Nebulizer Or Breathing Treatments

[momatheart]

Do you allow these?

I noticed on Nannyd's site she does not. NannyD can you explain why?

[youretooloud]

I don't mind using those, but I prefer the masks with the elastic strap so I'm free to move around. I can't imagine having to stand in one spot for five or ten minutes.

[momatheart]

I don't want to breath that stuff into my lungs and I can't stand the smell.

[nannyde]

https://www.daycare.com/forum/showthread.php?t=26221&highlight=nebulizer

[squareone]

We don't do any medications at all over here. Only topicals like diaper cream, orajel, sunscreen, etc. Anything outside of that requires MAT certification which I don't plan to get (one less liability). Medications must be given before they arrive or after they leave. If they have an illness so severe that they have to have medication during the daycare day then mom or dad has to come administer it.

[momatheart]

We don't do any medications at all over here. Only topicals like diaper cream, orajel, sunscreen, etc. Anything outside of that requires MAT certification which I don't plan to get (one less liability). Medications must be given before they arrive or after they leave. If they have an illness so severe that they have to have medication during the daycare day then mom or dad has to come administer it.

I wish our center would do this.

[momofboys]

I haven't done them for a DCK but since I do them for my own son occasionally I am familiar with the process. My son takes them at night as a preventative aid for asthma (he takes Pulmocort). Anyway, he isn't "Sick" though if that makes sense. I think there is a difference when a child needs to take albuterol all day b/c of constant coughing & a med that is given for prevention & I guess the difference is with my son it is only done 1x a day, so it can be done at home. IMO if the child is having so much trouble that he needs them done every 3-4 hours he should be at home with mom or dad.

[Meyou]

I give them to my neice when she's here. In fact she was here yesterday home from school because her cough was making her asthma flare up and her parents don't trust the school to give her treatments.

My youngest had severe asthma when she was born until about age 4 so I'm very comfortable using them. That being said if it was anyone other than a family member I would insist the parents give at least 2 treatments in front of me so I see how their child reacts and sign a waiver authorizing me to administer it. I also need package inserts and the pharmacy information on any prescription drugs the kids need to take like antibiotics.

[QualiTcare]

i think parents who want their daycare provider to administer breathing treatments are just lazy to be honest. i say this as the mother of a child who was on a nebulizer as an infant. it was ordered 2-3 times daily (and i've never known of anyone to be ordered MORE than that) which meant i could give him a treatment in the morning before going to daycare and again at night after going home. it was definitely a chore since i was working, going to school, and driving pretty far between work, school, and daycare - but it had to be easier for me to do it than it would be for a daycare provider with a room full of other children. i would've felt silly asking my provider to do it. now if it was an anitbiotic that HAD to be administered during daycare hours or something - that's a different story, but breathing treatments aren't so crucial that they can't be done outside of daycare. i wouldn't do it for the simple fact that i wouldn't and didn't ask anyone else to do it.

when i worked at a daycare center there were several children whose parents sent nebulizers and it annoyed the crap out of me. my son was even in the same class with other children who received treatments while at daycare. again, i think it's just rude and lazy.

[Meyou]

i think parents who want their daycare provider to administer breathing treatments are just lazy to be honest. i say this as the mother of a child who was on a nebulizer as an infant. it was ordered 2-3 times daily (and i've never known of anyone to be ordered MORE than that) which meant i could give him a treatment in the morning before going to daycare and again at night after going home. it was definitely a chore since i was working, going to school, and driving pretty far between work, school, and daycare - but it had to be easier for me to do it than it would be for a daycare provider with a room full of other children. i would've felt silly asking my provider to do it. now if it was an anitbiotic that HAD to be administered during daycare hours or something - that's a different story, but breathing treatments aren't so crucial that they can't be done outside of daycare. i wouldn't do it for the simple fact that i wouldn't and didn't ask anyone else to do it.

when i worked at a daycare center there were several children whose parents sent nebulizers and it annoyed the crap out of me. my son was even in the same class with other children who received treatments while at daycare. again, i think it's just rude and lazy.

***Edited to add that I missed the part where you said ones with crucial timing are different for you which is what I posted about below. ****

I don't the parents should all be classified as lazy. My niece is taking treatments at 7am, 1pm and 7pm (sometimes a 1am treatment if she needs it) right now per doctors orders. Outside of her mother going to school to give them (which means a day off work) she doesn't have much choice. She decided to keep my niece home and send her here so I can do the neb at one but changing the neb time drastically isn't an option.

When my dd was small and had severe asthma she took her 2 inhalers with aerochamber twice a day at daycare for the 3 years she was there. Again, there was no way to move the needed doses around so I could administer all of them myself.

[QualiTcare]

***Edited to add that I missed the part where you said ones with crucial timing are different for you which is what I posted about below. ****

I don't the parents should all be classified as lazy. My niece is taking treatments at 7am, 1pm and 7pm (sometimes a 1am treatment if she needs it) right now per doctors orders. Outside of her mother going to school to give them (which means a day off work) she doesn't have much choice. She decided to keep my niece home and send her here so I can do the neb at one but changing the neb time drastically isn't an option.

When my dd was small and had severe asthma she took her 2 inhalers with aerochamber twice a day at daycare for the 3 years she was there. Again, there was no way to move the needed doses around so I could administer all of them myself.

i wouldn't say "all" because there are exceptions to every rule, but breathing treatments are pretty flexible and i can't imagine a doctor being concerned in the least if they needed to be adjusted. it's just easier to get someone else to do it and say it's prescribed than it is to consider that option so that's the route many if not most parents will take if given the option.

oh - and asthma inhalers are way different than breathing treatments. that's a whole different thing.

[Childminder]

It all come down to what you feel comfortable doing. I personally have no problem with administering breathing treatments to children that are in need of being able to breathe better. Over the years I have had a few children with asthma and bronchitis that need to have the treatments, have one right now. Gets up at 7a has a treatment and comes for care at 10a. She is at my house 6 hours later, while her parents are at work and needs to be able to breathe, she can't make till mom gets here at 5p.

Also happens to be my granddaughter, almost 2. Just developed it and it is hereditary, grandfather, uncle and mom all needed to be able to breathe.

Do it if you feel right doing it, if not you will figure out a way to not give the treatments.

[nannyde]

It all come down to what you feel comfortable doing. I personally have no problem with administering breathing treatments to children that are in need of being able to breathe better.

Hear hear

That's exactly right. Do what you are comfortable doing. That's an awesome piece of advice.

I want kids here who can already breathe really well. That's what I feel comfortable with.

[QualiTcare]

Hear hear

That's exactly right. Do what you are comfortable doing. That's an awesome piece of advice.

I want kids here who can already breathe really well. That's what I feel comfortable with.

i agree - it might sound harsh, but honestly - if a kid has trouble breathing even when their parent(s) give them a pre and post daycare treatment then chances are they have more serious issues than simply needing a nebulizer. the thing i noticed about the daycare kids who took treatments that just "had to be given at daycare" is that the parents would "forget" and leave the machine at daycare on a regular basis - or they would take it home and return it in the morning and it would be obviously untouched/unused. if it's not that big of a deal to skip the treatment at night and/or in the morning then i don't see how it would be a big deal to skip it at daycare in the afternoon. i guess i've just seen too much to make me biased.

[nannyde]

i guess i've just seen too much to make me biased.

Yes me too.

I did a lot of work for two centers this year revising their nebulizer administration policy. They were getting SLAMMED with them and it was financially just more than they could absorb.

They went about it the right way. They did a time study and figured out the true hard cost of administering them in their setting. They did a survey of other providers of that service (Dr's offices, Acute Care Walk in Clinics, Hospitals, and Emergency rooms) and how much they charged for providing that service.

They were able to work directly with the ADA to identify which children they cared for who qualified under the disability act. Once they took out that subsection (one child) of their population then they were able to put a fee on the administration for acutely ill children and it stopped the problem cold. In their setting the "free" part of it was their problem. Once they attached a fee that was one third of the cost of the lowest price in any other venue and offered the service "ala carte" in addition to base pay then the number of children who needed them dropped to zero.

It's not just the time it takes to administer the meds. There are a lot of administrative costs, training costs, and parent coference costs in that setting. All of that had to be considered just like it is considered in other medical venues that provide the service. Even with offering it for the actual HARD cost... not including any profit at all.. they haven't had any takers.

The parents of the acutely ill children were able to work the treatments into their schedule and if necessary ... not utilize care on days where the cost of the treatments would outweigh the cost of loosing their salary. They have a room in the building with comfortable seating equipment and outlets to provide the parents or their deignee a place to come and do the treatments on site. They also have an acute care clinic in the same parking lot so the parents have the option to have the child go directly to the Dr's office if an emergency arrises. They haven't had much takers for either but it's avialable.

There are situations where day care can be confused with medical care. There's a kind of unwritten expectation that we women just DO. DO as we are told because it's for the sake of the babies. That can get you into some serioius financial problems when it comes to a medical treatment like this that can take hudreds of dollars a day in staff time in a large group.