By Anne Federwisch, OTR
December 12, 1997

If it weren’t for the nurses at Feeling Better Get Well Daycare for Kids, complications from pneumonia might have killed 10-month-old Austin Shirley. But by tracking his vital signs and pneumonia symptoms, the nurses were able to avert disaster by advising the boy’s mother and physician that Austin’s condition had worsened.

"If it weren’t for them, I wouldn’t have known to take him back to the hospital," said Austin’s mother, Shirley J. Shirley. She had taken off two weeks of work when her asthmatic son initially got sick. But his recurrent illnesses drained her paid time off. So she turned to the facility in Sunnyvale, California, for help. "I still worry about him, but I feel so much better with him at Feeling Better," she said.

Filling a need

Feeling Better is one of approximately 300 day cares nationwide devoted to caring for mildly ill children. Gail Johnson, MS, RN, president of the National Association for Sick Child Daycare estimates that parents miss five to 30 days of work annually because of their children’s illnesses. Those with younger children tend to miss more work. "But it’s difficult to find hard data, because parents lie, depending on how the benefit package is written at their place of work," she said.

Nurses play a crucial role in the growing field by not only tending to the children, but also providing much-needed training for parents, who are often unsure how to care for their ill children at home, Johnson said.

That’s one of the aspects of the job that Sandy Hagel, RN, nurse manager for Kid Med in Dallas, likes best. "It’s rewarding, helping parents know when to go to the doctor, how to measure a dose, how to restrain a child to get a dose in, and all those kinds of things," she said. The pace at the day care is much slower than on a typical pediatric ward, allowing plenty of time for teaching both parents and children, Hagel said.

Salaries vary. Nurses working for facilities affiliated with a healthcare system receive salaries comparable to hospital staff nurses. Those at independent centers tend to earn less.

Teaching health

Centers often follow a routine similar to that of day care, but with plenty of time for napping and convalescing. At Feeling Better, the staff devote part of every day to a health and safety class for the kids, said Ellen Johnson, RN. They review fire safety, conduct earthquake drills, and emphasize hand washing as the key to good health.

"We watch the children extremely closely. If they touch another table, they have to wash their hands," Johnson said. "We stress that this is Feeling Better—the day care that doesn’t share!"

Children are isolated by illness to minimize contamination and grouped by age for activities. Johnson develops individualized care plans for each child and keeps careful records of medications and activities.

Like many such centers, Feeling Better provides meals and snacks tailored to the child’s dietary needs during their illness. "Chicken noodle soup is a staple. That’s on the menu every single day," she said.

Providing a perk

Nationally, fees average $40 per day for the specialized child care. Kid Med costs $6 an hour for the community and $4 an hour for employees of Presbyterian Healthcare System, its parent organization. Feeling Better charges $55 a day, though many clients’ fees are subsidized by their employers. Shirley pays just $10 a day for Austin’s care. Her employer, Applied Materials, a semiconductor manufacturer, picks up the rest of the tab.

Johnson said that financial backing from corporations is essential for centers to stay afloat since their census fluctuates considerably.

Many companies are clamoring to offer the perk. Gloria Debs, an employee services manager for Sun Microsystems Inc., a computer systems manufacturer, said that offering reduced rates for Feeling Better has been an important benefit. Sun does not require employees to come to work when their children are ill, Debs added, but providing Feeling Better as an option contributes to the overall impression that Sun values its employees.

As for Shirley, the center has provided both quality care for her child and peace of mind for her. "If I didn’t have Feeling Better, we wouldn’t be able to financially handle his illness," she said.