To think this schools policy on prescribed medicines is wrong?

(135 Posts)
ForrinForrinerFromForrinLand Thu 10-Oct-13 18:24:34

I just wondered weather there is a standard rule about this for all primary schools?

DN has just started school in. He suffers from severe asthma, its especially bad in winter months to the point where he has hospital stays monthly. His school initially requested that an inhaler was taken in. However after a little probing it seems they haven't been giving it to him. He's very wheezy. When asked the teacher responded by saying that he didn't request it. They expected a 4 yr old to prompt them every 4 hours for an inhaler! And now the school is saying they won't be responsible for ensuring the inhaler is regularly given to DN.

Now I'm a little shocked as I assumed schools had a duty of care. And certainly had to have plans in place for children who needed prescribed medication during the school day.

Spirulina Thu 10-Oct-13 18:26:39

huge class sizes and little can they tailor themselves to the care of one child? also,has he had attacks at school? has he been hospitalised from school?

I thought inhalers were only given as required

ChestyCoffin Thu 10-Oct-13 18:28:38

Sounds common.

Friend is having issues with 4 year old DGS, newly diagnosed diabetes but school won't check his glucose levels hmm

Trapper Thu 10-Oct-13 18:29:30

That alarming. Do children on regular medication have to be home schooled then?

notanyanymore Thu 10-Oct-13 18:32:12

But the children are in their care, and therefore it is their responsibility to ensure their safety. People die of asthma and diabetes. These medicines form part of the basic care for these children.

ForrinForrinerFromForrinLand Thu 10-Oct-13 18:32:51

So huge class sizes and little time means that a child with a serious medical condition is simply forgotten about. hmm
I'm not asking for special treatment for a PFB I can assure you of that. No, he hasn't had any attacks at school, yet. But it doesn't fill you with confidence if they're not willing to administer an inhaler!

Sirzy Thu 10-Oct-13 18:33:00

What have the parents asked?

DS has severe asthma and is currently at the pre-school attached to the school he will go to next year. I have given the school full written instructions, talked to all of the staff involved with him about specific signs and symptoms for him and exactly what is needed when a problem.

I don't think just sending an inhaler in and then expecting school to know when to give is fair.

Spirulina Thu 10-Oct-13 18:33:01

some schools don't put sunscreen or plasters on!

Sirzy Thu 10-Oct-13 18:34:05

And I don't think expecting a child with severe asthma to be able to ask for their inhaler is asking a lot. DS is only 3 but because of the severity he knows when he needs it and will ask

ForrinForrinerFromForrinLand Thu 10-Oct-13 18:34:50

Trapper that's what I was thinking.

What other option do you have if the school isn't taking a medical condition seriously?!

Spirulina Thu 10-Oct-13 18:35:26

serious medical condition? so what if half the class have something which needs medication?how are the teachers supposed to teach? he knows how to administer it himself?

think chools are damned if they do and damned if they dont

teacherandguideleader Thu 10-Oct-13 18:35:56

Don't know about primary but that isn't the case at my secondary. Some children have lunch etc at different times due to medical needs. Sounds wrong to me.

teacherandguideleader Thu 10-Oct-13 18:37:18

We employ someone whose job is to ensure these things happen, it is not the teacher's responsibility.

ForrinForrinerFromForrinLand Thu 10-Oct-13 18:38:38

sirzy we'll have to disagree on that one. I think all children are different, I certainly wouldn't expect a 3yr old to manage their dosage.

They've requested a meeting with the head. The school didn't just as for inhalers to be sent in. There were forms to fill in regarding usage.

Morgause Thu 10-Oct-13 18:39:41

DC1 had chronic asthma and I used to have him home for dinners until I was sure he would remember to take his inhaler at school. That way I knew he had taken it and was able to make sure he had used it properly.

From the age of 4 he was able to tell teachers if he needed his ventolin inhaler.

Teachers cannot be expected to be responsible for the health needs of all the children in their classes.

ChestyCoffin Thu 10-Oct-13 18:39:49

spirulina inhalers aren't only when required, there's lots of different regimes.

Bring back the school nurse!

Iwaswatchingthat Thu 10-Oct-13 18:40:01

His parents probably need to be more explicit about when he needs it - like asking them to give him a certain number of puffs of it it before lunch.

They will need to sign when it has been administered and do the time - he needs a list with a date and time column for the staff to initial.

If he needs it once in the school day then the school will only have to give it once. The parents/childcare could do the before and after school ones.

ForrinForrinerFromForrinLand Thu 10-Oct-13 18:40:19

spirulina are you delibarately trying to be obtuse?

Does he just need it every few hours or does it depend on how he is?

Spirulina Thu 10-Oct-13 18:41:15

ok,so what is his regime op?

uselessinformation Thu 10-Oct-13 18:42:04

The school should put a plan in place for dealing with a child with a chronic condition. You need to meet with the school and draw up a written plan with the names of the staff responsible for carrying out the plan. Those staff need to be trained by you and an asthma nurse. In fact you could ask your asthma nurse what has happened in other schools. Apart from the particular trained staff, all other staff need to know what to do in an emergency.

Sirzy Thu 10-Oct-13 18:42:11

Asking for their inhaler isn't managing the dose though. I think it is vital for children with chronic health conditions to understand when they need treatment - they are the one who knows before others when they are feeling rubbish.

It sounds like it has been badly handled all around. If it is that serious surely the parents would have had a meeting well before he started to ensure that they were confident in him being cared for?

Spirulina Thu 10-Oct-13 18:42:27

*ForrinForrinerFromForrinLand Thu 10-Oct-13 18:40:19

spirulina are you delibarately trying to be obtuse?*


ForrinForrinerFromForrinLand Thu 10-Oct-13 18:42:34

He needs to take it every 4hrs. Daily.

Sirzy Thu 10-Oct-13 18:43:53

So why didnt the parents sort that before he started? I am really struggling to understand that side of things.

Morgause Thu 10-Oct-13 18:44:32

That's why I had my DC home for his dinner. Inhaler at 8.30 am then 12.30 pm while home for his dinner. Then again after school.

ForrinForrinerFromForrinLand Thu 10-Oct-13 18:45:01

>>>serious medical condition? so what if half the class have something which needs medication?how are the teachers supposed to teach? he knows how to administer it himself?

Are you asking if asthma is a serious medical condition? I mean really?

LittleMissWise Thu 10-Oct-13 18:45:54

I agree with Sirzy.

DS2 is a severe asthmatic. By 4 he was perfectly able to ask for his inhaler if he needed it.

When DS2 went to pre-school and school I sent in a letter along with the inhaler so they knew exactly when and how much to give.

Did the parents fill in the forms and give them to the office staff? If they did, they need to make the teacher and TA aware as well.

ForrinForrinerFromForrinLand Thu 10-Oct-13 18:48:03

He's only just started doing full days.

My questions really were;

Is the school obligated to help manage his medication whilst at school?

And if not what do other parents do if daily meds are needed?

uselessinformation Thu 10-Oct-13 18:48:27

Also, most people wouldn't let a child with a chronic condition start school until all of the plans were in place for dealing with it.

ForrinForrinerFromForrinLand Thu 10-Oct-13 18:49:31

YY forms were filled in and given to the office.

Sirzy Thu 10-Oct-13 18:50:07

Did the parents sit and talk to the teacher before he started?

LittleMissWise Thu 10-Oct-13 18:52:16

So the parents need to make the teacher and the TA aware then. All they need to do is tell them or write a little note.

ForrinForrinerFromForrinLand Thu 10-Oct-13 18:52:37

I'm not sure of the exact details to be honest. Apart from the form filling bit. I was just a little taken aback at the schools response.

LittleMissWise Thu 10-Oct-13 18:54:20

I totally agree, Useless, before DS2 went to secondary school I had a meeting with his tutor, the head of his house, and the medical person at the school so I knew everything was in place.

YouTheCat Thu 10-Oct-13 18:54:51

At our school first aiders will administer or supervise medication so long as forms are filled out.

If your ds has to have his meds at a regular time, then school should sort this out.

We've got kids on ritalin, kids with diabetes, asthma, various kids with antibiotics - should they all stay off/be home schooled? Would you allow a diabetic child to do their own blood sugar check independently at 4?

Sirzy Thu 10-Oct-13 18:55:35

Before complaining about the school it is probably worth finding the full story out then! Like I said sounds like failings on both sides.

I think as the parent of a child with severe asthma it is becomes such a part of daily life for you you easily forget that others aren't used to it and aren't as finely tuned into the little signs that something isn't right. Teachers may be used to dealing with 'normal' asthma but when it gets to the more severe end they won't be as used to that which is why they need it explaining in person and with a constant communication between home and school

jacks365 Thu 10-Oct-13 18:56:26

I had to go into school or if I couldn't appoint someone else (not staff member) to go in and administer my dd's medication. The school would deal with emergency use of things like Inhalers, epi pens etc but not regular needs.

CitrusyOne Thu 10-Oct-13 19:00:16

It sounds like it's down to the school. At my school we had a little boy in reception class who got diagnosed as diabetic. All staff had to have training on the condition and 2 staff working closest with him had to have training on administering his insulin. Admittedly as time went on the little boy was able to administer the insulin himself, but staff still supervise him doing it every day.

candycoatedwaterdrops Thu 10-Oct-13 19:01:20

It's bonkers IMO and no, YANBU.

tilbatilba Thu 10-Oct-13 19:02:36

I work in a school in Australia and it is most certainly the class teachers responsibility to assist or remind a small child to take their meds according to parental&doctors guidelines - it falls under duty of care. Obviously there are a raft of policies and procedures to follow but all very straight forward - clearly named medication, original packaging, pharmacists directions etc etc.
There is no way a 4 yr old would not receive his 4 hrly inhaler or a top up when needed.

uselessinformation Thu 10-Oct-13 19:02:37

Just to reiterate, it's not about filling in forms, having a chat with the teacher or sending in a little note. A proper meeting needs to be set up and written plans put in place and training given.

BrianTheMole Thu 10-Oct-13 19:06:30

Ask to see their policy on medication management. Really someone in the school should be able to take responsibility for this. Its unrealistic for a 4 year old to take sole responsibility.

uselessinformation Thu 10-Oct-13 19:08:34

A class teacher doesn't have to be responsible for administering medication, but of course in an emergency they would. However, for chronic conditions a named person (and a spare for back up) will be on the child's management plan.

pigletmania Thu 10-Oct-13 19:11:35

Yanbu at all, schools are in loco parentis and have a duty of care towards the child. You cannot expect young children to be enirely responsible for medicating, not all children will be mature or have the right skills. Every school should have a nurse, or a first aider who is responsible for this

TwoAndTwoEqualsChaos Thu 10-Oct-13 19:12:47

I was annoyed that my YrR son asked for his inhaler and wasn't given it, especially after I approached the Teacher and TAs and explained about it (and filled in their forms, too!).

TwoAndTwoEqualsChaos Thu 10-Oct-13 19:13:54

Oh, and they had removed it from his bag, so he couldn't do it himself.

MidniteScribbler Thu 10-Oct-13 19:15:48

There needs to be an asthma management plan put in place. That means that a doctor needs to be involved and the asthma medication formally prescribed. The school won't give medication that hasn't been formally prescribed by a doctor at such a regular interval. If the doctor has only prescribed the inhaler as "as needed" then that is not acceptable, if it must be done every four hours, then the prescription needs to state what times and in what dosage the medication must be given.

arethereanyleftatall Thu 10-Oct-13 19:18:53

I agree with sirzy and little miss wise. Yes, the teachers should measure the dose, and should be responsible, but only once a proper plan was put in place by the parents. If it we're my child, I wouldn't have just filled in a form and forgot about it. I would have made damned sure the teacher knew what she,was doing, BEFORE his first day.
But, assuming he's 4, he must be used to this, inhaler at breakfast, lunch, tea and before bed. I'm very very surprised his parents didn't think to mention it to him that he should be requesting his inhaler at lunch time

pigletmania Thu 10-Oct-13 19:20:22

That is disgusting twoandtwo angry, obit be their heads if anything happened to him

sweetestcup Thu 10-Oct-13 19:21:39

spirulina why did you put a question mark after writing "serious medical condition", I know things can be misconstrued on the internet but that looks as if you are questioning it, do you realise people can and still do die of asthma attacks, its not the case of being just a little breathless!

martinedwards Thu 10-Oct-13 19:25:13

the clue is in the teacher's job title.


not Nurse, not Doctor

when there are 30 kids in the room, yes they'll react to a need, but they are not trained or paid to treat illnesses, which, if they give the child two puffs instead of 3, you'll drag their over worked butts into court.

MrsDeVere Thu 10-Oct-13 19:31:14

You don't have to be a doctor or nurse to be attentive to the needs of a child with potentially fatal condition.

A proper plan needs to be put in place to meet the OP's child's needs.

What is the alternative?

Not all children are able to make their needs known at four. For lots of reasons.

Littlespeckledowl Thu 10-Oct-13 19:31:38

It's not about teacher's being too busy, or not caring. As a general rule, staff are not allowed to administer medications. Usually, asthmatic children administer their own medications, with staff supervising younger children as necessary. At our school, if a child was, for example, taking a course of antibiotics, a parent would need to come in to administer these if necessary. A serious, chronic condition requiring daily medication requires special consent forms signing and a care plan putting in place. You need to meet with the school and discuss the requirements so they understand exactly what's jnvolved.

TwoAndTwoEqualsChaos Thu 10-Oct-13 19:35:51

Piglet I was very unamused and still haven't got to the bottom of it due to having four children who are all, to one degree or another, ill, especially as I had flagged up his cold and the fact it exacerbated his breathing problems. Fortunately, he is an "as and when" user, so not as severe as others, but he isn't a child who would ask unnecessarily and it's jolly hard to instill confidence in their actions when something like that happens and I reminded a different TA the following morning.

Noggie Thu 10-Oct-13 19:36:01

Teachers are not allowed to administer medication other than in an emergency so every school should have a member of staff (probably non teaching) to help the child administer their own medicine. It is not ideal but class room teachers cannot be responsible for medication. Schools need nurses!

IHateWinter Thu 10-Oct-13 19:38:00

YANBU. Have to say I would ensure DS has one concealed in his bag or pocket somewhere. I always carried one in school myself. Think what happens if you're in the playground and you have a sudden severe attack. Hardly being able to speak, you have to alert a teacher or dinner lady. They then have to go into the office where the inhaler is kept, retrieve it, and bring it to you. By then you could need an ambulance.

I wouldn't risk it. By all means give one into the school and tell DS to take it. But let him carry one in his pocket just in case.

Screw the rules. Asthma is serious. People often treat it flippantly and it annoys the hell out of me.

ForrinForrinerFromForrinLand Thu 10-Oct-13 19:38:54

I'm happy to be told I am completely and utterly unreasonable.

I say this again. I would not expect a FOUR YEAR OLD to be responsible for alerting a teacher at FOUR HOUR intervals that he needs his inhaler.

Yes teachers are busy. Yes there are other children's needs to consider. Yes I agree with other posters. If it was my child I would make damn sure that those working closest with my child was made fully aware of his needs BEFORE he started school. But it is what it is. It's happened.

Thanks to the posters who have shared their experiences. It's been an eye opener for sure.

mrsjay Thu 10-Oct-13 19:40:37

that is strange and bloody dangerous they dont give him it when dd was in primary they were great the infant years all the inhalored (not a word) went to the school office and the school nurse or an SLA gave it out I hope you can get to the bottom of it and your son gets his medicine when he is supposed too

Sirzy Thu 10-Oct-13 19:41:32

But the simple way for him to do it is to remember that when he has his dinner he needs his inhaler. That isn't a lot to ask a 4 year old to remember surely? And then come up with a system by working WITH the school to ensure that happens.

I'm not sure why everyone seems to be over complicating that? When everyone is lining up you DN goes to the teacher has his inhaler and then carries on his day! simple.

Finola1step Thu 10-Oct-13 19:42:34

Hi Forrin. I am an Assistant Head of a primary school. Your son's school is failing in its duty of care to your son. This may well stem from a confusion over his exact requirements rather than anything untoward. Your next step is to write everything down on paper (if you have not done so already). Detail what needs to be done and when. It is perfectly reasonable for a qualified first aider to administer or oversee a child administering their own pump. Copy of letter to class teacher, Senco and Head.

At my school we have a whole troop of children who after their lunch, go straight to the office to have their pump. The younger ones in Reception and Year 1 are reminded by an adult. It doesn't take long for the children to get the hang of such a system.

You could request a meeting with the school's Senco and the school nurse attached to the school to draw up a care plan. Your son is entitled to his medication during school time. Do not let them fob you off.

ForrinForrinerFromForrinLand Thu 10-Oct-13 19:44:29

FFS martin do you have any experience of a seriously sick child.

I get really pissed of with stupid comments like yours.

Teachers are not just teachers. There are lots of aspects of the job that doesn't fall under "teaching" that is expected of them. And frankly if they're not prepared to show a little compassion they're in the wrong job!

ForrinForrinerFromForrinLand Thu 10-Oct-13 19:45:53

Thanks Finola

MidniteScribbler Thu 10-Oct-13 19:46:05

I would not expect a FOUR YEAR OLD to be responsible for alerting a teacher at FOUR HOUR intervals that he needs his inhaler.

But you can't expect a teacher to adhere to four hourly intervals. They don't know when the dose was given in the morning before school. 6am? 8am? What if the parent forgot that morning? When does that interval start? The prescription needs to state exactly what time the medication needs to be given, and the parent should try and organise it so that it falls at a time that works within the class setting if possible (eg not right in the middle of a lesson, but at the start or end of a break) to make it easier for classroom management.

NellieTheEllie Thu 10-Oct-13 19:47:43

A school is under no legal obligation to administer medication. Right or wrong, that is the case. Some schools take this literally and refuse to administer ANY medication (including prescribed antibiotics etc), some will administer prescribed medication only and some will give anything you ask them to!
This is often a deal breaker when parents are choosing the school for their child with chronic illness. As stated above, it is something they should have discussed prior to the child starting school.
If it is a chronic condition (diabetes, asthma, anaphylaxis etc) then schools often accept this (anti discrimination and all that) but a care plan will need to be put in place with input from their medical team.
I'm guessing if the childs asthma is that bad and NEEDS regular daily medication, then this needs to be discussed with the parents, school and the doctors, and a care plan put in place.
The care plan will outline the problem, the needs of the child and how the school will meet these needs (eg, by giving meds every 4hrs) This will then be adhered to by all relevant staff, and will be a point of reference for anyone else. It will also be sent to the county council insurance dept, because unfortunately that's why medication in schools is such a nightmare - because people now complain and sue.

colleysmill Thu 10-Oct-13 19:50:05

I work with children with a very specific medical condition which requires medication at school.

Usually one of the team (nurse or physio usually) will liaise with school and parents, organise training in the condition and school write a school health plan with input from parents and the professionals covering medication, any specific requirements and what to do and who to call in an emergency.

In primary schools usually a ta is assigned to ensure this happens with others aware in case that ta is away for any reason. Bit different in secondary school where we try and encourage the children to administer their own meds but we still encourage school to have a plan in place so there can be no confusion to what meds they are carrying and why.

Ultimately the aim is to make life as regular as possible for the children making sure they are in school and the meds are in place to prevent them becoming ill which means their attendance decreases.

I think in the op case the first step is to approach school and sit down and talk about what is needed when and why. School can't help if they don't know what is needed and usually they are very open to input if there is a medical need.

mikkii Thu 10-Oct-13 19:54:20

In the summer term DS came off his bike and the grazes got infected.

I wrote explaining he would not be at school until his antibiotics had finished as he was on doses 4 times daily which could not work around school. I asked for his homework to be sent via DD so he didn't get behind.

The school office called to say that since he was not ill they would administer the medication (could have something to do with the expected OFSTED?)

morethanpotatoprints Thu 10-Oct-13 19:55:30

My friend was told the school was under no obligation to treat her dd who has diabetes. So she goes home for lunch, her mum checks insulin levels and administers any medicine as required. The school have been given info of what to do in an emergency and friend is happy for school not to be involved. She says they aren't doctors or nurses and wouldn't trust a teacher to know what they were doing.

My dds old school wouldn't even give plasters in case of allergic reaction

pigletmania Thu 10-Oct-13 19:56:49

Bring back the school nurse, or welfare Officer, ack in the day.

Tabby1963 Thu 10-Oct-13 19:57:55

OP, if you have a doctor's prescription which states that the inhaler has to be used every four hours, then the school has to adhere to that prescription. It is exactly the same as if it was prescribed medicine or eye drops etc.

At my school we have support staff who have completed first aid training who administer all medication for pupils, at the time they require it.

I haven't heard of inhalers being used every 4 hours, usually it is as required and the child will alert a member of staff to ask for access to their inhaler (if they are in the playground they will be escorted inside immediately and supervised while taking the correct dosage then class teacher informed). However, if your GP has requested this, and it is on his prescription, then it should be adhered to.

Hope you can sort it out pronto.

ForrinForrinerFromForrinLand Thu 10-Oct-13 19:58:57

Children going home for lunch only works if one parent is a SAHP.

Anyway, thanks for all the input.

I would expect the school to take on the responsibility. They should be able to absorb a child's additional needs (i think its 16 hours pw) and ensure he takes his meds.

martinedwards Thu 10-Oct-13 20:02:44

forrinforin oh sod it you know who you are...

yes, as a parent of 4, 20 year teacher (secondary) and 1st aider I have lots of experience of kids with illnesses.

also lots of experience of parents who expect the school to do EVERYTHING and accept no responsibility whatsoever.

It is NOT the teacher's job to administer medication.

in my last school we had a former nurse who was a classroom assistant who made sure that all the kids who had medication got them.

as a classroom teacher, if I saw a kid who was off colour I took notice and helped if I could, but there was no way on earth I'm going to crack open the medicine cabinet.

having ended up in a Police interview room for standing between two 11 year olds who wanted to fight (naturally no case to answer) the idea of becoming some sort of dispensing chemist with no extra training, insurance or pay?

no thanks

BetsyBell Thu 10-Oct-13 20:03:21

I suspect this is a miscommunication issue (I hope) - lots of kids have inhalers at school but not many of them need to have them administered regularly. Please explain to the teacher than he does need it and isn't able to remind them.

Usually the TA would be responsible for actual administering so see if you can arrange to talk to teacher and TA together to show them what's needed.

stillstanding29 Thu 10-Oct-13 20:11:04

Hi Forrin. I thought that was a really helpful message from Finola. Your DN should be being supported. He should have a care plan. If you are struggling with school I have a book called - a parents guide to the equality act and their children's education by Geraldine Hills - which I have found really useful when arguing with schools.

School should make reasonable adjustments to allow your DN To attend school safely or they could be discriminating against him. I found the every child matters or counts (I can't remember) government literature which is online very useful to back up my argument too.

Keep talking to school and hopefully they'll see sense.

Children with medical needs are entitled to an education and school should make reasonable adjustments to enable your DN to attend school safely and without it compromising his/her health.

MrsDeVere Thu 10-Oct-13 20:11:41

I work for the specialist children's service.
Our community nurses regularly train nurseries and schools to deal with ng feeds, epipens, trachies, suction, in fact anything and everything a child needs to enable them to to attend school.

No excuse.

Children have a right to as normal as life as possible and if that means a school getting their arse in gear and getting free training for a few members of staff they should bloody well do it.

Anything else is unacceptable and lazy.

ForrinForrinerFromForrinLand Thu 10-Oct-13 20:15:13

martin well I hope my child never comes across a teacher like you.

AmberLeaf Thu 10-Oct-13 20:24:46

I haven't heard of inhalers being used every 4 hours, usually it is as required and the child will alert a member of staff to ask for access to their inhaler

There are two kinds, preventative [taken at regular intervals] and relievers [taken when needed]

I don't see how this kind of thing doesn't come under duty of care/loco parentis.

MrsDeVere Thu 10-Oct-13 20:27:33

The way inhalers are given has changed a lot over the years.
DC5 is currently on the step up, step down approach.

This could mean he needs his inhaler 4 times a day.

His nursery is more than happy to give it too him and they wouldn't wait for a 3 year old to ask.

He wouldn't. He doesn't know that he is having an attack. He runs around as normal. He is just that sort of kid.

mrspremise Thu 10-Oct-13 20:27:35

Inexcusable. The school that I work in not only gives antibiotics when needed, but also does diabetic glucose tests/insulin injections as needed and asthma etc inhalers/nebulisers as needed. All we ak for is a consent form and arrange training as necessary. This strikes me as lazy and unhelpful on the part of the school.

Sirzy Thu 10-Oct-13 20:28:29

With severe asthma often the reliever is needed on a regular basis too just as part of the basic management. At the moment DS has 5 puffs of ventolin as his morning and evening routine but often when he is bad he also needs extra during the day and there are times when his normal treatment involved dinner time ventolin - normally over winter!

mummeeee Thu 10-Oct-13 20:45:11

Forrin, it sounds like you are having a hard time ( both on mn and in rl) and I really don't think it should be so

My dd(5) (in year 1) has a rare chronic condition and requires certain care and medication at school.

Fortunately, her condition was fairly stable when she started year R. I prepared a lot of written information & talked to the school and the nominated person from the local authority regularly from the first open day through till the will be ongoing. I arrange times to train staff etc. Because my dd has multiple needs, we got something called an IPA ( which, and I'm not an expert, appears to be much less than a statement & doesn't carry any specific funding, but allows the school and parents to have a formal agreement, which is reviewed regularly).

I prepared a spreadsheet with what to do in certain circumstances, what constitutes an emergency etc. I have another spreadsheet with what medications are required on which days of the week etc.

Basically, dd needs different care throughout the day, so it is perhaps a bit more complicated than your ds, but from a medications point of view, the office staff do her medications every lunchtime. They have a fridge to store the medications in and she goes to the office every lunchtime and takes her meds.

I completely agree that the inhaler should be achievable in your ds's school. I would advise you to make an appointment with the senco to discuss it and explain what is required. Good luck.

mummeeee Thu 10-Oct-13 20:47:07

Oops, just re-read original post. I mean dn not ds.

mrslaughan Thu 10-Oct-13 21:02:03

It's the schools responsibility - ask for a meeting with the head teacher, and ask what plan is in place to ensure his medical needs are meet.
People can be so blasé about asthma, but it can kill.
This is about access to education for all, and that means some children need medication administered or tests (as in diabetes) taken.
If no joy with the head teacher I would escalate it to the local education authority.
For advice on this ask in the special needs board.

youarewinning Thu 10-Oct-13 21:14:05

Theres 2 issues here:

1) were proper plans drawn up with community school nurse in place before the child started school with a signed plan to say he'll have his meds at X time?

2)If they weren't then why does a child with such severe asthma attend without plans being in place and if yes why are the school not following this plan?

My DS took AH daily and he didn't have a dose once (year 1) as he didn't go to office for it and they didn't go get him. They tried to blame a 5yo for forgetting. I would have accepted mistakes happen but they were so defensive and quick to blame a 5yo with SN I roasted their arses and provided them with some stats re anaphylaxis and asked for proof their epipen training was up to date.

I'm easy going and as someone who works in education I can see both sides - but I can't abide it when adults blame a child who isn't legally responsible for themselves for their policies, organisation etc not working as well as it could.

Damnautocorrect Thu 10-Oct-13 21:20:41

Isn't this why schools had welfare ladies? But it was decided they weren't needed and ta's could do it?

pudding25 Thu 10-Oct-13 21:25:56

We have a welfare lady at our school who deals with all things like that and the child would be given it when needed.
We also have a diabetic child who has everything done for them at school.

NewNameforNewTerm Thu 10-Oct-13 21:31:10

Has it been made clear to the school that the "blue" reliever inhaler needs to be every four hours. Our asthma permission form that parents sign say something along the lines of "as needed, following directions on the pharmacist's label", which often says as needed. This is very different at regular intervals every four hours.
Was the original form that you filled in when he was less asthmatic and rarely needed it and have you been in or written to confirm any changes?

SummerRain Thu 10-Oct-13 21:40:14

Dds inhaler is kept in the office and she has to ask for it. Standard policy these days. If she's on regular doses I tell her when she'll need to ask for it (before lunch for example) and she lets her teacher know.

Ds2 is 4 with severe speech issues and he's able to tell me if his chest is bad, I do think your dn should be able to tell the teacher if he needs his inhaler, a lot of wheezing isn't obvious to an observer, the teacher really can't be expected to know when he needs it.

I assume the regular doses are temporary whilst he's getting over an attack, the rest of the time he should only be using it as needed so he has to be able to speak up.

northlight Thu 10-Oct-13 21:40:51

This sounds so wrong. Where I teach children on regular medication are catered for. Usually by the school secretary or HT and class teachers know where to find the meds and protocol. Inhalers are kept in the classroom and accessible to children if necessary.

I don't know if its the case everywhere but in recent years there has been a reduction in the number of children using inhalers. You can be pretty sure that if a child has one it is needed.

ForrinForrinerFromForrinLand Thu 10-Oct-13 21:59:16

Ok. Having spoken to Db this evening I asked exactly what steps were taken to ensure the school where aware of his needs.
They had a home visit from his teacher. Where they went into detail the exact support that DN needed. This was confirmed via both the home visit and via all the necessary forms that were filled out stipulating dosage as per priscription. No community school nurse has been involved to date. How

So it does look like the school is somewhat at fault here. Db is arranging a meeting with the head to discuss exactly what plans will be in place going forward to ensure DN is adequately supported.

newname he has only just started reception. And his Asthma hasn't changed in the 5 weeks he's been in school. However it seems to be worse in the winter iykwim.

Does anyone know how an appointment is made with Senco? Is that done via the school? And the community nurse? (Sorry I actually have no experience of procedures in primary schools, my little ones have yet to start.)

Nerfmother Thu 10-Oct-13 22:05:40
ForrinForrinerFromForrinLand Thu 10-Oct-13 22:12:17

Not every 4 yr old is the same. One might be perfectly capable of requesting medication as needed. DN isn't. Yes he knows he's wheezy but if there's something that's more interesting, a game he's playing, then that will take precedence. He doesn't truly understand the implication of not taking his meds. Nor would I expect him to at that age.

NewNameforNewTerm Thu 10-Oct-13 22:13:15

You would need to contact the school for a SENCo appointment. They are responsible for the special educational needs within the school, so it is very unlikely that asthma would come under their remit. Better option would be the headteacher.

Sirzy Thu 10-Oct-13 22:15:17

IMO his parents need to make him realise the importance of that. He is the one living with it he needs to grow up understanding it. If it it as bad as you say then he needs to realise the importance of taking his medicine and asking for it.

youarewinning Thu 10-Oct-13 22:19:30

GP surgery will have the number of your local school nurse.

PeppiNephrine Thu 10-Oct-13 22:25:52

There is a simple answer here. You buy a childs digital watch with an alarm, which you set for the medication time (if every four hours he must only need it once in school time) and you train him to ask for his inhaler when the alarm goes off. A four year old should be able to do this.

MortifiedAdams Thu 10-Oct-13 22:26:49

What tme is Lunch? If it is at 12.30, get him to take the inhaler at 8.30 with you and tell him to take it again at the start of lunch.

he doesnt then have to remember it every four hours - just once a day at a set time.

BrianTheMole Thu 10-Oct-13 22:29:27

I assume the regular doses are temporary whilst he's getting over an attack, the rest of the time he should only be using it as needed so he has to be able to speak up.

Thats not necessarily true. I have severe asthma and have to take the preventative inhaler always. And not all 4 year olds will speak up or remember. Great that your child is able to do this. But if you're not having an attack or feeling wheezy, it is easy to forget to take medication. It is not acceptable to lay the entire responsibility on the shoulders of a 4 year old, because if and when they do forget, their health is put at critical risk. Ridiculous.

nennypops Thu 10-Oct-13 22:31:48

Apart from issues such as the basic duty of care, if a school fails to give essential medication it could be guilty of disability discrimination. Most schools have someone like a welfare bod whose specific responsibility it is to deal with issues like this, either giving the medicine themselves or training and supervising TAs.

NewNameforNewTerm Thu 10-Oct-13 22:34:37

But surely if someone needs to permanently take full dose of the reliever it means the asthma is not under control and the preventers need reviewing?
As an occasional reliever the adults need some input, but it is important that the child starts to learn to articulate his need for it. I can feel inside I need it, without wheezing loud enough to alert others.

KatyPutTheCuttleOn Thu 10-Oct-13 22:34:48

Yes, their policy is wrong. They need to do it and take responsibility for remembering.

I am with OP on this. A 4yo child is too young for all the responsibility to lumped on to his/her shoulders. There are adults in the equation here, who need be be adults and support the child.

Sirzy Thu 10-Oct-13 22:39:41

New - yes it means it not under control but sometimes asthma just can't be controlled. My son is 3 and on maximum doses for under 16s of his meds including one which isn't licenced for under 4s. He still requires 10 puffs of ventolin minimum to get through the day.

His consultant is aware of that but at the moment it's he best option, especially as options are limited because of his age.

Juuhyt Thu 10-Oct-13 22:40:19

My 8 yo needs reminding constantly to take his inhalers, he wouldn't bother if no-one made him take them, even if he ends up in hospital.
I wouldn't expect a 4 yo to take responsibility for this..

At my ds's school, there are several first aiders who administer medicines/inhalers etc.

We had issues with a TA who wouldn't let ds have his inhaler as he could talk hmm. This happened twice (and one subsequent hospital admission). We asked our GP to write to the school about how dangerous asthma can be, and how important it is to ensure all staff know how to deal with it. Never had a problem since.

A child is at school for 6 hours at least. Of course it's not unreasonable to expect the school to give a 4 yo his inhaler during that time.

IwishIwasmoreorganised Thu 10-Oct-13 22:41:04

It's no a senco that is needed here as from what has been said your DN has no special educational needs, just needs their puffer at about lunchtime.

At our ds's school - forms must be filled in detailing exactly what and how much medication should be given and at what time. Details of the last dose should be given too. All of this needs to be agreed verbally and then in writing (form countersigned) by the headmaster before the child is handed over to the care of the school.

This means that if the child is essentially well (eg ab's with a grazed knee after coming off their bike or preventative inhalers) then they can be at school as usual as long as the school have agreed to this in advance.

That's key - open and full communication between all parties with full agreement being gained in advance and that's what seems to be missing here IMO.

StayAwayFromTheEdge Thu 10-Oct-13 22:52:21

I am disgusted with the attitude of the teaching staff.
Would they refuse to give medication to an epileptic or diabetic child? Or one with a life threatening allergy.

This news story is particularly horrifying, although it does involve an older child...

We are hoping to do some work with pupils and teachers around inhaler technique and use - it looks like it couldn't come soon enough.

ForrinForrinerFromForrinLand Thu 10-Oct-13 23:00:09

I'm a little hmm at the number of posters who are slightly <meh> my 1yr old self medicates....So this 4yr old should be more than competent.

Fwiw I expect a school to be in loco parentis during school hours. Therefore if any harm comes to my child the school is 100% responsible. I wouldn't give a child a bottle of pills and expect them to self medicate. And I don't see an inhaler as any different.

peppi I would be fine with this for an older child but not for a child who is in reception.

ForrinForrinerFromForrinLand Thu 10-Oct-13 23:02:26

stay that's shocking!

Sirzy Thu 10-Oct-13 23:04:25

It's not about self medicating though its about them understanding their condition. That's not a lot to ask of a child with severe asthma who lives with it day in day out. They know before anyone else that they are struggling so they need to learn to ask for help at that point

StayAwayFromTheEdge Thu 10-Oct-13 23:11:48

SIrzy - he is 4 years old. Yes he does need to learn, but he has to be supported to do that and it will take time. The frightening thing is that teachers don't seem to realise just how serious asthma can be.

Hospital admissions for childhood asthma are incredibly high and many could be prevented with proper treatment.

My DS is 4. He missed reception this year by one week. There is no way he could manage his condition himself yet, and I am highly trained in asthma management.

ForrinForrinerFromForrinLand Thu 10-Oct-13 23:15:26

sirzy but he's not struggling to breath is he, he needs regular dosage of his medication at 4hr intervals. Tell me does your 3yr old know how to tell the time? So he would be capable of alerting an adult when his meds are due?

NewNameforNewTerm Thu 10-Oct-13 23:15:43

Maybe this is a breakdown in communication. School asking for an inhaler to give when they recognise the child is wheezy, before PE, etc. without knowing it to be treated as regular interval medication, not as needed occasional emergency relief medication. Bearing in mind this is probably at least third hand information (not OP's child, but DN) it may not be as simple as school won't give inhalers. There is nothing in OP about school refusing to give the medication, in fact that actually asked for it.

When a child needs their inhaler I hold it and they hold their spacer. I press the dosage and the child breathes. This is until they have long enough arms and the coordination to press the puffer themselves with me there just counting their breaths. Sometimes I'll hear a child that needs their inhaler or know it is PE or cold or damp so they'll need it before playtime, but much of the time I do rely on children telling me they need it, their chest feels funny, etc. But then I've never had a child that need it every four hours like the OPs Niece/Nephew.

PeppiNephrine Thu 10-Oct-13 23:18:29

My son is only a year older knows to ask for his meds if he isn't given them. You can easily train a four year old to respond to a watch alarm. Hell you can get a puppy to do it, it should be easy for a child!

Goofymum Thu 10-Oct-13 23:28:21

You really need to get a care plan in place with your surgery's practice nurse, or the local asthma nurse, since this is a chronic condition that needs regular medication. At my DD's school they make a big deal about care plans and they're updated every year by our asthma and allergy nurse. With something this important you can't expect kids that sgd to remember to keep taking their medication whether they are able to self medicate or not. But do make it official otherwise it won't get done.

NCFail Thu 10-Oct-13 23:33:42

Ask to see their medicines policy - they have to have one.

Read the DfE policy on this and contact the school nurse.

I had to do exactly this, for exactly the same reason in reception... The school nurse and asthma nurse worked together to change the regime so it was given outside of school.

Schools should give medications but its variable.

Altinkum Thu 10-Oct-13 23:46:49

Legally the school is acting illegally. Their is literature about this, go to the asthma UK website.

Ventolin is just a reliever, you can be on the right steroid dosage but still need the reliever, me and my sons are triggered by animal hair, chemicals, cigarette smoke and also weather changes (currently off work, with a asthma attack yesterday because a lady who came into the restaurant worked in a animal shelter which triggered my attack).

3 people a day die from asthma attacks, it isn't a Mickey Mouse illnesses people die and people die daily!!!

My sons school currently gives him 5 puffs of inhaler every 4 hours and 10 puffs if outside at break time, they currently also give him his antibiotics in between this. At just turned 4 he cannot use his inhaler without his spacer.

Contact asthma Uk, speak to the head teacher, get a medical plan in order, and a doctors letter explaining the importance of his medication and his illness.

If this doesn't work, contact the board of governors and the LEA, if that doesn't work, contact the papers and your prime minister!!!

Altinkum Fri 11-Oct-13 00:02:11

My son is 4 is also S&L delayed, is also 9 months developmentally behind his peers, if he gets a coughs/wheeze he asks for cough medicine. hmm no matter how much I explain to him, he just doesn't get that he needs his inhaler.

About 11 months ago our ex child minder took ds to a home with 3 large hairy dogs, 2 hours later (after being given antihistamines, emergency dosages of inhaler, 200 ml of predistone, 4 nebulisers, at the walk in centre, he was blue lighted to out local hospital where he was resuscitated!!!

I have a thread on here in the children's health asthma, and a later one too, in that he needed to be put onto resus (can never spell that word) ward as his heart rate was 160-180 beats per min, and his oxygen 53!!

NewNameforNewTerm Fri 11-Oct-13 00:18:05

At least he's recognising he's in need asking for something Altinkum smile. When you share that story hopefully it will alert people he needs his inhalers. He'll get there.

I had a pupil with ASD that used to tell me he needed banana bread ... this meant he felt the symptoms he often had before an epileptic fit, nothing to do with cake! We knew this so could move him to a safe place (although he frequently didn't fit then, but better safe ...)

Altinkum Fri 11-Oct-13 00:30:50

Yeah I've told them, he honestly just dosent get he's ill, even when he's very poorly, he just ask for me or his dad, to make him better. smile poor mite has had serious life battling extensive medical history, but because we are their every step of the way, he looks to us to help him. (Actually does a little cry sad )

BrianTheMole Fri 11-Oct-13 01:31:07

But then I've never had a child that need it every four hours like the OPs Niece/Nephew.

You learn something new every day then. Like if I don't take my becotide inhaler every four hours, then I will end up in hospital. Not every case of asthma is dealt with in the same way.

Sirzy Fri 11-Oct-13 06:21:48

Forrin - DS knows he needs his inhalers when he wakes up and before he goes to bed. When he is having them at dinner he knows he needs to take them at dinner time. That sort of routine really shouldn't be hard for a child without special needs to understand, especially not one with such severe asthma.

I am not saying the school shouldn't help not at all but surely it is in the child's best interest to ensure they are fully aware of the condition and take some sort of "control" of it from as young as possible?

NewNameforNewTerm Fri 11-Oct-13 07:37:28

Of course we learn something every day Brian, what an odd statement! I didn't understand the complex medical condition one of my new class has, but the mum didn't assume I would because despite needing frequently blood tests throughout the day and action from the results it is not basic diabetes. But if teachers have a clear care plan they do understand. My point was that it may be a communication breakdown both ways, not just teachers being ignorant!

Altinkum Fri 11-Oct-13 07:46:32

Really is boiling my piss today with quite a few of these comments concerning this thread because no one seems to read the OP!!!

Not all children are the same, shockingly they are different, comparing a puppy to train in the same way as a child is not only rude but offensive too!!! Not all puppy's can be trained, do you expect the animal to tell you when it needs ya medication!!!!

Not every child knows why they are ill, like most children they just carry on being children..... I can speak for ds only, but one minute he can be happy playing, the next he can be in a full blown asthma attack and something has triggered it off.

The op's child ISN'T having breathing difficulties, he is needing his inhaler every 4 hrs to maintain open airways, legally the school have to do this!!!

Contact Asthma UK, OP because some people are making lots f assumptions based on little knowledge or even any knowledge on the condition itself!

Sirzy Fri 11-Oct-13 07:50:47

I have plenty of knowledge which is exactly why I think is important for the child to understand his condition as much as possible as well as for the parents to work with the school to come up with a proper action plan. So far it sounds like its been something mentioned in passing rather than arranging specific meetings to sort if out.

Altinkum Fri 11-Oct-13 07:58:42

Sizry my comment wasn't aimed at you, however since to mentioned it, see my above post, I can talk to my son about his condition till I'm blue in the face, but at 4 years of age, he is still a baby, in terms of his ability to understand, physically and emotionally, as well as deveplomentally.

Personally too going by him and his understanding of the word around him, he's just dosent "get" that he needs them, no matter how much we try, we have the asthma sticker chart currently, to show his consultant how much he's needing it, he still dosent get it, but at 4 it's not a big deal, because ll of us adults remind him, be that us, grandparents and his teachers, who really do take his condition seriously, but then thy have had to phone a ambulance for him, in full attack.

Sirzy Fri 11-Oct-13 08:01:45

But you are trying to encourage that understanding even though he has additional needs. From what the op has said they don't seem to even be doing that with him (of course that may not be the case)

Altinkum Fri 11-Oct-13 08:08:39

But in fairness to the OP, she hasn't mentioned about his understanding if his condition, only that he needs it every 4 hours and that the school is refusing to do so, based on the fact he hasn't asked for it.

Both of these are wrong, and life threatening to a child with chronic asthma. As a asthma nurse (I think that's what you said) is just wrong and is putting the child at massive risk.

At the end if the day the child is 4, tell me off a child who is aware if time?

SilverApples Fri 11-Oct-13 08:09:12

He needs an individual care plan so that the responsibility for his welfare lies with a named adult. IMO, the school is being negligent, he needs medication to be supported and supervised until he is ready to self-medicate independently.
So, meeting with SENCO can be arranged through the school, your sister can contact the school nurse independently, ask for her support and she can train the relevant staff 9(CT, TA and a MDS as a minimum) To ensure that they are aware of the signs and can be pro-active about his safety and care.
The current state of affairs isn't OK, or acceptable. Someone needs to be pointing this out firmly and clearly to the management and the CT.

SilverApples Fri 11-Oct-13 08:11:34

School nurses are usually fantastic at getting teaching staff to see the reality of what needs to be done and the potentially fatal consequences if not.

Sirzy Fri 11-Oct-13 08:11:56

Like I said that is why I would link it to lunch time, most 4 year olds can understand to have lunch then ask for it or ask as he goes to pick up his lunch box - even if at first mum needs to put a picture of his inhaler on the lunch box to remind him!

School should do it but if they can find a way to make it part of the routine all around then that has to be best for everyone!

Altinkum Fri 11-Oct-13 08:16:07

Actually completly agree with you their and will be something I may use, if ds goes onto packed lunches.

ForrinForrinerFromForrinLand Fri 11-Oct-13 09:49:34

Altinkum thank you. As I keep saying at 4 DN is a young 4 iykwim. His speech isn't particularly clear and unless you knew him well he'd be hard to understand. I completely understand that some posters here have ch

ForrinForrinerFromForrinLand Fri 11-Oct-13 09:51:34

Sorry meant to say some posters have children with severe asthma. I don't think it's been helpful making sweeping comments about the needs of a 4yr old asthmatic without knowing about this childs needs/ condition in particular.

Sirzy Fri 11-Oct-13 10:12:35

That is all I have been saying (perhaps badly) altkin.

With children with asthma (and I assume other medical conditions) it is so helpful for the child to learn to manage it from a young age - with support and prompts of course. A child of school age is soon going to be invited to friends houses to play and to parties and things so getting that little bit of "independent" control is useful for them to be able to carry on as normal without being held back by their asthma.

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