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  #1  
Old 06-24-2014, 07:00 AM
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Default Sick Kids From A Physician's View

This is ridiculous.

http://www.huffingtonpost.com/claire...ushpmg00000037
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  #2  
Old 06-24-2014, 07:12 AM
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I am a provider who is strict in my illness policy, and I completely agree with this physician. I've been around long enough to know when a rash needs attention, and will not send away for every rash. I don't send home a child with a fever of 100, whom a acting normal, but the one who is 100, droopy eyes, lethargic I would. I don't close for normal childhood illnesses such as HFM, croup, but will exclude when the child is miserable. It's all common sense. I trust my instincts, and so far they've served me quit well. I've not had to send a single ill child home this year so far as alm my parents have kept them home when required. My rules are clear and fair, so there isn't too much fuss anymore. They're all long time clients as well who know that I don't exclude lightly so they are able to respect my decision when I have to make it.
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Old 06-24-2014, 07:12 AM
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So pretty much what the Dr. says is "Daycares are requiring Dr notes when they are barely sick and that's dumb" (im paraphrasing here) and then goes on to say that "only kids that have high fevers, feel so bad that they can't function and need more care than the provider can offer should stay home" .... um, that's what we're doing.
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Old 06-24-2014, 07:14 AM
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Please excuse my above typos. On my phone
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Old 06-24-2014, 07:14 AM
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Originally Posted by Unregistered View Post
I am a provider who is strict in my illness policy, and I completely agree with this physician. I've been around long enough to know when a rash needs attention, and will not send away for every rash. I don't send home a child with a fever of 100, whom a acting normal, but the one who is 100, droopy eyes, lethargic I would. I don't close for normal childhood illnesses such as HFM, croup, but will exclude when the child is miserable. It's all common sense. I trust my instincts, and so far they've served me quit well. I've not had to send a single ill child home this year so far as alm my parents have kept them home when required. My rules are clear and fair, so there isn't too much fuss anymore. They're all long time clients as well who know that I don't exclude lightly so they are able to respect my decision when I have to make it.
What about the providers that have illness regulations that require exclusion? The Dr should be discussing policy, not that providers are following what we were told to do.
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Old 06-24-2014, 07:16 AM
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I feel kind of attacked, you know? Like we're just using any excuse to make parents miss work. And asking for a major overhaul of the childcare system? I agree that it's a common sense thing...but I am also not a doctor. I do not claim to know for 100% sure that something is not contagious or that it's "just" a little virus.
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Old 06-24-2014, 07:26 AM
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I just completed a webinar put together by the AAP that basically says there are very little reasons to exclude.

Here's the specific webinar:
http://www.healthychildcare.org/PDF/...?eventid=43532

Here's a list of their other webinars:
http://www.healthychildcare.org/webinars.html


For many of us, it's up to what our regulations say. My surveyor actually told me she highly recommends that we create our own policies that are stricter than the state regulations.
http://www.kdheks.gov/bcclr/applicat..._Exclusion.pdf

Of all of my policies, my symptom policy is the strictest. Yet, I don't actually have to send anyone home very often. Maybe ever few months or so? So it's not like I'm just itching to keep everyone home and for all of my parents to lose their jobs. I care for children ages 0-3 and in order to provide the safest and healthiest environment I feel it's important to have a strict symptom policy. Everyone else can do what they want. That's the awesome part of owning our own businesses

Last edited by craftymissbeth; 06-24-2014 at 07:44 AM. Reason: typo
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Old 06-24-2014, 07:28 AM
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A lot of providers have been burned too many times by a parent who said that the child "only puked once", or "it's just allergies", and then everyone ends up sick. Or the provider themselves ends up sick enough that they have to close, and no one can go to work.

I think both sides just need to be honest and work together. I don't exclude for minor illness, but I expect parents to be honest, and know when they should keep their child home.
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Old 06-24-2014, 07:31 AM
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Quote:
Originally Posted by NoMoreJuice! View Post
I feel kind of attacked, you know? Like we're just using any excuse to make parents miss work. And asking for a major overhaul of the childcare system? I agree that it's a common sense thing...but I am also not a doctor. I do not claim to know for 100% sure that something is not contagious or that it's "just" a little virus.
This. I have NO medical training! I am NOT going to make a decision about what illness a child has. I do not diagnose! Hence the reason they're sent to the doctor.

Also, the examples that the writer included about the daycare requiring eye drops or the daycare requiring medicine for the fever to go down... I will never, ever, ever require a child's doctor to do or prescribe anything. That's something that's between the doctor and their patient and I have no business telling a parent that their child requires medication before coming back. In fact, I don't require them to even take them to the doctor.

My policy simply states that if their child has any of the listed symptoms then they have to be excluded.
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Old 06-24-2014, 07:37 AM
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Thanks so much for sharing that link to the webinars! I am reading through the illness one right now and getting so annoyed. There is another post going on right now about pink eye, and YES I exclude for pink eye, but that webinar claims that pink eye should be treated just like the common cold and not excluded for!
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Old 06-24-2014, 07:43 AM
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Quote:
Originally Posted by NoMoreJuice! View Post
Thanks so much for sharing that link to the webinars! I am reading through the illness one right now and getting so annoyed. There is another post going on right now about pink eye, and YES I exclude for pink eye, but that webinar claims that pink eye should be treated just like the common cold and not excluded for!
Isn't it infuriating?! I have to do what's best for my whole group of children AND my family AND myself. I don't want to get sick and I don't want my son getting sick.
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Old 06-24-2014, 08:05 AM
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I guess we are not too concerned about what makes the child most comfortable, what gives them the best care when unwell, or their overall emotional well being either. I know when I am not feeling well I do not want to be at work with a bunch of people and a busy environment. I want to be in the comfort of my home, and rest so I can get better or prevent myself from getting even more sick. I very much believe a child that is unwell belongs in the care of family, in a lower ratio setting where they can be more focused on & monitored.

I'm trying to picture the chaos if all my daycare children attended ill. I simple can not hold & snuggle them up all day. Even when they all get a cold it makes for stressful days.
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Old 06-24-2014, 08:10 AM
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The exclusions listed in the article are common practice. The article supports these exclusions. Exactly what, I wonder, does the article believes to be overhauled?
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Old 06-24-2014, 08:14 AM
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Quoted from the article:

"If we really want to support working families, then we are going to have to tackle this problem. We need to find a way to change the culture of daycare and understand that minor illnesses are part of life -- and very much part of early childhood.

We need to find a new middle ground, one that takes care of not just children, but families."


If you really want to find a middle ground, how about we start educating parents on what THEIR responsibilities are and what the PROVIDERS responsibilities are.

Parents need to start stepping up and start paying their providers what they are really worth and stop bitching left and right about the high cost of children THEY choose to have.

If you really want to support working families then maybe working families need a MAJOR lesson in priorities so they understand that their child is only a child for a short while and putting that paycheck before their child's needs is an embarrassment to our entire society.

The culture of daycare doesn't need to change.

PARENTS do!

Parents need to come to understand that if they didn't try to pull a fast one on their provider, or didn't keep their kids up until midnight, feed them crappy foods and park them in front of their DVD players, i-pads and video games, and stay the he77 home once in a while instead of racking up more miles than Dale Earnhardt Jr on a Sunday afternoon, then maybe JUST maybe.... these kids wouldn't be sick as often as they are.

I am so sick and tired of daycare being the problem but NEVER the solution when WE (DC providers) do THE most for a child. Children that aren't even ours.

Yet, we're the bad guy that needs a lesson in early childhood illness...

Seriously?!

Just keep telling yourself that Dr McCarthy. Because while you bring home the big dollars and point your finger at us...WE are the ones raising YOUR child.
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Old 06-24-2014, 08:19 AM
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And hopefully they will have more sense than you Doctor.
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Old 06-24-2014, 08:21 AM
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Quote:
Originally Posted by Blackcat31 View Post
Quoted from the article:

"If we really want to support working families, then we are going to have to tackle this problem. We need to find a way to change the culture of daycare and understand that minor illnesses are part of life -- and very much part of early childhood.

We need to find a new middle ground, one that takes care of not just children, but families."


If you really want to find a middle ground, how about we start educating parents on what THEIR responsibilities are and what the PROVIDERS responsibilities are.

Parents need to start stepping up and start paying their providers what they are really worth and stop bitching left and right about the high cost of children THEY choose to have.

If you really want to support working families then maybe working families need a MAJOR lesson in priorities so they understand that their child is only a child for a short while and putting that paycheck before their child's needs is an embarrassment to our entire society.

The culture of daycare doesn't need to change.

PARENTS do!

Parents need to come to understand that if they didn't try to pull a fast one on their provider, or didn't keep their kids up until midnight, feed them crappy foods and park them in front of their DVD players, i-pads and video games, and stay the he77 home once in a while instead of racking up more miles than Dale Earnhardt Jr on a Sunday afternoon, then maybe JUST maybe.... these kids wouldn't be sick as often as they are.

I am so sick and tired of daycare being the problem but NEVER the solution when WE (DC providers) do THE most for a child. Children that aren't even ours.

Yet, we're the bad guy that needs a lesson in early childhood illness...

Seriously?!

Just keep telling yourself that Dr McCarthy. Because while you bring home the big dollars and point your finger at us...WE are the ones raising YOUR child.
PREACH it.
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  #17  
Old 06-24-2014, 08:31 AM
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Could other children get sick from being near the child?


So we are supposed to take in sick kids and let all the others get sick too.

I disagree with this article. the only way to stop the spread of illness is to keep sick kids home.

what was not covered by this doctor that most of these parents are getting sent to see the doctor because the child is having the runs for 3-4 days at a time.

I don't require parents to go to the doctor unless they have been sick for more than 7 days and the illness is not improving.

It is 100% up to the parents if they want to take their child to the doctors, but if they do, yes I will want to see a note of diagnosis. In my eye, if you felt that your chlid was so ill they needed to see the doctor, then I need to see a note.

No one is ever happy, they say we are too strict and if we were not then we would be getting slammed for allowing it................
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Old 06-24-2014, 08:33 AM
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<<<Besides, if your daycare would take care of your child if she gets sick, then at least you won't have to worry about missing work.>>>

The line above (from the article) really takes the cake. I'm running a daycare, not an infirmary. I'm not a nurse, and I'm not the parent. I also don't want to be trying to figure out how to rush a kid to the hospital, a kid who is having a febrile seizure (because his "low fever" suddenly spiked), with four other kids in tow. Not my flippin' job, thank you very much.
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Old 06-24-2014, 08:39 AM
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Quote:
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Could other children get sick from being near the child?


So we are supposed to take in sick kids and let all the others get sick too.

I disagree with this article. the only way to stop the spread of illness is to keep sick kids home.

what was not covered by this doctor that most of these parents are getting sent to see the doctor because the child is having the runs for 3-4 days at a time.

I don't require parents to go to the doctor unless they have been sick for more than 7 days and the illness is not improving.


It is 100% up to the parents if they want to take their child to the doctors, but if they do, yes I will want to see a note of diagnosis. In my eye, if you felt that your chlid was so ill they needed to see the doctor, then I need to see a note.

No one is ever happy, they say we are too strict and if we were not then we would be getting slammed for allowing it................
THIS (the bolded part) could be solved immediately if the parent simply took the time and allowed the child to get good rest and good food at the very beginning of the illness so that the illness isn't allowed to grow and get so bad that the daycare provider ends up "forcing" the parent to go to the Dr.

The Dr visit wouldn't have been necessary if the parent had been proactive in the first place at the first inkling of illness.
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Old 06-24-2014, 08:40 AM
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Here's my "middle of the road" suggestion:

Open daycares that cater specifically to ill children. All providers must have a nursing degree, at minimum. No parent will need to miss work.

Of course, the cost for a daycare like that would EASILY be double the going rate for well-child daycares.


Not enough families would enroll due to the high rates needed for that level of care and the place would shut down quickly.


Parents need to understand that if they want a daycare to accept ill children they better be ready with their wallets open. I'm not introducing illness on a consistent basis into my home without some serious money behind it. Again, parents already want the cheapest child care possible... there's NO WAY they're going to pay for sick care.

(Even the "right" amount of money wouldn't convince me to allow it... my family's health is just way too important. Just making a point)
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Old 06-24-2014, 08:45 AM
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Quote:
Originally Posted by craftymissbeth View Post
Here's my "middle of the road" suggestion:

Open daycares that cater specifically to ill children. All providers must have a nursing degree, at minimum. No parent will need to miss work.

Of course, the cost for a daycare like that would EASILY be double the going rate for well-child daycares.


Not enough families would enroll due to the high rates needed for that level of care and the place would shut down quickly.


Parents need to understand that if they want a daycare to accept ill children they better be ready with their wallets open. I'm not introducing illness on a consistent basis into my home without some serious money behind it. Again, parents already want the cheapest child care possible... there's NO WAY they're going to pay for sick care.

(Even the "right" amount of money wouldn't convince me to allow it... my family's health is just way too important. Just making a point)
We had one of those. Strictly for mildly ill children. NO regular attendance

The child could only stay for a max of 4 hours per day and it was strictly drop in for those times in which parent HAD to wrap up things at work or had to go in for a bit to get some work done.

It was run by two pediatric nurses. It closed down within a year.

They couldn't keep enough staff on site to maintain ratios...

Why?

Because everyone kept getting sick
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  #22  
Old 06-24-2014, 09:31 AM
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I thought the whole purpose of quality child care and the efforts behind QRIS was for improvements, especially in consideration to children's safety.
Isn't it a safety issue for us to contain illnesses?
Of course it's going to be the parents of sick children that complain!
I know my parents are happy and trust in me to exclude the sick child, to help keep their child and other's healthy.
And it's not like we're running to call parents to pick up their children from the first sight of a runny nose.....please!

Funny thing.....one of my clients had the same pediatric doctor as my children. I always exclude for unknown rashes, especially when accompanied with a temp. And when I had to exclude this clients child for a rash, the pediatrician agreed 100% for rash exclusion, and gave the client a list of the possible reasons why. Never again did this client question exclusions for rashes.
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Old 06-24-2014, 09:51 AM
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Quote:
Originally Posted by Blackcat31 View Post
We had one of those. Strictly for mildly ill children. NO regular attendance

The child could only stay for a max of 4 hours per day and it was strictly drop in for those times in which parent HAD to wrap up things at work or had to go in for a bit to get some work done.

It was run by two pediatric nurses. It closed down within a year.

They couldn't keep enough staff on site to maintain ratios...

Why?

Because everyone kept getting sick
The problem sick bays have is that they have little attendance on Monday and Friday. On Monday the kid has been home so provider is unaware the kid is sick so the parents dope and drop and get by till after nap. On Friday the worst thing that can happen is the same thing that happened monday. The provider isn't going to exclude the next working day do it's worth the risk.

They have to make their money Tuesday through Thursday.
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Old 06-24-2014, 09:53 AM
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When I was a teacher and my husband and I were planning when to have our first, one of the first things we discussed was what our backup plan would be when our child couldn't go to daycare because neither of us could take many days off. It was never even a THOUGHT that we would send our child to daycare sick. I wouldn't want that for my provider or for my child. When or backup person was no longer able to watch our child on short notice, we changed OUR lifestyle and I became a provider so that our jobs would not have suffer from us taking days off. If you have a job and have children it is YOUR responsibility to juggle them. I don't understand the argument that parents lose their jobs because the providers wouldn't provide care when the child was sick. The provider did not choose for that parent to have the child, the employer did not choose; the parent did. Their problem and their problem only.
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Old 06-24-2014, 10:00 AM
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Everyone should share their opinions with the Dr! Here is the Facebook link

https://www.facebook.com/ClaireMcCarthyMD
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Old 06-24-2014, 10:05 AM
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Everyone should share their opinions with the Dr! Here is the Facebook link

https://www.facebook.com/ClaireMcCarthyMD
-I just see so many children excluded from daycare for illnesses that are truly minimal.

yeah well I would rather be safe than sorry. Especially when it comes to rashes that are unexplained.
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Old 06-24-2014, 10:09 AM
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-I just see so many children excluded from daycare for illnesses that are truly minimal.

yeah well I would rather be safe than sorry. Especially when it comes to rashes that are unexplained.
See, but what she's not understanding is we aren't normally qualified health professionals therefore we cannot determine when an illness is "minimal". And oftentimes those "minimal" illnesses wipe out our whole daycare, family, and US.
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Old 06-24-2014, 10:14 AM
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What a stupid article. Kids can stay home if they have "frequent vomiting?" Ummmm, I'm not trying to clean up more than one vomit episode per day, and I certainly don't want to go through it with lots of other children who get sick from it. Not to mention, if I get sick, then ALL of the parents are going to miss work, which has happened from them bringing their kids in with the stomach bug. If you bring get a sick kid in my daycare knowingly, you get termed on the spot.
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Old 06-24-2014, 10:18 AM
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Most of us providers don't jump the gun and keep kids home for every tiny instance like is suggested. We keep them home when they can not participate fully or need more attention than we can give or WHEN OUR STATE POLICIES SAY WE HAVE TO!

We aren't stupid. We understand that by the time symptoms show the others MAY HAVE CAUGHT THE GERMS but not always, and by keeping the sicky in daycare we are prolonging the exposure to kids that MAY NOT have caught the illness if the kid stayed home.

If parents wouldn't LIE so often about their kids' illnesses, if they would just be honest...ugh!

This is a hot topic for me, but I'll just stop now. This has been a HUGE issue in my daycare and since I have tightened down on my illness policy kids are getting sick much less. I'll keep doing it my way.
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Old 06-24-2014, 10:21 AM
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-I just see so many children excluded from daycare for illnesses that are truly minimal.

yeah well I would rather be safe than sorry. Especially when it comes to rashes that are unexplained.
Ask me how infantago spread through my day care a few years ago
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Old 06-24-2014, 10:21 AM
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I also love the "we don't have any more sick/personal/vacation days to use so pookie HAS to go to daycare." I got this after a parent used all their vacation days by May, going on vacations. Pookie ended up getting termed.
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Old 06-24-2014, 10:22 AM
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Hmmm

Maybe the good doc could profit from a different perspective. ;-)
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Old 06-24-2014, 10:24 AM
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Wait, I want to add...We are not doctors. We can not accurately say for certain what is or is not something to worry about. We can not look at a rash and say "oh no big deal".

These kids are in OUR HOMES with illness! How about we send all of our "not really sick kids" to the Dr's home to hang out all day, wiping their noses on his furniture and spreading their germs everywhere?! Maybe he'll think differently about it then.

I guarantee if the majority of providers did this, we would be the ones getting blamed for the spread of illness (more than we already are) instead of being praised for keeping the kids out of the doctors office and keeping the parents in work like the article suggests.

There is a reason the states have these policies...because WE ARE NOT THE ONES CAPABLE OF DIAGNOSING PROPERLY!!! Obviously it was enough of an issue that the states had to enforce policies

Ugh, this just pushes my buttons!
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Old 06-24-2014, 10:27 AM
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I often think that some providers take it too far and exclude for every sneeze, sniffle, and cough, BUT this article is ludicrous.

1) I don't know about other states, but the state (not me) defines well, mildly ill, and ill children for home daycares. I am licensed for well and mildly ill. I can choose what I want to be licensed for but I cannot define the terms.

2) The article said we send home for one instance of vomit or diarrhea. Well, we have to clean the child up, comfort him, make sure the other kids stay away, clean and sanitize the area, check the child for other symptoms like fever, contact the parents, etc. We DON"T KNOW if it going to ONE INSTANCE or if the child is going to be vomiting or having diarrhea ALL DAY. Crystal ball anyone? How many hours and minutes would it be appropriate to wait & see if there are going to be consecutive "deposits?"

3) I know it is hard to take time off work. I really do. And I try really, really hard not to complain about this, but if you can take a day off to get a pedicure, massage, or just have a day to yourself, you can take a day off to be with your sick child.

4) I've heard of providers asking for a Dr's note to return to care, but I have never heard of a provider demanding a certain treatment. That to me seems to happen more often with parents (wanting antibiotics and nebs for colds for example.)

Why did this rub me so wrong? Could it be because I have been battling a nasty, nasty cold all week?
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Old 06-24-2014, 10:33 AM
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I also love the "we don't have any more sick/personal/vacation days to use so pookie HAS to go to daycare." I got this after a parent used all their vacation days by May, going on vacations. Pookie ended up getting termed.
I've gotten this line, too, but it was because of SNOW days. Vacation days hadn't even been used yet. AND DCM had taken a few "me" days....it's great to know where some folks' priorities lie.
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Old 06-24-2014, 10:35 AM
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I replied to both the article and her facebook - just couldn't help myself
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Old 06-24-2014, 10:35 AM
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It reminds me a bit of the antibiotic overuse class that I took a few years ago.
Basically a blame-the-provider class for doctors who over-prescribed.
Really? Educate the docs We do not prescribe meds.
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Old 06-24-2014, 10:35 AM
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I feel kind of attacked, you know? Like we're just using any excuse to make parents miss work. And asking for a major overhaul of the childcare system? I agree that it's a common sense thing...but I am also not a doctor. I do not claim to know for 100% sure that something is not contagious or that it's "just" a little virus.
WSS.

I have let parents tell me ONCE that the doctor said it was x, y and you know what?! WE ALL GOT IT! Sure as heck wasn't blow outs from juice, mama! And then I closed for 3-4 days due to puking so much my throat bled! I don't know the difference and I am not hedging my bets anymore - you claim your 100.4 temp, coughing, hacking, wheezing kid is just suffering from seasonal allergies - whatever. Get a doctors note, then!

And, anyway, we're damned either way. Send them packing and we're too strict. Next week, we don't and suddenly we're horrible people running germ incubators. Whatever. Can't make everyone happy.
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Old 06-24-2014, 10:38 AM
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I often think that some providers take it too far and exclude for every sneeze, sniffle, and cough, BUT this article is ludicrous.

1) I don't know about other states, but the state (not me) defines well, mildly ill, and ill children for home daycares. I am licensed for well and mildly ill. I can choose what I want to be licensed for but I cannot define the terms.

2) The article said we send home for one instance of vomit or diarrhea. Well, we have to clean the child up, comfort him, make sure the other kids stay away, clean and sanitize the area, check the child for other symptoms like fever, contact the parents, etc. We DON"T KNOW if it going to ONE INSTANCE or if the child is going to be vomiting or having diarrhea ALL DAY. Crystal ball anyone? How many hours and minutes would it be appropriate to wait & see if there are going to be consecutive "deposits?"

3) I know it is hard to take time off work. I really do. And I try really, really hard not to complain about this, but if you can take a day off to get a pedicure, massage, or just have a day to yourself, you can take a day off to be with your sick child.

4) I've heard of providers asking for a Dr's note to return to care, but I have never heard of a provider demanding a certain treatment. That to me seems to happen more often with parents (wanting antibiotics and nebs for colds for example.)

Why did this rub me so wrong? Could it be because I have been battling a nasty, nasty cold all week?
I have one time sent home for a once only puker.

Every other time it's been days and suddenly they are better. And it takes a lot of time and effort to keep kids away from mess, clean and sanitize, etc. I would NOT want to do that more than once.
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Old 06-24-2014, 10:40 AM
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I deal with a lot of childhood illnesses and don't exclude for many things for which other providers will exclude. In return, if I call a parent and say "take this child to the doctor" they do exactly that.

I also have gotten respectful parents who know when to stay home and care for their child, or will call and say, "This is going on...what you like me to do?"
I don't think that physician is "ridiculous" but I do think parents, doctors and providers need to work together to find a balance.

There ARE providers out there excluding for every little thing, and I feel these are the people to whom he is speaking, not those of us who use common sense. As someone said, most of us are asking those same questions.
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Old 06-24-2014, 10:50 AM
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I replied to both the article and her facebook - just couldn't help myself
Me too! I'm watching the FB page and would love to see her eat her words lol
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Old 06-24-2014, 10:55 AM
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See, but what she's not understanding is we aren't normally qualified health professionals therefore we cannot determine when an illness is "minimal". And oftentimes those "minimal" illnesses wipe out our whole daycare, family, and US.
exactly, I am not a doctor, I could play the guessing game all day long of it could be this it could be that and more than likely I could be wrong.
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Old 06-24-2014, 10:57 AM
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exactly, I am not a doctor, I could play the guessing game all day long of it could be this it could be that and more than likely I could be wrong.
Sorry, daycare, I just reread what I wrote and it sounds like I'm disagreeing with you, but I'm not. I totally agree!
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Old 06-24-2014, 11:02 AM
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lol I knew what you meant and I hope you know I agree...

This Dr is making our day is she not!!! She got my husbands panties in a bunch. He on the other hand does have a PHD in medicine and he said it is always easy to see things from "YOUR" prospective. And for this doctor to complain that people are coming in for these reasons is just something to complain about. Money is money, mildly ill, severely ill, it's all the same money that goes into the doctors pocket.

He laughed at that article and said those are the doctors that keep our DCs full of sick children and allowing illnesses to pass because they only see if from "THEIR" prospective
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Old 06-24-2014, 11:05 AM
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There ARE providers out there excluding for every little thing, and I feel these are the people to whom he is speaking, not those of us who use common sense. As someone said, most of us are asking those same questions.
I guess my point is that there is usually a good and legitimate reason these providers are being so strict. These are the providers who have been burned, whose clients think they don't have to follow policy, etc.
I think for the doctor to write that type of article with out getting to the "why" of the policies is irresponsible.
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Old 06-24-2014, 11:19 AM
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I learned my lesson I don't trust doctors any more. A doctor told one of my daycare mom's on a Sunday his deep barking cough was due to allergies. Everyone had this virus by Friday and was on antibiotics and steroids. The fallowing week I have it and had to take antibiotics and this week a steroid I'm done with sick kids. Doctor's notes won't do it for me anymore. Doctors are not always right.

Don't let them tell you that the kids with a virus are only contagious when they have a fever this is not true! Some kids don't get fevers. You can be contagious without a fever!
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Old 06-24-2014, 11:28 AM
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Originally Posted by Blackcat31 View Post
Quoted from the article:

"If we really want to support working families, then we are going to have to tackle this problem. We need to find a way to change the culture of daycare and understand that minor illnesses are part of life -- and very much part of early childhood.

We need to find a new middle ground, one that takes care of not just children, but families."


If you really want to find a middle ground, how about we start educating parents on what THEIR responsibilities are and what the PROVIDERS responsibilities are.

Parents need to start stepping up and start paying their providers what they are really worth and stop bitching left and right about the high cost of children THEY choose to have.

If you really want to support working families then maybe working families need a MAJOR lesson in priorities so they understand that their child is only a child for a short while and putting that paycheck before their child's needs is an embarrassment to our entire society.

The culture of daycare doesn't need to change.

PARENTS do!

Parents need to come to understand that if they didn't try to pull a fast one on their provider, or didn't keep their kids up until midnight, feed them crappy foods and park them in front of their DVD players, i-pads and video games, and stay the he77 home once in a while instead of racking up more miles than Dale Earnhardt Jr on a Sunday afternoon, then maybe JUST maybe.... these kids wouldn't be sick as often as they are.

I am so sick and tired of daycare being the problem but NEVER the solution when WE (DC providers) do THE most for a child. Children that aren't even ours.

Yet, we're the bad guy that needs a lesson in early childhood illness...

Seriously?!

Just keep telling yourself that Dr McCarthy. Because while you bring home the big dollars and point your finger at us...WE are the ones raising YOUR child.

100%
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Old 06-24-2014, 11:29 AM
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.

Don't let them tell you that the kids with a virus are only contagious when they have a fever
Interesting. When a parent told me the doctor said this (not contagious because only a low grade fever) I actually thought she made it up, or misinterpreted. It's clearly not true, in my experience.
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Old 06-24-2014, 11:41 AM
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I also love the "we don't have any more sick/personal/vacation days to use so pookie HAS to go to daycare." I got this after a parent used all their vacation days by May, going on vacations. Pookie ended up getting termed.
You know......when I was a daycare parent, my DCP took two weeks off in a row, every summer. One week for vacation and one week for home maintenance. Our families lived far away, so my DH would take one week off, and I would take the other week. For years, that was our yearly vacation time. We did what we had to do. We knew that it was temporary, and we sacrificed accordingly.

When DH and I would get sick, we would try to go to work or work from home, anyway. We saved all of our sick days for DD. We would even split up the morning and afternoon, if DD required multiple sick days at a time.

I completely understand and sympathize with the frustration of sick days, but for the last five years, the majority of DCP that I provide care for, use their sick days for themselves, while their child and I will be trudging along, with the exact same cold. They take several vacations and long weekends a year, and use their personal days for "me" time. I'm just saying, don't bitch to me that you have to come and get YOUR sick child, when you took a half day, last week, to be home to receive a package...
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Old 06-24-2014, 11:46 AM
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Wait, I want to add...We are not doctors. We can not accurately say for certain what is or is not something to worry about. We can not look at a rash and say "oh no big deal".

These kids are in OUR HOMES with illness! How about we send all of our "not really sick kids" to the Dr's home to hang out all day, wiping their noses on his furniture and spreading their germs everywhere?! Maybe he'll think differently about it then.

I guarantee if the majority of providers did this, we would be the ones getting blamed for the spread of illness (more than we already are) instead of being praised for keeping the kids out of the doctors office and keeping the parents in work like the article suggests.
.............

Another funny story...... Years ago, with my first pediatric doctor, before she had discovered I ran a child care. My children were sick with cocksackie virus, which they had gotten from a dirty bubbler in a gym. The first question the good doctor asked, "Do they attend child care? Child care's tend to spread a lot of germs." Well....you can imagine the look on her face when I told her that I ran a child care, needless to say she was not our pediatric doctor long after that. Lol!

This was the same doctor's office, that regardless of what I brought my children in for, would end up sick with something new, 1-3 days after our visit.

Some doctor's are just quacks! .........
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Old 06-24-2014, 11:55 AM
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I see part of the doctors point seeing a Dr. and taking up their time for a note is stupid. But sending a child to childcare because it is just something viral is stupid also.

If it was the doctors newborn at childcare when the others had pink eye vomiting 1x a day and diarreah that Dr. would terminate care and report the provider.
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Old 06-24-2014, 12:03 PM
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If it was the doctors newborn at childcare when the others had pink eye vomiting 1x a day and diarreah that Dr. would terminate care and report the provider.
Or have a 'nanny' instead.
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Old 06-24-2014, 12:06 PM
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Maybe a slightly different perspective...
As daycare providers for a lot of kids you spend more time with the kids than their actual parents have done. In the US its not uncommon for kids to start daycare at 6 weeks. They spent the majority of their waking hours with you providers until they turn 5 and go to school. Your are their norm, their comfort, their home in many ways, kids come back to care after the weekend wild and exhausted because that norm was disrupted by biological strangers in a lot of cases.



TLEMother (can't log in from work)
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Old 06-24-2014, 12:12 PM
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Maybe a slightly different perspective...
As daycare providers for a lot of kids you spend more time with the kids than their actual parents have done. In the US its not uncommon for kids to start daycare at 6 weeks. They spent the majority of their waking hours with you providers until they turn 5 and go to school. Your are their norm, their comfort, their home in many ways, kids come back to care after the weekend wild and exhausted because that norm was disrupted by biological strangers in a lot of cases.



TLEMother (can't log in from work)
This is true, but sadly I don't have the time or arms to comfort a sick child and take care of all of the other children's needs.
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Old 06-24-2014, 01:33 PM
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Dr. Claire McCarthy,

My name is Tori Fees. I’m a Registered Nurse and veteran child care provider. I have cared for kids in the capacity of private nanny, elementary school nurse, and home child care provider for thirty years.

I came upon your article “Why Sick Kids Should Be Allowed at Daycare” published by Huffpost. As a veteran and expert child care provider, I feel it is important to address your publication as it speaks to many of the common misconceptions Physicians have regarding admittance into child care after the child has been excluded by a school, child care center, or home child care. My hope is that you will reconsider some of your viewpoints when you hear some of the concerns from the ladies on the ground who are caring for multi-level aged group children in these settings.

Each licensed and registered child care providers have illness policies. Every state in the U.S. requires that guidelines are set to differentiate an excludable illness and a “mild” or “minor” illness. Independently owned child care providers have the blessing and burden of developing their own policies that must at least meet the minimum standards set forth by their respective state. I’m certain you have come across variations in the policies of the privately owned child care services.

When a parent brings a child into your office, you may not be aware of what the child care policies are. Fortunately for you, you don’t have to know the specifics as your job is to simply diagnose the child and provide treatment should it be deemed necessary. The parent may ask you to provide a “return to daycare” note but you are not required to do so.

Your article laments on the frustration you feel when parents access expensive treatment such as emergency rooms and urgent care clinics for minor illnesses solely for the purpose of obtaining a return to daycare note. I agree wholeheartedly that these very expensive medical services should not be utilized for this purpose if the child is experiencing a mild illness. Remember that the parent is the one choosing to access this level of care. You would be hard pressed to find a child care provider who would encourage a parent to go to this extreme. It is likely the cost of the services in these expensive care centers far exceeds the salary loss the parent will endure while missing a few days of work. If the parent is given free or near free access to these services and chooses to utilize them for minor illness, there should be a swift and immediate financial recourse to recoup the unnecessary expense. As long as it is free or near free this practice will continue. I encourage you to use your position to campaign for financial accountability when these services are being misused.

When a parent accesses medical care for the purpose of obtaining a “return to child care” note the first question you need to ask is if the child care asked for one. It used to be standard practice to ask your opinion but that is no longer the case. Providers across the country have had SO many bad experiences with these notes that they have changed their requests to ONLY a diagnosis, determination of whether or not the child is communicable, and documentation of any treatment you may prescribe. There is also a high likelihood that the parent wasn’t asked to take the child to the doctor. The child may have been excluded based on symptoms observed by the provider and was simply excluded until the symptoms are no longer present within a certain time frame. There’s a good chance that a recommendation to seek medical care for the symptoms wasn’t requested.

Often, a parent who has received an exclusion comes to you because they want you in the middle of the “no” they have just received. They misunderstand our relationship because they believe your determination would somehow trump ours. It doesn’t.

Child care providers don’t work with or under your license. We can’t rely upon your determination for return to daycare because you don’t know our population. You can’t possibly know what children are in attendance in our care. You don’t know if we have newborns, children with compromised immune systems, special needs children, new children to the child care, or children who have been out on vacation. You don’t know whether or not the children in attendance have even met your patient. You don’t know if the children have been exposed before diagnosis and whether or not the illness could have devastating affects on one when the effect on your patient is minor. You don’t know if repeated exposure will increase the likelihood of infection.

We can’t rely upon your determination for return to daycare because we aren’t a part of the history you take on the child before the exam. We don’t know if the parent has been truthful to you when giving an oral account of the child’s condition. We don’t know if the child’s fever has been masked with antipyretics before coming into your office. We don’t know if the parent has minimized the account of the excludable symptoms by words such as “spit up” instead of “vomit”, “loose poop” instead of blowout diarrhea. We don’t know if the parent is attributing the symptoms to something he ate, undiagnosed allergies, or the infamous “teething” used in nearly every parental diagnosis.

The other parents of the children attending child care with a sick kid aren’t going to be bummed out when they find out your patient is attending with a fever. They are going to find another daycare. Parents are very concerned about the health of the other children BEFORE their child becomes ill. Once their child becomes ill the concern for the health of the other children wanes dramatically. That lack of concern often drives them to your office to ask for you to intercede and remediate the decision of the provider. There are some exceptional parents who have consistent concern regardless of what child is ill but they are becoming extremely difficult to find.

You are correct that children in child care have more viral illnesses than children who don’t attend child care. Have you ever considered that the reason for this is that the parents of the children attending day care are bringing their kid in for your return notes when parents of kids who are not in child care don’t access medical care for the same symptoms? If you stop offering return notes you may find the statistics change dramatically.

If you truly believe the illnesses are minor and the child should not be excluded maybe you should consider offering the child to hang out in your office the next day. Put him squarely in the middle of the waiting room lounge where the “well child” visit kids are. When the well child’s visit is over let their mothers know that the kids sharing their space were excluded from daycare because of “minor” illnesses like one vomit, a little fever, a diarrhea bout that’s on the tail end, and a slight case of pink eye. The mothers will be bummed and they will find a new doctor.

If you really want to make a difference and are willing to become involved in this vicious cycle of exclusion the best thing you could do would be to counsel parents on the average number of illnesses young children get per year. Explain to them that they are going to have to miss work because their kid is most likely going to get sick often. Encourage them to use their precious paid time off wisely. Tell them to not be tempted to squander their paid time off with “me” days. Tell them to suck it up and go to work when they are mildly ill so they have the time available to care for their baby when he is mildly ill. Tell them it is better for them to go to work amongst other adults with their mild illness than to send their mildly ill kid to daycare with other babies.

If you want to make a difference, put in writing that you will assume all liability if another child in the child care contracts the illness. Put in writing that you will cover the cost of the missed days of work the provider will have if she contracts the illness. Put in writing that the child care providers children can be cared for by you free of charge while you are at it.

Fever is the number one indicator of health and it is masked with a nickel worth of medicine. If you want to make a difference, test for the presence of antipyretics in the child’s system. Do not take the parents word for it. Let your client know that you will ask and you will check. Google “dope and drop” and get a real education of how providers are deceived by parents to buy time through nap time or a day of daycare. Realize that not only are we the unwilling victim of deception but you are too. It happens a lot. If you start testing for it you will write far fewer return notes in your future.

The things that would really make a difference you won’t do. It’s easy to write a return note. It’s easy to please your customer. It makes you money. It’s hard to tell a parent you can’t recommend return either way because you don’t have the information you need to make a decision and you don’t want the liability. Encourage them to find a provider with illness policies they agree with rather than use you to intercede when the illness exclusions they agreed to before enrollment are enforced.

Better yet, stay out of the return to daycare notes business. It’s not your job to make sure a parent keeps their job. Just offer a diagnosis, whether you deem the illness as contagious, and the treatment you are giving the child. That’s all we need.

If a child care provider or school asks you to give a determination then by all means, accommodate them. Make sure you are actually being asked before you offer it. Most child care providers can determine the return time on their own. Their policies are in place for a reason. With your diagnosis and declaration of contagiousness, we can make our own decisions on a case by case basis. If you have any questions feel free to call the provider. Maybe a few conversations with the ladies on the front lines will change your prospective a bit. I hope mine has.

Sincerely,

Tori Fees R.N., B.S.N.
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Old 06-24-2014, 02:02 PM
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I've said before.....I'll say it again......
Nannyde, LOVE YOUR LOGIC!!!!! .......
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Old 06-24-2014, 02:29 PM
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I didn't get to read all the post but here is the funny thing:

I exclude for the things my state says to exclude for!!!

Green runny nose
Diarehha
Fever over 100 degrees
Vomiting
Not able to participate with children
Any communicable dieses

How is this my fault? I'm following state guidelines!

Blame the state not me
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Old 06-24-2014, 03:18 PM
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<<<Besides, if your daycare would take care of your child if she gets sick, then at least you won't have to worry about missing work.>>>

The line above (from the article) really takes the cake. I'm running a daycare, not an infirmary. I'm not a nurse, and I'm not the parent. I also don't want to be trying to figure out how to rush a kid to the hospital, a kid who is having a febrile seizure (because his "low fever" suddenly spiked), with four other kids in tow. Not my flippin' job, thank you very much.
This for sure!!!!!
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Old 06-24-2014, 03:42 PM
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If you truly believe the illnesses are minor and the child should not be excluded maybe you should consider offering the child to hang out in your office the next day. Put him squarely in the middle of the waiting room lounge where the “well child” visit kids are. When the well child’s visit is over let their mothers know that the kids sharing their space were excluded from daycare because of “minor” illnesses like one vomit, a little fever, a diarrhea bout that’s on the tail end, and a slight case of pink eye. The mothers will be bummed and they will find a new doctor.
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Old 06-24-2014, 03:44 PM
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This for sure!!!!!
count me in on that one.... I always tell parents..

you want your child with you when they are sick because the only thing that I can do is something serious was to happen was to call 911.
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Old 06-24-2014, 05:36 PM
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So pretty much what the Dr. says is "Daycares are requiring Dr notes when they are barely sick and that's dumb" (im paraphrasing here) and then goes on to say that "only kids that have high fevers, feel so bad that they can't function and need more care than the provider can offer should stay home" .... um, that's what we're doing.
Loved your FB post! I'm hoping she responds
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Old 06-24-2014, 06:19 PM
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Loved your FB post! I'm hoping she responds
Yeah, I hope so too ... but I doubt it.

Nan ...

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  #63  
Old 06-24-2014, 06:36 PM
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I posted too. Couldn't help myself.
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Old 06-24-2014, 06:37 PM
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Why Sick Kids Should “NOT” Be Allowed at DaycareDaycare.com Presents
http://www.daycare.com/nannyde/why-s...at-daycare.htm

I added a few things to the original letter. Now to figure out how to post to her blog. I can't see where to comment
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Old 06-24-2014, 06:40 PM
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I only read through the first 8-10 responses, but I have to say I kind of agree with this doctor.

This:
"Already I get lots of parents complaining about how daycare makes their kids sick -- and it's absolutely true that kids in daycare are more likely to get viral illnesses than those who aren't.

But... that's not all bad. There's plenty of research these days to suggest that getting a few illnesses as a young child ends up being good for you in the long run. It helps to strengthen the immune system. And since very often we are contagious before we even realize we are sick, kids (and staff) are getting exposed anyway."
says it all.

I grew up with my mom doing DC before I was even born. She and Dad, as well as us kids, were exposed to all kinds of c.r.a.p. While I concede the fact that maybe good genes are part of the reason, I still say that it's BECAUSE of being exposed to all the c.r.a.p. that NONE of us are ones to get sick more than once every 10 years. I've done DC 20 years, and have called off twice - about 15 years apart. And only for one day each.

And I completely agree with this as well:
"Nobody is saying that kids should go to daycare if they are really sick. They shouldn't go if they have a high fever, if they are having frequent vomiting or diarrhea, if their cough is so bad it limits activity, if they are miserable in any way. But lots of daycares exclude kids for things like the slightest fever, any diarrhea, one episode of vomiting, the mildest pinkeye or any rash besides a diaper rash."
They need to be kept home if they're currently puking or have things like a high fever that make them lethargic. It's more work for US if these things happen, so of course they should stay home where THEY are most comfortable and comforTED by Mom.

"1. Does the child's illness keep him or her from comfortably taking part in activities?
2. Does the sick child need more care than the staff can give without affecting the health and safety of other children?"
^^^ Exactly!

I realize we're all different in our methods. Yours is great if you have strict sickness policies! But merely speaking for myself, I feel like kids are exposed to it before symptoms occur, so it's pretty much a moot point. AND I feel that kids NEED to have exposure to at least some germs.

I feel like as a society, we over-wash our hands too. So there!!! I know I'm the odd man out. Whatever.....
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Old 06-24-2014, 06:52 PM
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I deal with a lot of childhood illnesses and don't exclude for many things for which other providers will exclude. In return, if I call a parent and say "take this child to the doctor" they do exactly that.

I also have gotten respectful parents who know when to stay home and care for their child, or will call and say, "This is going on...what you like me to do?"
I don't think that physician is "ridiculous" but I do think parents, doctors and providers need to work together to find a balance.

There ARE providers out there excluding for every little thing, and I feel these are the people to whom he is speaking, not those of us who use common sense. As someone said, most of us are asking those same questions.
YES!!! You said it well. I ditto all of what you said!
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Old 06-24-2014, 07:01 PM
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Originally Posted by nannyde View Post
Why Sick Kids Should “NOT” Be Allowed at DaycareDaycare.com Presents
http://www.daycare.com/nannyde/why-s...at-daycare.htm

I added a few things to the original letter. Now to figure out how to post to her blog. I can't see where to comment
Loved this! Seriously good

You may just have to post a link in comments because I don't see a way to post either? Maybe Daycare.com can put your letter up on their facebook page
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Old 06-24-2014, 07:12 PM
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Dr. Claire McCarthy,

My name is Tori Fees. I’m a Registered Nurse and veteran child care provider. I have cared for kids in the capacity of private nanny, elementary school nurse, and home child care provider for thirty years.

I came upon your article “Why Sick Kids Should Be Allowed at Daycare” published by Huffpost. As a veteran and expert child care provider, I feel it is important to address your publication as it speaks to many of the common misconceptions Physicians have regarding admittance into child care after the child has been excluded by a school, child care center, or home child care. My hope is that you will reconsider some of your viewpoints when you hear some of the concerns from the ladies on the ground who are caring for multi-level aged group children in these settings.

Each licensed and registered child care providers have illness policies. Every state in the U.S. requires that guidelines are set to differentiate an excludable illness and a “mild” or “minor” illness. Independently owned child care providers have the blessing and burden of developing their own policies that must at least meet the minimum standards set forth by their respective state. I’m certain you have come across variations in the policies of the privately owned child care services.

When a parent brings a child into your office, you may not be aware of what the child care policies are. Fortunately for you, you don’t have to know the specifics as your job is to simply diagnose the child and provide treatment should it be deemed necessary. The parent may ask you to provide a “return to daycare” note but you are not required to do so.

Your article laments on the frustration you feel when parents access expensive treatment such as emergency rooms and urgent care clinics for minor illnesses solely for the purpose of obtaining a return to daycare note. I agree wholeheartedly that these very expensive medical services should not be utilized for this purpose if the child is experiencing a mild illness. Remember that the parent is the one choosing to access this level of care. You would be hard pressed to find a child care provider who would encourage a parent to go to this extreme. It is likely the cost of the services in these expensive care centers far exceeds the salary loss the parent will endure while missing a few days of work. If the parent is given free or near free access to these services and chooses to utilize them for minor illness, there should be a swift and immediate financial recourse to recoup the unnecessary expense. As long as it is free or near free this practice will continue. I encourage you to use your position to campaign for financial accountability when these services are being misused.

When a parent accesses medical care for the purpose of obtaining a “return to child care” note the first question you need to ask is if the child care asked for one. It used to be standard practice to ask your opinion but that is no longer the case. Providers across the country have had SO many bad experiences with these notes that they have changed their requests to ONLY a diagnosis, determination of whether or not the child is communicable, and documentation of any treatment you may prescribe. There is also a high likelihood that the parent wasn’t asked to take the child to the doctor. The child may have been excluded based on symptoms observed by the provider and was simply excluded until the symptoms are no longer present within a certain time frame. There’s a good chance that a recommendation to seek medical care for the symptoms wasn’t requested.

Often, a parent who has received an exclusion comes to you because they want you in the middle of the “no” they have just received. They misunderstand our relationship because they believe your determination would somehow trump ours. It doesn’t.

Child care providers don’t work with or under your license. We can’t rely upon your determination for return to daycare because you don’t know our population. You can’t possibly know what children are in attendance in our care. You don’t know if we have newborns, children with compromised immune systems, special needs children, new children to the child care, or children who have been out on vacation. You don’t know whether or not the children in attendance have even met your patient. You don’t know if the children have been exposed before diagnosis and whether or not the illness could have devastating affects on one when the effect on your patient is minor. You don’t know if repeated exposure will increase the likelihood of infection.

We can’t rely upon your determination for return to daycare because we aren’t a part of the history you take on the child before the exam. We don’t know if the parent has been truthful to you when giving an oral account of the child’s condition. We don’t know if the child’s fever has been masked with antipyretics before coming into your office. We don’t know if the parent has minimized the account of the excludable symptoms by words such as “spit up” instead of “vomit”, “loose poop” instead of blowout diarrhea. We don’t know if the parent is attributing the symptoms to something he ate, undiagnosed allergies, or the infamous “teething” used in nearly every parental diagnosis.

The other parents of the children attending child care with a sick kid aren’t going to be bummed out when they find out your patient is attending with a fever. They are going to find another daycare. Parents are very concerned about the health of the other children BEFORE their child becomes ill. Once their child becomes ill the concern for the health of the other children wanes dramatically. That lack of concern often drives them to your office to ask for you to intercede and remediate the decision of the provider. There are some exceptional parents who have consistent concern regardless of what child is ill but they are becoming extremely difficult to find.

You are correct that children in child care have more viral illnesses than children who don’t attend child care. Have you ever considered that the reason for this is that the parents of the children attending day care are bringing their kid in for your return notes when parents of kids who are not in child care don’t access medical care for the same symptoms? If you stop offering return notes you may find the statistics change dramatically.

If you truly believe the illnesses are minor and the child should not be excluded maybe you should consider offering the child to hang out in your office the next day. Put him squarely in the middle of the waiting room lounge where the “well child” visit kids are. When the well child’s visit is over let their mothers know that the kids sharing their space were excluded from daycare because of “minor” illnesses like one vomit, a little fever, a diarrhea bout that’s on the tail end, and a slight case of pink eye. The mothers will be bummed and they will find a new doctor.

If you really want to make a difference and are willing to become involved in this vicious cycle of exclusion the best thing you could do would be to counsel parents on the average number of illnesses young children get per year. Explain to them that they are going to have to miss work because their kid is most likely going to get sick often. Encourage them to use their precious paid time off wisely. Tell them to not be tempted to squander their paid time off with “me” days. Tell them to suck it up and go to work when they are mildly ill so they have the time available to care for their baby when he is mildly ill. Tell them it is better for them to go to work amongst other adults with their mild illness than to send their mildly ill kid to daycare with other babies.

If you want to make a difference, put in writing that you will assume all liability if another child in the child care contracts the illness. Put in writing that you will cover the cost of the missed days of work the provider will have if she contracts the illness. Put in writing that the child care providers children can be cared for by you free of charge while you are at it.

Fever is the number one indicator of health and it is masked with a nickel worth of medicine. If you want to make a difference, test for the presence of antipyretics in the child’s system. Do not take the parents word for it. Let your client know that you will ask and you will check. Google “dope and drop” and get a real education of how providers are deceived by parents to buy time through nap time or a day of daycare. Realize that not only are we the unwilling victim of deception but you are too. It happens a lot. If you start testing for it you will write far fewer return notes in your future.

The things that would really make a difference you won’t do. It’s easy to write a return note. It’s easy to please your customer. It makes you money. It’s hard to tell a parent you can’t recommend return either way because you don’t have the information you need to make a decision and you don’t want the liability. Encourage them to find a provider with illness policies they agree with rather than use you to intercede when the illness exclusions they agreed to before enrollment are enforced.

Better yet, stay out of the return to daycare notes business. It’s not your job to make sure a parent keeps their job. Just offer a diagnosis, whether you deem the illness as contagious, and the treatment you are giving the child. That’s all we need.

If a child care provider or school asks you to give a determination then by all means, accommodate them. Make sure you are actually being asked before you offer it. Most child care providers can determine the return time on their own. Their policies are in place for a reason. With your diagnosis and declaration of contagiousness, we can make our own decisions on a case by case basis. If you have any questions feel free to call the provider. Maybe a few conversations with the ladies on the front lines will change your prospective a bit. I hope mine has.

Sincerely,

Tori Fees R.N., B.S.N.
!!!
Words cannot describe how much I love this....especially the bolded.
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  #69  
Old 06-24-2014, 07:26 PM
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Is it just possible that this doctor is a bit of a crackpot?
Read this article on biting: http://www.boston.com/lifestyle/heal...her_child.html
where she says "If biting is happening in school or daycare, the stopping it part is reasonably straightforward. You have every right to expect that professionals (especially those you are paying) will keep your child safe. ... It's just not okay for that to happen in that setting. Anybody can be caught off guard once, but there should be no repeat biting."

And then this "It's way harder if Biter is a playgroup pal, or the child of a friend or a family member."

Yes, dear, it's soo much harder when each child has one-to-one supervision versus a group care situation
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  #70  
Old 06-24-2014, 07:34 PM
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Originally Posted by nannyde View Post
Dr. Claire McCarthy,

My name is Tori Fees. I’m a Registered Nurse and veteran child care provider. I have cared for kids in the capacity of private nanny, elementary school nurse, and home child care provider for thirty years.

I came upon your article “Why Sick Kids Should Be Allowed at Daycare” published by Huffpost. As a veteran and expert child care provider, I feel it is important to address your publication as it speaks to many of the common misconceptions Physicians have regarding admittance into child care after the child has been excluded by a school, child care center, or home child care. My hope is that you will reconsider some of your viewpoints when you hear some of the concerns from the ladies on the ground who are caring for multi-level aged group children in these settings.

Each licensed and registered child care providers have illness policies. Every state in the U.S. requires that guidelines are set to differentiate an excludable illness and a “mild” or “minor” illness. Independently owned child care providers have the blessing and burden of developing their own policies that must at least meet the minimum standards set forth by their respective state. I’m certain you have come across variations in the policies of the privately owned child care services.

When a parent brings a child into your office, you may not be aware of what the child care policies are. Fortunately for you, you don’t have to know the specifics as your job is to simply diagnose the child and provide treatment should it be deemed necessary. The parent may ask you to provide a “return to daycare” note but you are not required to do so.

Your article laments on the frustration you feel when parents access expensive treatment such as emergency rooms and urgent care clinics for minor illnesses solely for the purpose of obtaining a return to daycare note. I agree wholeheartedly that these very expensive medical services should not be utilized for this purpose if the child is experiencing a mild illness. Remember that the parent is the one choosing to access this level of care. You would be hard pressed to find a child care provider who would encourage a parent to go to this extreme. It is likely the cost of the services in these expensive care centers far exceeds the salary loss the parent will endure while missing a few days of work. If the parent is given free or near free access to these services and chooses to utilize them for minor illness, there should be a swift and immediate financial recourse to recoup the unnecessary expense. As long as it is free or near free this practice will continue. I encourage you to use your position to campaign for financial accountability when these services are being misused.

When a parent accesses medical care for the purpose of obtaining a “return to child care” note the first question you need to ask is if the child care asked for one. It used to be standard practice to ask your opinion but that is no longer the case. Providers across the country have had SO many bad experiences with these notes that they have changed their requests to ONLY a diagnosis, determination of whether or not the child is communicable, and documentation of any treatment you may prescribe. There is also a high likelihood that the parent wasn’t asked to take the child to the doctor. The child may have been excluded based on symptoms observed by the provider and was simply excluded until the symptoms are no longer present within a certain time frame. There’s a good chance that a recommendation to seek medical care for the symptoms wasn’t requested.

Often, a parent who has received an exclusion comes to you because they want you in the middle of the “no” they have just received. They misunderstand our relationship because they believe your determination would somehow trump ours. It doesn’t.

Child care providers don’t work with or under your license. We can’t rely upon your determination for return to daycare because you don’t know our population. You can’t possibly know what children are in attendance in our care. You don’t know if we have newborns, children with compromised immune systems, special needs children, new children to the child care, or children who have been out on vacation. You don’t know whether or not the children in attendance have even met your patient. You don’t know if the children have been exposed before diagnosis and whether or not the illness could have devastating affects on one when the effect on your patient is minor. You don’t know if repeated exposure will increase the likelihood of infection.

We can’t rely upon your determination for return to daycare because we aren’t a part of the history you take on the child before the exam. We don’t know if the parent has been truthful to you when giving an oral account of the child’s condition. We don’t know if the child’s fever has been masked with antipyretics before coming into your office. We don’t know if the parent has minimized the account of the excludable symptoms by words such as “spit up” instead of “vomit”, “loose poop” instead of blowout diarrhea. We don’t know if the parent is attributing the symptoms to something he ate, undiagnosed allergies, or the infamous “teething” used in nearly every parental diagnosis.

The other parents of the children attending child care with a sick kid aren’t going to be bummed out when they find out your patient is attending with a fever. They are going to find another daycare. Parents are very concerned about the health of the other children BEFORE their child becomes ill. Once their child becomes ill the concern for the health of the other children wanes dramatically. That lack of concern often drives them to your office to ask for you to intercede and remediate the decision of the provider. There are some exceptional parents who have consistent concern regardless of what child is ill but they are becoming extremely difficult to find.

You are correct that children in child care have more viral illnesses than children who don’t attend child care. Have you ever considered that the reason for this is that the parents of the children attending day care are bringing their kid in for your return notes when parents of kids who are not in child care don’t access medical care for the same symptoms? If you stop offering return notes you may find the statistics change dramatically.

If you truly believe the illnesses are minor and the child should not be excluded maybe you should consider offering the child to hang out in your office the next day. Put him squarely in the middle of the waiting room lounge where the “well child” visit kids are. When the well child’s visit is over let their mothers know that the kids sharing their space were excluded from daycare because of “minor” illnesses like one vomit, a little fever, a diarrhea bout that’s on the tail end, and a slight case of pink eye. The mothers will be bummed and they will find a new doctor.

If you really want to make a difference and are willing to become involved in this vicious cycle of exclusion the best thing you could do would be to counsel parents on the average number of illnesses young children get per year. Explain to them that they are going to have to miss work because their kid is most likely going to get sick often. Encourage them to use their precious paid time off wisely. Tell them to not be tempted to squander their paid time off with “me” days. Tell them to suck it up and go to work when they are mildly ill so they have the time available to care for their baby when he is mildly ill. Tell them it is better for them to go to work amongst other adults with their mild illness than to send their mildly ill kid to daycare with other babies.

If you want to make a difference, put in writing that you will assume all liability if another child in the child care contracts the illness. Put in writing that you will cover the cost of the missed days of work the provider will have if she contracts the illness. Put in writing that the child care providers children can be cared for by you free of charge while you are at it.

Fever is the number one indicator of health and it is masked with a nickel worth of medicine. If you want to make a difference, test for the presence of antipyretics in the child’s system. Do not take the parents word for it. Let your client know that you will ask and you will check. Google “dope and drop” and get a real education of how providers are deceived by parents to buy time through nap time or a day of daycare. Realize that not only are we the unwilling victim of deception but you are too. It happens a lot. If you start testing for it you will write far fewer return notes in your future.

The things that would really make a difference you won’t do. It’s easy to write a return note. It’s easy to please your customer. It makes you money. It’s hard to tell a parent you can’t recommend return either way because you don’t have the information you need to make a decision and you don’t want the liability. Encourage them to find a provider with illness policies they agree with rather than use you to intercede when the illness exclusions they agreed to before enrollment are enforced.

Better yet, stay out of the return to daycare notes business. It’s not your job to make sure a parent keeps their job. Just offer a diagnosis, whether you deem the illness as contagious, and the treatment you are giving the child. That’s all we need.

If a child care provider or school asks you to give a determination then by all means, accommodate them. Make sure you are actually being asked before you offer it. Most child care providers can determine the return time on their own. Their policies are in place for a reason. With your diagnosis and declaration of contagiousness, we can make our own decisions on a case by case basis. If you have any questions feel free to call the provider. Maybe a few conversations with the ladies on the front lines will change your prospective a bit. I hope mine has.

Sincerely,

Tori Fees R.N., B.S.N.
PERFECT!!
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  #71  
Old 06-24-2014, 07:48 PM
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Quote:
Originally Posted by SignMeUp View Post
Is it just possible that this doctor is a bit of a crackpot?
Read this article on biting: http://www.boston.com/lifestyle/heal...her_child.html
where she says "If biting is happening in school or daycare, the stopping it part is reasonably straightforward. You have every right to expect that professionals (especially those you are paying) will keep your child safe. ... It's just not okay for that to happen in that setting. Anybody can be caught off guard once, but there should be no repeat biting."

And then this "It's way harder if Biter is a playgroup pal, or the child of a friend or a family member."

Yes, dear, it's soo much harder when each child has one-to-one supervision versus a group care situation
"if your child has a bite that breaks the skin, you should definitely call your doctor"

yes, call your doctor right away if they have a bite that breaks the skin, but be outraged if daycare excludes them for an actual illness symptom.
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Old 06-24-2014, 07:50 PM
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"If biting is happening in school or daycare, the stopping it part is reasonably straightforward. You have every right to expect that professionals (especially those you are paying) will keep your child safe. So if your child comes home with a bite, complain up the wazoo. Expect explanations and responses, and don't stop complaining until you get them--and until the biting stops. It's just not okay for that to happen in that setting. Anybody can be caught off guard once, but there should be no repeat biting."

Here's the rest of that paragraph...
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Old 06-24-2014, 07:50 PM
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She seems extremely anti-daycare.
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  #74  
Old 06-24-2014, 08:23 PM
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Quote:
"If biting is happening in school or daycare, the stopping it part is reasonably straightforward. You have every right to expect that professionals (especially those you are paying) will keep your child safe. So if your child comes home with a bite, complain up the wazoo. Expect explanations and responses, and don't stop complaining until you get them--and until the biting stops. It's just not okay for that to happen in that setting. Anybody can be caught off guard once, but there should be no repeat biting."
So funny that she says that it's reasonable to expect us to keep their child safe (true, that's very reasonable), but she wants us to put children (the same children we are expected to keep safe) at risk by playing a guessing game with illnesses.
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Old 06-24-2014, 09:24 PM
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Great post NannyD!


Parent picks up sick child from DC goes to doctor irritated about leaving work, parent complains about DC, Doctor writes article.

I will not post on her FB...so difficult!
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  #76  
Old 06-24-2014, 09:56 PM
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I tried really hard not to post but couldn't help myself and ended up posting multiple times. Ugh, I'm so mad. Every day we see the posts and articles about how expensive daycare is but now we also want providers to take sick children? The same providers that are lucky to make minimum wage when you count all of the time outside of daycare spent cleaning, shopping and planning. Not to mention all of the times we have to go to a doctor or get a prescription for us or our families because of "teething" or "allergies" that were brought in by a daycare child.
We once had a child with headlice make it in to daycare. I sent him home and treated my family and house. He came back and I realized an hour later that he still had it so I had to re-treat everything and spend all of that time dealing with it. It ended up costing me more than I even made watching the child that week. The same thing has happened with HFM when my child got painful sores in his mouth and could barely eat and colds that turned into bronchitis. In some instances it cost me to watch the child after you took what I made and deducted what the illness ended up costing my family.
I now have strict illness policies and I don't remember the last time I sent a child home for illness. On top of that the children in my care stay home on an average of 3 days a year because of illness but in those cases their parents kept them home and sometimes for mild symptoms but only because they didn't want to take the risk of spreading illness and having to find new daycare.
Parents need to understand that when they pay for group care they are paying for a portion of our time. 8 children = 1/8 of my time and after cleaning up and sanitizing after that one episode of diarrhea or vomiting you've used up your time.
I know I'm ranting. I've probably said the same things previous posters have mentioned but ugh, I'm so mad!
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  #77  
Old 06-25-2014, 04:26 AM
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Quote:
Originally Posted by nanglgrl View Post
I tried really hard not to post but couldn't help myself and ended up posting multiple times. Ugh, I'm so mad. Every day we see the posts and articles about how expensive daycare is but now we also want providers to take sick children? The same providers that are lucky to make minimum wage when you count all of the time outside of daycare spent cleaning, shopping and planning. Not to mention all of the times we have to go to a doctor or get a prescription for us or our families because of "teething" or "allergies" that were brought in by a daycare child.
We once had a child with headlice make it in to daycare. I sent him home and treated my family and house. He came back and I realized an hour later that he still had it so I had to re-treat everything and spend all of that time dealing with it. It ended up costing me more than I even made watching the child that week. The same thing has happened with HFM when my child got painful sores in his mouth and could barely eat and colds that turned into bronchitis. In some instances it cost me to watch the child after you took what I made and deducted what the illness ended up costing my family.
I now have strict illness policies and I don't remember the last time I sent a child home for illness. On top of that the children in my care stay home on an average of 3 days a year because of illness but in those cases their parents kept them home and sometimes for mild symptoms but only because they didn't want to take the risk of spreading illness and having to find new daycare.
Parents need to understand that when they pay for group care they are paying for a portion of our time. 8 children = 1/8 of my time and after cleaning up and sanitizing after that one episode of diarrhea or vomiting you've used up your time.
I know I'm ranting. I've probably said the same things previous posters have mentioned but ugh, I'm so mad!
Now THAT was a rant nan!! Good job! Notice she hasn't responded since we all jumped on the bandwagon?
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Old 06-25-2014, 04:59 AM
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Dr. Claire McCarthy,

My name is Tori Fees. I’m a Registered Nurse and veteran child care provider. I have cared for kids in the capacity of private nanny, elementary school nurse, and home child care provider for thirty years.

I came upon your article “Why Sick Kids Should Be Allowed at Daycare” published by Huffpost. As a veteran and expert child care provider, I feel it is important to address your publication as it speaks to many of the common misconceptions Physicians have regarding admittance into child care after the child has been excluded by a school, child care center, or home child care. My hope is that you will reconsider some of your viewpoints when you hear some of the concerns from the ladies on the ground who are caring for multi-level aged group children in these settings.

Each licensed and registered child care providers have illness policies. Every state in the U.S. requires that guidelines are set to differentiate an excludable illness and a “mild” or “minor” illness. Independently owned child care providers have the blessing and burden of developing their own policies that must at least meet the minimum standards set forth by their respective state. I’m certain you have come across variations in the policies of the privately owned child care services.

When a parent brings a child into your office, you may not be aware of what the child care policies are. Fortunately for you, you don’t have to know the specifics as your job is to simply diagnose the child and provide treatment should it be deemed necessary. The parent may ask you to provide a “return to daycare” note but you are not required to do so.

Your article laments on the frustration you feel when parents access expensive treatment such as emergency rooms and urgent care clinics for minor illnesses solely for the purpose of obtaining a return to daycare note. I agree wholeheartedly that these very expensive medical services should not be utilized for this purpose if the child is experiencing a mild illness. Remember that the parent is the one choosing to access this level of care. You would be hard pressed to find a child care provider who would encourage a parent to go to this extreme. It is likely the cost of the services in these expensive care centers far exceeds the salary loss the parent will endure while missing a few days of work. If the parent is given free or near free access to these services and chooses to utilize them for minor illness, there should be a swift and immediate financial recourse to recoup the unnecessary expense. As long as it is free or near free this practice will continue. I encourage you to use your position to campaign for financial accountability when these services are being misused.

When a parent accesses medical care for the purpose of obtaining a “return to child care” note the first question you need to ask is if the child care asked for one. It used to be standard practice to ask your opinion but that is no longer the case. Providers across the country have had SO many bad experiences with these notes that they have changed their requests to ONLY a diagnosis, determination of whether or not the child is communicable, and documentation of any treatment you may prescribe. There is also a high likelihood that the parent wasn’t asked to take the child to the doctor. The child may have been excluded based on symptoms observed by the provider and was simply excluded until the symptoms are no longer present within a certain time frame. There’s a good chance that a recommendation to seek medical care for the symptoms wasn’t requested.

Often, a parent who has received an exclusion comes to you because they want you in the middle of the “no” they have just received. They misunderstand our relationship because they believe your determination would somehow trump ours. It doesn’t.

Child care providers don’t work with or under your license. We can’t rely upon your determination for return to daycare because you don’t know our population. You can’t possibly know what children are in attendance in our care. You don’t know if we have newborns, children with compromised immune systems, special needs children, new children to the child care, or children who have been out on vacation. You don’t know whether or not the children in attendance have even met your patient. You don’t know if the children have been exposed before diagnosis and whether or not the illness could have devastating affects on one when the effect on your patient is minor. You don’t know if repeated exposure will increase the likelihood of infection.

We can’t rely upon your determination for return to daycare because we aren’t a part of the history you take on the child before the exam. We don’t know if the parent has been truthful to you when giving an oral account of the child’s condition. We don’t know if the child’s fever has been masked with antipyretics before coming into your office. We don’t know if the parent has minimized the account of the excludable symptoms by words such as “spit up” instead of “vomit”, “loose poop” instead of blowout diarrhea. We don’t know if the parent is attributing the symptoms to something he ate, undiagnosed allergies, or the infamous “teething” used in nearly every parental diagnosis.

The other parents of the children attending child care with a sick kid aren’t going to be bummed out when they find out your patient is attending with a fever. They are going to find another daycare. Parents are very concerned about the health of the other children BEFORE their child becomes ill. Once their child becomes ill the concern for the health of the other children wanes dramatically. That lack of concern often drives them to your office to ask for you to intercede and remediate the decision of the provider. There are some exceptional parents who have consistent concern regardless of what child is ill but they are becoming extremely difficult to find.

You are correct that children in child care have more viral illnesses than children who don’t attend child care. Have you ever considered that the reason for this is that the parents of the children attending day care are bringing their kid in for your return notes when parents of kids who are not in child care don’t access medical care for the same symptoms? If you stop offering return notes you may find the statistics change dramatically.

If you truly believe the illnesses are minor and the child should not be excluded maybe you should consider offering the child to hang out in your office the next day. Put him squarely in the middle of the waiting room lounge where the “well child” visit kids are. When the well child’s visit is over let their mothers know that the kids sharing their space were excluded from daycare because of “minor” illnesses like one vomit, a little fever, a diarrhea bout that’s on the tail end, and a slight case of pink eye. The mothers will be bummed and they will find a new doctor.

If you really want to make a difference and are willing to become involved in this vicious cycle of exclusion the best thing you could do would be to counsel parents on the average number of illnesses young children get per year. Explain to them that they are going to have to miss work because their kid is most likely going to get sick often. Encourage them to use their precious paid time off wisely. Tell them to not be tempted to squander their paid time off with “me” days. Tell them to suck it up and go to work when they are mildly ill so they have the time available to care for their baby when he is mildly ill. Tell them it is better for them to go to work amongst other adults with their mild illness than to send their mildly ill kid to daycare with other babies.

If you want to make a difference, put in writing that you will assume all liability if another child in the child care contracts the illness. Put in writing that you will cover the cost of the missed days of work the provider will have if she contracts the illness. Put in writing that the child care providers children can be cared for by you free of charge while you are at it.

Fever is the number one indicator of health and it is masked with a nickel worth of medicine. If you want to make a difference, test for the presence of antipyretics in the child’s system. Do not take the parents word for it. Let your client know that you will ask and you will check. Google “dope and drop” and get a real education of how providers are deceived by parents to buy time through nap time or a day of daycare. Realize that not only are we the unwilling victim of deception but you are too. It happens a lot. If you start testing for it you will write far fewer return notes in your future.

The things that would really make a difference you won’t do. It’s easy to write a return note. It’s easy to please your customer. It makes you money. It’s hard to tell a parent you can’t recommend return either way because you don’t have the information you need to make a decision and you don’t want the liability. Encourage them to find a provider with illness policies they agree with rather than use you to intercede when the illness exclusions they agreed to before enrollment are enforced.

Better yet, stay out of the return to daycare notes business. It’s not your job to make sure a parent keeps their job. Just offer a diagnosis, whether you deem the illness as contagious, and the treatment you are giving the child. That’s all we need.

If a child care provider or school asks you to give a determination then by all means, accommodate them. Make sure you are actually being asked before you offer it. Most child care providers can determine the return time on their own. Their policies are in place for a reason. With your diagnosis and declaration of contagiousness, we can make our own decisions on a case by case basis. If you have any questions feel free to call the provider. Maybe a few conversations with the ladies on the front lines will change your prospective a bit. I hope mine has.

Sincerely,

Tori Fees R.N., B.S.N.
This is very articulate, very to the point, and really speaks to our (providers) side of the illness debate. Nice work!
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Old 06-25-2014, 05:32 AM
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I can't even with this article...

Does the Doctor author not realize some of these decisions are not even ours to make?

Maybe this Doctor should open a sick child care facility so all of the working parents can have the "support" they need.

I am so over the ever so common argument lately that everyone else needs to accomodate for parents who do not want to be parents when things get tough. No one ever promises you that parenthood is easy....children get sick, suck it up buttercup!
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Old 06-25-2014, 05:41 AM
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Default Sick kids at daycare

I read the article in the Huff--okay doc--I get part of that.
I also have a home day care where a parent (who worked for The World Health Organization) doped his twins up when they were sick and sent them to day care. By the time the meds wore off it would be naptime. Then by the time the parent finally managed to get there to pick up the child--WOW! It was almost "day over"!! These were kids who spiked fevers of 102 while playing this little game.

My issue is this--almost everyone has Sick days, personal days, and vacation days at their jobs. I have parents who will use a whatever day from work to stay home and wrap Christmas presents so the kids aren't there???? but would balk at picking up a sick child when I called! Take a day off work for "ME" time......but come get the child?!?!?!
I agree with the other comment----they choose to have the children---choose to let someone else raise them ---- and then give grief to the person trying to do the best job for all concerned.

The problem with the DOC is--he's accustomed to having a room full of sick people all day--desensitized is the word I think.

On the plus side--MOST of my parents for the past 10 years have been of the other type---they keep the child home if ill--and hurry to get them if I raise a doubt about them being here. THANK GOODNESS!!!
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Old 06-25-2014, 05:43 AM
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Great post NannyD!


Parent picks up sick child from DC goes to doctor irritated about leaving work, parent complains about DC, Doctor writes article.

I will not post on her FB...so difficult!
Yep! This is exactly how her article happened!
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Old 06-25-2014, 06:00 AM
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I don't get why the docs just don't get out of the business of writing them. The docs are educated. They want their cake and eat it too. They want the quick office visit and the happy customer who gets the note.

If they did just the visit and no note the parent would stop coming to them with the minor illness. That would hurt their bottom line.

It takes TIME to counsel a parent on transmission of illness, how many sick days to plan on for the average kid, and warning to be frugal with the days the parent takes off. Those are icky convos and they are going to have to sit thru the crying and pissed off arguments they WILL get when this generation gets a no.

That is exactly why they get in the middle of it. Get in... get out.... get paid.
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Old 06-25-2014, 07:54 AM
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i am REALLY appallled by this seeing that I am a new provider (2 years) and my trying to be flixible and helpful to parents work schedule and accepting excuses caused a spread of stomach virus and a few pink eye cases in my daycare and family. In both cases once i FINALLY insisted the parent go to the dr for something they felt was allergies or growth spurt, the child turned out to be sick. By the time i got my backbone and enforced what STATE REGULATIONS required, it was too late.

Now I understand a note sometimes seems a waste of time to him, but as someone else said before I require a note only after a long stint of symptoms and nobody has had to bring back one yet WHY? because the child WAS sick
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Old 06-25-2014, 08:16 AM
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i am REALLY appallled by this seeing that I am a new provider (2 years) and my trying to be flixible and helpful to parents work schedule and accepting excuses caused a spread of stomach virus and a few pink eye cases in my daycare and family. In both cases once i FINALLY insisted the parent go to the dr for something they felt was allergies or growth spurt, the child turned out to be sick. By the time i got my backbone and enforced what STATE REGULATIONS required, it was too late.

Now I understand a note sometimes seems a waste of time to him, but as someone else said before I require a note only after a long stint of symptoms and nobody has had to bring back one yet WHY? because the child WAS sick
I was thinking back on the last year or two and I can only think of twice when I asked for a diagnosis from a doc. Both were breathing issues and one I was right and one was nothing.

The one I was wrong.was a tiny newborn and he was making a breath sound I had NEVER heard before. It scared the be$hit out of me. The parents brought him right back and the doc was right. There was nothing wrong. I just didn't know what else to do.

Other than that I haven't asked for doc visits. If the parent asks me what I would do then I tell them what I would do as a mom. As a child care provider, I only ask for a visit if it's serious.

Now I have had LEGIONS of times where parents have taken their kid in to undo an exclusion. Countless. I have even had sick kids I didn't exclude who have been taken to the doc on Sunday to get a note so they could come Monday with excludable illnesses.

I tell the parent the same thing... if the kid has x symptoms they are excluded regardless if they are concomitant with allergies, teething, blocked tear duct, or ear infection.
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Old 06-25-2014, 10:42 AM
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She seems extremely anti-daycare.
She can afford nanny care. And for those that can't......let them eat cake. That logic worked really well for Marie Antoinette, didn't it?
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Old 06-25-2014, 11:04 AM
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"Already I get lots of parents complaining about how daycare makes their kids sick -- and it's absolutely true that kids in daycare are more likely to get viral illnesses than those who aren't.

But... that's not all bad. There's plenty of research these days to suggest that getting a few illnesses as a young child ends up being good for you in the long run. It helps to strengthen the immune system. And since very often we are contagious before we even realize we are sick, kids (and staff) are getting exposed anyway."
says it all.

I grew up with my mom doing DC before I was even born. She and Dad, as well as us kids, were exposed to all kinds of c.r.a.p. While I concede the fact that maybe good genes are part of the reason, I still say that it's BECAUSE of being exposed to all the c.r.a.p. that NONE of us are ones to get sick more than once every 10 years. I've done DC 20 years, and have called off twice - about 15 years apart. And only for one day each.
Not flaming you
Just saying that you and your family were lucky to have the exposure to germs work for you.
My first three were around before I did day care and are healthy as horses.
My last two that were present while I did day care, were sick when they started school, even to the point of being held back for absences, and are still always sick.
Exposure to germs can still go both ways, and think your more correct about the good genes factor, vs. that doctors article.
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Old 06-25-2014, 01:36 PM
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Not sure why she singled out my comment as the one to respond to.

I want her to respond to the other issues with her article.
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Old 06-25-2014, 01:37 PM
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Not sure why she singled out my comment as the one to respond to.

I want her to respond to the other issues with her article.
link please.......
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Old 06-25-2014, 01:39 PM
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link please.......
Oh, it's the Facebook link from the first page of this thread. I THINK one of the Vaca ladies posted it
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Old 06-25-2014, 01:42 PM
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Not sure why she singled out my comment as the one to respond to.

I want her to respond to the other issues with her article.
I thought that was odd also. She's just going to keep responding by rewording what she said in the article and is too full of herself to admit otherwise. She said that she knows when parents are lying by the exam, I call bull. Even a 20 minute exam isn't going to show if the parent gave the child fever meds and besides that she doesn't know these people, at least not like we do, and you can't tell if people are lying until you've gotten to know their regular habits of speaking and acting. I wish she'd respond to nanny d but she can't because nanny was spot on and there is no response other than "I never thought of it that way" which this woman would never say.
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Old 06-25-2014, 02:05 PM
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I thought that was odd also. She's just going to keep responding by rewording what she said in the article and is too full of herself to admit otherwise. She said that she knows when parents are lying by the exam, I call bull. Even a 20 minute exam isn't going to show if the parent gave the child fever meds and besides that she doesn't know these people, at least not like we do, and you can't tell if people are lying until you've gotten to know their regular habits of speaking and acting. I wish she'd respond to nanny d but she can't because nanny was spot on and there is no response other than "I never thought of it that way" which this woman would never say.
I can't see where she has responded to the Facebook comments. Is there other comments?

If she can tell when the parents are lying then she is in the wrong profession. A human lie detector makes way more money than a Dr.
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Old 06-25-2014, 02:10 PM
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I can't see where she has responded to the Facebook comments. Is there other comments?

If she can tell when the parents are lying then she is in the wrong profession. A human lie detector makes way more money than a Dr.
lol coffee just came out my nose.......................
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Old 06-25-2014, 02:12 PM
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Everyone should share their opinions with the Dr! Here is the Facebook link

https://www.facebook.com/ClaireMcCarthyMD
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Originally Posted by nannyde View Post
I can't see where she has responded to the Facebook comments. Is there other comments?

If she can tell when the parents are lying then she is in the wrong profession. A human lie detector makes way more money than a Dr.
I clicked the link in the above post and on the right side are all the comments

No log in necessary
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Old 06-25-2014, 02:40 PM
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I clicked the link in the above post and on the right side are all the comments

No log in necessary
Found it....
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Old 06-25-2014, 03:50 PM
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It's kinda crazy I know, but I do NOT trust drs. There is too much liability in it for them so they cover their butt every chance they get. This dr's POV almost proves it even more. They don't see anything wrong with having a contagious illness in my daycare and will voluntarily send the parent with a note releasing them back with sympathy that their big bad DCP won't let little Timmy come back with a green snotty nose and goopy eyes.
I have been told SO many different lies by different doctors over the years its hard for me to trust any of them. I trust our own pediatrician more than probably any other doctor I've known but even he admits he's made mistakes! Recently I requested a doctor's note for a DCB before returning because he had these sores on his mouth and they looked awful. Mom kept him home and everything but the dr released him with a note that was so stupid... "Johnny can return when his sores are no longer active"... Uh DUH! LOL That didn't really tell me anything! I already told her that to begin with. They had done a culture but didn't know what it was at that point. Of course that was a new client's first week and his first day back the sores were scabbed up and almost gone but his face still looked tore up from the sore scars. Ugh! They were like "ummm... what's up with the..." and points to their mouth while looking at little Johnny. I assured them that it wasn't contagious and that he was released back to care and had been out an entire week before. I also assured them of my illness exclusion policy and that I had just sent another DCG home sick with a fever and lethargy. I don't do it often, but when I do it's for a good reason. Why should this dr make such a large and ignorant blanket statement which then gives these entitled parents already pushing the limits with illnesses another excuse to bring their kids and then refuse to take them! This Dr is setting herself up for some serious backlash! I saw the FB page but wasn't signed in. I read the comments and she tries to backstep and say "minor illnesses"... well HELLO? Who is excluding for minor illnesses?? Most professionals have an illness policy in place and do allow for minor illnesses! But to say a feverish child should be at childcare is ridiculous!
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Old 06-25-2014, 04:00 PM
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It's kinda crazy I know, but I do NOT trust drs. There is too much liability in it for them so they cover their butt every chance they get. This dr's POV almost proves it even more. They don't see anything wrong with having a contagious illness in my daycare and will voluntarily send the parent with a note releasing them back with sympathy that their big bad DCP won't let little Timmy come back with a green snotty nose and goopy eyes.
I have been told SO many different lies by different doctors over the years its hard for me to trust any of them. I trust our own pediatrician more than probably any other doctor I've known but even he admits he's made mistakes! Recently I requested a doctor's note for a DCB before returning because he had these sores on his mouth and they looked awful. Mom kept him home and everything but the dr released him with a note that was so stupid... "Johnny can return when his sores are no longer active"... Uh DUH! LOL That didn't really tell me anything! I already told her that to begin with. They had done a culture but didn't know what it was at that point. Of course that was a new client's first week and his first day back the sores were scabbed up and almost gone but his face still looked tore up from the sore scars. Ugh! They were like "ummm... what's up with the..." and points to their mouth while looking at little Johnny. I assured them that it wasn't contagious and that he was released back to care and had been out an entire week before. I also assured them of my illness exclusion policy and that I had just sent another DCG home sick with a fever and lethargy. I don't do it often, but when I do it's for a good reason. Why should this dr make such a large and ignorant blanket statement which then gives these entitled parents already pushing the limits with illnesses another excuse to bring their kids and then refuse to take them! This Dr is setting herself up for some serious backlash! I saw the FB page but wasn't signed in. I read the comments and she tries to backstep and say "minor illnesses"... well HELLO? Who is excluding for minor illnesses?? Most professionals have an illness policy in place and do allow for minor illnesses! But to say a feverish child should be at childcare is ridiculous!
I agree. And honestly, I don't even trust ds's pediatrician all that much. We only go when I know something is really wrong or if I simply need his advice for my own piece of mind. He asks leading questions, too. Actually, now that I think about it every doctor I'VE had has pretty much asked me what I think is wrong and what I'd like to do to fix it.

It makes me wonder if this is simply how doctors run their businesses... a parent shows up, tells them what they just KNOW is wrong, the doctor confirms it (whether it's true or not), parent pays the fees, and that's all she wrote.
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Old 06-25-2014, 04:10 PM
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I agree. And honestly, I don't even trust ds's pediatrician all that much. We only go when I know something is really wrong or if I simply need his advice for my own piece of mind. He asks leading questions, too. Actually, now that I think about it every doctor I'VE had has pretty much asked me what I think is wrong and what I'd like to do to fix it.

It makes me wonder if this is simply how doctors run their businesses... a parent shows up, tells them what they just KNOW is wrong, the doctor confirms it (whether it's true or not), parent pays the fees, and that's all she wrote.
See, that's where our Ped is different! He really doesn't just care about the bottom line of money making. He has gone above and beyond to help our family in times of need. We have had serious illnesses with one of my sons and I can tell the difference in his face from "yep he's got a cold/strep/flu" to "let's bring in the pulse-oximeter" or when he asks him to say certain things while listening to his lungs. He knows me well at this point, we've gone to him on and off for 15.5yrs now. I don't just want an Rx and a note to return to work. He knows I want my child to get BETTER!! I have taken in an ex-DCB numerous times because I was concerned about him and mom wasn't. I could always tell when he was sick by his eyes getting red and puffy and he would always run a low grade fever. One time I insisted on him being seen and told her I would take him myself if I needed to and he was SO sick! I could tell immediately our dr was worried. He's called me at home after hours, he asks my mom how we're doing when he sees her, my dh has worked for him in his home as an electrician. I just love the man!! I really despise most drs but he has a special place in my heart. BUT his partner is an idiot!! She is the type to just write a note and say "oh he's ok to go to daycare" when he isn't!! I cannot stand her! I can't tell him that though!! LOL
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Old 06-25-2014, 04:46 PM
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These stories are what made me think of the anti- antibiotic class I took a few years ago. This training made it sound as if providers were insisting that doctors provide antibiotics. Even if they were - what doctor would provide a prescription because a provider demanded it?
It sounds more like some doctors need to grow some integrity and some backbone and not prescribe something unless it should be prescribed. And not give in to the demands of parents for a "return" note to child care unless that is called for either.
Sure, parents are caught between a rock and a hard place sometimes. Work, sick child, it's not easy. But that does not mean that a sick child belongs in group care.
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Old 06-25-2014, 06:29 PM
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Hunni Bee Hunni Bee is offline
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*sigh*

All this is, is another person who feels as though daycare, especially home daycare, shouldn't operate as actual businesses, but rather some sort of benevolent goodwill organization that seeks ease every wrinkle in the parents brow...by offering special.

And now in society, because you all are clearly overtaxing and weakening the health care system by not taking care of sick children. How could such benevolent public laborers behind such a dastardly situation?

Did she ever think about the fact that if a dc provider takes care of one really sick kid, she will undoubtedly will be taking care of two or more very soon, and with the cycles of terming and enrolling, kids will be sick in this daycare all the time? Maybe not in all cases, but you get the idea. Then she'll be writing an article describing how daycare are melting pots of disease, if she hasn't already.

Bottom line, we are not in business of taking care of sick kids unless we are. It shouldn't be forced on us.

As a parent as well, my kids health is my job. Like BC said, these illnesses would not knock these kids out if they were healthier to begin with. My 11 month old was born two months premature, and has attended daycare since three months. Outside of RSV and a couple tummy bugs, she has not been nearly as ill in her first year as i was told she would be. I do everything i can to bolster her immune system and I don't fill her with meds every time she gets a little sniffle, nor do I run to the ER constantly. It's called parenting

This woman is backward.
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Old 06-26-2014, 07:34 PM
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Littleplanet Littleplanet is offline
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I know this is an older post but I thought I would share my experience with HFM that went crazy through my daycare.
June 2014.
On a Monday, a parent brought a child in with a rash that he woke up with. She thought it was bug bites, which it did look like. He was miserable all day and I told her it didn't look like bug bites. On Tuesday, she said she thought it was Poison Ivy. She gave him an oatmeal bath the night before and it seemed to help him. No fever and it did look like poison Ivy. (I should have said to keep him home then) Wednesday, my husband called-he stayed overnight for work and said he thought he might have what the child had so I called the mom and told her she needed to take her son to the dr because whatever it was, it must be contagious. She said she had called the dr the night before and they told her to bring him in the next morning. she was still going to bring him over and call for an appointment. I told her no he had to be seen first. So, she takes him to the dr. It was HFM but not contagious anymore. She brought him back to the daycare and he stayed the rest of the week with blisters and tons of bumps. But the dr said he was fine. Now, with no experience with this before I let him stay.
Friday comes and my 20 year old daughter who works with me, gets a sore throat and becomes very sick on Sat. We suspect she has it. Then I get it, my 23 year old son gets it on Sunday. I call the daycare families and tell them we are closed until Wed because we all have it. We go to the dr. on Tuesday, can't get in until then. And the dr. closes us down until the following Monday. Now, my 20 and 23 year olds get it really bad with the blisters in the mouth, on the hands and feet and it is very itchy and very painful. I have spots and mouth blisters and then my 24 year old comes down with it. My husband did in fact have it, which at first the dr. told him he had an allergic reaction. So, my whole family came down with it even though we washed our hands and disinfected everything. We lost over 1200 dollars that week because a dr. told us the first child was not contagious and he was.
June 26th. My daughter is still healing from this. Her hands and feet and peeling. I have never seen anything like this before. I also had to tell a family they had to stay out the next week because they had the signs for it.
I learned a huge lesson this past month. No rashes are allowed to come in until seen by a dr. I'm not even sure the drs. know what they are talking about on this.
Just thought I would share since it is very contagious.
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