Intervention Visits, Practical Strategies, What Would You Do?

You’re on a Visit and the Children are Sick…What Do You Do?

You’ve been in a home working with a family for about 15 minutes when the child’s older brother walks into the room, sneezes on you, and sits on your lap. The child feels like he has a fever, has very runny nose and is coughing. The mother tells you that he’s been sick since yesterday and that the child you see started running a fever this morning but she didn’t want to cancel on you at the last minute. What do you do?

Do you continue the visit anyway and plan to use lots of hand sanitizer when you get in your car?

Do you tell the mother that you have to leave and reschedule the visit for another time?

Today is the first of a series of posts about real-life scenarios that early interventionists face. I’m hoping that you will weigh in on how you would handle (or have handled) this scenario!

What would you do?? Let us know!

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12 Comments to “You’re on a Visit and the Children are Sick…What Do You Do?”

  1. When setting up initial appointments, I have been, as part of my closing statement to parents state, “if anyone in the home is sick please call us and let us know so we can reschedule.” I let them know that we have a lot of children on our caseloads who are medically fragile and even if we get to the door; please turn us away. In the last month, we have had a lot of families calling off or turning us away at the door. But, in this case, you have already been in the home for 15 minutes and really would have already had the germs all over you. I would excuse myself since another sick child is now home who might be sicker and needs mom’s attention and strongly suggest rescheduling the appointment til everyone is better if there is more to discuss. A billable timeframe has already been met. I would then call other appointments I have scheduled for the rest of the day and let them know that I have been exposed to the cold/flu and are not in the position to go home to shower and change clothes. I would use sanitizer once in the car and if it’s first thing in the morning, if able to go home and change, take an early lunch and go home to shower/ change; then try to keep appointments for later in the day. All our staff has been sick for several days at a time this year and we gave it to one another from doing the same thing; being in a home and getting exposed then passing it on. We are trying to head the advise now since we are in the height of the cold/ flu season.

    • That’s a great idea, Dee, to let parents know the expectation about cancelling due to illness when you first meet the family. I used to remind families that I had other children to see who were sometimes medically fragile so I needed to be careful not to expose them too. Usually, when parents knew this, it helped them understand why it was important to cancel with me if someone was sick. Sometimes parents feel that intervention is so important that they don’t want to miss it so it can be a tough call when to cancel. Thanks for the suggestions!

  2. Ummm…run for the hills! Nah, just kidding! I like all of Dee’s suggestions, especially the part of making it a natural part of the discussion about each visit..”If anyone is sick, please call to reschedule.”

    After spendin ALL night last night with a very sick teenager, I would not want this shared with ANYONE!

  3. Yes, everyone is tired and feeling yucky when there is a sick child in the house! I think Dee made another good point about the children needing their mother’s attention rather than her having to give it to us. Setting up the “permission” and expectation to cancel from the get-go is always a great way to go!

  4. I have to say that I agree with Dee. I have a ton of preemies and medically fragile on my caseload and gently remind parents often that not only do I have a caseload, but tiny ones at home and we try not to expose others or myself. Parents are usually OK with this.

    I actually had this very situation happen to me recently. I politely asked the older child to not the toys we were playing with, but she did anyway, so I found a polite way to say that we were going to excuse ourselves. It felt a little awkward, but I’m really glad we left!!!!

    PS–The flu is no joke these days! 🙂

    • I’ve heard that too, Lauren, that the flu is going to be everywhere this year! Thank goodness for hand sanitizer! It’s definately tricky when you’re in the visit and the sick child wants to join the activity. When we use the toys the family already has, we know that the germs are probably already on them so I guess the choices are, as you tried, to either keep playing (and plan to wash your hands later) or do what you did and excuse yourself.

  5. We have a sheet that we provide to our families at the intake appointment, explaining our sick/cancellation policy. I usually use that time to go over the policies and explain to families WHY it’s important not just for us and other families, but for them too, to cancel/reschedule when the child OR another family member in the home in sick. Thankfully, in our system, we are able to reschedule usually the next week or so, so the visit is often not *missed* but rather just postponed until the week or two after.

    I agree that it can be awkard sometimes to leave when you’re already there and doing a visit, but staying will most likely result in the family not cancelling when it happens again. If you politely talk with them and explain why the visit needs to be reschedule, there’s a better chance that next time they might call to cancel beforehand 🙂

    • Great points, Jen! Explaining WHY is so important so that everyone understands the expectation, especially for next time (because with infants and toddlers, its likely that there will be a “next time”). And it definately helps to be able to reschedule soon so that families don’t feel that they are missing out. Thanks for your comments!

  6. I always call or text my families the night before to confirm the schedule, and am upfront about the fact that I would rather they cancel then if there is any question. I explain that they have a limited number of visits, and the child won’t get a lot from the session if sick. They also know that I’m pregnant and can’t be exposed to sickness either. No major problems this year and I try to be flexible to reschedule so they don’t lose time.

    • You’re right, Cheryl, the child won’t benefit much from the session if he’s under the weather. That’s an important point. Same for the parent too. If the parent isn’t feeling well or is distracted by the child’s illness, he or she might also not be able to participate in the visit as well as if everyone felt better. Checking in with the parent before the visit is a great way to try to head off a challenging situation!

  7. As Cheryl proposes,calling ahead during this season is a good idea; however, but I would ask if there’s anyone sick at home, to include others that may be at home but are not the child or the parent. If that’s not possible then I would ask at the door before going inside. It may sound a bit rude, but if we remind our clients about our policy, they will understand that by restricting ourselves from entering the home where someone is sick, we are also protecting them from bringing germs into their home.

    • Yes, Cheryl, with this flu season it’s probably not a bad idea to check when you arrive, especially if you know someone in the home has already been sick. I agree that our responsibility really is two-fold – to keep ourselves well and to avoid spreading germs to the families we visit, including the family with the sick child.

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