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Judy Radich discusses balancing health policy with the emotional concerns of staff and families.
The health and wellbeing of young children is central to the creation of high-quality early childhood environments. Services are also required by legislation and accreditation to have policies on managing illness and infectious diseases. However, these policies only provide basic guidelines; day-to-day family and centre conditions can often complicate practice.
One of the big difficulties staff face is when to inform a parent that their child is too sick to remain in a centre. Frank Oberklaid says in Health in early childhood settings (2004) that this decision will:
‘ … vary according to a number of factors, such as the age of the child, the perceived severity of the symptoms, how competent the staff are in managing common problems, the wishes of the parents and access to good and immediate advice from a nurse or doctor.’
Planning ahead
Research is clear that young children in group-care are more susceptible to upper-respiratory tract infections—such as colds—as their immune systems are immature and often unable to cope with the numbers of viruses around them. An enrolment interview is the ideal time to let parents know that this is normal and their child may be barely over one cold before they catch another. It is also a good opportunity to talk about centre policy and the requirement for families to prepare for their child being sick; in particular to consider how they can be collected before the end of a normal session.
Care-providers need to ensure that their relationships with families remain at a professional level and that there are clear boundaries in place; so that parents have manageable expectations in regard to their child’s health.
Medication and alternative therapies
Giving medication to children in care can also be problematic. This is especially true with the increased use of ‘over-the-counter’ medications by parents. One simple way to avoid conflict about their value and necessity is to make it service policy that their use be supported by a doctor’s letter.
A related problem is the use of alternative therapies and medication, about which families and staff may have strongly contrasting views. Ultimately this issue falls into a service’s ‘duty of care’ obligation and you should consult with health professionals and consumers to decide how you will manage it, being especially mindful of using medications or therapies whose effectiveness has not yet been scientifically proven.
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Dealing with head lice
Head lice are a ‘health’ concern in early childhood settings, although not a serious medical condition. Due to the contagiousness of lice, parents must remove their children from care and treat them themselves. This obligation often causes tension for staff—certain children have head lice repeatedly—and parents, since the problem is often inconvenient, expensive and embarrassing.
It is up to services to have policies—based on best practice, centre-culture and local practice—which deal with all kinds of health issues, including how services will manage head lice when a parent is unable to collect a child.
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Managing both major and minor health issues in early childhood services is a complex issue, as the emotions of both families and care-providers are affected. Centre policy must be developed and reviewed regularly by health professionals and consumers to ensure that it supports best practice and ultimately has the best interest of children at its forefront. As service providers we have an obligation to families, from first contact, to inform them of our policies and the range of health issues that may affect them.
Judy Radich
Director
Cooloon Children's Centre
Reference
Oberklaid, F. (2004). Health in early childhood settings: From emergencies to the common cold. NSW: Pademelon Press.
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Health in early childhood settings: From emergencies to the common cold is available from Early Childhood Australia for $74.95 (including p&h). To order, or to find out more, visit www.earlychildhoodaustralia.org.au/sund113 or freecall 1800 356 900.
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