I had a skewed group of patients in urgent care last evening. I saw lots of teenagers/young adults who were there for STD testing before returning to college and I saw several infants who had just started daycare because their mothers returned to the workforce after the new year.
I like the older kids, I must say. They are often candid, worried, confiding, mature and silly. Their issues cross economic borders and involve concerns from straight and gay teens alike. Often, without acknowledgement of consequences, these young people leap into situations which may lead to illnesses they never wished for. I can tell you that there is a lot of laughter and crying during many of these encounters. It is not my strong suit to counsel young adults but I have forced myself to become more knowledgeable around the issues of the age group.
The dilemma of returning to work and putting young infants in daycare is also a slippery slope in terms of advice giving. There are many reasons why mothers feel compelled to return to work, but that is not my business. What does call for my opinion is in the lengths to which parents will go to in order to have their sick babies go back to daycare the next day. A mother of a 18 month old tried to wrangle antibiotics out of me from every direction. The toddler looked exhausted and mildly ill but there were no findings in the physical exam to warrant a prescription.
Often I will talk to the little ones directly. Last evening I had a chat with a five month old. I asked him how he was doing, if anything hurt, and if he was tired. He gave me a wan smile that seemed to indicate that he was not feeling his best but well enough to interact. I asked the mother to keep him home for a day or two in order to recover from his current viral illness before he got launched into another. "I can't really miss work" was her response.
Employers are frequently harsh with young parents in the workforce. They need notes from us to explain the need to stay home with their children. I was surprised to find out that the postal system is very intolerant of worker's absences related to sick kids. Children in all day daycare are like workers as well. They leave early in the morning and return home at about 6 PM. It's a long day for all concerned.
I managed to always work unusual hours and had coverage at home. There was lots of wear and tear on all of us but nothing in comparison to what many working mothers have to accept. Still, I think it's bad policy to send sick little ones back to a less comfortable, more stressful environment where no one is absolutely crazy about them.
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