How much should nannies know about dealing with a sick child?

[MGMidget]

Just wondered what's realistic to expect from a nanny who has a first aid certificate and childcare diploma when it comes to applying some common sense regarding illness?

My son developed a high temp yesterday (now we suspect swine flu) - he was out for the day at a 'playdate' with other nannies and toddlers. She called me when she got home towards the end of the day to report his high temp (nearly 40 degrees) and said she couldn't wake him. When I got home I found him somewhat overdressed (i.e. could have been stripped down to nappy but instead had a couple of layers of clothes on) temp still rising, no calpol given. Further questioning established he had 'felt hot' when at his playdate but she hadn't thought to test his temperature or be concerned. Possibly having too much fun chinwagging with the other nannies I wonder? She mentioned in passing he had started shaking badly in the middle of the day (when hot) (possibly febrile convulsions I wonder?) and also mentioned he had almost been sick and had runny diahorrea. Now I'm wondering why she didn't think to ask the host nanny for a thermometer to check his temp or why she kept him at the playdate with other toddlers when he had runny diahorrea. And wasn't the fact that he was shaking a bit concerning? Or indeed why she hadn't stripped him down to his nappy, and made other attempts to lower his very high temp when she discovered it.

So I wondered what do nannies learn on the childcare diplomas and first aid courses about toddler signs of illness and how to deal with them? Also what do they learn about isolating sick children from others to reduce risk of transmission of illness?

I'm concerned not only at my own nanny's ignorance (or disinterest) but also that of the other nannies at the playdate. I don't think a nursery would have let things carry on like that for several hours without batting an eyelid. And if I was a parent of one of the other children present I would have been concerned that an obviously sick child was allowed to mix with my children and not taken home when the symptoms started. Any nannies out there who can give me their thoughts? And any mums with nannies who have had similar or better experiences with their nannies?

Have to say all of that was covered in my 12 hour first aid course! Can't speak for the childcare diploma as I was a primary teacher, before having my own DD and becoming a nanny. Saying that talking to my previous employer she specifically choose me as I was a mother and she felt that with things like this a mother's instinct kicks in - no idea how true/untrue the instinct thing as as only been a nanny since I became a mum. Also now that there are other fab nannies out there that would act as you or I would!

I hope he is ok and am sure you will get more advice soon xx

I am 22 and a nanny though have no formal qualifications or a first aid certificate.

However - all you say seems blatantly obvious to me, I would have left the party immediately if my charge was hot! I would have gone directly home, checked his temperature and given capol as needed. I also could have taken his clothes off and either put him in a luke warm bath or sponged him with a flannel, while giving him some lemonade or something sugary to drink. When he had begun shaking I'd have taken him directly to the emergency department at the private hospital his mother has told me she'd like me to use.

I have a copy of his health care card and would have authorized any necessary treatment and then phoned his mother immediately.

I think this is all common sense, I have no formal training as either a nanny or even in first aid but I think it's best to be cautious! Though is a doctor so maybe I am more aware than most. Your nanny sounds a bit thick.

Speaking as a nanny, I find that very worrying. Surely common sense would have told her to take your child home straight away?

To be honest, if I had been in her shoes and I hadn`t been able to wake him, I would have phoned an ambulance first and yourself second. I then would have stripped to his nappy and routinely checked his breathing until help arrived- better to be safe then sorry.

Have you spoken to your nanny about this? Her first concern should have been your son and not her social life at the playgroup. I think in your shoes I would at least give a verbal warning and make it clear that if anything ever happens like that again, 1) you want to know straight away and 2) that you are PAYING her to look after your child, and that that means knowing what to do in a situation like that.

Your 'Nanny' was incrediably ignorant and the chance your DS could have become gravely ill was a really posibility.

A first aid course covers fevers etc in children.

First off she should have taken his temp, noted it down and then called you, given Calpol on your say so (my insurance prefers parental consent each time if possible) and come home, had he had runny nappies before party they shouldn't have gone.

Once home he should have had his temp taken again and again noted down, if it had reduced then clothing should have removed/lessened and DS offered drinks and made comfortable.

Had his temp not come down then off to A&E and another phone call to yourself.

I think there's a large element of common sense here too. Regardless of what a first aid course might entail, a sick child needs looking after properly, and I would expect a nanny to know what that involves.

Our nanny (who had worked in a nursery and has an NVQ level 3, but had no previous nannying experience) had to deal with ds being extremely ill when she'd been with us for a couple of weeks. She dealt with it extremely well - she couldn't get hold of me or dh, so she took him to the doctor and demanded they see him even though they claimed they were too busy, then with the doctor's prompting took him to A&E and waited for us there. Having done the Calpol, stripping off etc already. I'd already decided she was a great nanny, but that really confirmed it in my mind, and gave me the utmost confidence that she would do the right thing in any situation.

I agree with snickersnack, first aid training aside, it really comes down to common sense. Everything you, OP, said is so obvious that it is so surprising that she didn't think of taking your son's temperature when he felt hot and hadn't taken him home once she saw he had a runny poo. Very worrying I think, given that you trust this person to keep your child safe when you are not there.
For what it's worth, we went for first aid training with both the nannies we have had so far, well worth it.

After one of my charges had a febrile convulsion in my care I went on a first aid course.

I think your nanny was negligent tbh and that would be a written warning in my book. All these things happened but she didn't think he would be better off at home?

How old is your child and how is he now?

v v worrying in my book. A nanny should def know how to deal with a child that sick and have the sense to have at least taken him home and checked temp. She should have been taught what to do on both her diploma and first aid courses.

I know I'm overcautious when it comes to child health as I had to whisk one to hospital with suspected meningitis once but the fact she did nothing is not good. Nannies need to be up to date with their first aid knowledge because you never know when a child will get sick but failing that common sense would do. Sadly it sounds like your nanny has neither.

I don't have a nanny, but I would expect, as a minimum, that they would reduce the clothing, give calpol, and ring me. And leave the playgroup/come home as soon as runny poo noticed.

If they couldn't contact me I would expect them to contact the Dr or NHSDirect for advice in the meantime.

I would be very concerned that she doesn't sound suitable to be in sole charge if she is unable to deal with common childhood ailments in an adequate fashion. And a fever and runny poo are both common problems IMHO.

Next time I saw this nanny, I would go tap on her head and see if there was hollow echoing sound. Poor thing appears to have no brain and should definitely ring the NHS about that!

your poor ds midget - how is he now?

i am very that your nanny did nothing no calpol,stripping clothes, taking temp,going home

unfortunally not all nurserys ring parents/send home though many do

your nanny behaved in a very unprofessional manner and tbh i would be very concerned about her lack of care and would be wary in trusting her judgement in the future

Incidentally, I once picked DD up from the childminder who said shee seemed unwell. When I asked if she had a fever the childminder said she didn't have a thermometer in the house. And I was mildly annoyed about this because I thought it was her job to have one and keep on top of this.

Generally speaking, she was a fab childminder and we love her. But, this one incident did kind of bother me. But, she would definitley not have missed that whole cascade of symptoms your nanny (and all her nanny friends) missed.

Also,I had/have a nanny who once had to take DS to the hospital in emergency with a mild concussion. She was fantastic. Has not a single nanny "qulaification".

Some people are just plain stupid. And no amount of nanny training is really going to fix that.

am shocked to read that post.

I would know how to deal with a sick child, and would have made an effort to reduce his temperature and to go home.

Im sure all my nanny friends would do the same too.

So sorry to hear that your nanny didnt.

I think you were unlucky and that all of that IS covered on our courses etc... it certaily was for me, but regardless of it being on the course, (it was) i certainly didnt learn it on the course... i would call it more general knowledge

As a nannyI am quite concerned with her lack of basic home nursing skills/first aid knowledge. In all honesty though, unless a person has donea first aid course or learnt through some other means,most people have no idea what to do when someone is ill or injured. It is not taught at school anymore. Parents do not pass down the information to their children.
Your nanny should renew her certificate ASAP and possible do some reading on childhood illnesses and basic treatment.

Thanks for the comments. My son is 2. We had a bad night, his temperature goes up and down (had to wake him up to give him more calpol) and the cough was very bad in the night. He just requested 'cuddles' and wanted to be held. He's full of mucus poor chap. I was hoping to get him swabbed (we have swabs for a swine flu test for a lab in London at home left from a previous incident) and tested through a private lab. Happy to pay for it just so we know how long we may have to incubate him for and also whether we can avoid him having the swine flu jab. However, it seems we have to have a doctor send a referral note or they won't test. Doesn't look like there's much hope with the GP as they won't call me back. Not sure whether he might have a chest infection but can't really take him to the surgery so it would have been nice if a doctor had called back to talk to me!
I'm wondering whether to crack open the Tamiflu (we have a pack left from the last swine flu scare when we decided not to give it to him as he seemed to be coping OK). Anyone given their little one's Tamiflu and if so did they get halucinations, vomiting etc? He seems to have stopped vommiting and diahorrea for the moment so I'm rather hoping it doesn't come back. I'm just wondering if the Tamiflu is worse than the illness. On the other hand I don't know if the symptoms get worse after a couple of days and then its too late to take the Tamiflu. Oh what to do?!!! It could just be another of the many viruses that circulate in winter.

Just wanted to add that I will be having a chat with our nanny when she is next in. I suggested she didn't come in today in case he had swine flu so she's at home. Everyone's comments are very useful in giving me an idea of how I should tackle this.

If you want a GPO referral and are willing to pay for it, try Dr. E-med.

The thing with tamiflu is that it is most effective if taken very early. So, if you are going to use it, you should use it immediately. If you wait until things look bad it will be too late to be of much use.

I had what I think was probably swine flu over the summer. I took tamiflu at the first hint of it. I was still miserable. The worst part was not being able to breath. If I were in your place, I think I would give my 2 year old the tamiflu. But, of course, that is easy for me to say since I'm not in your shoes.

Oh, and I didn't have any side effects to the tami flu. But, maybe it is different for a grown up.

Agree with what others have said. Common sense above all else would have suggested that as soon as she realized he was poorly he should be taken home ASAP. She obviously didn't want her social life/"playdate" interrupted, which is unacceptable. It's bad enough she ignored the diarrhea, but the fever and shaking, which could have been a febrile convulsion, is just scary!!!!! I'm not a qualified nanny. I've been doing this for 12 years, and I know that if my charge had displayed all of those symptoms I would probably have taken him to A and E, especially with the potential FC and also not being able to wake him!!!! Poor mite sounds really unwell.

I would hold off on the Tamiflu. It's side effects are often as bad as the swine flu to start with and if you can control his fever with Calpol, get lots of fluids in him, have him rest/sleep lots you might find that's just as effective. I hope he's feeling better soon.

I had SF - it was hideous. Your poor, poor DS. I didn't take Tamiflu (or whatever the French equivalent is) and if you are coping without it then I'd be inclined to avoid the side effects if it was my own child.

I thought of this thread this afternoon. I had an unwell sounding charge with an unusual nappy - first thing I did was check his temp (which was normal so I suspect teething) but did make me wonder why your nanny didn't check the temp! It struck me that it's one of the first things I do if I think a child is ill.

agree - the average professional nanny would check temp and probably give calpol and see how is after 30mins

certianly wouldnt continue playing at friends house - very weird none of your nannys friends didnt say go home/check temp/give medicine/strip etc

My 6 year old would know to check his temp.

think i read that op nanny is 19

nothing wrong with that (we were all 19 once) but she obviously needs a refresher course in first aid/common sense

Do you think there is a common sense course? I always regarded common sense as something everyone should possess without having to go on a course. Maybe a big ol' stick could knock some sense into her?

I never say this on these threads but if I were you I would have to have serois harsh words with my nanny. God forbid but what if he had a time sensitive illness (menengitis/appendicites etc) and she left it all day to get it sorted.

I have no nanny qualifications but do have first aid. But to be honest at 10 years old I would have known feeling hot warrants a temp check and a dose of calpol.

As an aside are you giving him any neurofen as that can be given with calpol (2 hours apart) and is apparently mroe effective at reducing a temp. If you do mix calpol and nurofen make sure you read the labels on both and don't just take my word for it as these things do change often! I'm sure you know but a coll flannel often works wonders as does opening a wondow but coveing DC with a thin cotton sheet.

Hope he feels better soon.