Medication Administration

Last night was our last class for this PS MAPP section. (We still have Medically Fragile in August but that won't hold up our licensure as that is a licensing agency requirement verses a state requirement.)

The topic last night was Medication Administration and was the only class that had a test. We were given the test at the beginning of class and told that it would mirror the powerpoint. Sadly, I still saw people leaning over and copying from their neighbor. If you can't answer some simple true/false and fill in the blank questions that are almost verbatim off a PowerPoint then I don't think you should be parenting. Luckily for them, I don't make the requirements otherwise I would have failed some people.

Most of what we covered is pretty basic stuff. Wash your hands before administering, explain what you are doing, check the labels, make sure there are no funny pills mixed in with the regular, you know, the norm. Then we started walking through the documentation required. If you know me, you know I am OCD about being organized but even I am overwhelmed by the amount of paperwork we'll be completing. If you're curious on how many forms I get to keep track of here's the  DES foster parent forms website. Although the only form that appears to be missing is the medication one.

For med's alone, I have to document every single time I or someone else give the child any meds including over the counter (cough medicines, ointments, aspirin, tums, etc). According to our instructor this apparently includes sunscreen. Last time I checked, sunscreen wasn't considered a medicine but what do I know? Don't mind me if you see me with a child and my head in a tablet, I'm probably documenting that we just put some aloe on the child because we forgot to use sunscreen because I didn't have time to document it so now we have a burnt child. That's another thing, most of these forms have to be signed so we are not sure if they can be done electronically. We are going to look into it and then I'll just carry a tablet around instead of a binder full of silly paperwork. Someone needs to tell DES to get with the 21st Century!






Needless to say, Jon and I passed our exams and received our certificates for both PS MAPP's and Med Admin. Look how pretty they are! We worked so hard for these! 

For all our loyal blog readers, you get a sneak peek at a little project Jon and I have been keeping secret. We've been looking for a way to make the foster/adoption announcement public (right now it's mostly close friends and family) and we thought, why not do a foster/adoption photo shoot? So we did and we just got the pictures back. Here's a sneak peek of our soon to be official announcement:

We are excited to share all the photos very soon...

I'm not sure how often our updates will come now that our main classes are completed but I will still try to do things every couple of weeks so no one gets bored :)

Parenting Preparations

Our families are throwing us a foster care / adoption shower on June 29th and my sister has been bugging us to get registered so she can send out the invitations. The invitations are extremely adorable, what do you think? 

We think she did an AWESOME job - Thanks Lisa! 

I don't know how first time parents figure out what they need and what they don't need. There are SO many things at baby stores and 50 different types of every item. Do you want a big bottle or a little bottle, a slow flow bottle or a fast flow, a jogging stroller or a regular stroller and then do you want a single or a double? Baby stores are very overwhelming for first time parents if you ask me. We did manage to have a little fun and not just get stressed out. Jon had a lot of input on the diaper bag as he didn't want to be carrying a pink purse, what do you think of our selections?

My biggest concern is the stroller. I refuse to own 3 strollers. Everyone suggests a regular stroller and an umbrella stroller since they are so compact however I'm concerned I'll also need a jogging stroller. We are trying to find a stroller that can be used everyday and I can take jogging. I spent a good 30-45 minutes at each store testing strollers, running down aisles with them and testing their turning radius. Don't think that I was the only one having fun though, Jon was making sure they could do some wheelies! Does anyone have some good advice on strollers?

 

 

This week we also had our CPR/First Aid Certification course. Neither Jon nor myself have ever taken a class like this and we heard from other people in our regular class that it is quite boring so we were less than thrilled. Luckily we had an excellent teacher named Nick from Heart Savers who was extremely interesting! After about a 30 minute run through of CPR we got to practice on Bob (Adult mannequin) and Stewie (Baby mannequin). Here's me saving Bob's life :)

After our break we completed the First Aid certification. We also found this class very interesting and practical. We learned what to do for internal bleeding, asthma attacks, allergic reactions, seizures, strokes, scrapes and cuts, eye injuries, nose bleeds (interestingly enough you actually don't put your head back and pinch your nose like we were all taught), tooth injuries, burns, poisoning, and bites and stings. We now have a handy book with phone numbers and quick reference for all the different situations. I'm very happy we had to take this course.

Any advice for first time parents from all our experienced friends and family?

PS MAPP 10: Endings & Beginnings

Technically our last PS MAPP course! *Commence all the cheering and applause* We actually made it through!! I say technically our last because we still have to attend class next Tuesday in order to graduate. It's a class called Med Admin.

This class started with a woman from the agency who explained how the foster care placement process works. Basically there are 2 types of placement:

1. Emergency/immediate
2. Regular

With emergency the child is in need of a safe home right now. We will receive a phone call from our agency asking if we are willing to accept the placement. They will know only basic details: age, gender, ethnicity, etc. If we accept, they will submit us to CPS. CPS will receive families from numerous agencies. If they pick us, we will receive a phone call from the CPS Shelter Coordinator who will notify us that we will be receiving a child/children. Then we'll get a call from the CPS Case Manager that will schedule a time to pick up the child/children. 

The most interesting thing about this is you cannot check with your spouse before accepting an emergency placement. There is not enough time for it so whomever answers the phone has to make a wise decision.

Regular placement occurs when there were no foster homes available on the day the child was removed and so they were placed in a group home or shelter. If a child matches our specifications then an initial meeting is set up with the child, us, and the CPS case manager. If the meeting goes well, then we set up a day visit where the child can come to our home or go out for an activity. If the day visit goes well, then we can schedule an overnight visit. There are generally only 3 visits prior to placement. Children in regular placement tend to be older than age 6 so we will most likely be in the emergency situation.

Next we did a few activities regarding shared parenting and then we quickly moved onto the end of PS MAPP's and the Next Steps we have to take.

While going through this 4 page document, I quickly became overwhelmed. Here is a quick overview of it:

• Once all your completed paperwork is turned in, all of the references are received, fingerprint and CPS checks have cleared, and your packet is complete, you will be assigned a licensing worker. (We still need our CPR/First Aid Certification which is scheduled for this Saturday)
• Your licensing worker will contact you to set up a meeting to complete your home study. This interview process takes approximately 4 hours to complete!
• The home study must be completed within 30 days of class ending.
• The state licensing department has 60 days to approve or deny our license.
• At a minimum you must have a bed and dresser for the number of children you are seeking, prior to licensing.
• It is a good idea to have items on hand that you may need in the first month. (For us this is a crib, car seat, formula, couple of sizes of clothes, etc."
• You will need to have a couple of day cares selected as you can receive a placement within a day of being added to the available bed resource list.
• You are required to keep a file folder for each child that is placed in your home. This will be checked by your licensing worker on a regular basis.
• You will need to log all contact on the contact log, this will be checked during monthly visits. 
• On a quarterly basis your worker will be checking the Life book for each child and checking your medication storage.

It's crazy to think that in about 2 months we could be fully licensed and potentially have children in our home! I definitely do not feel ready especially considering we don't have anywhere for them to currently sleep, no car seat, no clothes, no baby food...pretty much we have 1 book, 1 bottle, and Cat in the Hat with Thing 1 & Thing 2 that need to get on the walls! We have a lot to do!

Steven Part 2

Envelope #2: Second day after placement

During the comprehensive developmental exam, the doctor has concerns about Steven's developmental delays and recommends that he be evaluated for services through the Arizona Early Intervention Program. The pediatrician also wants Steven to have an extensive eye examination by a Pediatric Ophthalmologist and would like the exam completed this week.

At 5:00pm today, you have the introductory meeting with Sara Smith (Steven's mom). During the meeting you each share information and learn about each other. It is apparent that Sara is angry at CPS and desperately wants to have her child returned to her care. Sara is courteous with you because you are caring for her son although she seems scared of your motives and fears she will never get her son back. She did provide you with an abundance of information so you can care for her child as she would. The first parental visit is set for tomorrow at 5:00pm.

1. How do you feel after meeting Sara?
• Surprisingly positive because she is working with us, sharing information, and doing what's best for Steven.
2. What are the benefits of this type of meeting when a child is first placed in your home?
3. How do you prepare Steven for his parental visit?
4. Who is responsible for transporting Steven to the visit?
• CPS and the foster parents but primarily the foster parents.

Envelope #3: Third day after placement

The CPS Case Manager reports all went well with Steven's visit with mom. He was so excited to see her that he clung to her leg when informed that mom needed to leave. Mom bought him a new teddy bear to sleep with and a new blanket to carry around that he brought to your home when he returned from the visit.

While the case manager is there she asks to see your home. You give her a tour. In Steven's bedroom she checks on his bedding and opens the closet and dresser drawers. Then in the kitchen she opens the cupboards and checks the refrigerator.

Once the case manager left your home, Steven begins to act our. He is screaming, crying and running around having a tantrum. He continues to be inconsolable after using every technique you know.

Steven, in anger and frustration, grabs something very special to you. The piece has great sentimental value and is irreplaceable. It falls to the floor and breaks.

After Steven has cried himself to exhaustion, you tuck him into bed for the evening. You finally can take a breath.

1. What is your immediate reaction to the loss of this item?
• Anger. I would need to take a deep breath before I react.
2. How do you handle Steven's behavior?
• Timeout for 2 minutes in order to help him calm down. Talk to him about what happened at his visit and why he is feeling the way he is. Explain to him that is behavior is unacceptable.
3. How do you feel about this outburst?
4. If it continues how will you deal with such incidents in the future?
5. What do you think of the actions of the CPS Case Manager while in your home?
• Intrusive and frustrating but at the same time we understand that it's in the best interest of the children.

Envelope #4: Ninety days after placement

This evening while you are fixing dinner one of your children and a friend are playing their favorite video game in the next groom. Steven enters the room where the children are playing and says, "mine...froggy game...now". Your child pauses the game and tells Steven that as soon as they are done with this game, he will put on the froggy game and play with him. Steven does not want to wait and goes over to the game system and pulls it onto the floor, it is attached to the tv and the tv falls to the floor. The TV has hit Steven in the head and he is now bleeding. Steven is crying and still yelling that he wants to play the game.

After you remove Steven from the area and attend to his wounds you believe that he needs stitches.

1. Where do you go to seek medical attention?
• If only stitches are required, we can only go to an urgent care.
2. Who do you notify and how do you document it?
• CPS must be notified within 2 hours. We will have to file a significant incident report.
3. What are you going to do about Steven's actions?
• No TV & video games. Explain the reason these items are being taken away and begin working on his patience and sharing.
4. What assistance might you have with the property damage?
• We can file a claim with the Provider Indemnity Program. 
5. How do you feel right now about your decision to bring Steven into your home?

Envelope #5: Six months after placement

This morning you take Steven to Target to get some more clothes. Once inside, Steven yells his mom's name and runs to his mother. He is not going to leave her side.

Later in the day, Steven is quietly playing with building blocks on the living room floor. You step away to use the restroom. When you re-enter the living room, Steven is no where in sight and the front door is open. You rush outside and yell his name; frantically you search everywhere for him. You are unable to find him.

Thankfully, Steven was found by the police. He had run after a dog that was in the front yard. The police found him six blocks away from your home.

1. How do you handle the situation in Target?
• Say hi, talk for a few minutes. Explain to Steven that we only have a few minutes but he'll see his mom again on the specific date of the next visit.
2. How do you feel about the situation in Target?
• Awkward and uncomfortable
3. What reports do you need to file after the runaway incident?

Congratulations, you have just completed a simulation of your life with a foster child in your home!

1. How do you feel?
2. What type of impact has this experience had on you and your family?
3. Did anything have to change with Steven entering your family?
• Yes, work schedules, patience level had to increase, our roles within the house changed

Meet Steven

You receive a phone call from your licensing agency at 3:00 am stating the following: 

• Steven is 2 and a half years old and was removed during a police raid of the home, Methamphetamine's were found to be cooking in the trunk of the family's only vehicle. Mom, Sara Smith, had called the police to inform them of the operation. Mom stated she was in fear for her life and that of her child because the boyfriend beats them both. The police were able to confirm signs of domestic violence. The boyfriend was arrested for the manufacturing of meth and possession with intent to sell. Mom was released and placed in a shelter. Steven was placed in the care of CPS until his safety in the care of his mother could be assessed. CPS is concerned that Steven's mom stayed in the home after she knew about the meth operation. There were additional concerns as to whether or not she would bail out her boyfriend.
• The police warrant was served at 11:00 pm and Steven was sleeping in the home when the police arrived. Steven underwent all the necessary precautions to safety remove him since he was believed to have been exposed to toxic, active chemical agents. He was then taken to Hope Hospital for an intital medical examination and toxicology testing. His clothing was taken due to a chemical smell and he was given a shower to remove any trace chemicals. Steven was released with instructions that he was to have a comprehensive medical examination from a pediatrician within the next two days.
• Steven is an only child.
• Mom reports she is unsure of whom the child's father is, she has no family living in the state and has no friends, neighbors, or co-workers who can care for Steven.
• Three months ago, Mom relocated to the area with her boyfriend of one year. They had been living 250 miles away in another part of Arizona.
• Mom reports that Steven has no known medical issues. He is a loving and obedient child who is very attached to her. No other information was able to be gathered since the Mom was ushered away to the hospital for an evaluation and then taken to a shelter.
• The child has only the clothes on his back due to the possibility of chemical contamination from the meth production. The clothes were provided by CPS.

Even though there is very little information known about this child, you and your family decide you are willing to make a commitment to this child and to provide a stable and nurturing home while he is out-of-home foster care. Steven arrives at your home at 5:00 am.

1. What do you need for Steven?
2. You need to schedule Steven's medical exam. What proof of insurance do you have?
3. Who will take Steven to the medical examination?
4. Who can sign the forms?
• We can for the initial exam and routine care.
5. How do you get the examination paid for?
• We sign them "Tina Lyons for DES/CMDP" in order to not be liable for payment.
6. What do you want to learn from Steven's mom at the ice breaker meeting?
7. How are you feeling about this day?
• Nervous, excited, scared, sympathetic & sad for Steven, overwhelmed

Get a good night's sleep and get ready for tomorrow's envelope!

PS MAPP 9: Teamwork & Partnership

This class had so much potential. Last week we were told we'd have a panel at the beginning of this class that would have resource (foster care) parents, community resources, and adopted kids. We were going to be able to ask questions but we should be mindful of their situation and only ask respectful questions (obviously!). 

For the first hour, the panel consisted of a woman from the Department of Health Services, a man from a foster readiness/permanency program (this program is ending soon), a kinship licensing woman,  and an HCTC (Home Care Training to the Home Care Client) parent. HCTC is for children with extreme behavior issues. The first hour was pre-approved questions that were pretty dry and irrelevant to our situation. After that a resource parent arrived. She has 7 kids in her home, 5 have been adopted. She was very helpful, honest, and realistic. I took away 2 things from her:

1. Have a family album ready to go and give it to the child when you pick them up and are taking them home for the first time. That way they can look through the album and see both of us, our house, Maggie, our siblings, our parents, our niece and nephews, activities we enjoy doing, etc. She said it is very helpful especially for younger kids because they are so scared at first. 
2. Always ask the GAL (Child's lawyer) when the court date is and attend. Apparently that is the only way you are going to get the full story.

The rest of the class we discussed the different team members systems we will be working with and the problems we might have with them. We broke into groups and each received a system to discuss what roles we have with that system, any problems we might encounter, ways to solve the problems, and who we could reach out to.

The last topic of the night was abuse. As resource parents, Jon and I are both mandated reporters. As resource parents we have a 1 in 2 chance of being accused of child abuse. That is a 50/50 chance! This part scared me quite a bit, I can't imagine being accused of child abuse or going through the investigations required when I know I didn't do anything. The goal of this part of the class was to make us aware that it occurs, why it occurs, and how to deal with it when it occurs. We are to keep our perspective, be honest, cooperate, document everything, ask questions, and get support. 

Our homework for this week sounds interesting and for the first time, a little more realistic than the previous assignments. This week we were given 6 envelopes. The first envelope has a child's name. We are to open the first envelope the day after class (That's today, Wednesday). Then we open an envelope each day after that in numerical order and complete the assignment based on the situation that has occurred. They seemed to also give us a case that was within the age range we are looking to foster/adopt. Our child's name is Steven. 

I'll do my best to give a daily update on each envelope so you can join us on our mini journey! We haven't read today's envelope yet so look for an update tomorrow!

PS MAPP 7 & 8 & Home Safety Inspection

Again we are playing catch up - we were out of town for Memorial Day, preparing for our home safety inspection, and working long hours. If we think we are busy now, I can only imagine how crazy life will be once we have 1 or 2 little ones to keep track of also. Google calendar is going to be an essential in the Lyons household.

PS MAPP 7: Helping Children Leave Foster Care

This class was about disruptions, dissolution, and transitioning the child from foster care. The main goal of foster care is reunification with the birth parents so we discussed how to help the child have a successful transition through communication, thoroughly explaining things to the child, helping the child prepare, updating the child's Life Book, and honoring and celebrating going home.

The most interesting discussions of this class related to disruptions and dissolutions and how to identify the signs of a disruptions in order to fix it and move forward.

Disruption: an unplanned move from one foster or adoptive home to another out-of-home situation

Dissolution: the legal act of ending an adoption, much like a divorce in marriage (Yes, this does happen and yes, we were flabbergasted that this was even an option!)

 The stages of disruption are very similar to the stages that lead to a divorce:

1. Diminishing Pleasure: In the early months when the negatives beginning outweighing the positives

2. Child is seen as blame for all

3. Talking to friends and family begins increasing the bad feelings

4. A critical incident occurs that is almost the last straw

5. A timeframe is set for improvement or a threat is given "One more time..."

6. The child fails to meet the deadline or ultimatum and the parents decide to disrupt


PS MAPP 8: Understanding the Impact of Fostering or Adopting

Confidentiality was the big topic of this class. Information about the child should only be given on a "need to know" basis. This is going to be a difficult thing to understand as we will not be able to discuss the reason the child is in foster care with us unless it is pertinent to the situation. We are not even allowed to share the child's first name when discussing the child's behavior in a foster parent support group, however if the child wants to participate in Little League, we are allowed to share the child's name as the Little League team has a "need to know" in order for the child to participate.

We also created a family map that allowed us to see what activities we get energy from and what activities we give energy to. After we created it we had to pick a child scenario and adjust our family map accordingly to include the child in our family. The goal was to identify our strengths and identify what child would best fit into our world.

The last thing we discussed was what to do in the first 24 hours with the child.

Home Safety Inspection

Our home safety inspection was Wednesday, May 29th at 2pm. Jon was off work in time to get home and I was able to take my lunch break a little later in the day. The inspector was right on time and started in the kitchen. He went straight down the list - see page 15 of the DES Checklist. We had a minor hiccup with the fridge temperature due to Jon making some adjustments but the inspector let us turn the gauge down and he re-checked it at the end of the visit and we were in compliance! He basically walked throughout our entire house opening all cabinets and drawers and asking us where different hazardous items were stored. All smoke detectors were checked to make sure they were in working condition. My favorite part of the inspection was the emergency evacuation plan. Apparently most people fail the whole inspection because they can't follow these simple instructions:

1. Identify 2 routes to evacuate from bedrooms used in care
2. Identify the location of fire extinguishers
3. Designate a safe meeting place outside the setting
4. Maintain the plan on the setting

If you know me, you know my love for Excel. I looked at the example and realized I could use excel and got right to work. Here's my finished product:

At the end of the day we got the golden stamp of approval! We are now certified by the state of Arizona as living in a house that is safe for children!