to think they should really take the doctors advice

[Oakmaiden]

It could be that I am, because it all worked out fine, and I'm not really even cross about it, but I just have this niggle that says it wasn't a choice they should have made....

Situation (certain details changed in a probably futile attempt to make this a bit less identifiable for the individuals concerned). Teenager on a school trip in a hot county. 12 teens, 3 staff members. One child suffers a minor injury - it is pretty much shrugged off (fair enough) for 13 hours, until child's entire limb swells, changes colour and is hot to the touch. And extremely painful. Child still feels well, just in pain.

A visit is made to local medical clinic. Doctor takes one look at leg and without doing any further investigation says they would like to admit child to hospital for IV antibiotics. Staff member declines and asks for oral antibiotics instead. Dr asks staff member to bring child back the following day.

On leaving staff member tells child she didn't want her to go into hospital as she "didn't want to spend the next 2 days sat there with her". And that they wouldn't go back for a checkup the next day, but might go on the day after. It is important to note staff member IS a qualified nurse.

Now, as it happens it was fine, but I am just really uneasy about the decision making, even though the result worked out OK. Clearly the Dr was worried about sepsis, and I just feel it wasn't really the staff members call to make. She should either have taken the Drs advice or consulted the child's parents to ask for permission to ignore the Drs advice. Even though in the end it all worked out OK, I do wonder if some sort of discussion should be had about this sort of decision making process.

Is my unease unreasonable?

can't edit - but typo spotted. It was "shrugged off for 36 hours"...

Yanbu. She didn't even check with the parents?!

That's shocking. They have a duty of care and they didn't follow advice at all

Teacher should have followed doctor’s advice. Turned out fine this time but that is due to luck rather than anything else. Doesn’t matter whether teacher is a qualified nurse, a doctor trumps a nurse. I would be putting in a complaint with the governors over this. Things could have gone terribly wrong.

I would be very uneasy. A qualified (but presumably not practicing?) nurse does not have the same qualifications as a doctor. They can’t prescribe medicine and don’t necessarily possess the judgement about treatment.

More seriously, the person in question has negligently ignored medical advice, for their own convenience, risked the child’s health, potentially invalidated any insurance claim by ignoring it, and not taken their role ‘in loco parentis’ seriously.

If it was my child I would be furious, and seeking an investigation.

I would be furious! would 110% take this further.

That's awful.

This is the definition of a little knowledge being a dangerous thing. Arrogant, stupid and dangerous.

Even though it was fine this time.. what if a similar situation happens again and it isn't fine? I don't think this is OK. Surely the parents should have been consulted? The staff should have gone with the Drs opinion I think.

Covet - yes, that completely sums up my feelings about it.

I think I am going to write and suggest they look at their training for decision making in situations like this.

Chills also reports that staff member (and she is a working nurse as well as being a staff member) swore all the way through. As well as having more than one unacceptable outburst of temper. I am not sure about mentioning that though, as I think it would detract from my real concern which is failure to properly safeguard health...

I think the outburst of temper and swearing are relevant, as it explains the motivation for ignoring advice (i.e. the individual felt inconvenienced). Also, this is not a person who should be working in a capacity with children if she or he can’t keep their temper in a very common scenario on a school trip. Someone will always hurt themselves, be sick, need to see a doctor! Goes with the territory.

I’d lay out your concerns about negligence around health, and in a second part relate that the child reported the staff member swore all the way through, and that you/others observed the frustration and temper. You can’t be 100% sure the child is telling the whole truth about swearing, but you know what you directly witnessed.

Any Governor worth their salt will shit a brick about ignoring medical advice so I wouldn’t worry about it getting lost. Do report it.

As a teacher who runs a lot of trips, this is unacceptable. You always err on the side of caution and certainly inform the parents. I had a situation where the doctor recommended a test (non-emergency) but the parents were not sure. I spoke to them, had them speak to doctors and all was fine. I would have treated the wound myself initially but kept a close eye on it and not left it for hours. I think you have to raise a concern (not becesssrily with ambulance chasing lawyers) but definitely the school.

This is awful. The teacher was responsible for the child and she refused to follow medical advice! The fact that she’s a nurse is a red herring. She had advice from a doctor and she chose a different treatment for her own convenience. I am really glad the DC is OK but this is pure luck. If the infection had not responded to oral antibiotics the situation could have become much more complicated. Doctors don’t just hand out IV antibiotics, it’s a costly and serious intervention, so if the doctor thought he needed that escalation then there was a significant risk.

Bad bad bad, need iv anti b’s sounds like cellulitis or worse... can cause blood poisoning

Funnily enough the initial post was based on what the staff member told me.

I asked my daughter what exactly had happened at the doctor's today. She said the doctor said immediately it was cellulitis, asked if permission would be given for surgery. Staff member said no. Dr then said she recommended ivy antibiotics in that case - staff member again said no and asked for oral abs.

I am a little bit shocked that this wasn't reported to me. They didn't even tell me what the dr said it was. And I definitely don't think child is exaggerating because she wouldn't have come up with "cellulitis " on her own.

That is even worse. That is a disciplinary offense, possibly one over which she should lose her job, for the teacher. I think you should look up the school’s complaints procedure and follow it to the letter. I wouldn’t trust this teacher with my child again.

wow bloody awful I would get in touch with the doctor and ask them for the relevant notes as a back up.

Actually ( as an ex nurse) I’d report the behaviour to the NMC , hopefully she would get at least a warning if not more .

Absolutely should be reported to the NMC. She's using her capacity as a nurse (while not even working as one, which is telling tbh) to make decisions that put a child at risk... because the appropriate treatment would be inconvenient to her!