CMs - need advice on this tricky health situation

[looneytune]

I have a new mindee who started at the beginning of the month but only ended up with me 2 mornings and has unfortunately been in and out of hospital since.

Poor things has Strep Septacemia caused by Streptococcus Parasanguinis. This can attack the heart and as he has a VSD (Ventricular Septal Defect) he is being treated for Endocarditis

He's going to be on IV ABs every 4 hours for the next 4 weeks and another something 3 times a day. This means he'll have to stay each night at the hospital to allow them to give him at the right time but the parents are hoping to be trained how to give this themselves as he'll have a line through his body.

The most info has come to light this week and mum is still unable to give clear picture of what's likely to happen as they are still seeing how things go. Apparently he is now ok in himself and they are hoping for him to be released after the weekend.

All being well, mum is still keen for him to come back here and hopefully even during the time he'll be having these 4 hourly ABs. She said he's not contagious at all as it's in his blood and not elsewhere.

I've told mum not to worry about things my end (i.e. I WON'T be charging for this time he's been off) and she's going to call me again when knows more but I want to ready myself for in case she asks if he can return whilst still being treated. I'll of course ask for the Dr to put something in writing saying he's not contagious and therefore not a risk to others aswell as confirming he's fit to be looked after in this environment.

What else do I need to think about?

IF they were to ask me to give these ABs if I was shown how to, I'm right to say I can't do this aren't I? The sessions are only 5 hours each atm so maybe during this time I could suggest we change it to 4 hours so he can have them just before and just after coming?

I've made it clear to his mum that he can ONLY come back if he is well in himself but I'm just not sure about all the other stuff.

Any advice would be much appreciated Thanks.

Personally I wouldn't have him back until his treatment was finished and he had been discharged from 'hospital' led care. But thats just me. I would be too concerned about complications/ relapse and the possible consequences for me and my family if something were to happen while he was in my care.

But that is just my personal opinion.

Legally Im sure you would be ok to have him (though I might check with my insurer) I wouldn't think you would be able to administer IV antibiotics...not without an awful lot of form filling/ risk assesments etc

Hope he gets better soon. Im sure someone will be alomg who can give 'proper' advice rather than just their opinion.

I too, would prefer him not to return until 100% clear and fit.
The treatment you would have to give him will require total concentration and in that case, who would care for the other children In Your care?
Maybe he could come with mum occasionally for coffee just for continuity?

Sally x x

I must admit these were my first thoughts until she said that in himself he is totally fine and the line is inside his body so no risk of anything happening like that but I did say to mum I was concerned in case something did happen whilst in my care. I'm more than happy to wait until he's better, this would be my preferred option. Just when the mum said he's fine and because I know she needs the break (she has medical problems herself), I just wanted to look into it before speaking to her again.

Keep the opinions/advice coming and I'll make a decision later

Oh, and yes, I did think of contacting NCMA to check insurance ok.

Thanks

Even if insurance, etc all OK, then you have to make sure you feel comfortable yourself with taking on this care. It may be absolutely fine, but don't do it if you feel at all nervous, or unsure. Taking him for the 4 hrs between meds seems like a sensible solution?

I'd never take them unless I was 100% ok with it. Just wanted other peoples thoughts and wanted to check where I stood legally etc.

Personally, I would take him back. As long as he is not contagious, I , personally would and have in the past, taken children with health problems but thats just me its not for everyone and you have to feel totally comfortable with all aspects of the childs care.

Can the hospital/district nurse train you and put it in writing that you are competent in administering? Then risk assess and check with your insurance and then do as you would for normal medication administration (forms, signatures etc)

Or can he come back and mum/dad/district nurse do his meds in the day time?

I did think about learning to do it but tbh, the condition he's got can be so serious, I don't want the responsibility of something like that and not even sure where I stand with it anyway. For example, our first aid trainers always does a quick thing with epi-pens but it's made perfectly clear we would not be covered to use one without the actual epi pen training session. And this is with them being SOOO easy to use. I'd look more into it if it was a really long term thing, parents needed to be at work etc. but for me, it's not worth the worry when he only comes for 5 hours 3 times a week. For those few weeks he'd need it, it makes more sense to just reduce the sessions by an hour (mum doesn't work atm so should be fine).

ah well you didn't say she didn't work in OP - that puts different slant on it, yes reduce the sessions and everyone is happy