School refusing to give antibiotics

[Slayerofmyth]

My daughter has warts on her arm that have become infected. She has been prescribed antibiotics four times a day in liquid form that have to be kept in fridge. She has one dose upon wakening but needs 2 more doses throughout school day. I work so can't get to school to give it, theres no one else. School are refusing to give it, I've said I'll keep her off then so I can administer ( taking time off work,), they say I'll get a fine for absence. What the heck am I supposed to do? Please advise.

[quote Walkaround]**@Nith* - except it is clinically possible to prescribe a different antibiotic which is only required to be given twice a day. Personally, I would be just as angry at the thoughtless GP as the school. It does not require a great intellect to understand that it is ridiculous* to prescribe a primary school aged child an antibiotic that needs to be taken every six hours if they can be prescribed one that can be taken every 12 hours.[/quote]
Flucloxacillin is first line, yes there are other possible choices but flucloxacillin is preferable. And despite someone’s comments above causes less sickness as a side effect than alternatives such as erythromycin. You can’t call a GP thoughtless for prescribing the optimal medical treatment! Most parents could facilitate giving it and most schools will give antibiotics. A normal school day is only around 6 hours. OP is the exception to the rule as her child does breakfast and afterschool club and she has no support and she struggles with sleep and the school won’t give it. Shame this wasn’t known before it was prescribed but it can be changed, it’s really not appropriate to give a second line treatment to everyone just in case

*The nurse?

You'd be hard-pressed to find a school nurse these days...

Nurse, first aider, whatever. You aren't telling me that there isn't a single person in that school who has so much as a first aid course under their belt. Where do the kids get sent when they fall and bang their heads or throw up in class or have an asthma attack? Who gives them their inhaler and insulin and epi pens?

I'm sure that person is perfectly capable of measuring out a dose of liquid into a spoon or a little plastic cup and handing it to a child.

@nothingcanhurtmewithmyeyesshut

*The nurse?

You'd be hard-pressed to find a school nurse these days...

Nurse, first aider, whatever. You aren't telling me that there isn't a single person in that school who has so much as a first aid course under their belt. Where do the kids get sent when they fall and bang their heads or throw up in class or have an asthma attack? Who gives them their inhaler and insulin and epi pens?

I'm sure that person is perfectly capable of measuring out a dose of liquid into a spoon or a little plastic cup and handing it to a child.

Government statutory guidance is quite clear that a first aid certificate is not sufficient training for school staff to administer or supervise medication for students under 16, even if it’s prescribed and self-administered.

The slap-dash fixes you suggest are the sorts of things that have caused harm to students in the past and lead to a more robust framework that schools must follow. It is maddening and unreasonable that some schools have been unable or unwilling to step up and provide under these safeguards, but that doesn’t mean the safeguards should be ignored.

I’m a GP.
I’d either do as someone else suggested and ask for erythromycin (twice daily).
Or I’d give a double dose of flucloxacillin in the morning, a dose at tea time and a dose at bed time. It’s not ideal, but unless her infection is horrendous, it should still do the job.
My son had flucloxacillin 4 times daily for 6 weeks when he was 3. I tried to space it properly but over a 6 week period it just wasn’t possible every time, but his infection (which was severe) still got better.

Way to completely miss my point.

I'll ask again then. Who administers other medication? Diabetic pupils, those with asthma or allergies? Someone in that school must be qualified, you cannot seriously be saying that a school would refuse to give an asthma inhaler for example? The kid could be dead by the time a parent arrives. Lots of children are on regular medication. So who gives it? If they are able to give an epi pen, they can give antibiotics.

@nothingcanhurtmewithmyeyesshut

*The nurse?

You'd be hard-pressed to find a school nurse these days...

Nurse, first aider, whatever. You aren't telling me that there isn't a single person in that school who has so much as a first aid course under their belt. Where do the kids get sent when they fall and bang their heads or throw up in class or have an asthma attack? Who gives them their inhaler and insulin and epi pens?

I'm sure that person is perfectly capable of measuring out a dose of liquid into a spoon or a little plastic cup and handing it to a child.

First riders are a legal requirement. But there's not someone sat around waiting for injuries or illnesses. No one to "send kids to." At least not in my school.

Real truth on what happens at my school when someone needs first aid? An SEN child loses their TA support for as long as it takes to sort out. So the five to ten minutes it would take to get the key from the office, go to the medication fridge, bring it in to class, administer, record, return to fridge, return key and return to class is five to ten minutes from a needy child, twice a day for two weeks. A couple of hours of support taken from a child with special needs. Depending on the child, that time of lost support might lead to issues that impact the rest of the class.

Fine if vital, but I hope you can see why schools might try to ask for an alternative solution wherever possible.

‘Thoughtless GP’ 😂😂😂😂😂😂😂😂

What an absolutely moronic comment.

Fluclox 4x daily is first line for skin infections
In the BNF. So it is clinically proven to be the most likely to work. Of course there are alternatives but it really would be the clinical decision of the prescriber based on the full picture.

This thread is crazy, I am honestly shocked that there is not someone trained up to administer meds in every school. What are you all doing for diabetic children? How could you possibly be a working mum and manage nipping into school for that? Or other serious health conditions? I see some people are suggesting that antibiotics are not an immediate life saving medication and that's why they can give inhalers but not antibiotics. It irritates me that people without medical training are able to make that decision on behalf of their school. I also see people are pretty judgemental of paracetamol...so if Freddie has a broken arm but perfectly capable of being in school with his cast you think that he's going to concentrate in that last lesson im agony because you don't think that analgesia is necessary during the school day?!

Could you negotiate with your boss to be able to nip up to school on your lunch break? At least your pharmacy would have a temp checked med fridge! You may end up taking extended lunch breaks for the course but would be better for your boss than 10 days off? I agree about waking your child for a dose, she will need rest to recover from the infection.

@Jent13c

When we have diabetic children in school, a few members of staff get diabetic training. When we have epileptic children, epilepsy training. We have training for children with peg feeds, heart conditions and cystic fibrosis. This is what the school nurse does for our school.

I'm not saying it's not all a bit nuts that schools are hesitant to administer medication, but an unwillingness to administer medication is not suggestive of the school's approach to long-term health conditions.

Sorry if this has already been suggested but have you thought of buying one of those cool bags for storing insulin in? I used one when I went on a long haul flight and it kept the insulin cool. You could order one from Amazon Prime (if you have it) or maybe get one in a pharmacy. She'd have to use it without the teachers knowing but would that be so bad in this case?

Is it a Covid thing? DC2 has autism and sometimes needs help with personal care. They have to mask visor and glove up before they can 'breach' the 2metres to help them. DD1 had intense period pain recently and school were more than happy to give some paracetamol when what I'd given her had run out.
Yes you can give it around school hours but obviously you're probably thinking the more doses she gets inside her the better, it does appear they are being a bit difficult for the sake of it. I think the previous poster who mentioned the school nurse route is good advice. Hope she's better soon.

@endofmytether26

Sorry if this has already been suggested but have you thought of buying one of those cool bags for storing insulin in? I used one when I went on a long haul flight and it kept the insulin cool. You could order one from Amazon Prime (if you have it) or maybe get one in a pharmacy. She'd have to use it without the teachers knowing but would that be so bad in this case?

Do you know anything at all about safeguarding children?

I think the previous poster who mentioned the school nurse route is good advice.

Sadly, that poster lives in another world, where all schools have an on-site school nurse, sitting waiting for child to come to her for their medication.

I need hardly say that is not how it works in the real world.

I had this and challenged why they felt it was appropriate to overrule a medial prescription without any knowledge of why it had been prescribed. I wasn’t being a pain about it- I have a lot to do with the school and know they are not there to dispense as a hobby.
But.
The school have a duty of care to their pupils and will have a medical policy
In my case ours said that 4x day could be given at 9 & 3.15 just as easily as 10.40 (break) and 2pm (lunch end)
I pointed out they were then In (on school site!) wrap around childcare and whole point ‘as someone with dispensing experience’ that the meds are better evenly throughout day or would be a large single dose...
I asked for principal to call me
She did and was saying the same
So I calmly asked if I was correct in understanding that a non medical professional and a paper nurse policy were over turning the medical prescription and therefore preventing my child to attend school on grounds they couldn’t support the medical needs.
She paused.
I asked if I should put it in writing to Governors
She quickly then agreed.

Send it in a cool bag and let her self-administer at lunchtime. Don't even involve school further.

The world has gone mad. Yes, school staff may be overworked, but a school that has that attitude and would rather child was off school shows very clearly how well they value the kids. Ridiculously rigid.

Could you put the medicine in a box with a freezer pack, and at 10 years old she should be able to put a drop on each wart, ( or however many neccessary) herself. She'll be fine.
I think you are in a very difficult situation, and I sympathise.

@DianaT1969

Send it in a cool bag and let her self-administer at lunchtime. Don't even involve school further.

And she inadvertantly drinks half a bottle - who's then responsible? Absolutely do not send her in to self administer!

My mum woke me up in the night to take them when I was little. I barely woke up by the time the course finished. You could do 9am, 3pm,9pm, 3 am? It will be hard work but maybe you wouldn't have to miss any work or school then.

@IrishCharm - A 10 year old would drink a bottle of disgusting tasting medicine??
The real risk is that she might forget or just not take it. But she'll want her skin to clear up.

@nothingcanhurtmewithmyeyesshut

Way to completely miss my point.

I'll ask again then. Who administers other medication? Diabetic pupils, those with asthma or allergies? Someone in that school must be qualified, you cannot seriously be saying that a school would refuse to give an asthma inhaler for example? The kid could be dead by the time a parent arrives. Lots of children are on regular medication. So who gives it? If they are able to give an epi pen, they can give antibiotics.

You have to train up for different scenarios. Training for administering medication to diabetic students will be different from training for administering for asthmatic students.

To be in a position to give out meds for this child the school would have needed to consider what training would be needed for antibiotics, decide what sorts of cases that training would be suitable for, find staff willing to be trained, train the staff, and assess whether this case fitted the training the staff had received and monitor whether or not they still had the capacity (i.e. had staff left, were they still willing, is the training still in date).

I would think it would be possible to come up with training that would be suitable for the vast majority of ad-hoc medication needs, especially since it seems many schools do seem to provide this service, but I don’t know that. To be in compliance with statutory guidance they would have to have staff trained for this situation and it isn’t obvious that they would if they hadn’t proactively decided to. Which, given their policy, they clearly haven’t.

[quote DianaT1969]@IrishCharm - A 10 year old would drink a bottle of disgusting tasting medicine??
The real risk is that she might forget or just not take it. But she'll want her skin to clear up.[/quote]
Liquid medicines for children are disguised to taste nice/sweet/banana/strawberry to encourage children to take them.
I'm not saying a ten year old would - but it IS possible and that's my point - IF that happened who is responsible?!

I had this with my dd who was Yr2. I ended up measuring the doses in syringes and wrapped them in cling film. Stood them in a plastic cup and labelled the cup and syringes with the times each had to be taken using a permanent marker pen. Then I handed it to school receptionist at drop off for breakfast club, so she could put it straight into the fridge.

Dd was called out of class for 5 minutes to administer herself the dose.

I probably had to fill in some form or other, but it was the work around as they were not measuring the doses and my dd was taking it herself.

I think they are being spectacularly unhelpful and they can’t have it both ways.

It’s not particularly good but I suppose it is their right to say no to administering the medication.

However, they can’t then threaten you with a fine for keeping her off so that she can have it.

Effectively they are denying her adequate treatment.

Tbh my concern - putting to one side the whole situation wrt staff having to administer medications or not - would be the storage and constant changing of hands that the medicine would have to undergo during rhe course of the day.

Unless the Breakfast club and after school clubs are run by the school directly (and even if they are) the staff may not have access to the areas of the school where medicines are usually securely kept and may not have access to anywhere to keep it adequately refrigerated and away from other students.

It also puts the onus on multiple groups of staff to ensure that the medicine is adequately stored whilst also being passed from breakfast club, to school to afterschool club "custody" appropriately. Its not like they can just hand the bottle over and be done with it, I assume there would have to be some sort of paperwork or documentation to confirm that Mrs Smith from breakfast club took the medicine from their fridge in the secure kitchen; gave the medicine to Mrs Jones who stored it safely in the school medicine fridge; who then passed it to Mrs Thomas at after school club to put in their nonexistent fridge etc which is hugely time consuming and is not part of their job.