell me they've done so. Personally, I don't want to exclude children from my care for being sick. I want the parent to be able to go to work so that I can continue to work. If a parent continually has to take time off because of a runny nose or persistent coughing, etc., eventually their job could be in jeopardy. If their job is in jeopardy then so is mine. It's usually my clients who decide their child is too ill to come for the day and since it's rare that they have to miss work because of a sick child, they don't mind when they have to do so.

Yes

As long as you agree to care for the sick child without any additional financial obligations you will ALWAYS get the truth. The reason parents lie or lie by omission is to have their child be taken care of by the provider. Once the provider says she will do it there is no reason to lie.

In order to do this you have State regulations and possibly insurance that allow you to care for ill children. That's the hard part. If you allow ill children and one of the other children contract an illness that takes their life or disables them you will need to be covered financially and legally. Many providers do not have the legal option to do this or the insurance to cover them financially.

(I'm not discussing the care of moderately ill children.. All States allow this. I'm referring to children who are vomiting, have a fever over 100.4, have repeated bouts of diahrrea, rashes etc.)

[MyAngels]

I have this covered in my policies:

"In the event of illness, I will be the one who decides whether your child will be allowed to attend, not your doctor."

Originally Posted by Lilbutterflie

The doctor's objective is for the one child to get well, not always to keep the other children and yourself from getting sick.

I think this hits the nail on the head. The dr. is only concerned with his patient. Is he/she physically able to attend day care. The dr. isn't necessarily concerned with you or the other kids in care. They aren't his patients so he's not thinking in terms of whether his patient is contagious - only whether his patient can attend day care without undue risk to his own health.

I would definitely enforce my illness policy in a case like this. Dr. note or not, the child would not be coming back until he hadn't vommitted for 24 hours. I'm very firm about this and have sent parents back home with their kids. It has only happened once or twice in 13 years of doing day care. Once they know you are serious about enforcing your policy and that you will turn them away at the door if they try to bring their sick child back too soon, they don't tend to try it again.

[SilverSabre25]

Originally Posted by MyAngels

I have this covered in my policies:

"In the event of illness, I will be the one who decides whether your child will be allowed to attend, not your doctor."

That's an awesome way to put it.

I started work and enrolled my 6 month old son into a ABC child care. I told the director at the time of enrollment that he had gastric reflux is currently and has for 2 months been taking medicine for this and needed rice mixed into his bottles to help way down the formula in order assist the food in staying down. I also informed her that i have a doctors note confirming all of this. She said it was fine with a doctor note (typically no rice in bottles for infants). My first day to drop him off she changes her mind and tells her staff to inform me. My son threw up 6 times and had diarrhea because of it that day and because of it i had to switch daycare midweek with a new job and no money

[Sprouts]

_____/______In certain situations, a medical form must be obtained before your child can be re-admitted into care. These forms require a written diagnosis from the child's physician and must state the following information:
the diagnosis , the treatment , length of recommended exclusion

(ex: If a child comes to day care with a runny nose, coughing, congestion, and the parent feels this is due to allergies we must have a Doctor's diagnosis stating*what the child is allergic to)

Re-admission to child care will be at MY discretion. Please do not assume the doctor can give permission for re-admittance.


The ____ /______ is for BOTH parents to initial....I doubt the parents actually read everything...but they do when I remind them to refer back to this!

it never fails...... when a child comes in with the first symptoms of a virus they say "oooh i think its just allergies" ....and in my head i say....
"Allergies my @ $ $ ...."

I have learned my lesson...the kid then comes in sneezing and drooling everywhere...and with in a week everyone has the flu or what have you....a minor cold, a major cold, the flu and the measles all start the same way....

[Starburst]

Make sure your policies state something like:
"I (or the provider) reserve the right to do a daily health check of every daycare child upon arrival at the daycare. I also reserve the right to not admit a child who is showing signs of illness, even if a doctors note is presented. In many cases a child can return to daycare after 72 days from certain illnesses with a doctors note but I have the final word as to if the child can return"

[Blackcat31]

Originally Posted by Unregistered

I started work and enrolled my 6 month old son into ABC child care. I told the director at the time of enrollment that he had gastric reflux is currently and has for 2 months been taking medicine for this and needed rice mixed into his bottles to help way down the formula in order assist the food in staying down. I also informed her that i have a doctors note confirming all of this. She said it was fine with a doctor note (typically no rice in bottles for infants). My first day to drop him off she changes her mind and tells her staff to inform me. My son threw up 6 times and had diarrhea because of it that day and because of it i had to switch daycare midweek with a new job and no money

Sounds like a communication issue. You should have provided the paperwork from the doctor PRIOR to attendance (the director should also have asked for it prior to the first day of attendance).

They should also have had a food program diet statement given to you to have your doctor fill out in regards to the rice cereal in the bottle.

I am sorry you had this experience with a child care but I think that like 99% of all issues between a parent and a child care provider/center, this entire situation could have been remedied with good open communication.

I am surprised that you weren't asked to provide any of this documentation BEFORE attendance. Did you get a handbook that outlines feeding schedules and procedures for infants?

[youretooloud]

I'm not required to take a doctor's note. I have never asked for one, and honestly, if someone tried to hand me a doctor's note to get me to let their child come to daycare, i'd be mad.

The parent and myself can make that call, a random doctor does not get to make that decision for me.

I have enough common sense, (and so do the parents) and frankly, I think most doctors are either idiots or thoughtless. They will write a note saying anything a parent wanted, because it doesn't disrupt their lives.

[AllDeezBabies]

Originally Posted by bgmeyers

My policies trump a doctors. I don't care if you have a note. The only thing I want a note for is something like an unexplained rash. Note must say child is not contagious. Even then, if child is uncomfortable and I can't reasonably take care of them and the rest of the group, they belong at home.

This all day!!!