Administering Medication Help!

[Guest]

A parent has demanded that I use E45 cream from a tube to wash his childs hands as he has ezema on his wrist. I have asked him to go to his G.P for some prescribed cream/soap as I felt it came under the heading of medication. Our polices and procedures require only prescribed medication with the childs name and the strength and dosage on it. He has given me written permission to use E45 as a soap. He has stated that if I refuse he will put a wriiten complaint into the Committee (Which his wife is one) and complain to OFSTED.

Ofsted have said I should follow my Polices, however if they deem them inflexible to the childs needs I an in the wrong, in there eyes.

My local CYPD say I am not to administer not prescripted Medication.

So if I administer I am in the wrong and if I don't I'm in the wrong.

I have got my appraisal with the committee on Wednesday, why did it have to happen this week?

HELP what should I do?

 

 

Do your polices allow for non-prescripted meds.

Any thoughts would be apreciated

Clare

[finleysmaid]

say that it will be absolutely fine .....as long as it has a perscription label on it ...our doctors surgery used to us asking for this and then you are covered. as this child is under 18 he wont need to pay for the percription so shouldnt be a problem

(if you are concerned lookup managing medicines on the web and check the advice there)

[mundia]

Hmm, got 2 views on this.

On the one hand, I wouldnt really consider E45 as a medicine (in the same way I wouldnt class sunscreen as a medicine), although I would be curious to know why they dont use the E45 wash which is specifically designed as a soap substitute.

 

On the other hand, if you are concerned, then you are not refusing to do it, you are just asking if they can get it on prescription, so even of he did complain, you can indicaste that.

 

I think this one possibly boils down to what is a medicine and what isnt?

[HoneyPancakes]

I understand the need to follow your policies, but in the short term, would you be acting in the child's best interest to use regular soap or exclude them? No. This case is more along the lines of sunscreen application than medication application. Or providing a dairy free alternative for a lactose intolerant child. It may take a week or so to get a doctor's appointment and I'm sure the parent will be glad to receive free creams with the required labels as soon as they can get to a doctor.

 

Honey

[Inge]

we too saw this in same way as a sunscreen and had parents letter to cover us allowing us to apply it...

 

my other concern is that E45 cream is not actually washing hands.... you are just moisturising the skin but all the 'bugs' dirt etc remain on the hands and will just be moved about and have a mice warm 'moist' surface to multiply in. Which in turn is not good if the skin is broken in any way..

 

or is it just me that sees it this way?

[Rea]

As a parent of a child with exzema, I'd be really annoyed that you were refusing to apply a moisteriser that can be bought over the counter, so I can see Dads point. Do you have to apply it or will he be able to do it himself?

On the other hand if your policy says you wont administer anything to do with medical conditions without prescribed products then for now you'll have to stick with it. I'd personaly review the policy too, like others have said its no different to using sun cream. Maybe that way mom will be able to be involved and will understand why you have refused without a prescription. Would you react the same way if he bought in E45 soap?

[finleysmaid]

try the link here (you need to upload) page 9

http://nationalstrategies.standards.dcsf.gov.uk/node/84514

E45 has active ingredients and is available in several forms(also one i'm allergic too so i'm always careful with it!)

[Guest]

I think I would go with the parent's wishes on this one. I don't see E45 as a medicine, although he could probably get it free if he requested it from his doctor so that might be an approach to take with the parent!

 

He might be better off with an aqueous type cream prescribed by a doctor rather than a branded one.

[finleysmaid]

just trying to find the info but we are informed by our first aid training company not to have any creams or lotions in our first aid box...it says

the medication should be perscribed by a doctor and should be in its original packaging(to prevent a parent from inappropriately administering medication, and you are unwittingly helping them)

i think rea has a point but you are not refusing to apply it just needs to be done under your rules

[Deb]

·

 

Only prescribed medication is administered. It must be in-date and prescribed for the current condition. NB Medication that is recommended (prescribed) by a pharmacist or nurse without a prescription, including over the counter medicines such as paracetamol, may be given as well as medication prescribed by a doctor or a dentist or an appropriately qualified pharmacist or nurse (taken from the Ofsted factsheet ‘Giving medication to children in registered childcare’ 2009)

 

Hi

In a bit of a rush but the above is taken from our policy. Take a look at the Ofsted fact sheet which clarifies the word 'prescribed'. I would personally do this if it was in the best interests of the child and there is a geniune health reason to do so.

HTH

 

hy

[Guest]

Thank you for all your replys.

I think I need to clarify a few points, as I did not explain myself as I was upset.

The parent was extremly rude and unpleasent. It was not a request but a demand, with threats of disipline as his wife is on the committee.

The E45 is to be used as a hand soap.

The parent is calling it a medical condition and the E45 medication.

It is to be used only on the hands (which has no ezema, the ezema is on the arms).

The parent says the E45 is not to be used on the ezema in fact I am not to put anything on it at all.

My concerns;

As the parent is calling IT a medication, they should meet our polices, which is prescription only and labelled appropriatly.

It is not a soap substitute.

After last years Norovirus and the Swine flu I feel that not using a soap or substiute I am putting everyone at risk.

Am I being unreasonable asking the parent to use prescrition medicine as they have been 'suffering for the last year' parents words, surely they would have been to a GP.

Am I being unreasonable asking the parent for a soap substitute?

I was extremly polite he was not!

I have no problem administering medication I have been doing it for over 13 years for the CACD (Community and Adult Care Directoriate) and have a NVQ level 2 in Administering Medication.

 

OFSTED have stated that only administering prescrition medication is out of date and no longer applies.

CYPD have stated that only prescription medication can be applied.

So if only this parent would use a soap substitute and stop calling it medication and be a bit more polite all would be well.

No one likes to be shouted at and threatened in front of children, parents and staff!!

 

 

Many thanks

Clare

[Guest]

Hi Clare

 

Sorry to hear about how this parent treated you. No wonder you are upset.

 

Your committee have no right to use this against you in an appraisal, and in any case appraisal should be a positive thing, focusing on what is going well and setting a few targets, not a chance to seek revenge!

 

Could you ask your early years team for advice? Ask also if you can have a colleague sit in on your appraisal maybe?

[Guest]

Have you gone to the child's Health Visitor and get some advise from them, or nursery nurse, at least you have a medical opinion, which at the m oment you don't have.

I'm of the opinion that E45 is not a cleanser of any sort so would not disinfect the hands.

tricky one but good luck

[Panders]

[quote name='4x4clare' date='Jan 15 2011, 16:46' post='28035

 

 

OFSTED have stated that only administering prescrition medication is out of date and no longer applies.

 

 

Many thanks

Clare

Clare, I am sorry to learn that this parent has treated you so badly in front of your colleagues and children - what can he have been thinking of? I hope you come to an amicable understanding about what to do very soon.

 

Did you telephone Ofsted and get this response from them? What a shame we don't get up-dates from dear old Ofsted each time they change their opinion on things!

[Cait]

Yes, I think it's the term 'medication' that's the sticking point. As a coeliac, I need special things for me to eat, but I'd not consider a gluten free pizza to be 'medication' even though I get them on prescription. It's an odd one, isn't it.

 

As others have said, I'm not sure it's possible to 'wash' your hands with a cream, without water. How would it destroy germs and things? He'd surely then be transferring greasy germy fingerprints to everything he touched - which isn't good for anyone else. No, it's a strange one this

[finleysmaid]

i think the factsheet refered to by deb is this one

http://www.ofsted.gov.uk/Ofsted-home/Forms...tered-childcare

though it obviously is not the answer to clare's problem ...so sorry if i mistook where you were coming from! thats the problem with writing things sometimes the emphasis is not where you want it to be

[Fredbear]

Hi Cait i hope you don't mind me asking and this is not too personal a question but apart from foods containing gluten, wheat, malt, making playdough and playing with it, play with pasta, junk modelling boxes, is there any other hidden gems i should be mindful of. We are due to have a little one whom is a Coeliac start soon, will do the obvious diet/snack care plan, just don't want to inadvertently miss something.

Will understand if you don't wish to answer.

Sorry for hijacking the thread too.

Edited January 15, 2011 by bridger

[Panders]

Thanks for that info Finleysmaid

[Cait]

Hi Cait i hope you don't mind me asking and this is not too personal a question but a part from foods containing gluten, wheat, malt, making playdough and playing with it, play with pasta, junk modelling boxes, is there any other hidden gems i should be mindful of. We are due to have a little one whom is a Coeliac start soon, will do the obvious diet/snack care plan, just don't want to inadvertently miss something.

Will understand if you don't wish to answer.

Sorry for hijacking the thread too.

 

You need to be aware of barley, malt type things, like in cornflakes, rice krispies etc and get used to reading simply EVERYTHING on the ingredient packets. Most things nowadays have allergy information, which is a real help, but well-meaning folk can often make mistakes.

 

If you do birthday cakes you'll need to be aware of if the child will be in on that day, and either provide gluten free cake for everyone (which is bloomin expensive!) or have something different for this child. (which doesn't seem fair, sometimes) either way, you are going to have to reassure and reassure again with Mum. It's important to find out how severe the allergy is - some children will be ok with ordinary playdough and pasta as long as they don't ingest it.

 

the coeliac society has lots of useful info. Ask if you need more

[Fredbear]

Thank you so much Cait, have already purchased gluten/wheat free flour for making our playdough.

Mum is going to provide some alternatives after giving her our snack rota list.

We actually have a wooden cake so that won't be a problem, going to keep mum informed when our celebration days are so we can plan for this too. We have also purchased a separate lidded container to keep all his foods and equipment in chopping board, knife, cup plate and alternative foods.

Thank you for the link too.

[Fredbear]

Can we still use cornflour[gloop] Cait.

Edited January 15, 2011 by bridger

[Cait]

Yes that shouldn't be a problem - if in doubt, check with Mum as he may have dermatitis herpetiformis with his coeliac, and the cornflour may dry his skin.

[Fredbear]

Thank you will check with mum.

[Guest]

he has stated that if I refuse he will put a wriiten complaint into the Committee (Which his wife is one) and complain to OFSTED.

 

I think that as this is a policy issue which needs clarification YOU should take this matter to the committee BEFORE the parent does. I think you should raise your concerns with cross reference to other policies such as health and hygiene, state that you do not understand the purpose of the E45 (as it is not for the area of the wrist) and to do your job properly you need to know why it needs administering and then request that the committee gives you (and all of THEIR employees, the other staff) clear guidance as to how to proceed.

 

The ultimate responsibility of the health and welfare of the child lies with the registered persons, ie: the committee.

 

If you still have concerns for the child's health and welfare following the committee's decision then you can decide whether to take it up with Ofsted on the child's behalf.

 

It is totally wrong for this parent to 'threaten' you in the way he did, you could be generous and put it down to him having a bad day, stressed with his child's eczema, and through your professional response hopefully he will learn that the committee are not a power to be wielded against staff but a partnership between parents and staff in the best interest of the child(ren).

 

I hope this concludes with the committee ensuring that the health & hygiene, child welfare, and medication policies are clarified and adapted if necessary.

 

Let us know how it goes.

 

Peggy

[Guest]

My view comes from that as a nursery practitioner with an independent nursery background.

 

Firstly I think that you have to stick to whatever your policies inform you to do, and explain to parents that you have a duty to do so.

 

I think I would establish whether the E45 cream is medication or not, whether or not the parent calls it mediciation.

 

I would then meet with staff team to discuss and, if it was felt upon reading of the policy that it was no longer 'fit for purpose', I would update the policy to include application of non medicated creams and lotions.

 

I would then again speak to the parent, explaining that in an endeavour to meet the child's individual needs the policy had been updated and with permission letter you could now apply.

 

If it turns out E45 is classed as 'medication' due to its contents, then I'd stick to existing policy.

 

I would not want to be drawn into a battle of wills with the parents.

 

Excuse my ignorance, but do pre-school committee's draw up policies rather than the staff team?

Edited January 16, 2011 by Guest

[Fredbear]

Hi Committees are a representation of the users of the provision and in partnership with the staff team write up and adopt the policies.This normally happens each year at our AGM.

As they are working documents, it is important to evaluate regularly and make changes if deemed necessary.There is no point having them if they are not a true reflection of your practice.

[Gezabel]

Sorry to hear dad was so rude about this issue

I don't understand how E45 cream can be used as a soap? However the welfare requirements state that non prescribed medicine can be administered with written parental consent and we have this in our policy.

 

However, I think professional judgement needs to come in to play. I had a child who came in with a drink in a cup. Mum just happened to mention that she had made a drink up with medised in it!!! I refused to keep the drink on the premises as I was not happy giving a child an unprescribed sedative and the drink was a risk to other children.

[Deb]

Hi

 

Am up to my neck in assignments but wanted to add to the debate, apologies for brevity but I should be writing my assignment.

 

It is very sad that the parent should be so rude. I think Peggy's idea about being proactive and seeking clarification from the committee is a very good one.

 

I think the issue of the wording 'prescribed' is relevant.

 

I have a dim memory of being told by a doctor to use E45 as soap for my hands, so do check that. It could be that E45 was recommended/prescribed by a doctor or pharmacist to use.

 

With regard to hand hygiene, we don't use anti-bac soap in our setting - I think there may be a discussion on here somewhere about the merits of which soap we should use. I beleive it is the act of rubbing the hands that removes the germs??

 

If there is a geniune health reason, and the E45 was recommended or prescribed by a doctor or pharmacist, I would be inclined to meet the child's needs having first sought clarification of my policy with the committee.

 

Just my opinion, no offence intended, hope you get the problem sorted out and the parent apologises for being so rude.

[finleysmaid]

you can get e45 in various forms including a soap

you might want to have a look here

http://www.e45.com/emollients/index.php

 

looks like there might be lots of useful info...you could 'blind him with science'

[Inge]

just to add to this...

 

document everything... write down all that has happened and all that was said.. get statements from staff and any parents present that witnessed that parents attitude towards you.

 

Include statements on why you are concerned about how this may be inappropriate and against policy.. include the bit about hand washing and removing germs.. this was my initial issue with this.. does he want you to use water too... if so there are better creams for hand washing perhaps suggest an alternative that you will both be happy with.

 

never deal with the parent without someone else being present- member of staff

 

as they were confrontational this was hardly a confidential matter so there will hopefully be people who will be able to do this for you.

 

open up/ complete a complaint form for the parent to sign and show you are taking this seriously and how you are proceeding..

 

as Peggy has said be proactive and go to the committee first... always much better if you are the one shown to be trying to sort this out before it goes any further..

 

I know it may seem over the top but you need to cover yourself.. if nothing else it gives perspective to have it all documented.

 

had a similar issue of a parent being very vocal and shouting at me , over a different issue, but was aggressive and did actually take it further to Ofsted... I was so glad I had documented all, done a complaint form and contacted committee etc before they had the letter.. really helped when they eventually visited... and it was not upheld a I had followed what was written in the policy and done all I should have... had I not followed our policy they said it may have had a different outcome..