AIBU to expect nursery to follow instructions on medication???

[confuddledDOTcom]

Stuck here because I don't want it to turn into a horrible mess on AIBU.

Toddler has chronic brittle asthma. It's taken a long time to get the medication to a point where we don't have attacks all the time. From six months it was monthly, then they added something in and it became alternate months etc until now the last one was 18 months ago with just a little more delicate than other kids, not no attacks.

Started nursery last September, come October/November the weather changed and we needed to add in a blue inhaler into the middle of the day as a cough developed. Over the winter Toddler has had bags under the eyes, very pale skin etc so we've constantly been reminded to keep up with this blue.

We tell nursery, nothing happens. I say "the cough is really bad today, it's brought on retching all the way here, you must give that blue at lunch time before playtime". End of day "cough has been fine didn't need inhalers, it was probably just the walk".

I've been in, Mum's been in (she's scarier than me without losing her temper like me) between us we've signed three times - twice because we've told them to give it and once because it was needed.

Just over a week ago nursery went on holiday to a farm for a few days. Medication was put in a shoe box and a sheet emailed to them explaining the medication.

Shoe box contains
Brown inhaler
Green inhaler
Blue inhaler
Three Montelukast tablets (one for each night and one for dropping on the floor )
A bottle of Piriton

Copied from the sheet:

Morning
? 1 puff of green for a count of ten
? 2 puffs of brown for a count of ten twice
For a count of 30
Afternoon (around lunch time, before going outside)
? 2 puffs of blue for a count of ten, twice (count of twenty)
Evening
? 1 puff of green for a count of ten
? 2 puffs of brown for a count of ten twice
For a count of 30
? 1 Montelukast (Singulaire) tablet to be chewed (Toddler calls this "special sweetie")
? 5ml of Piriton (it?s very runny so pour slowly)

Emergency is unlikely but just in case:
Getting breathless
? 2 puffs of blue for a count of ten twice

I that Toddler is very good at medication so to ask if they're not sure.

I was a little anxious but thought they might get the hint! A few days after getting back I was talking to the manager and she explained how Toddler, with hand on chest, had said one day "I can feel my asthma coming on" so the teacher had given one puff of green. I felt a little about that.

Although green is the same as blue, so not really a problem if Toddler's not feeling good but it's a higher dose and longer acting, so you can't do what I've put there and it doesn't kick in as fast (a bit like gas&air vs paracetamol!)but the main reason for feeling was it suggested they hadn't read the sheet. Then I opened the box and found the 3 tablets still in the tray and Toddler tells me that they'd given one green and one brown morning and night.

Last Thursday Toddler stayed over at my parents house. Friday I got a call from Mum to say she was on the way to the GP as it looked like Toddler may have chicken pox. No chicken pox but some sort of an allergic reaction (we know there is an allergy which is why the daily piriton, but not what) the eczema is bad,conjunctivitis and Toddler is run down.

May not be related but Mum is ready to kick off at nursery! She was going to do nursery run this morning so she could have a word but having spent all night awake with Toddler throwing up all over her bed we've decided it's not a nursery day!

I'm just glad all this is over soon with school starting, but I'm so angry that they've done this to my child. They've never seen an attack Toddler style! They've never watched an oximeter and looked at each other knowing that reading means a heart attack is imminent or felt the life draining from the fragile body limp on your shoulder AND NOR SHOULD THEY OR WE AGAIN BECAUSE THEY THINK THEY KNOW BETTER THAN THE PAEDIATRICIAN!!!

I'm glad (sort of, but not, IYSWIM) that I'm not the only one with a teacher who thinks they knew better than a paediatrician! It's almost tempting to stop all medication to show them why she takes it! I wouldn't of course, having watched her pushing a heart attack last time I never want to get there again.

Usually her attacks are quiet, not like you normally think of as an asthma attack. She slows down, becomes quiet whilst the colour drains from her face and her eyes go dark. At the same time the gaps appear (tugging and pulling) as her breathing speeds up. I notice when we get home from nursery she'll collapse in a corner of the sofa and beg to be allowed to go to bed or for a blanket so she can sleep on the sofa. So for them to say she wasn't coughing or was OK or whatever, they can't honestly say that because they most likely wouldn't notice (she didn't need her inhaler today but she's been quite tired...)

I send her Mon/ Wed/ Fri because I knew she'd need alternate days to recover. I do worry how she'll cope at school without the day in between. I know on a personal level she'll keep up with the other kids because she doesn't want to miss out (toilet training is fun!) but she'll be worn out from it.

What a terrible situation to be in.
I am in education and as far as I know there is one major factor here- the nursery are not allowed to discriminate because of a child's illness/treatment and to me, it sounds like they are (even if they don't know it).
Of course, if the treatment is too specialised (which I don't personally think it is) then an appropriate person will have to be funded. I don't know whether it would be appropriate- probably not BECAUSE it is not that specialised and hard to undertake the administration of the medicine- but children with severe medical needs are often eligible for SEN statements or funding. For example, children who need 'peg feeding' through the stomach.
This sound like they can't cope so you could:
Speak to/write to the nursery about your exact feelings on this- a letter can often get across the severity of the situation and you can express what you want to say in a calm, clear manner
Get advice from your county council regarding SEN/funding or even just their opinion
Move to a different nursery (quite drastic?)
Contact OFSTED and see what their opinion is (I would personal only resort to this at the very last step)
Hope it get resolved soon for you all. Keep in there and be strong.
x

if your child has a long term chronic condition then a "care plan" should be in place that all staff at the nursery should sign on to.
It may be that you need to formalise the process a little.

Does your child have an Asthma nurse that she visits.
Could the Nurse complete a care plan & maybe even give the nursery a quick training session??

Sounds like the nursery need to take your childs health more seriously, sometimes people listen to healthcare profs a little more than they listen to us fussy parents.

YANBU. When DS1 or DS2 has needed medication, their nurseries followed a carefully thought out medication plan. I filled in a form every day saying what had to be given when and how it had to be stored. At the appropriate time, the medication was administered and signed off by a second member of staff. I believe this is standard procedure.

Once, they realised that DS1's medication had been overlooked (by an hour) and the room leader immediately rang me at work to say what had happened and get instructions as to what to do. If I had not been available, they would have rung DS1's GP's surgery for advice. Again I believe that this is standard procedure.

I think that where the nursery might be struggling and what they might reasonably find difficult, is making a judgement as to when medicine is needed. For this, you and your DD's medical team need to work with the nursery to develop an action plan.

If there are any more mistakes with compliance with the action plan or regular medication, I would complain to ofsted because these poor procedures endanger your DD and other children with chronic conditions.

1. asthma policies may be in place, but that doenst mean that all staff are aware or knowlegble about asthma. head office may make the paperwork, but with little understanding and support they will make mistakes.

2. are the staff responsible for all days medicine intake?
   do you do the morning and evening stuff at home?

3. the nursery nurse managers are responsible for drug administration.......if they arent that on the ball........it would out in to question other areas of care.

4. if you truely think that they may not notice your child not breathing in a corner, by all means contact ofsted, but consider first your child, move her to another setting where you feel your childs well being is secure.

5)the unknown allergic cause is a problem , and should be sorted, the culprit discovered, just in case even daily meds dont control the reaction.

As the mother of a child with many life treatening allergies, have had plenty of difficulties with schools, to the extent that i teach THEM about my child/allergies and reactions. I tell them at the start what the situtation is, get medical support from comunity school nurses, in setting before i left my son in their care.
i never expect teachers/ school staff to understand asthma, and in fact am a volunteer for a charity that goes into schools and teaches the kids about asthma and allergies. half the time we are teaching the staff, who are not greatly supported in this area.

nursery is not compulsery, you can move your child and find different care.