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Toileting Issue - Advice...


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Ok can you wise souls help? :o

 

I am new to Nursery having been in FS2 and above previously. We are a maintained Nursery so all our children are rising 4 (start the term after third Birthday). we have a an afternoon session child who is (sorry here for tmi) pooing in her pants at least twice an afternoon! we have decided she saves them up? xD Perhaps she has been told off for this at home, or clearly not toilet trained properly... either way it is becoming a serious issue for staff.

 

We have spoken to mum and pointed out this is not acceptable and she need to help her daughter to understand she needs to go to the toilet... Mum seems to think that we should be observing her continuously and when she looks like she is 'going' we should encourage her to go to the toilet! Hmmm.... well that just isn't feasible with our ratios and the layout of the room

 

So what are your policies in a situation like this?

 

Call mum in every time to change her? Ask her not to attend till she is 'clean' for the majority of the time? Not sure where to go next with this one.. so calling on your experience and wisdom folks!

 

Thanks Kaz

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I thought that they had to be toilet trained to attend school or nursery? That what i was told.

 

If it was me I would call mum in to change her, not to take her home but bring clothes, wipes etc every time. She will get sick of coming in so might do some proper training.

Is it possibiliy that the parents dont know what to do to train her?? if you can ask parent ..... Do you want some support with this? she might dare not to ask without a push. Sit down togehter and divise a plan that is fair for all and explain that you cannot 1:1 this child with so many other children with needs.

 

Tell her you will help her is she helps you too lol

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oh gosh sorry you're not going to like this but i think mums right....this child is in the process of learning and trying ...she needs help and support. She is seeking to do things for herself, becoming independent etc this is all part of the eyfs and needs to be supported as much as teaching phonics or how to kick a ball. If you have children with sen needs how would you deal with this situation? i'm sure if you concentrated on it for a few days your team would crack the issue.

Good luck :o

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Think you're right, finleysmaid - I don't think it's acceptable (or allowed!) to say a child cannot attend a setting until they are completely toilet trained.

 

I think you should work closely with mum here, seeking 'pointers' that you may be unaware of and just go with it. What sort of setting are you in? You have posted in an area that suggests your ratios may be more generous than maintained (schools or nursery classes) but even they now (in my understanding) can't turn a child away for not being fully toilet trained - I stand to be corrected!

 

Sue

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Hmmm..... we have talked to mum several times and advised on how to help toilet training, the reason I asked was because this has been ongoing now for 2 weeks and we are all trying very hard!

I know we shouldn't expect fully trained (i have 2 little ones of my own so know what its like). However it seems like it is every afternoon, every day......

I am aware we would treat SEN differently (have had children on FS2 in nappies previously), but i suppose we are just gettign frustrated we dont have 'changing facilities' only toilets and she is 'covered'

I suppose we could also speak to HV as well as have mum in again (sadly she isn't very interested, we have socio economic factors here too, mum still hadn't taken yesterdays dirty clothes out of her bag when we went in for spares today).

 

Keep chucking the advice at me!

Ta Kaz xxx

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Kaz how about passing on info from eric (http://www.eric.org.uk/) to Mum there are info sheets on the website (which i print off for my parents and hand to them!...subtle not1) changing facilities can be quite basic as long as parents know what you are doing so we just have a changing mat on the floor....be pleased you've only got one doing this.....i've got 5 not toilet trained yet...oh and my little chap with serious sen needs is NOT one of them! :o

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I'm about to put my head above the parapet here and I hope that you do not take too much offence at what I have to say in response.....(ducking and crossing fingers......)

 

I the area I live we are not able to exclude or discriminate against children who are still not clean and dry. In fact it may even be that the probems you are experiencing come from the child being forced into toilet training before they are fully ready.

 

As for the changing issues......the reason why most pre-schools etc had high ratios was to cover this type of occurance which is perfectly normal for small children. Other places such as schools etc have jumped on the band wagon of accepting ever younger chilren in order to obtain the funding and yet opt out of the less savoury aspects of caring for small children. Ratios are often related to economic factors and have nothing to do with children's welfare but what allows for cheap child care.

If one works in a nursery then changing smelly bottoms is just part of the job as is being sicked over, wiping noses and having them share their nits with you.

 

Mums approach sounds very fair minded and child centred.....as for the suggestion that the child is deliberately doing the poos during session to either annoy your staff or provide respite from stress at home....I think you should all take a long hard look at that and question your professional response.

Edited by enuffsenuf
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My advice? Change her, don't make a fuss about it and maybe remind her to try the toilet every half an hour or so. I cannot imagine that the child is doing this 'deliberately' and although it might be unpleasant for you to deal with, it's surely no joy to her either? I don't think you can blame mum.................and telling her it's 'unacceptable' just adds to the pressure here, surely? I'd just persevere..............it's part of your care for the child to deal with it, clean her up and to encourage her to use the toilet. It will get better! ( I had one child last year who didn't open his bowels for days at a time........and when he did, it was often at our setting, it was like Vesuvius erupting. Not his fault and not a big deal,we simply cleaned him up, reassured him it was ok and I always used to rinse out the soiled garments before i returned them to mum in a double carrier bag). I just don't ever understand why this is such a problem in so many settings. We are in childCARE after all and this is part and package of that care?

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No need to duck "enuffsenuf".... The reason we think it might be a response to being in Nursery (clearly not to annoy us) is the child's reaction, she tends to hide and has an almost frightened, we have obviously not scolded or upset her, we have all had children and my Nursery Nurse and other staff are all very experienced, so understand its a tricky one, no-one takes it personally!

 

We have a ratio of 1:9 as I am a teacher.. so not as high as some... hence less easy to keep a 1:1 track on her..

 

We have had a Nursery/ pre-school at the school since the 1980's (poss before that!) so not necessarily for funding more because we have a transient military community so need to offer 'education' and consistency for our local children - demonstrated by the fact we have 26 Am children, currently have 15 afternoons with 10 booked in for summer start taking us to almost capacity... It is for us less about funding but providing opportunity..

 

 

Thanks for the 'eric' link "finleysmaid" will look into that one as well...

 

Kaz xxxxx

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Guest terrydoo73

We had a child in the same situation as yourselves when we opened last January. This child was not completely potty trained so mum kept her away until she felt confident. Child did have the odd accident (both poo and wetting) but we just got on with changing her although there were some days when there was nothing to change her into which was something we raised with mum but she felt there was no need to have a change - it was the only way to teach her according to mum! It got to the point that we had to ring the mum every time an accident happened to come and bring a change of clothes.

 

Anyway in June last year she seemed to be having an increase in accidents and mum took the decision to withdraw her completely from the Playgroup. Mum was very insistent that it was not the same at home, just when she came to us. Anyway the child returned after the summer and it started all over again with an increase in the accidents by the end of the month. We had to do the same again - ring mum every time and mum got more convinced it was related to being back with us. The child was very quiet and knew she had soiled immediately after she did it and would go to the bathroom without us even being told or realised - sometimes the other children would come to us and inform us that the seat or floor was wet! There was just no way of us watching the child to see her in the process because it happened so quickly!

 

We waited and waited in the weeks following hoping that we would not receive an inquiry into how we handled the situation but have learned since then to record every toileting incident with any of our children and what we have done, who has witnessed it (adults), informing parents accordingly.

 

At present we have both 3 and 4 year olds attending the Playgroup. There were twins supposed to start last October but as not fully toilet trained mum decided not to send them just yet - this is the same story every month as I continually ring her to check how things are. She was a parent who made such a fuss on the last day of June determined to have place for the twins asap. We have been advised not to start any children after Christmas as it can be unsettling for the others and we need to move on in terms of activities and extending learning opportunities but this mum is determined it will happen for her on her terms!!

One Monday morning in October we received a letter from the mum to say she would no longer require a space for her child at our Playgroup - she left to join another one 2 miles away. We saw the child at Christmas when we were attending the local Primary School's Nativity Play - the child just stared at us even though we were as friendly saying hello etc.

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This is the first time I have written on the forum after many years of just reading the forums, so here goes. I used to get very embarrassed my daughter had a similar problem after years of medication for constipation. I couldn't understand why she couldn't control her bowels, it turned out she couldn't her bowels had stretched because of the constipation and had lost the sensation In our case the dr's weren't intersted until after I got got cross and upset with them, she had a little operation and it improved. Your child may have a medical problem has the mum taken her to the dr's?

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This is the first time I have written on the forum after many years of just reading the forums, so here goes. I used to get very embarrassed my daughter had a similar problem after years of medication for constipation. I couldn't understand why she couldn't control her bowels, it turned out she couldn't her bowels had stretched because of the constipation and had lost the sensation In our case the dr's weren't intersted until after I got got cross and upset with them, she had a little operation and it improved. Your child may have a medical problem has the mum taken her to the dr's?

 

 

Thank you so much for your reply, i have considered this as i thought twice in an afternoon might be unusual, so will def talk to mum about it i would hate it to be an undiagnosed issue!

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this does come up quite regularly.. it is not acceptable to exclude or call parents in for this, it comes under the disability discriminations act and you are expected to work with the parents and arrange a way you can change the child and help with the toileting.

 

A ratio of 1:9 is not very different to those of us in nursery etc where it is 1:8 and many like us it is a changing mat on the floor

 

It is hard to target a child for this but a record of the times may give a pattern where you could anticipate and take her , there are so many reasons as to why this could be happening, working with the family may give a few clues.. at this stage we would just change her when needed with no fuss so that she gets the idea it is not an issue.. get her trust and work on it form there with mum..

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this does come up quite regularly.. it is not acceptable to exclude or call parents in for this, it comes under the disability discriminations act and you are expected to work with the parents and arrange a way you can change the child and help with the toileting.

 

A ratio of 1:9 is not very different to those of us in nursery etc where it is 1:8 and many like us it is a changing mat on the floor

 

It is hard to target a child for this but a record of the times may give a pattern where you could anticipate and take her , there are so many reasons as to why this could be happening, working with the family may give a few clues.. at this stage we would just change her when needed with no fuss so that she gets the idea it is not an issue.. get her trust and work on it form there with mum..

 

 

thank you, i know what i think, but really wanted it backed up iykwim i am happy we should change but have one member of staff who is a bit negative about it.... i think i will put her in charge of tracking times etc...

 

Thanks xx

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Some very good advice here. I certainly would make the changing as low key as possible and if the child is capable get them to help with the process as well, rather than just doing everything for them.

 

Also, I'd just like to point out that settings should not be rinsing out soiled items. Any solid waste can be tipped into a toilet and flushed away but soiled clothing should always be double bagged and sent home for laundering.

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I have read this with interest and would agree with what others have said so far.

 

However not having had children or worked in a nursery I was wondering - is soiling herself twice during the course of a three hour session unusual in terms of the number of times? Certainly if an adult was going this much it would be a worry. Would you expect a child of this age to be needing to go so frequently?

 

Also why should settings not rinse out garments? Is this just because of damage/staining?

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Good infection control procedures should include not rinsing soiled items. Hepatitis is very easily passed on through poo, and the process of sluicing and rinsing increases this risk of this greatly.

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Some very good advice here. I certainly would make the changing as low key as possible and if the child is capable get them to help with the process as well, rather than just doing everything for them.

 

Also, I'd just like to point out that settings should not be rinsing out soiled items. Any solid waste can be tipped into a toilet and flushed away but soiled clothing should always be double bagged and sent home for laundering.

 

 

I know that at nursing homes and care homes, they have special bags into which they put soiled clothing and this bag goes straight into the washing machine and the bag disintigrates and disperses, so there is very little need to handle the items, maybe early years could look at something similar.

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As I think I'm the only one who said they rinse out clothes that are soiled, I guess i should explain:I DO tip the worst of the soiling down the loo, then flush the loo while holding the garment. I then use an old bucket kept specifically for the purpose, and good hot soapy water to rinse the garments. This water is flushed down the loo and the bucket is refilled with hot water, emptied again, then filled with a solution of milton and left to soak overnight, before that water is flushed down the toilet as well. I always wear disposable gloves and an apron while i deal with all of this and those are double bagged before being disposed of. I do this because it's horrid to be presented with a bag full of heavily soiled clothes and it also smells! Of course the clothing is double bagged prior to going home. I can't imagine just putting a bag of soiled clothes straight into a washing machine.

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I know what you mean Narnia, but this is standard practice in care home environments I believe. Obviously the bag in question is fit for purpose and I assume is impregnated with something. I venture to add,that there wouldn't be any "solids" trapped within the clothing, that would have been dealt with by using the loo as a sluice as you do yourself.

 

I do very similar to you, but then we are only dealing in a small number of cases of soiling and perhaps not every day so our way with dealing with it is very manageable and I am sure that parents appreciate not being handed a bag of smelly soiled clothes to deal with, and, one might ask would they deal with them? I know a couple of parents in my present cohort who wouldn't, they would be disposed of a new bought.

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This is quite a common problem and one which we have to deal with calmly and sensitively with the child as there could be many reasons for it. To refuse to accept the child would go against the DDA as others have said. In our pre-school we have a ratio of 1:8 so not very different to 1:9.

 

We had a child once who kept soiling his pants, not badly but quite frequently. We suggested Mum approach the health visitor which she did.

 

Eventually Mum found some information on the internet with a PDF entitled 'poo goes home to pooland' which seemed to do the trick eventually. You could probably find it with a search on google.

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I work in a maintained nursery attached to a primary school with a staffing ratio of 1:13 . We have never refused a child who is not toilet trained yet however we know of other local settings in the private sector who seem to do so! We have just admitted new children many of which are not toilet trained, some in nappies/pullups and some who are wetting and soiling every time they are in, sometimes 3 times in one afternoon!!

I feel all I've done today is clean up poo! Because there is only two of us the member of staff who is inside has to deal with the child who is soiled, leaving the activity they were involved with.

We seem to be getting more and more children who are not toilet trained and many parents seem to be leaving it later and later to toilet train their children. I don't know what the answer is, I know it will get better but it's a nightmare at the mo!!

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I know what you mean Narnia, but this is standard practice in care home environments I believe. Obviously the bag in question is fit for purpose and I assume is impregnated with something. I venture to add,that there wouldn't be any "solids" trapped within the clothing, that would have been dealt with by using the loo as a sluice as you do yourself.

 

I do very similar to you, but then we are only dealing in a small number of cases of soiling and perhaps not every day so our way with dealing with it is very manageable and I am sure that parents appreciate not being handed a bag of smelly soiled clothes to deal with, and, one might ask would they deal with them? I know a couple of parents in my present cohort who wouldn't, they would be disposed of a new bought.

 

We had a child do a poo in boxers the other day - poor little lad, it went everywhere because of the boxers! I gave his parent a ring to let them know, we'd cleaned him up as best as we could but he was going to need a bath when he got home & I asked what they wanted doing with the boxers - she said to bin them. (Which we did doubled bagged as dirty nappies.) I did make sure she realised I was only phoning as I didn't want to be calling her in away from the other parents to tell her about it, there was no question of not keeping him. He's been in pants since ;-)

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