Daycare.com Forum
1 2 3 

Daycare.com Forum (https://www.daycare.com/forum/index.php)
-   Daycare Center and Family Home Forum (https://www.daycare.com/forum/forumdisplay.php?f=2)
-   -   Sick Kids From A Physician's View (https://www.daycare.com/forum/showthread.php?t=71946)

NoMoreJuice! 06-24-2014 07:00 AM

Sick Kids From A Physician's View
 
This is ridiculous.

http://www.huffingtonpost.com/claire...ushpmg00000037

Unregistered 06-24-2014 07:12 AM

Not ridiculous
 
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.

MarinaVanessa 06-24-2014 07:12 AM

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. :confused:

Unregistered 06-24-2014 07:14 AM

Please excuse my above typos. On my phone

MarinaVanessa 06-24-2014 07:14 AM

Originally Posted by Unregistered:
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.

NoMoreJuice! 06-24-2014 07:16 AM

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.

craftymissbeth 06-24-2014 07:26 AM

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 ;)

Maddy'sMommy 06-24-2014 07:28 AM

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.

craftymissbeth 06-24-2014 07:31 AM

Originally Posted by NoMoreJuice!:
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. :rolleyes:

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.

NoMoreJuice! 06-24-2014 07:37 AM

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!

craftymissbeth 06-24-2014 07:43 AM

Originally Posted by NoMoreJuice!:
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.

Unregistered 06-24-2014 08:05 AM

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.

Leigh 06-24-2014 08:10 AM

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?

Blackcat31 06-24-2014 08:14 AM

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?! :rolleyes: :rolleyes:

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. ;)

Unregistered 06-24-2014 08:19 AM

And hopefully they will have more sense than you :) Doctor.

drseuss 06-24-2014 08:21 AM

Originally Posted by Blackcat31:
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?! :rolleyes: :rolleyes:

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. likethis

daycare 06-24-2014 08:31 AM

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................

debbiedoeszip 06-24-2014 08:33 AM

<<<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.

Blackcat31 06-24-2014 08:39 AM

Originally Posted by daycare:
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.

craftymissbeth 06-24-2014 08:40 AM

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)

Blackcat31 06-24-2014 08:45 AM

Originally Posted by craftymissbeth:
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 :lol: :lol: :lol:

KiddieCahoots 06-24-2014 09:31 AM

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.

nannyde 06-24-2014 09:51 AM

Originally Posted by Blackcat31:
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 :lol: :lol: :lol:

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.

Indoorvoice 06-24-2014 09:53 AM

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.

NeedaVaca 06-24-2014 10:00 AM

Everyone should share their opinions with the Dr! Here is the Facebook link :)

https://www.facebook.com/ClaireMcCarthyMD

daycare 06-24-2014 10:05 AM

Originally Posted by NeedaVaca:
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.

craftymissbeth 06-24-2014 10:09 AM

Originally Posted by daycare:
-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.

SunshineMama 06-24-2014 10:14 AM

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.

CraftyMom 06-24-2014 10:18 AM

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.

Play Care 06-24-2014 10:21 AM

Originally Posted by daycare:
-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:rolleyes:

SunshineMama 06-24-2014 10:21 AM

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.

nannyde 06-24-2014 10:22 AM

Hmmm

Maybe the good doc could profit from a different perspective. ;-)

CraftyMom 06-24-2014 10:24 AM

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!

Leanna 06-24-2014 10:27 AM

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? :lol:

Naptime yet? 06-24-2014 10:33 AM

Originally Posted by SunshineMama:
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.

Play Care 06-24-2014 10:35 AM

I replied to both the article and her facebook - just couldn't help myself:o:lol:

SignMeUp 06-24-2014 10:35 AM

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 :lol: We do not prescribe meds.

Unregistered 06-24-2014 10:35 AM

Originally Posted by NoMoreJuice!:
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.

gracepatiencelove 06-24-2014 10:38 AM

Originally Posted by Leanna:
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? :lol:

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.

Angelsj 06-24-2014 10:40 AM

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.


All times are GMT -7. The time now is 08:22 PM.
1 2 3