Get a note from your doctor: Toilet Pass

[EightOranges]

Hello, teachers!

I'm not a teacher so I hope you don't mind outsiders butting in, but I do have a topic I'd like to raise with you.

I am a doctor working in NHS general practice. A recurring theme in general practice will be a mum or dad pitching up with their school-age child, and asking me to provide a 'toilet pass' for school. Sometimes they tell me that the school has specifically told them to go to their doctor to get a toilet pass.

My response to this is always the same: "I do not provide toilet passes. Is there anything else you wanted to talk about?"

If pushed, I will go on to explain that whilst I can assess any urinary symptoms (it's usually wee) and potentially provide a diagnosis, plus advice or treatment, I will not write a 'toilet pass'. I do give them the practice email address and ask them to pass it on to whichever teacher has (allegedly) asked for a toilet pass because I would, out of respect and professional courtesy, be willing to talk to them at a time that suits them. So far I have never received an email or call from a teacher.

So my question for you all is: Do you really tell kids/parents to go to the doctor to get a toilet pass?

I assume that kids who constantly disrupt lessons, by asking if they can go to the toilet frequently, are a pain in your ass. I also assume that you occasionally have some sincere concern that there may undiagnosed infections, or diabetes, or other problems which require the attention of a doctor - or maybe some other medical/psychological/safeguarding issue for which needing a pee is a less embarrassing thing to announce to the class when they want to get out of there. In these cases it's generally reasonable to signpost kids/parents to a doctor and that's why, once I've put my cards on the table re: the toilet pass, I'll always try my best to screen for these issues and discharge my professional duties.

BUT, I also assume that in many cases, you suspect this is just a kid's way of getting out of class when they are bored or wanting to go and smoke etc. And here is where I want to make it plain: once I've ruled out significant pathology, I actually can't tell any better than you can whether or not a child is genuinely desperate for a pee, or if they are just playing up. There is no validated medical way to know this.

In most of these cases, kids who go to the toilet more frequently than normal just have what we call 'functional' issues. It's a software issue, not a hardware one. I can advise parents / kids on how to train their bladder - or, more accurately, given that by this point I have about 3 minutes left, I can point them towards Eric.org.uk and give them some homework and invite them to come back to discuss it again. (they generally don't come back).

I also strongly suspect that the concept of a 'toilet pass' is something conjured up by parents who, as seems to be the trend these days, give in to their kid's whims and demands far too readily.

I'm glad I got that off my chest, and I'm very interested in hearing the teachers' side of this.

(Btw my wife is a teacher, so I know exactly how hard and shit your job can be. However my wife vehemently denies ever telling kids to get a toilet pass, so she is no use to me)

Teacher here.

We tell pupils that if they think they need a toilet pass then they need to go to the doctor and get some medical evidence. We don't tell them that the doctor can issue the pass. I think the pupils are telling their parents what they think the teacher says.

Several of my pupils have toilet passes. They certainly aren't given out frequently at my school, and reviewed annually.

We tell the children that they must go to the toilet before the day starts, at break time and lunch time. This is good training ofcourse for life. We tell them the only exception is if any of them have a medical issue, and this must be proven (i.e medical evidence). If it isn't proven, then we assume they are making it up and therefore are just trying to get out of the lesson. We can ofcourse always tell if it's a genuine emergency and they need to go, when the child that never normally asks to go, suddenly asks to go. The problem is the children who say they need to go about ten times a day. It's then we say, well perhaps there is a medical issue. Nine times out of ten, they are just trying it on.

Unfortunately, if we didn't have a stance like this, the children would pretend they need to go ten times a day, either for a little walk, time away from having to work hard in the classroom or to meet up with friends. The increased requests are probably due to more and more parents thinking it's unfair and they just love to say to the school "You have to let my child go to the toilet, the doctor said, so there". It's more about today's society I'm afraid and the pushback against authority.

Agree with all of this @PrimaryTeacher123. I'm secondary and we really have to have restrictions. They don't go for more than two hours without a break. I've no sympathy for the child who chugs away at a water bottle then demands the toilet (but plenty for the child who very quietly tells me they aren't feeling well and would I mind if they excused themselves and went).

Sadly some parents are somewhat unreasonable. When a year 8 tells you that their mum has said it's his human right to go to the toilet whenever he wants, for example...

It's parents passing on a sense of entitlement and saying nobody can stop anyone going to the toilet, it's a human right. Parents think that doctors are so overworked (which they are) so will issue letters etc to get rid of you quickly.

Entitlement is becoming a problem in primary about many issues, not just toilet access.

On the other hand, my dd, who has just started secondary, feels intimidated going to the toilet at breaktimes because of the girls vaping and acting 'gangish' in there so will often ask to go during lesson times to avoid them. So far, she's been allowed to but I can see this being stopped soon so she'll have to be brave as she wouldn't qualify for a toilet pass.

Teacher here -primary.

We don't give toilet passes but do have some SEND children who have a card so that they don't have to verbally ask permission.

We aren't super strict on going to the toilet, but we do have a few students with toilet passes (generally IBS related) so we know not to query them if they have urgency to go to the toilet, or they are gone for a long time. We don't ask the doctor to write a toilet pass, but the school would want to see some medical evidence of diagnosis or investigations.

If a student is feeling urgency or struggling to hold on multiple times in the school day, then I would guess that's something you'd investigate? If there's no obvious medical cause, I'm not sure what you'd suggest? But if there's a diagnosis or ongoing investigations (are you allowed/able/willing to confirm this?) then we'd issue a toilet pass, no problem.

If there's been investigations and nothing has been found, then I think it's between the parents and the school?

Some schools really do have to have restrictions around who goes to the toilet when, due to things including vandalism, vaping in toilets and mental health issues (toilets can be a popular place to self harm/eating disorder symptoms etc). But I fully accept that's not really your problem and I think it's fine to tell parents what you can/can't do?

Agree with the other comments. It’s a real issue in my current school and I usually tell the worst offenders that if they need to go to the toilet every single lesson then they need to see their GP because it assumed that the average secondary school student should be able to control their bladder. This usually nips it in the bud because they know their parents want them in lessons and learning. However, I can well believe that there’s a growing number of nightmare parents who are probably actually taking their little darlings to the GP deliberately misconstruing what has been said in school. To give you an example, one child in a colleague’s class asked to go to the toilet a few weeks ago (just after break) He was asked to wait as is school policy. There were parental complaints from parents whose kids didn’t even ask to go to the toilet! These parents clearly don’t understand the chaos caused by kids being out of lesson’s unsupervised! Behaviour and entitled parents are the worst part of the job!

I agree it is a real issue with entitlement, increased use of water bottles and life skills in upper primary.However, I notice some chn with hypermobility tend to need the toilet more and don't necessarily have medical evidence.

No teacher has ever asked a pupil to get a toilet pass from a doctor.

School staff may have said they need medical evidence in order to give a toilet pass. ‘Medical evidence’ wouldn’t necessarily (or often) mean a letter from a GP though.

Yes this is probably a miscommunication from the parents.

Schools issue toilet passes where there is a medical need.

A parent who thinks that their kid needs a toilet pass would be asked what the medical need is, and for evidence. So a kid with diabetes, or IBS, or a girl with really heavy periods would be able to show that.

A parent who insists to the school that their kid needs a toilet pass would be directed to the doctor to get that medical evidence.

There are lots of parents who would ask the school for a toilet pass for their kid not because they have a medical condition but because they would like their kid to be able to walk out of lessons whenever they want.

No one has mentioned periods here. As someone who has very heavy periods, how does this work? 2 hours is a long time to go between toilet breaks when you are bleeding heavily and petrified about bleeding through your clothes. And yes this includes wearing period pants and using tampons and pads, all at the same time. Does every girl who has heavy periods have to get a doctor's note?

I mentioned periods. And you'd hope that a girl with periods that heavy would be taken to see a doctor!

There needs to be legally mandated breaks and numbers of toilets per pupil in schools. My local school until recently had a 20 minute morning break and a 20 minute lunch break. The morning break was fine but there was a big campaign by parent to get the lunch break lengthened as there was simply not enough time to walk to the canteen, queue up and buy and eat lunch, and go to the toilet in a school with 1,000+ pupils (or walk to locker to get packed lunch, find somewhere to sit and eat it, and go to the toilet). There was also reports that only a few boys and a few girls toilets were being opened at break and lunchtime with the rest remaining locked. If you were late to a lesson because you were queuing for the toilet this would result in being sent to reset for a whole day’s worth of lessons.

I'm a Secondary teacher but not in the UK. We don't have toilet passes and I let kids go to the loo whenever they want, but I have noticed a serious rise in how many kids and how often they're going. For sure some of them just go for a dilly-dally. I genuinely think their attention spans are so poor, some of them just can't get through an hour of class without a break.

Recently we had a Year 8 event which required around 120 kids to sit in the auditorium for just over an hour. Around 30 of them asked to use the bathroom during this time. When I was at school, I would have needed to be absolutely DYING for the loo to stand up in front of my whole year group and ask to be excused, but it didn't bother them at all!

I will add that we're in a very hot country so they definitely do drink a lot of water. But still, the amount of bathroom use during lessons is huge.

I'm sure the disruption caused to lessons in an average UK school must be massive if anyone can use the loo anytime, but as a parent I would also be furious if any of my children were not permitted to go when they needed to. I don't have a solution and I definitely see it from both sides.

The problem is not being told to wait until break to go to the toilet, but the situation that ensues at break time. Not enough toilets, toilets left locked, unclean toilets, toilets with 'big kids' taking up residence and scaring younger children out of using them.

No child should have to plan not to go to the toilet all day at school because they don't feel safe to do so, either through fear of other kids or fear of staff if it makes them late to a lesson. That is the sad situation many kids are in. I don't blame the parents of those kids for looking for a solution for their child.

This.
I have pupils who are literally plugged into their water bottles like the baby off The Simpsons -
Chugging away constantly is a good description.

Yes they do.
many hate the toilets at breaks for the usual reason of bullying pupils hanging about in them or senior pupils in them.
Pupils are told to go between classes but then late for class.Teacher then spends wasted time giving pupil into trouble.
The kids who would abuse the going to the toilet are usually well known for truanting class, why ruin it for everyone else.
Some just need to decompress from a stressful class (in ours its HE) and why not. Teacher times them!
Honest to God let them go to the loo without a stewards enquiry, or humiliation.

I’ve just come across this thread, I find it disgusting that most of these teachers find it normal to deprive a child from going to the toilet. I bet most of you work for an outwood academy? Well I’ve got a SEN son, who’s been sent home by medical 3 times since September due to stomach pains because they aren’t allowed to go to The loo. He won’t go at break or dinner. 1- because the ques are massive and he waits and waits but won’t dare tell the other students who are pushing in to stop. So never gets to go. He came home last Thursday in agony again, Dr on Friday said it’s because he’s holding his pee in too long and it’s affecting his bladder. I’ve been talking to school last Friday and today and they’ve asked for Medical evidence. Either off CAMHS or his Dr. I asked the question to his Dr last week and she said no way do they need medical evidence to allow a student to go to the toilet. But I will show her the email tomorrow and waste her time. Just so you lot can feel empowered over a 12 year old and not letting them go to the loo. He doesn’t even want to go back to school now. You ought to all feel ashamed. Also when you say “getting them ready for work and adulthood” load of crap. I don’t know many jobs where theyd say no piss yasen.

What a goady and ridiculous post!
If your child has medical issues then you’ll have a no problem getting them a note. The vast majority of kids in a secondary school are perfectly capable of waiting until break or lunchtime. No child with a medical reason will ever need deprived from using the toilet in school.
You clearly have no idea what it’s like to work in a school. Are you seriously suggesting that kids should just be allowed to get up and leave lessons whenever they want to go to the toilet? Can you really not see any potential problems if this was the case? What if half of the class all ask to go at once?
Behaviour is pretty shit in schools these days, toilets have to be supervised at break and lunch times as a result. The biggest issues are bullying, vaping, self harm etc. Who exactly do you think will be supervising the toilets during lesson times? Are you expecting teachers to leave their classes? I bet you’d be the first to complain if your child was attacked by another in the toilets because they weren’t supervised.
Your doctor sounds just as clueless, they are a bit misguided too if they seriously think they have some sort of authority over schools and rules they put in place to keep children safe!
No teacher is going to feel bad for enforcing rules to protect students.

The majority of drs don’t give medical toilet notes. A quick search on google tells you that. In fact they put a template letter for parents to take explaining they don’t on there website. Most teachers are aware which kids want to truant and which kids vape, and which kids legitimately actually want the toilet. (Teachers own words at the academy) Toilets aren’t manned in lesson times anyway in most academy’s. SLT staff walk the corridors. Teachers don’t have to leave lessons either. God forbid that, they’d be striking again! Also self harm? If that’s a massive problem in the school you work in maybe you Teachers in that school should be wondering why? It sounds like you work in a boot camp not a school., and by the CLUELESS fiction post you’ve just wrote you must be an English teacher.

@Bastardthedog
Of course doctors can and do provide notes, I’ve seen hundreds!
You have absolutely no idea of what it’s like in schools. SLT walking the corridors? Don’t make me laugh 😂 With multiple teachers calling for on call support at any one time they really don’t have time to be walking the corridors. I’m pretty sure they’d be offended at that suggestion too given how stressed and overworked they are. Plenty of posts on here demonstrating that.
In my experience MH issues in children are predominantly the result of previous experiences or general poor parenting.

@Bastardthedog As for the low dig about striking, your lack of awareness is really coming across here. How embarrassing for you! I bet you’ll be the first to moan when your DC has no teacher because they’ve all left due to ridiculously entitled parents. Believe me, I know many of great teachers who have. I bet you still won’t see that attitudes like this are the problem. Quite sad really!

Theres at least 2 SLT staff on the corridors at the academy I’m talking about. Oh yesss the ‘walkie talkies’ how did teachers cope without these when the majority of schools were mainstream and not academy’s. The days when kids fagged it, no vapes then. God they wouldn’t cope these days. They don’t all provide Drs notes and should only be asked for if parents aren’t believed. My Autism son has today got his toilet pass and an apology to us from SENCO as it’s took a week for them to realise it should have just been dealt with as a reasonable adjustment. MH, Autism, ADHD, attachment disorders, Ticks is not caused by bad parenting. You really are showing yourself up here and coming across as an over privileged snob. Peoples opinions are actually allowed to differ from yours.

This is South Yorkshire. No evidence should be given or needed.

This is the Staffroom, which is a hidden section for teachers, not a place for people to come and hurl abuse at teachers. Please take your posts elsewhere.