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Old 10-04-2019, 09:05 AM
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littlefriends littlefriends is online now
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Default Don't Want to Give Medications

For those of you that don’t give medicine of any kind how do you explain your reasoning to parents? I changed my illness policy that I won’t administer medication of any kind. (of course because even me having everyone sign a copy of the new policy stating that they’d read it and understand I still have someone asking to be special) I sent a little home two days ago with pink eye symptoms. He went to dr, does have it and got antibiotic. Mom is wanting to know why I won’t give him his medicine (has to have it 4x a day). I have a million reasons why I don’t want to give medicine anymore but I need a professional and unarguable way to tell her NO.
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Old 10-04-2019, 09:42 AM
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Originally Posted by littlefriends View Post
For those of you that don’t give medicine of any kind how do you explain your reasoning to parents? I changed my illness policy that I won’t administer medication of any kind. (of course because even me having everyone sign a copy of the new policy stating that they’d read it and understand I still have someone asking to be special) I sent a little home two days ago with pink eye symptoms. He went to dr, does have it and got antibiotic. Mom is wanting to know why I won’t give him his medicine (has to have it 4x a day). I have a million reasons why I don’t want to give medicine anymore but I need a professional and unarguable way to tell her NO.
I don't administer any meds beyond life saving measures (epi pens, asthma meds, etc- all conditions must have documentation).
Administering meds is a liability. One liability that should be on the parent's shoulders- not mine. My insurance company agrees with me.

Any child needing a medication to get through their day is required to stay home under parental supervision OR they find a provider who will administer meds.

I also require any child needing antibiotics to be on them for 2 full days before returning to my care. Most meds can be handled at home anyway- for example 4x a day (which seems excessive to me btw) can be done at 5am, 8am, 5pm, 8pm. Totally doable at home with some minor schedule changes if necessary.
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Old 10-06-2019, 05:34 PM
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Most doctors will prescribe something that doesn't need 4 x day if the parents asks. Most antibiotics can be given morning and night by the parents, thus eliminating the provider from having to do it.

As for giving the parents an explanation for your medicine policy....you don't owe them one. You don't do it. All they need to know.
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Old 10-06-2019, 08:42 PM
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Most doctors will prescribe something that doesn't need 4 x day if the parents asks. Most antibiotics can be given morning and night by the parents, thus eliminating the provider from having to do it.

As for giving the parents an explanation for your medicine policy....you don't owe them one. You don't do it. All they need to know.
This. And if they persist I would say I am not comfortable administering medicine. And keep repeating no matter what they say to try and talk you into it.
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Old 10-07-2019, 06:13 AM
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I don’t have this policy because I exclude for pink eye until it is gone but I would say “administering medications is beyond my scope of services that I provide as mentioned in my contract”.
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Old 10-07-2019, 06:25 AM
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Would you allow a parent to administer during the day? If so, could mom come during lunch to give medications? If so, you could offer that to mom as an alternative.

I would avoid telling the parents " Most meds can be handled at home anyway- for example 4x a day (which seems excessive to me btw) can be done at 5am, 8am, 5pm, 8pm. Totally doable at home with some minor schedule changes if necessary." This may not be medically appropriate, as the half life of the medication generally drives the number of times it is given daily. Parents should ask their doctor if changing the dosing is possible. You do not need to provide the solution to how they dose. You only need to tell them what services you can provide and work with the parents within your comfort zone.
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Old 10-07-2019, 08:29 AM
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Originally Posted by lblanke View Post
Would you allow a parent to administer during the day? If so, could mom come during lunch to give medications? If so, you could offer that to mom as an alternative.

I would avoid telling the parents " Most meds can be handled at home anyway- for example 4x a day (which seems excessive to me btw) can be done at 5am, 8am, 5pm, 8pm. Totally doable at home with some minor schedule changes if necessary." This may not be medically appropriate, as the half life of the medication generally drives the number of times it is given daily. Parents should ask their doctor if changing the dosing is possible. You do not need to provide the solution to how they dose. You only need to tell them what services you can provide and work with the parents within your comfort zone.
To be clear: I did not intend for the OP to TELL the family how they should handle meds at home... That was an EXAMPLE of how medicines that need to be administered multiple times a day can be handled at home.

The schedule CAN be altered to be on the parent's time. Most families who request or demand that it has to be done on the provider's time are just unwilling to do the work themselves. Especially eye drops (in my experience).
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Old 10-07-2019, 04:21 PM
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In general, medications (particularly antibiotics) that are to be given 4 times per day should be given every 6 hours to prevent the level of antibiotic from going too low, making it ineffective and increasing the chance of antibiotic resistance. Again, if OP does not wish to give medications (which is understandable), the she does not need to. However, the advice that they can be given 4 times per day outside of DC hours is not necessarily sound medical advice. A parent who does not dose as you suggest does not mean the parent is being lazy or trying to inconvenience the provider. The parent needs to work with her provider to find a plan that will work for her child's medical needs in the care setting she has chosen.
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Old 10-08-2019, 09:41 AM
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Originally Posted by lblanke View Post
In general, medications (particularly antibiotics) that are to be given 4 times per day should be given every 6 hours to prevent the level of antibiotic from going too low, making it ineffective and increasing the chance of antibiotic resistance. Again, if OP does not wish to give medications (which is understandable), the she does not need to. However, the advice that they can be given 4 times per day outside of DC hours is not necessarily sound medical advice. A parent who does not dose as you suggest does not mean the parent is being lazy or trying to inconvenience the provider. The parent needs to work with her provider to find a plan that will work for her child's medical needs in the care setting she has chosen.
Such important info. 24/4 = 6

I am on a 5x med right now
(Q= 4.8 hours ). It is a nightmare. I will be so glad when it is over.
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Old 10-08-2019, 04:41 PM
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I completely agree that almost all medications can and should be given outside daycare hours (especially things like amoxicillin typically prescribed for strep or ear infections).

As a parent, I would prefer to administer myself for several reasons

1) the first time my child had amoxicillin for an ear infection, I wondered why the bottle had about 50 mL more than she needed to take as prescribed. She promptly spat out the whole first dose, with pink stains all over the bed and carpet. I had to decide if she got any and how much more to give. I recall chucking to myself regarding my experienced pediatrician that it was not his first rodeo, as I did not need to call in for more medications to complete treatment.

2) I have also spilled (on cream carpet) almost a whole bottle of pink amoxicillin and had to call to get it refilled.

3) Parents should almost always give at least the first 3 doses before a child returns to care (in my opinion), even if dosing is done outside of daycare hours. I would not put my child in care or school unless she had received 3 doses of medication, especially if a new medication (exception-allergy medication that she has had in the past such as nasal flonase or as needed medications like an Epi Pen). My child has even had some weird behavior issues after taking things like Zyrtec and side effects from Benadryl. That is my responsibility to sort out, not a provider with a group of children to monitor and care for.

Even when grandma kept my little one when she was home sick from preschool, I would come home from work to give medications if she needed them during the day, because I think it is the parent's responsibility, not daycare, not preschool and not even a doting grandma. Taking care of your own sick child is part of being a parent.
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Old 10-10-2019, 11:15 AM
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Thanks everyone! I did tell her she’s welcome to come here and put it in herself. I just gave her the “I just don’t feel comfortable” 10x until she gave up. She ended up just picking him up early for a special day together which was nice. She told me as she was leaving with him to send some luck her way and when I asked why she replied that he throws a pretty big fit because he hates having the drops done. So I bit my tongue...
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Old 10-10-2019, 11:56 AM
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Thanks everyone! I did tell her she’s welcome to come here and put it in herself. I just gave her the “I just don’t feel comfortable” 10x until she gave up. She ended up just picking him up early for a special day together which was nice. She told me as she was leaving with him to send some luck her way and when I asked why she replied that he throws a pretty big fit because he hates having the drops done. So I bit my tongue...
WOW!!! This ia why I do not believe anything a parent says.
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