AIBU to expect nursery to follow instructions on medication???

[confuddledDOTcom]

Stuck here because I don't want it to turn into a horrible mess on AIBU.

Toddler has chronic brittle asthma. It's taken a long time to get the medication to a point where we don't have attacks all the time. From six months it was monthly, then they added something in and it became alternate months etc until now the last one was 18 months ago with just a little more delicate than other kids, not no attacks.

Started nursery last September, come October/November the weather changed and we needed to add in a blue inhaler into the middle of the day as a cough developed. Over the winter Toddler has had bags under the eyes, very pale skin etc so we've constantly been reminded to keep up with this blue.

We tell nursery, nothing happens. I say "the cough is really bad today, it's brought on retching all the way here, you must give that blue at lunch time before playtime". End of day "cough has been fine didn't need inhalers, it was probably just the walk".

I've been in, Mum's been in (she's scarier than me without losing her temper like me) between us we've signed three times - twice because we've told them to give it and once because it was needed.

Just over a week ago nursery went on holiday to a farm for a few days. Medication was put in a shoe box and a sheet emailed to them explaining the medication.

Shoe box contains
Brown inhaler
Green inhaler
Blue inhaler
Three Montelukast tablets (one for each night and one for dropping on the floor )
A bottle of Piriton

Copied from the sheet:

Morning
? 1 puff of green for a count of ten
? 2 puffs of brown for a count of ten twice
For a count of 30
Afternoon (around lunch time, before going outside)
? 2 puffs of blue for a count of ten, twice (count of twenty)
Evening
? 1 puff of green for a count of ten
? 2 puffs of brown for a count of ten twice
For a count of 30
? 1 Montelukast (Singulaire) tablet to be chewed (Toddler calls this "special sweetie")
? 5ml of Piriton (it?s very runny so pour slowly)

Emergency is unlikely but just in case:
Getting breathless
? 2 puffs of blue for a count of ten twice

I that Toddler is very good at medication so to ask if they're not sure.

I was a little anxious but thought they might get the hint! A few days after getting back I was talking to the manager and she explained how Toddler, with hand on chest, had said one day "I can feel my asthma coming on" so the teacher had given one puff of green. I felt a little about that.

Although green is the same as blue, so not really a problem if Toddler's not feeling good but it's a higher dose and longer acting, so you can't do what I've put there and it doesn't kick in as fast (a bit like gas&air vs paracetamol!)but the main reason for feeling was it suggested they hadn't read the sheet. Then I opened the box and found the 3 tablets still in the tray and Toddler tells me that they'd given one green and one brown morning and night.

Last Thursday Toddler stayed over at my parents house. Friday I got a call from Mum to say she was on the way to the GP as it looked like Toddler may have chicken pox. No chicken pox but some sort of an allergic reaction (we know there is an allergy which is why the daily piriton, but not what) the eczema is bad,conjunctivitis and Toddler is run down.

May not be related but Mum is ready to kick off at nursery! She was going to do nursery run this morning so she could have a word but having spent all night awake with Toddler throwing up all over her bed we've decided it's not a nursery day!

I'm just glad all this is over soon with school starting, but I'm so angry that they've done this to my child. They've never seen an attack Toddler style! They've never watched an oximeter and looked at each other knowing that reading means a heart attack is imminent or felt the life draining from the fragile body limp on your shoulder AND NOR SHOULD THEY OR WE AGAIN BECAUSE THEY THINK THEY KNOW BETTER THAN THE PAEDIATRICIAN!!!

[moaningminniewhingesagain]

I think that is quite a complicated medicine regime to expect non-healthcare workers to comply with, TBH.

While I understand that you wouldn't want the child to miss out on stuff because their condition, if the asthma is brittle and they are at high risk of a life threatening attack then they either need a parent or one to care care from someone with suitable training.

I am a nurse, and I would find caring for them, with these needs, plus other children, quite demanding. Must be very worrying for you?

[coldtits]

I doubt they have time. Looking after your child's health needs looks like a full time job and the carers will have at least 3 other children to care fore. they can't neglect them.

However, they should make it clear that they aren't able to care for your child.

[moaningminniewhingesagain]

Agree with Pixie too though it is very dangerous and I would be very frustrated/angry/livid that they put their health at risk. But I do think it is a complicated regime for a non-healthcare person to follow as well.

[MrsBadger]

hang on, can I just check:
you sent a prechooler with that medication regime away for a few days with nursery, without you?

and once he was home you didn't check the shoebox to check drugs had been administered correctly until a few days later?

[confuddledDOTcom]

She only has inhalers when she wakes and before bed (3 puffs), plus two blue at lunch time (which is all they normally need to worry about) plus 5ml medicine and a "sweetie" at night. It's not a lot and normally we don't even need emergency inhalers, over a year I think since I've given any out of routine. They've had more need to give it than we have at home (surprises?)

It was only a small group, three nursery staff and I think 5 or 6 children, so they weren't taken away from other children. 30 seconds for her inhalers plus loading time so a minute, a 5ml spoon doesn't take long to pour or swallow and she chews her "sweetie" so that one's not a big thing. Her doses are higher than normal but 3 puffs is pretty standard, I'm not bad but have 3.

If they had a problem they had my mobile number which they could have called, they told me they spend the evenings talking to parents but not once did anyone call me. I wasn't worried because she loves being away and knew they'd call if there was a problem or she was missing me.

The box came from my parents house as they dropped her off the night before, it went back there so I didn't see it for a few days and only looked because of what they'd said to me.

However complicated it is or isn't though, they wouldn't know as they obviously didn't read the sheet!

[reikizen]

Am am bit surprised you sent him on holiday with them with these concerns tbh. I wouldn't send my toddler on holiday with the nursery under any circumstances and she has no health needs whatsoever. I do think that is extremely complicated and there is no way my dd2's nursery could follow that no matter what I said or did. It may not be a big thing for you but that is a lot of responsibility for a nursery worker.

[confuddledDOTcom]

Pixie, that's the impression I'm always getting, I say she needs them then when I pick her up they say she didn't. She is under the hospital, the consultant has already had to write to the GP who think they know better.

The nursery knew and have from the start how bad the asthma is, I explained to the manager who was there before they went how bad things are and how much she takes. The manager's son had the same problems so she said she understood. They had the consent form with everything on, even the enrollment for nursery, so this shouldn't be a surprise to them. I wouldn't have let her go if they'd have had a problem with it but I don't see how they could have had a problem when they didn't even read the information sheet. It reminds me of MWs who say "oh look a birth plan. Never mind"

She's stayed over with other people, sometimes just on a "can we keep her?" basis and no one has ever had a problem doing her inhalers.

[gorionine]

I am thinking like reikizen.

How many children when you let her stay over with other people usually? I think it is a bit different talking about a couple of DCs or amongst a large group like a nursery setting to keep up with complicated medication.

Now if they did presume it would be "easier" than it actually was they need to review their actions and maybe warn parents in the future that it could be complicatd to keep up with the medication. they could also advise parents who have real concerns about their children health/medication to maybe accompany on the trip?

[confuddledDOTcom]

5 or 6 children and 3 adults (plus however many staff) is not a large nursery setting.

At nursery all she needs is two puffs in the afternoon before going to play. She can't be the only asthmatic they've ever had, that's fairly standard. I remember being lined up outside the HT's office not much older than her waiting my turn for my asthma meds.

[louii]

Not being smart but if you can't trust them to follow a medicine regime during the day why the hell would you allow your toddler to go away with them, i have never heard of a nursery taking children away for a couple of days.
Far to young for that i would have thought.

[hocuspontas]

Agree with louii. A farm is a bad place (for us anyway) for asthma and allergies and no way would I let a child go who couldn't self-administer. But I wouldn't have let my pre-schoolers go away with a non-relative full-stop let alone a child with a medical regime.

Regarding the normal nursery day I wouldn't be happy knowing they are ignoring the medical plan and would remove I think because I'd have a problem trusting them.

No sure why your mum wanted to kick off at the nursery after having spent the night at her place - maybe I've not read properly!

[MrsBadger]

I know you say 'it's not complicated'

but actually it is
sorry

[Shaz10]

It's slightly complicated (although not impossible) and a bit of a faff but that doesn't mean they shouldn't be doing it. I have some people in my class with inhalers (although nothing like this) and lots of different instructions as to what should be taken and when. Personally (very personally!) I feel that some of these children don't need them but it's not my call - I follow the parents' instructions.
If it's complicated I ask for help.

YANBU. They absolutely should be doing as you ask, and if they can't do it or are experiencing problems they need to be talking to you, not just ignoring your instructions.

[Shaz10]

Just realised it's not in AIBU . You're still not!

[confuddledDOTcom]

louii I didn't want her to miss out, the staff talk about this trip all the time because they do it each year and everyone enjoys it, I thought with an information sheet there reminding them they might do it and it would roll over to nursery if they've seen it's part of her routine. I didn't count on them not even reading it!

hocuspontas she goes away a lot to places like that with both sets of grandparents so we knew allergy wise it wasn't going to be a problem, in fact usually when she's away she's better than at home. I know a lot of mums from the nursery who let their children go last time and others who have done it with other nurseries and it's been a positive experience. Other than the meds I think it's been good for her and she really enjoyed it. Other than this it's a good nursery and this close to the end of her time at nursery I don't really want to move her, we're not at the nearest anyway because everywhere filled up fast. It seems to be one teacher doing it so I'm hoping speaking to the manager will make a difference.

Mum was angry because she's been up all night with her throwing up.

MrsBadger, that's an entire day, looked at in one go maybe but when you do three puffs in the morning that's not a lot. Three puffs at night with a tablet and medicine is not a lot either. Regardless of how complicated though they obviously didn't even read it as they did something totally different.

Thanks Shaz10, it is an entire day though so your class may have more at home. During the day all she has is two puffs of blue which is nothing and what you'd expect for someone who needs inhalers. You'd think Toddler doesn't need it, she joins in and rarely lets it stop her but the two blue in the day keep her going in between. She's a total star.

Pixie, that's a good idea! Probably won't be a next time now but if it happens at school that they go away I'll remember that.

[hennipenni]

Confuddled, I've had similar issues with DDs school with regards giving inhaler before excercise -mainly from a TA refusing to let her have ventolin before PE as "You don't need it because you don't cough anymore" to which my DD answered"I don't cough because I take my inhaler" we got around this after an angry exchange between myself, headteacher, class teacher and TA by getting her asthma nurse to educate the TA. Might this work for you?

[hennipenni]

thankyou pixie, she is delightful most of the time . she's lived with her asthma for as long as she can remember so she is pretty clued up about it.

[mspotatochip]

My dds nursery regularly dont give her her reliever at lunchtime when I give express instructions to do so as shes had a dodgy night/ when weaning down after a bad week etc. They say things like "oh she didn't seem to need it" or "we don't like to give them too much medication" or " she wasnt coughing that much!"

Its like they think we give it to her for no reason not on doctors orders! Its not such an issue for us as I just keep her home when shes in that funny getting over it phase now as her breathing has generally been under control until the last few weeks