Our Pediatrician's Office

[RUDisney]

This morning, I had a huge meeting with all of the senior officers of my bank to get my budget for next year approved. As such, my Mom said she'd take my kids to get their booster shots. I got a call on Monday from the school saying that they had to have their final 2 DTs and 2 polio boosters within the next 30 days or they can't come to school.

Now, one thing I'm mad about is that every time I've asked the dr's office if they were UTD, they have told me, "yes." This is the second time this school year that I've had to drop everything to get them updated shots because the state doesn't agree with the dr's office. Since the kids will only officially be in this country for a year tomorrow (11/6) we have played catch-up all year to reimmunize them for everything as if they were newborns.

So, Mom takes them to the dr's office. The nurse I spoke to last night didn't write down what they needed, so the office gives each of them a flu shot. This doesn't sit well with me because DS has surgery scheduled for Thursday that will have to be cancelled if he has a reaction to the flu shot. My Mom called me when she left the office because they didn't want to make the next appointment for the final boosters. She didn't question what they were giving to the kids since she assumed that they understood what I wanted.

I had to call the office. They were all apologetic. The nurse I talked to yesterday said she ran late this morning so she wasn't there in time to give the correct shots herself. Mom had to take the kids back so they could have the shots that they were supposed to have in the first place.

Two things learned... the office has one strike against itself... and I either have to write down specific instructions for my mother if she takes them again for me, or I have to take them myself. I'd definitely take them myself if it was for a problem, but I thought it would be ok to send them with my Mom for a simple shot.

 

[rbuzzotta]

I just can't believe the pediatrician's office just gave the flu shot without your consent!!! Do you keep a log of all your immunizations that your children have had?? You should for future reference!!

Maybe look for another office. If she was too busy and unknowingly gave the wrong shot.........hmmmmmmm, makes me think twice!!!

Hope your son can still have his surgery and all goes well.

 

[SonjaB]

I am REALLY concerned about a doctor's office that feels comfortable with "Well, we have no idea what shot this child needs, so I'll just give him THIS one and hope it's right." Not good. Not good at all.

 

[jfulcer]

Ok, I don't think it's the Office's fault...

Flame proof clothes = <b>ON</b>

Your mom should have known what they were getting, and if she forgot (or forgot to ask you) they should have gotten nothing at all.

 

[RUDisney]

My very anal-retentive, to the letter mother had explicit instructions from me as to what they were supposed to get. She just had a pre-senior moment and didn't question anything about why there was only one hypodermic for each child except two and they never told her, as they usually do with me, exactly what each shot is for. I also blame my mother for not calling me from in the dr's office. She's already been chastised by me for this and I've told her that if I trust her again, she's going to go with written instructions instead of verbal ones.

I blame the nurse I talked to last night. She didn't write our conversation in their charts and the others did check there first, although they shouldn't have assumed that they were there for a flu shot without it being in the chart or having my consent to do so.

 

[DocRafiki]

I blame the nurse I talked to last night. She didn't write our conversation in their charts and the others did check there first, although they shouldn't have assumed that they were there for a flu shot without it being in the chart or having my consent to do so.

Yes, all communication should be written in the charts, and the last few entries should be read before every appointment. My techs & nurses think I'm anal for having this rule (it slows us down), but it's just irresponsible not to do so. Of course, in my place, it's the nurses' responsibility to find what vax are needed, so it still could have happened at my place. Still, communication in a busy office is one aspect of practice that I have yet to see conquered effectively.

But, if your mom brought them in for "whatever shots they need," and the nurses decided they needed flu shots, then they have all the consent they need.

 

[Toby'sFriend]

I'm also confused as to how the Dr.'s office could even give the shots without a parent/guardian there to sign the consent and release forms.

 

[Briar Rose 7457]

I've never had to sign a form when either of my dd's got a vaccination. the only time I've had to give written consent was for a procedure done in the ER.

my doctor will treat my girls if someone other than a parent brings them in, if he's spoken to me and gotten my verbal consent.

 

[Deb in IA]

Every immunization we give requires a parent/guardian consent and signature.

I don't think we would even give an immunization to a child if their grandmother came with them.

 

[Shannon G]

Like others have said, I would have a BIG problem with an office where the nurse didn't know what shot the child needed, and gave them the wrong one. I understand what has been said about your mom not questioning it, but it seems like the only reason she even had to question it was because they were each only given one shot instead of two. So, was it only AFTER they were each given one shot that she had reason to question it? If so, even if she had asked why they each only had one shot, by then it was too late - they had already been given the wrong shot, correct?

I would have a HUGE problem with this - although it was not a serious mistake from a medical perspective (no life threatening result) this time, I would always wonder what mistake the nurse might make next time. A nurse should never just "guess" at what shot a child (or adult for that matter) should be getting - yes, the nurse you spoke to didn't note it in the chart, but in that case the nurse on duty for the appointment should have questioned why they were there. If a patient's chart doesn't indicate what the appointment is for, why would you just decide to give them a flu shot? Sounds very careless, and dangerous, to me.

 

[missymouse3367]

I too have a big problem with this. #1 a signature should have been obtained for these shots. #2 it should have been written in the chart what was to be given. #3 the nurse or receptionist should have said they are here for DT# 5 or whatever. #4 why didn't the Dr catch this @ the last visit? I really would either talk with the Office Manager or Dr. I would think about leaving the office.

 

[RUDisney]

All immunizations require a signature. The office had my verbal consent to allow my Mom to sign for these shots. She has taken them once before, so her signature was already there. Funny thing is, no signature was required for the flu shot.

Leaving a pediatrician in this area is hard. It was difficult for me to find a physician who would take children who weren't infants. That's all anyone wants to take as new patients. This dr came highly recommended and I very much like him. He also adopted a child from Russia, so he was thorough about researching the health concerns for children from that country. I like him also because he is in a single-physician practice. I didn't want to go to an office where I'd get the Dr. Du Jour and have no consistancy of treatment.

Yes, I believe that this could happen in any office. What I've also thought about is that I'll want to see the vials that the boosters or other shots come from so I am comfortable that the correct med is being given. One clear liquid looks the same as another when it's already in the hypodermic. I never thought to be concerned about this, but I'll be doing that for myself, my kids and my dogs from now on. We're all human and mistakes happen. Thankfully, this one wasn't catastrophic. I guess any steps we can take to protect ourselves are good ones.

 

[gepetto]

Originally posted by DocRafiki

But, if your mom brought them in for "whatever shots they need," and the nurses decided they needed flu shots, then they have all the consent they need.

Good point.

 

[aahmom1]

She's already been chastised by me for this and I've told her that if I trust her again, she's going to go with written instructions instead of verbal ones.

I would suggest next time taking your kids to the Dr. yourself, that should save everybody a lot of headaches, especially the poor kids who got an extra shot they didn't need.

 

[Deb in IA]

Originally posted by RUDisney


Now, one thing I'm mad about is that every time I've asked the dr's office if they were UTD, they have told me, "yes."

Also, I would suggest that instead of putting all the responsibility on the "dr's office", that YOU could have checked on what is required for school entry in your state. Since you mention that you have only been in this country for a year, YOU would have the best records on what the kids have, and have not gotten yet.

 

[RUDisney]

Originally posted by Deb in IA
Also, I would suggest that instead of putting all the responsibility on the "dr's office", that YOU could have checked on what is required for school entry in your state. Since you mention that you have only been in this country for a year, YOU would have the best records on what the kids have, and have not gotten yet.

You make a good point, but the school nurse was happy with how UTD they were until she had to send the records to the state. So, if the school nurse tells me they are UTD, and the dr's office says they are UTD, I "shouldn't" have to do the extra legwork of trying to find the information on the state's website. Have you ever been to the horribly designed PA website? Good luck even finding the things that they advertise on TV. Hmm, I wonder if she has anything in writing that I can use as a guideline. I'll send my note in for her tomorrow.

Is everyone else that vigilant about making sure, with the state, that their kids have had all of their immunizations? I've asked people at work about this and everyone relies on the dr and the school for guidance on this, and neither they nor I are the types that would withhold an immunization from our kids.

As for taking the kids myself, I would have if I didn't have the meeting. I should be able to rely on my mother to help me out every now and then with the kids, even when it comes down to taking them to get shots. What if I'm out of town for business and one of them gets sick? Are you suggesting that I fly home to take them myself instead of relying on her? I try to be a super-mom, but there are only so many hours in a day and I don't see any indications of God adding any more.

As for my DH taking them, he can't handle anything medical without passing out, not even medical talk, so it's not worth the risk of him taking them.

 

[Shannon G]

I would suggest next time taking your kids to the Dr. yourself, that should save everybody a lot of headaches, especially the poor kids who got an extra shot they didn't need.

But would this necessarily solve the problem? If I took my DD to the Dr. for two shots, and then saw the nurse only give her one shot, yes, I would question it, but probably not until after the fact. At that point, she would have already received an extra shot that she didn't need. If I make an appointment for my DD to receive a particular shot, should I really have to ask the nurse "are you sure you have the right one?" before the shot is administered? My DD is 2 months old, and, frankly, I rely on her pediatrician to tell me which shots she needs and at what age. I'm not sure that having the parent take the child rather than someone else is really going to prevent the nurse from doing what she did. Yes, it would make a difference if the nurse asked what the child was there for, because the parent may be better able to answer that. But if the nurse simply looks at the chart, doesn't see what the child is there for, and then takes it upon herself to decide to give them a flu shot, without asking that question, I don't think it would make any difference who brought the child in. How was grandma supposed to know that the nurse didn't know what the kids were there for?

RUDisney - I know you said you talked to the other nurse (the one you had scheduled the shots with) about this mistake, but did you speak to the Dr.? He should be made aware of this - not only is this a potential health issue, but also a potential legal issue for him. He could have big problems if one of his employees makes a mistake like this that does have more serious consequences. What if a child had a history of reaction to the flu shot and the nurse did what she did? The consequences could have been much more severe than they were.

 

[aprincessmom]

Is everyone else that vigilant about making sure, with the state, that their kids have had all of their immunizations?

Where I live the immunizations required are state mandated so, yes, I am vigilant about it on a state level. In addition, when I book check-ups and physicals, the scheduler will always remind me what vaccinations/boosters/blood tests DD will be receiving that year. And also remind me that if I am not going to be taking her, I must have a written note giving authorization and consent privileges to the adult bringing her to the appointment. No written note from me, no shot.

When DD was born, I received an immunization booklet when we left the hospital. In it was all her immunizations/shots/blood tests to date and I was told to bring it with me to every check-up so it could be updated properly and I'd always have a record. Inside the booklet was a listing of all the state mandated vaccinations and blood tests and the age at which a child should receive them.

I didn't realize this wasn't the norm in all hospitals.

 

[Shannon G]

Where I live the immunizations required are state mandated so, yes, I am vigilant about it on a state level. In addition, when I book check-ups and physicals, the scheduler will always remind me what vaccinations/boosters/blood tests DD will be receiving that year.

It sounds to me like that is similar to what RUDisney has been doing - relying on the Dr.'s office and the school nurse to tell her what is required by the state. I think her question was whether anyone really went a step further, and actually checked with the state to see if what they were being told is accurate. Realistically, I doubt many people, if any, actually go that far.

 

[Pin Wizard]

Originally posted by RUDisney
As for taking the kids myself, I would have if I didn't have the meeting. I should be able to rely on my mother to help me out every now and then with the kids, even when it comes down to taking them to get shots. What if I'm out of town for business and one of them gets sick? Are you suggesting that I fly home to take them myself instead of relying on her? I try to be a super-mom, but there are only so many hours in a day As for my DH taking them, he can't handle anything medical without passing out, not even medical talk, so it's not worth the risk of him taking them.

Well, you're lucky to have your mom's help. And I would think if you're away on a trip, whoever is responsible for your kids at the time would take care of it. However, as a single parent myself, I have to say that even though there are time crunches, DS' needs come first. I take him for his appointments either during evening hours or on a Sat. morning. If an emergency pops up, I call work and let them know I'm either staying home or I'll be in when arrangements are made. The last time I stayed home with DS, I had a meeting the night prior. Being that my employer doesn't want to pay over time, I didn't think they would mind if I stayed home with DS. When I went in the following day, I got the cold shoulder. GIVE ME A BREAK! MY SON COMES BEFORE ANY JOB!