Advice please!!!!!!!!! Feeding tube

You also have to understand that this child will almost definitely try to pull this tube out. She is so young, and then a community nurse will either have to come out to replace it or she will have to go back into hospital and this may happen frequently because she is so little. I am sure she will adapt, but she will require much more one on one attention which you just won't be able to give her.

DCW- I agree that she deserves childcare as much as the next person, but I have read many posts from you and others who give notice to families for far less. I see so many people who won't even tolerate bad behaviour and work with a child in terms of behaviour modification, which is also in most cases a normal part of child psycho-social development. This is a medical issue, one that requires a much smaller ratio than 1:5 or 6 in some cases to make sure that the tube doesn't get pulled out, get caught on anything, get grabbed, get dirty etc etc. It increases the workload AND responsibility on the daycare provider. The liabilities of childcare are high enough already, do we really think that overall it's necessary to increase that at the expense of the child and other children regardless of prior experience in healthcare??? I think not. It doesn't even get beyond this to talk about charging extra money for the extra service.

I think a Nanny would be best. Someone qualified, licensed and insured to carry this out, or a Nanny in addition to a Community Care Nurse making daily visits to administer and train the parents. This seems much more realistic. Also if there is a sibling, it will quite possibly be cheaper to have a Nanny for two children than two daycare spots.

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Originally Posted by bright sparks

You also have to understand that this child will almost definitely try to pull this tube out. She is so young, and then a community nurse will either have to come out to replace it or she will have to go back into hospital and this may happen frequently because she is so little.

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Yes mom told me that if it gets pulled out she has to go back to the hospital to get it put back in again. With all the little ones I have in care (2 others under 2 years old) I am sure that more than once someone would try to pull on it. It goes from her stomach out her nose, taped across her face and then down her back so I have a feeling its a very long tube and it has lots of extra down her back to be able to hook it up to a pump and pole while she is laying in bed napping.

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Originally Posted by bright sparks

You also have to understand that this child will almost definitely try to pull this tube out. She is so young, and then a community nurse will either have to come out to replace it or she will have to go back into hospital and this may happen frequently because she is so little. I am sure she will adapt, but she will require much more one on one attention which you just won't be able to give her.

DCW- I agree that she deserves childcare as much as the next person, but I have read many posts from you and others who give notice to families for far less. I see so many people who won't even tolerate bad behaviour and work with a child in terms of behaviour modification, which is also in most cases a normal part of child psycho-social development. This is a medical issue, one that requires a much smaller ratio than 1:5 or 6 in some cases to make sure that the tube doesn't get pulled out, get caught on anything, get grabbed, get dirty etc etc. It increases the workload AND responsibility on the daycare provider. The liabilities of childcare are high enough already, do we really think that overall it's necessary to increase that at the expense of the child and other children regardless of prior experience in healthcare??? I think not. It doesn't even get beyond this to talk about charging extra money for the extra service.

I think a Nanny would be best. Someone qualified, licensed and insured to carry this out, or a Nanny in addition to a Community Care Nurse making daily visits to administer and train the parents. This seems much more realistic. Also if there is a sibling, it will quite possibly be cheaper to have a Nanny for two children than two daycare spots.

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I guess we just look at it differently. I'm saying I would consider doing a medical treatment I am licensed to do in my State as long as I was compensated at whatever the going rate is in hospitals or clinics for the procedure. I wouldn't consider taking it on without payment. Just like any other business providing the service, I would expect to get paid. As long as I was educated and trained and felt comfortable I would consider it. I would not consider it if it was free or there was an expectation that the costs of the treatment was to be dispersed among my other clients. My client base is way way too small to put that on them.

I've never termed a kid for normal bad behavior nor have I ever advised anyone to do so.

Well I told dad at pick-up that insurance says I can't do the feedings and he was shocked...I am off next week on holidays so I have no idea what will happen when I get back!

There would be no cost to the caregiver in this situation and in fact less because no food would be provided - the bags would come filled from the parent. The one thing mom hasn't thought through is the lugging of the feeding pump back and forth every day. Just a lot of factors mom needs to deal with and truthfully at this point I would be considering offering family a deal of keeping the brother till either Sept or Thanksgiving while they get the girl settled in a centre or with a nanny so go ahead and fill one spot and then play the second spot by ear once plans are in place.

I'm confused. How is there no cost? Where could the parents take this child and supply the equipment and liquid and have the labor free? She's already out the time to parent conference and dealing with her insurer.

I just had my first level of my house renovated and with every job I provided the materials. I had painters, flooring removers, flooring installers, drywall repairers etc. Not one single worker came in here and did the work for free because I provided the materials. The labor was expensive.

Daycare providers get stuck into the trap of that ANYTHING a kid should need while they are under our roof we should DO and not charge if it's labor intensive or requires special skills. We are expected to build the cost of special care into our fees from our really small client base.

This care SHOULD be expensive and I promise the labor fees from any other health care providers would be reflected in their fee for it.

Just because they provide the equipment it doesn't mean there is no cost.

I thought you were talking about you as the caregiver providing all of the equipment etc. and having absorb those costs into your program. That is what I meant by no cost to the caregiver as in nothing to have to take money from other clients to pay for. Whether the caregiver decides to add a premium to the fees she charges is not her question - it is about whether this is something than can be accommodated in a home daycare given what information she has to work with at this point.

by the sounds of it, wouldn't this child also have therapy too. So most therapy is done during the day, so what is going to happen when she has to go to therapy.

ok, you know how we talk about bad providers and all the stuff that happens in the news, I was just wondering if this would be a neglect case because the parents did this to this child. Also, wouldn't the dr notice something amiss at the yearly check up and why wasn't anything done sooner, is he to blame too.

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Originally Posted by momofnerds

by the sounds of it, wouldn't this child also have therapy too. So most therapy is done during the day, so what is going to happen when she has to go to therapy.

ok, you know how we talk about bad providers and all the stuff that happens in the news, I was just wondering if this would be a neglect case because the parents did this to this child. Also, wouldn't the dr notice something amiss at the yearly check up and why wasn't anything done sooner, is he to blame too.

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She will be getting extensive therapy (physical, occupational, music, etc) however there is a waiting list and they can't get in until October I think they said. That would be done at a hospital an hour away from here as it si more equipped to deal with this type of case.

I was thinking the same thing momofnerds....there is no way the parents couldn't see anything wrong with her, I mean she came to me at 12 months old and couldn't sit up from a laying on back position, couldn't crawl, didn't eat/drink anything, couldn't pull up on furniture, couldn't walk, extremely weak muscle tone.........From the first week I was here I could tell there was something wrong and the mom would see the other two children in my care who are the same age as her and they were walking, eating, drinking, crawling, etc but her excuse was that she was a girl and girls are probably different...her brother was an eater, crawler, walker, etc and I couldn't figure out why she couldn't see anything wrong. She would even say that her family doctor told her the little one was just slower to do things and that with time it would come so they would just wait and wait. I tried many times to voice my concerns but they would just brush it off and say in time it will come. Finally she took my advice and got a pediatrician and a dietician referral and they saw her once and then a month later had a follow up with her and that's when she was admitted to hospital.

DCW, while it is true that the nurse or other healthcare provider is paid for their labour, here in Canada, we do not directly pay for our healthcare nor do we have to put it through insurance (except for medications, prescriptions, etc). So if the parents are having this procedure done at the hospital, they do not pay for it.
Personally, I think this child should not be in a home daycare any more. Her issues are too big for one provider to deal with unless running a specialized care facility.