Drs appointment for children

[Dragonfly1982]

Posting here for traffic…wondering what others would do in this situation / thoughts & advice please. I have 2 young children, every time I call my drs surgery for them (which has been a lot in the last 6 months) we are given an appointment with a duty team nurse, not a GP. This is not made clear when making the appointment. Reasons for appointments have been for various infections and each time children have been given antibiotics. They are usually quite thorough but on two occasions I’ve not felt confident in their diagnoses. Now, 2.5 yr old is unwell again, was given antibiotics 4 days ago for tonsillitis by duty nurse on appointment. I’m now wide awake because he’s been up coughing away and tbh the tonsillitis is no better, perhaps worse, than it was when I took him last week. He’s in bed with me now because I’m so paranoid about his breathing, it is ok but he’s snoring and I want to make sure it doesn’t get any worse. Im going to call up in the morning, will I be unreasonable to request a GP? Last time I did that I called and specifically asked for a gp appointment, was given an appointment and when I asked again to confirm if that was with a GP I got told oh no there are no gp appointments it’s with a duty nurse! He has to be seen today so you’ll have to take that appointment! Obviously I want my child to be seen so didn’t want to turn it away. But felt a bit duped by the way it was done. The reason I want to see a GP tomorrow is because I’m worried about the amount of infections he is getting - he’s had 5 or 6 lots of antibiotics in the last 6 months. I don’t know if this is normal or not? Is a duty nurse qualified to see the bigger picture (if there is one?) I just have less trust in their ability than I would have with a GP if I’m being totally honest. I don't know if that is warranted or not or just my perception. Genuine opinions welcome and apologies if this would offend anyone in the medical profession, I genuinely would like to hear from people who might know what qualifications they may have / the difference between them and an actual GP. WWYD?

On the day emergency appt for minor illness likely to be a triaging nurse.

gp kept for complex patients and difficult to manage appts.

if you’re worried about recurrent illnesses and want to discuss that then book a routine appt in advance with a gp. If it’s for his sickness this time book the urgent appt.

and it’s like the recurrent illnesses are viral and never needed a doctor or antibiotics. Do you consult the pharmacy, do self care, regular analgesia etc and give it time before booking the appt?
not a criticism, more form the tone of your post and that you seem very anxious/worried?
its really common to have back to back illnesses for a period.
have a think about how dc is outwith these? Normal growth and development? Good sleep, weight gain? Active in themselves?

Thank you for replying at this time, yes good idea I will do 2 separate appointments if need be I think it’s been enough times now to have a GP look into this? I do tend to see how he goes before calling up, ear infection went to pharmacist for but our local ones are terrible at answering the phone so can be really hard to get through to them they’re always really busy. Last time he was very poorly antibiotics didn’t work i took him back and he ended up being sent to hospital due to low oxygen levels & given another course of antibiotics so i am a bit more wary now of leaving things, he just seems to go downhill quite quickly. I never had this with my older child so it feels really extreme in comparison. I don’t know if it’s just a case of different child different problems, or something bigger going on he just seems to never catch a break. Pretty healthy otherwise I would say, sleep isn’t great but only really getting 2 weeks of being well before catching another illness. Not going to the drs for every illness either

Sounds like the child didn't need antibiotics. Frequent viral infections are very common at that age especially if they go to childcare. By all means make an appt with the GP but I'm not too sure what you're expecting to get from it. Kids get lots of viral infections, with symptoms such as sore throats, high temps and vomiting. If you're concerned by your child's breathing go to A&E though.

The things he’s had antibiotics for are strep throat, scarlet fever, ear infections and now tonsillitis. Genuine question i thought all those things are bacterial so do need to be treated with antibiotics? Maybe tonsillitis can be viral or bacterial? He hasn’t started pre-school yet but is due to

6 lots of antibiotics in 6 months is A LOT for a 2.5 year old.

If you're worried about his current illness worsening, then ask for an urgent appointment in the morning. If you're worried about the ongoing illnesses then you need to book an advance appointment to sit with a GP and speak about that. With the way the GP surgeries are at the minute (and the lack of availability of appointments) the duty nurse may be all that's available for on the day bookings.

There's been some really nasty colds/coughs/viruses going around at the minute, and antibiotics won't do anything for those which may be why they're not working. Tonsillitis is often viral too. Doesn't mean that it's any less nasty but it just requires conservative management (paracetamol/ibuprofen, fluids, rest, ice lollies to soothe the throat, Olbas oil plug ins, propping DC up to help with breathing..)

Tonsillitis is most often viral. Was your child tested for strep throat? Id not be happy about being continually given antibiotics for things which don't definitely require them.

I mean this in the kindest way but I think maybe you just need to manage your expectations of childhood illnesses. They're rough and not nice but it's all in the management. As other have said regular paracetamol and ibuprofen, encourage fluids etc.

You probably would benefit from seeing the GP to give you some perspective about routine childhood illnesses and when antibiotics might be needed. Strep throat needs antibiotics (when actually formally diagnosed according to criteria) but the rest is usually watch and wait. Maybe the nurses are a bit inexperienced too.

Sorry you are having so many problems OP, it’s such a worry when you are up all night sitting with a poorly child propped up on you.

My dd has ear drops from the pharmacy for ear infections. Scarlet fever she just battled through. We have never had a diagnosis of strep throat - that requires throat to be swabbed and sample sent away (can’t tell just by looking) and I didn’t want to put my dc through the trip to the GP surgery as she gets a bit hysterical about those kinds of procedure.

Anyway in short my kids have never had antibiotics, and I do think some GP practices still over-prescribe and then the longer term effects (as well as short term side effects) of the ABs cause other problems.

On the other hand antibiotics can save a child's life

6 lots of antibiotics in as many months is concerning...I have three kids and only one of them has been prescribed antibiotics one time for comparison. I'm very reluctant in general to give antibiotics in general unless 100% needed as it wrecks the gut micro biome. Could your child's illnesses have been viral? My three are always catching some random virus that is going round.

If you think the antibiotics have genuinely been needed for your child due to infections then I would definitely push to see a gp for blood tests etc.

I’ve always found nurses 8/10 better than the doctors. In the last 10 years I’ve had 2 doctors that I have seen that were actually listening and helped me. Normally I feel rushed and unheard. Nurses always seem to be more understanding.

Nurses tend to hand out antibiotics much more frequently than a GP will.

An illness a month is not uncommon in pre school kids. What made you think they were unwell enough to need a dr/nurse each time or is it something you just think you should do?

Thought I’d do an update almost a year on as had a few more comments on this post. End of last year my son was hospitalised after being misdiagnosed with croup as a result, in my opinion, of not seeing a GP. He was extremely unwell and is now being assessed for asthma among other things (although not sure if they can diagnose this in under 5s), as after detailing his medical history it was clear to the drs in the specialised children’s hospital that there is something wider going on. My other child was also given a chest x ray (after months of appointments with nurses) and they also have a wider set of issues going on.

in response to the poster who asked what made me think my child was unwell enough to need a dr or nurse each time - I’d like to make it clear I do not ring the doctors each time my child has a sniffle or a cough. Although I’ve now been told we need to be very careful with my youngest catching any kind of virus. (Not sure how we are going to avoid this one!)

Thank you for the update op- I’ve just stumbled across this thread for the first time and was horrified by the amount of posters undermining you. I hear these sorts of comments all the time and yes antibiotics are a bit overused but they are also life saving and a big part of the reason for the decrease in child deaths (alongside better sanitation, vaccination etc). There’s a big difference between a normal amount of childhood viruses and the risks to children with asthma or underlying conditions. Glad you trusted yourself and not the keyboard warriors.

This isn't true of most qualified ANPs, who tend to prescribe less antibiotics than GPs. But a nurse led minor illness clinic may be different. And this one certainly sounds like over prescribing, but can't tell without knowing the background of each presentation.