Sunday, 9 November 2008

Blame culture

This lady is ‘considering suing her son’s school’ for ‘failing to exercise their duty of care’ when he fell in the playground, bumped his head and subsequently – hours later – developed neurological problems, as the result of an intracranial bleed.

I train at many schools around the country - I teach the staff basic first aid and that's all they need to know. I also tell them some home truths about their position and what their actual duty of care is when it concerns children and accidents.

I feel very angry when people try to use their limited or flawed knowledge of the law to persecute for the sake of blaming someone for things that could NOT have been foreseen. Instead, these same individuals complain when their life is interrupted in the interest of the self-preservation of others. For example, school staff. They are an easy target, aren't they? Let's all blame the people with whom we trust the care and education of our children. Let's give them such a hard time that they are drained of power and no longer care whether their job is valued by us or not. Many of them leave the profession, rather than spend another minute listening to the constant whining, bitching and bossing of parents, some of whom are ignorant and unreasonable. Start taking responsibility for your own kids for Pete's sake!

Would it be reasonable for a school to call you every time your child fell? No. You'd have a go at them for that too.

I am a parent, so I have the right to speak about these things. I am a professional clinician, so I have the right to defend the principles upon which these words are based. I know the law and therefore I can categorically state in fact what would be right or wrong in some, but not all, cases where first aid care is concerned. I am also a member of society and was brought up to respect my teachers and all the adults working in schools. I had a healthy fear of the consequences of my actions and my parents were guided by the better judgment, in most cases, of the professionals they had put their trust in.

Now, here's the problem at schools. This case, sad as it is for the unfortunate little boy and his mother, will cause repercussions throughout the country and every nervous school will call an ambulance EVERY time a child falls and bumps his head! This is intolerable. We have all bumped our heads. Every now and again, just like in adult life, a complication occurs...sometimes people die. We can't scan every head that meets a pavement or a classroom floor.

Now who is to blame for this boy's injury? Did a teacher throw the child to the floor? Was he pushed, shoved or tripped by someone or something? Probably not. He fell by all accounts. The school staff monitored him and did exactly what they were supposed to do. What they did NOT do was dial 999 and say 'We need an ambulance for a....err...well, a child who has fallen'.

'What injuries does he have?' they would have been asked.

'Well, none that we can see'.

'Is he conscious?'

'Yes'

'Is he breathing?'

'Yes'

'Is he vomiting?'

'No'

'So, you want an emergency ambulance for an uninjured, conscious child, who is breathing and behaving normally?'

'Yes because if we don't the parents might sue us.'

'Okay but have you considered who may die of a heart attack because our ambulance is travelling to your school for nothing at all?'


In the end you have to ask yourself a perfectly logical question. Do you have any reason to send this child to hospital, other than an irrational fear that something untoward may have taken place inside his skull that you cannot see?

What if this had happened at home? Is this lady honestly saying she would have rushed him to hospital or called an ambulance because he fell and hit his head? Has he never hit his head before?

What kind of person tries to blame a school for such an unfortunate accident? A scared person? An ignorant person? A embittered person who needs to express her anger at God?

I will apologise for all these words if it transpires the child was abused in some way or there was a hazard in the school environment that caused the fall but I protest at society and it's need to hound people who care for our kids whenever it suits them. Pursue them for a reason, don't bully them just because it's easy and you feel guilty that you weren't there.

Why not sue the school for having a hard floor in the first place? Why don't we start fitting rubber flooring everywhere? While we are at it, let's ban rain because it makes the outside ground slippery and a child could fall.

When I teach, I rarely get a negative reaction to my views and generally the vast majority of people in front of me will nod their heads in agreement and debates will begin on the spot. Nothing changes though and I blame the parents for that. It's time parents got together with their schools and talked these issues through. Let's look at some of the other examples of an automatised blame culture society that seeks to justify it clingy cotton-wooled sentiments over health and safety.

Plasters; you are not allowed to put one on a child because he may react to it. RUBBISH! Even the HSE has produced a poster informing everyone that this is untrue. In fact, not putting a plaster on could be seen as neglect because it is a first aid 'tool' and an alternative may not be sterile and could cause infection. I've seen filthy toilet paper put on a wound instead of a plaster because of this stupidity.

Splinters; taking one out of a child's finger is illegal and is assault. ROT! It is NOT illegal to do the duty of a parent when you are in charge of their child. By proxy you 'become their parent' - In loco parentis - a legal term which literally means 'in the place of a parent'. So, legally, a teacher/school must show the same duty of care towards a pupil as would a reasonable parent. In other words, if you think a mother would remove a splinter, then you should remove it. Why on earth, unless there are complications, would you send your child to hospital with a microscopic bit of wood in his finger? Are you mad?

Inhalers; you can keep a spare inhaler and use it when a child has forgotten to bring theirs to school. NO, you can't...not unless it belongs to the child himself. It is illegal to use someone else's prescription medicine in any circumstance, unless it is on the exempt list (epipens are on this list). I know of at least one local authority that actually sanctions and authorises (as if they have the right) the use of anyone's inhaler in cases of emergency. In a real emergency it probably won't be effective and giving a drug that you know nothing about and does not belong to the recipient is negligent. By all means store a spare belonging to the child, and then only in term time.

Or how about this? Let the child take care of his/her own medicines. If they are deemed to have capacity, they can keep their own.


I could go on and on...the list seems endless and the capacity for parents to make life miserable for school staff seems inexhaustible. I feel very sorry for them.

Have a look at the other myths being circulated as truths on the HSE's own website.

And for the record, here are some extracts of relevance from the Government's guildelines on medicines in schools. The government also makes it clear that there is no legal responsibility for school staff to administer first aid to pupils but there is a duty of care.

13. Parents have the prime responsibility for their child’s health and should provide schools and settings with information about their child’s medical condition.

16. There is no legal duty that requires school or setting staff to administer medicines.

25. Medicines should only be taken to school or settings when essential; that is where it would be detrimental to a child’s health if the medicine were not administered during the school or setting ‘day’. Schools and settings should only accept medicines that have been prescribed by a doctor, dentist, nurse prescriber or pharmacist prescriber.

34. Misuse of a controlled drug, such as passing it to another child for use, is an offence.

89. Teachers’ conditions of employment do not include giving or supervising a pupil taking medicines.

107. Large volumes of medicines should not be stored. Staff should only store, supervise and administer medicine that has been prescribed for an individual child.

108. Children should know where their own medicines are stored and who holds the key.
The head is responsible for making sure that medicines are stored safely. All emergency medicines, such as asthma inhalers and adrenaline pens, should be readily available to children and should not be locked away.



If you are a teacher or work at a school, you may find some of this information interesting, especially if it comes as a shock to you. In my experience, not many schools have seen or even know about the Government's guidelines on first aid and medicines policy in schools.

I'd like to know your views on this but please don't bombard me with stories that simply highlight rare and unusual circumstances because that's just missing the point.

Xf

25 comments:

Jake said...

I will grant this lady some benefit of the doubt and consider the possibility that signs of neurological insult that should have been obvious to someone meeting the first aid qualification for a teaching post were somehow overlooked. Her grief and anger are entirely understandable, also; the death or serious, possibly lifelong injury of one's own child would impair anybody's judgement.
However, someone needs to take this woman aside and explain to her, gently and firmly, that lashing out with accusations before all the facts are known is not going to heal her little boy. We really do need to extend the immunity from civil action granted to aircrew, sailors and railway staff for the duration of an accident investigation to everything the HSE has to get involved in.

Flossy said...

If my son has tonsillitis, which is a fairly regular occurence, he gets a week off school, as the school will not give him antibiotics during the school day. Then they have a go at me because his attendance is low.... wtf?

John WH said...

Over a number of years employment as a First Aid trainer, I seemed to do a LOT of schools courses, and nearly all of them produced at least one of SG's horror stories. Most common was 'can't use plasters on a cut, so we keep a wad of toilet paper in our pocket'

GrumpyRN said...

This woman is angry at the world and wants to 'blame' someone, the school is easiest. Unfortunately people are being brainwashed to believe that everything bad that happens to you is someones fault. Encouraged by adverts for no win, no fee, no self respect lawyers like the one fronted by ex Bill actor Billy Murray which actually says that accidents are someones fault. The public seem to have forgotten that much of life is a risk and people do get hurt and people (including children) die.

Anonymous said...

An unfortunate situation for the child, I hope he can recover with time. However, accidents will always happen, and some ,not all, mothers will always seek someone to 'blame'. This attitude is not helped by the legal professions no win- no fee
bottom feeders encouraging everybody to 'sue' for something.
As the insurance companies will settle even blatant fraud cases out of court because its the cheaper (for them) option, perhaps a change in the law to allow punitive costs to be awarded against the lawyers who encourage these speculative cases would be helpful? Or should society stop out of court settlements that have not been assessed by an independant judge as 'justifiable'?

Anonymous said...

'So, you want an emergency ambulance for an uninjured, conscious child, who is breathing and behaving normally?' - If only the powers that be would allow us to say such a thing...

Whilst this incident must be awful for all concerned, I do feel that the mother needs to understand that sometimes accidents simply do just happen. If he fell at home, or in the street, what would she have done? It's a sad reflection on today's society when people automatically look for someone else to blame (and therefore sue).

lightsandsirens said...

If you had been called to this incident (immediately after) would you have been likely to do vital signs, secondary survey, CNS survey and be happy to let the lad return to school after finding nothing?

If you had decided to take the kid to hospital (at the insistence of the school, or just to cover your arse) would the ED have even kept him in for observation? Or simply send him home after confirming your own observations?

Seems like this kids condition was pretty much impossible to foresee without a cat scan which would not have been indicated, and an ambulance at the begining would not have changed that one iota!

But seriously, if called, would you have taken him to hospital? If you didn't would your arse feel comfortable in the line of fire?

Flossy said...

I agree with the whole accidents will happen thing too. I fully expect my sons to do all sorts of damaging things to themselves / each other as they grow up. Am I allowed to sue the school for being overprotective and stifling their natural curiosity? I doubt it :)

Keith said...

I'm a first aider in a primary school and I'm proud to say that I knew all the myths to be just that. I see countless banged heads - if I called for an ambulance each time, I may as well have a paramedic permanently in school.
Yes, I'm wary about head injuries, but I am confident in my own abilities and common sense to assess the situation.

Sam Lloyd said...

I feel for the woman, but they arent to blame.
my friend is a primary teacher and she says only the head is trained in first aid - none of the teachers, makes me laugh as by the time the head (if she is in!) gets to a serious say choking incident - what wouldve happened..
As mum of a child that takes 8 meds 4 times per day (chd baby) I dread the day he goes to school and has to put up with this rubbish!
I also think the world is going mad what self respecting/trained person would stand by a serious incident rather than help for fear of being sued.... crazy - i promise i will never ever do that :-)

Anonymous said...

NB: I'm not referring to this case, just to this type of knee-jerk defensive behavior in general.

It's not bitterness or anger in isolation. It's a culture (not just in the UK) of needing someone to blame. Someone has to be blamed for any mishap short of a lightning bolt hitting them.

What's the first thing that happens if someone falls over? Look around to see what caused it. WHO IS TO BLAME. What happens if an idiot puts a hot cup of coffee on their lap and spills it? Get the vendor. WHO IS TO BLAME.

People are getting to the point of thinking they are totally and utterly without fault, and so anything (no matter how minor) goes wrong and it automatically is someone else's fault.

Know what that is? Arrogance. We are becoming more and more arrogant and narcissistic by the day.

Shame on lawyers and courts who entertain frivolous lawsuits.

Anonymous said...

In theory, you are totally correct. A child who had knocked their head would will normally be completely fine. But you do not want the hassle that comes with it if you come across the one boy in a thousand that turns out to be more seriously injured.

The teachers will probably not face prosecution. If they did, they will probably be cleared. It should be investigated, since as you say, there might be some abuse or other hazard. But the teachers do not want to be hauled up in court. Neither does the council. All concerned don't want the negative publicity that this has generated!

So we could come round to bashing the media: if they didn't report it, we wouldn't need to get up in arms about it all.

(Or maybe many more kids do die from head injuries that we don't know about, and this one women is doing us a favour in reporting the issue. While I respect your anecdotal evidence, its only from one point of view.)

So I wouldn't really blame the teachers if they rang 999 for every little accident. Do you want on your conscience that this boy became brain-damaged because of your inaction?

Anonymous said...

Thanks again for the outstanding job you did training our staff in basic first aid. You were informative, engaging, and all of us found your straight talk (similar to your great post here) extremely refreshing. A most enjoyable day! (a teacher saying this about an Inset day? High Praise Indeed!)

Louise said...

As with the general feeling, accidents happen, its part of life and unfortunately sometimes life deals you a bad hand.

I get the feeling that if the hospital hadn't scanned him (as lightsandsirens says does not appear to have been indicated) the mother would cling to blaming them.

Its always easier to blame someone then to accept that it was just a horrible accident.

Conor said...

Plasters.
Someone should tell the Blood Transfusion Service.
I've heard the words "Are you OK with plaster?", 89 times now.
At least it's only one small plaster nowadays. It was to be one small plaster, a huge wodge of cotton wool, and two long strips of plaster to keep the cotton wool in place

Anonymous said...

Hello. I think the language used by the woman is actually the language of her solicitor. The aim of the action is to get a lump sum which can be used to look after the of care of the child when he becomes an adult since the state provision is insufficient. I think the use of language is a function of the adversarial nature of our legal system.

Xf said...

Lightsandsirens

Yes, I would take him but only because I'd been called. If you look at the post 'A mixed bag' you will see that I had a case example to take to hospital and, even though he was vomiting, I'm sure he left a few hours later and went home absolutely fine.

The point I'm making has nothing to do with diagnosis - it's to do with reactionism. Why on Earth would the school be to blame for something they could not possibly see?

Xf said...

Anonymous

My 'anecdotal evidence' is a wee bit more than that. If you care to look at the amount of research that has taken place, especially since 1990, you will see that head injuries in children are common BUT only a small percentage suffer life-changing injury and MOST of them were forseeable due to signs and symptoms.

I don't just rant for the sake of it...I look into things first.

As for your comment about not blaming schools for calling 999 every time...with respect, that's just plain ridiculous! How can any society function on that basis?

We simply do not have the resources to cope with such behaviour and someone, I promise you, WILL die as a result of knee-jerk buck-passing as a result of doubt and fear of litigation. You would not be pleased if it affected your ill or injured loved one at home.

You must stop and think about how those teachers are going to feel - the emotional harm such a hounding will cause and what affect it will have on other schools. People are eventually going to give up taking care of our children altogether.

As I said, it's a terrible thing for the child and his mother to go through - horrible. But there are kids with cancer out there and they are dying. Who's to blame for that?

Pass the buck said...

In reply to xf:

Oh - I agree its ridiculous. We can't have 999 called every time. It's stupid. It's not the way to do it. There aren't the resources to cope.

But if this negativity (the discussion, media intrusion into the school and the family, the stress and the threat of your career being destroyed) is what comes about when you don't call 999, then what do you do?

The point is that no-one is to blame. It is no-ones fault. But if the teachers can hand it off to someone else, it definitely isn't theirs. And if you take the patient into hospital, it won't be yours.

It is discharging liability. They are saying 'I know that its probably not seriously, but it might be. I don't want to face the hassle of an investigation, even though I've acted properly, so I'll call in the professionals.'

Perhaps we need to guarantee that the teachers won't lose their job. But how can we - we want them to take some responsibility if the kid is obviously hurt and they do nothing.

Or, we need to ban the media from reporting on frivolous cases. But maybe it wasn't as simple as it seems. (BTW, I'm not trolling, but unless stats are cited and so can be verified and open to investigation, they don't mean much. But I'm not arguing against you anyway.)

So what should we do? Re-educate every single person in the country? Completely end with the blame culture? Stop people lashing out, looking for reasons? How realistic is that?

But that's the only way. Until we can stop upset mothers dragging everyone through the mud, the sane option is to avoid as much muck as possible, by passing it someone else.

Pass the buck said...

Oh I also meant to say:

Don't you know that it is electricity pylons that cause cancer? No, its mobile phones! hang on, its WiFi!

Feeling helpless is not something we cope with well.

Dani said...

hey Xf,

great post. And I totally get this. I work in a school as a science technician (I think you visited my blog once, so you you probably already know that) I am the schools first aider, so this post actually meant quite a lot to me.

To be honest, it is a big worry. And I have had a couple of scares. Notablely the time when the px had fallen in PE and hurt her ankle. It wasn't serious. Full movement in the joint, no swelling or bruising (the accident had occoured period 1, the Px came to me period 5. Think she wanted out of Maths) So, I sat her down in my office, foot up, ice pack on, shoe off. Standard. I had to dash back into my lab because I was interupted while making up Hydrochloric Acid. Leaving a 5L container of concentrated acid in a fume cupboard is just begging for trouble. I clear up, and find that my Px has disappeared. A quick call to front office finds she hasn't wondered up there, so I assume that she's gone back to class (and nicked my ice pack)
Any way, next day, I get senior management on my case. Appears the px walked home without her shoe on, and now the mother wanted me 'struck off' Her words not mine. At no point did I say not to wear shoes, nor did I give permission to leave. Couldn't even use her common sense that child, who I saw next day tottering along in heels, and completely blanked me. Never did get my ice pack back.

Cases like these that prove the general ignorance rule.

By the way. You have Drunks On Bus', I get Drama Queens. Mine may smell nicer, and get put into detention if they swear or bite me, but I do have to carry them to the medical room.

Which reminds me. I have to apologise. I'm sorry Xf. My school wasted ambulance time. I'm so embarrassed. Drama Queen on field, panic attack and a feint. Always recovers in 8 mins (almost exactly) but the PE teacher panicked, and called an ambulance, and I didn't stop her in time. A very nice FRU turned up, did his obs, said exactly what I knew he was going to say. Px mum turns up panicky, which odd considering that she works in the medical profession herself, but then again, it is her kid who is ill. In total, a major embarressement. I'm sorry. I have tried to make up for it all the other times I have been called out.

Lesley said...

I am glad I don't have a child in Sam Lloyd's friend's school!

Many moons ago, in what seems another life, I was a teacher. Part of my training was First Aid. I later topped up my knowlege, off my own bat, regularly during my career in order to keep up with new developments, however, all teachers then were initially trained in first aid.

Anybody can choose to go on a first aid course .... so why not do so?.... or do people not do such things in their own time these days, and have to wait to be 'sent' on a course (paid for, no doubt out of the council tax)

However, even with a school full of qualified first aiders, accidents can and will happen..and will be just that...accidents.

petrolhead said...

When I was a kid I somehow managed to whack my head on some double doors. Naturally I was very upset, and the receptionist/first aider sent me home as soon as a huge bump appeared on my head. In my opinion, this was exactly the right thing to do because then my mother could decide whether to take me to A&E or just keep an eye on me. In the end she took me to A&E when I became drowsy, but the point is that the school did the right thing by sending me home, rather than go completely OTT by calling 999 before any symptoms had occured. And that seems to be exactly what this school did.

Fiz said...

I remember this incident very vividly, from when teachers didn't care enough:- a boy I knew (who was alternately my friend and my bully!) caught his leg in some school railings and was pulled free with a sort of corkscrew effect on his leg. He was completely white and began to cry - Ross never cried, it was more likely he'd be making someone else cry. So I was worried about him. He cried all afternoon (it happened at lunchtime)and he had to walk home as well. Ross wan't at school the next day, but his mother was - he'd sustained a greenstick fracture to his leg, and she gave the staff merry hell. We were both six, and if I knew Ross was was no crybaby, the staff must have known too, but they did nothing. They also made me walk home a younger girl who had just had a bad asthma attack, and she was still blue round the lips! I was so scared, because it was a long walk and I hadn't a clue what to do if she started another attack. The system has gone from not caring at all to expecting the schools to cuddle kids in thick blankets!

Beachcomberswife said...

I think our school has it about right. If a kid bumps their head they hand out a "bump note" at home time saying that it happened and if we are at all concerned we should seek medical attention. I for one am glad that I've been informed, screw the note up and throw it away. So far both my kids are still alive.

I get the general impression, however, that a lot of people have a blinkered view of risk. They judge risks by feeling rather than reason.