Positive relationships: Let's talk about ... child sickness

Working parents often find it difficult to take a child home when they fall ill, but how should the nursery stand its ground, and why? Annette Rawstrone spoke to nursery managers.

Q: How do you make parents aware of your sickness policy?

'Among our policies is an exclusion procedure policy. It is in the parents' pack and we require parents to sign it to say that they have read it and agree with the conditions. It lists illnesses such as diarrhoea, measles, chicken pox, impetigo and how long children should be excluded from the nursery if they have these.'

'Our sickness policy is in the parents' booklet that all families are given. It is also displayed on the noticeboard so that everyone is aware of it.'

'Parents know that if a child has an infection that is contagious, they have to stay at home. We also ring parents and ask them to collect their child if they have sickness or diarrhoea, or in other situations such as a high temperature.'

'If a child is ill, or has been ill, then we will inform the parents and ask them to pick them up. We explain the policy to the parents when the child starts so that they understand.'

'Parents know that we don't send children home unless it is absolutely necessary, but of course if they are being sick or it is something contagious then they can't stay in nursery.'

Q: Do parents flout it?

'It is sometimes hard to know whether a parents has knowingly brought an ill child into the nursery. But if a child is ill we give the parents a courtesy call and ask them to pick them up. We also say if we think they need to see the doctor and we offer advice.'

'Our parents tend to be very good. When we phone them they often say to just give them half an hour so they can sort things at work before collecting their child and we're happy with that.'

'We often get children who come in and say they have been sick during the night but you never know whether it was actually last night or last week. But then when they are sick two hours later we call the parents up and they often deny it.'

'We do get the odd parent trying it on. Parents won't always say if their child has been ill in the night, but we know the individual children well and we can see changes in them if they are unwell.

'A few of the older children tell us themselves if they have been sick. In these situations we ring parents and ask questions, remind them of our policy and ask them to pick their child up, because children should be kept away from nursery for 24 hours since they were last sick.'

'Parents do sometimes try to bring children in if they are ill, but we don't allow it if they are still in the incubation period.'

'We have got chickenpox going around at the moment. We might get some parents who try to bring their child in after three or four days and we have to say that it is not long enough and explain that the child may still be infectious. We stick to the sickness policy completely.'

'Some parents play innocent and say they didn't realise their child was ill, which is very frustrating.'

'Chickenpox often starts off in areas that you don't easily see, so it can be the first nappy change before you spot them. At that stage you do not know whether the parent knowingly brought them in or that they have developed it since they arrived.'

Q: How does it impact on the nursery?

'If we have a sick child in the nursery we have to dedicate one member of staff to them until the parent collects them. This can make things complicated with ratios.'

'It also impacts on the child. When they are sick they just want to have a cuddle from their mum or dad - they don't want to be at nursery.'

'Some parents do not seem to recognise that if children are brought in ill then there is more chance of the staff getting it too. Who is going to look after their children if there are three or four staff members off ill?'

'If there is sickness or diarrhoea in the nursery then it spreads like wildfire, not only among the children but the staff as well. In the case of high temperatures, there is the risk that the child may suffer convulsions.'

'If members of our staff get ill, then we need to get in agency staff or bank staff, which costs more money. We appreciate that this is the same situation for the parents' line managers, but we simply can't have an ill child in the nursery.'

'It can be very worrying for the staff, especially in cases such as a baby with a temperature.'

'We have just had two children with chickenpox, which isn't too bad out of 22. We have been making sure that everything is sterilised daily to reduce the chance of infection spreading.'

Q: How do you deal with the parents?

'We understand that the parents have job commitments and that it is hard for them if their child is ill and we are their sole carer, but we do have to stick to the policy for the sake of the other children and staff.'

'We have a good partnership with the parents, so thankfully the policy isn't often flouted.'

'This morning we had to phone a parent at work and ask her to collect her child because they had diarrhoea. She arrived at the nursery upset and said that her manager at work had told her that she pays the nursery fees and that we should look after the child when they are ill, rather than asking for them to be collected. The manager had no understanding of working with children.'

'I said to the parent that if her manager wanted to ring us, then I'd explain why it is so necessary to send a child home.'

'We explain to parents that if it is contagious it will pass around, and then there will be a lot of unhappy children and even more unhappy parents.'

'Some of the employers are very abrupt and do not understand that the parent must collect their child. We have found that it is best to ring the parent on their work number, rather than their mobile, and then the employer knows for a fact that their child's nursery has called them.'

'We are an NHS nursery so we are well supported by the hospital. If parents argue their child hasn't got an infection and should be allowed in nursery, then we can get the support of Infection Control, who will back us up.'

'There is often one child in the nursery who is sickly and we find we're regularly calling the parent at work about. The odd parent has said that their employer has got really fed up because they keep being called out. We are sympathetic but we have to make sure the child is picked up. Some parents are able to send the grandparents to collect them, which helps.'

'We try to support the parents and are aware that they have to work. If a child is groggy and obviously wants to be at home but there is no specific illness, maybe just a runny nose, then it is a hard one to call. You can't help but feel for the child, because they want to be at home with their parents.'

See also 'Stop the spread', p28. To continue the discussion go to 'Have Your Say' at www.nurseryworld.co.uk

AN EXPERT'S VIEW

By Laura Henry, managing director, Childcare Consultancy

As a working parent, I fully understand the emotional pull placed upon me when my children are ill. There is a huge divide - first, on wanting to ensure that my children are well, and second, wanting to ensure that my work commitments are met. Nonetheless, the best place for a sick child is not in the setting.

In the current economic climate, we can sympathise with parents who feel pressured by their employers, as they feel that their jobs are at risk if they are seen to be taking time off to care for a sick child. However, parents should feel empowered to stress to their employers the importance of their parental responsibilities.

It is imperative to remember the difficulties that staff face when making the decision that a child is too sick to remain in the setting. They too can empathise with parents about work/home commitments. They equally have a legal responsibility to ensure that not only is the child protected, but the other children and staff are fully protected from the risk of infection.

A setting's sick child policy and procedure needs to be robust and effective. The policy also needs to make reference to the Early Years Foundation Stage Welfare Requirement, 'Illness and Injuries', that it is the provider's responsibility to inform parents about this procedure. We need to be honest with parents and state that it is our legal duty to exclude children who are unwell.

Parents should be informed of why we need an emergency contact. For example, is that person always able to collect the child, and if they can't collect, is that person aware that this is part of their responsibility as the emergency contact?

Children need to be kept comfortable while they are waiting to be collected. Preferably their key person needs to stay with the child in order to keep them safe and to reassure them.

As well as a policy for children, there needs to be a policy for staff. If staff are sick they too should be excluded until they are well enough to return.

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