The Fainting Au Pair: Should we rematch?

by cv harquail on May 5, 2014

Reliable, predictable, kind, and safe — that’s what we need childcare to be.

So what happens when we have an au pair who we like, who’s doing a great job, and then all of a sudden turns out to have a condition that is unpredictable, that makes her unreliable, and that makes you worry that s/he and your kids are no longer safe?

Here’s MetroHostMom’s story, and her request for advice.

Dear AuPairMoms — 

Our current au pair, with us since December, is a mature 19, mostly good with our kids – five and seven – and we like her a lot. She likes to go out on the weekends and often stays out very late – 4 AM or 6 AM.

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This past Monday she came upstairs for work in the morning and said she had been up all night coughing and wasn’t feeling well. She had been sick for a couple weeks, as we all had. Because I knew for a fact that she had been out very very late both nights of the weekend,  I was feeling a little less sympathetic than I might normally. We talked about her day and how she could manage it while not feeling 100% and then she abruptly left the room.

I wasn’t sure where she was but a few minutes later I heard a noise and realized she had gone to the bathroom. I went to check on her and found her passed out on the floor.

We called 911 because, well, we didn’t really know what to do. She wasn’t waking up, so we weren’t sure what was going on. She revived somewhat before the ambulance got there and was able to walk to the ambulance with help. She was taken to the ER where she (and I) stayed for the next four hours. She fainted two more times while in the ER, once when she was having blood taken and once when she walked to bathroom. Basic tests were done and nothing was found to have caused it. . Our au pair insisted to me several times that she was just hungry and the blood draw made her faint. The doctor mentioned something called a “Vasovagal Response“. The doctor recommended she receive follow-up care to look into it further and discharged her.

We made arrangements for childcare that day and the next day have tried to make things a little easier for her this week. In talking to her about it on the way home I tried to gently suggest that she needs to take better care of herself.  When I wondered aloud if she might not stay out so late, but she  responded that that was not why she’d fainted. She said “It’s just who I am.”

Our au pair seemed embarrassed about the whole thing but also annoyed with us for “making a big deal out of it” and sending her to the hospital.

We had another talk with her last night about it. We emphasized that she really needs to take care of herself and take it easy on the weekends. We asked her to go for a follow-up visit with a doctor.  We  told her that she can’t be in the situation where she faints again, especially when we are not home to help her. We’re concerned for her well-being and for the safety of our children.

But our au pair replied that she thinks it will happen again: When she’s cut herself or sees blood, she often feels like she has to throw up, and has fainted. I asked how often it happens and she said once or twice a year. This is not information that we were giving prior to last night. She seemed annoyed that we were making a big deal out of it.

In the meantime, I’ve done a little research on ‘vasovagal response’. Based on what I know about her it seems to be the exact condition she has – there is really no treatment for it, the only way to manage it is to avoid triggers like – dehydration, being tired, standing for long periods, seeing blood, heat etc.  At this point it seems like a doctor visit would just be a waste of money and time, since if this is what she has there is nothing that a doctor can do to help. (Our au pair claims she has never seen a doctor at home about her fainting, which is amazing to me).

The bigger issue for me is the safety of my kids – should someone who has repeated fainting spells be responsible for the safety of young children? Obviously bad things happen, and they can happen anytime, but they mostly happen without warning. Knowing (now) that the potential is there for her to faint pretty much anytime – especially with summer coming and very hot summers where we live – makes me concerned about her being the sole person in charge of my kids.

I wish it didn’t feel concerned. I wish I felt completely fine with the probabilities of her fainting again, and when she is caring for the kids.  But I am anxious and worried and honestly feel like she is just waiting for it to happen again. From my research it doesn’t seem to happen to many people while they are driving so I guess that is not a huge concern but just having my children see it would be very scary for everyone, whether they were in danger or not.

So we can tell her to go easy on the partying, drink a lot of water, sit down when she starts to feel faint, stay cool in the summer, don’t cut herself when she is making the kids lunch, and maybe it won’t happen again. But maybe it will.

I guess my question to the community here is – how cautious is too cautious?

  • Would it be ridiculous for us to rematch because of this when there are no other issues at all?
  • Would it be ridiculous for us to NOT rematch?  Should we continue as if everything is ok and just hope it doesn’t happen again?

I feel like I am a little too caught up emotionally to have any perspective on this and would love to hear from other parents. I know I can’t protect my kids from everything but I also don’t want to take unnecessary risks, right? But argh, rematch.

Help!!  ~MetroHostMom

 

Image:  “Undescribable Dissatisfaction” by Mary Belykh

 Some Rights Reserved

{ 58 comments }

Host mom in the City May 5, 2014 at 6:52 am

Unfortunately I think this is a rematch. Although your kids are old enough that they could at least know to call 911, they are young enough that it would scare me to put them in that position. The main thing they stands out to me is that she is completely brushing this off as an issue. She’s not going to focus on doing her best to make sure it doesn’t happen by taking care of herself. She’s too immature at this point in her life to take responsibility for it. If she had told you upfront, let you know what was happening, and worked with you to come up with done ways to prevent it, I might feel differently. Sorry, OP!

Taking a Computer Lunch May 5, 2014 at 7:20 am

Intriguing that this should come up. Our AP has this condition – and recently fainted after standing for a long time in a concert – and we have not felt the need to rematch. Why? Our AP takes very good care of herself – she generally eats well and exercises. She makes sure that she stays hydrated (I always give a lecture to new arrivals – “If your pee is dark yellow then you need to drink more fluids” – because it’s so hot here in the summer that dehydration can be an issue).

While you state that your AP is mature, she’s not mature enough to take care of herself – to give herself the rest she needs. I generally stay out of my AP’s social life – EXCEPT when it impinges on my ability to work. If an AP parties so much that she is too sick to work, then I sit her down and explain that I have hired her to work so I can work. I give her a warning, and tell her that if it happens again I will impose a curfew on her – 8 hours before her shift starts (can’t force her to go to bed – but a 10 pm curfew seriously curtails the social life).

For you, I’d advise something different. Your AP needs to propose changes in her behavior to reduce the chances that she will faint while taking care of your children. She needs to come up with a plan of what to do if they need to call 911 – that might include calling a neighbor to come and take care of them, obviously it includes calling you. If she is unwilling to do this, then tell her that you will need to call your LCC and go into rematch. I’d say with an episode of fainting severe enough to require a 911 call, and refusal to change her behavior, her changes of finishing out her year are nil.

One final statement – call the LCC and report the episode. She needs to be aware that the AP has a medical condition that was not reported to the agency.

Momma Gadget May 5, 2014 at 9:34 am

At the very least I would get your LC involved.

Personally , her cavalier attitude about this, and refusal/inability to acknowledge why this might cause concern about her ability to keep my children safe would be enough for me to rematch. There are just too many scary scenarios.

spanishaupair May 5, 2014 at 7:47 am

Well as an aupair with kind of that problems, specially when i was younger as she is, i have to say never crossed my mind to tell my HP about that, and yeah i had other medical problems that i point out during interviews, maybe because it happens not often, two years here i almost fainted once and for dehydration after stomach virus.
But sure she has to start to mind herself and if you want to keep working with her sit her down and talk about what she will do about that and inform the LCC

spanishaupair May 5, 2014 at 8:01 am

Oh and never went to doctors for that issue, at the beggining after fainting twice we (i wasnt 18 so my parents too) thought about going to doctor if happened again, but went well for a long while and never thought about that again

Always Hopeful HM May 5, 2014 at 9:27 am

If your kids were older, I’d think it may not be such a big deal. At 5 and 7 though, I would not want to take the risk, especially since she’s not will long to take steps to minimize the risk. What happens if one of your children has a cut that she needs to tend to? Would she be able to handle it without passing out?

Angie host mom May 5, 2014 at 10:42 am

She faints when she sees blood. This is different than just not taking care of yourself. When your kids bleed is when you need her not to faint. Sorry, doesn’t work, rematch.

I know folks who work with kids who faint when they see blood, but they aren’t the only adult present ever.

Old China Hand May 7, 2014 at 12:36 pm

I faint when I see blood but I have taken a lot of precautions for myself over the years so that I am able to handle emergencies. I used to teach first aid and CPR (wilderness first aid) and for 12 years was certified as a wilderness first responder. Having those skills made me able to handle emergencies when I needed to (including a scary one in China involving a mountain bike crash that resulted in a minor spinal injury) and holds off the fainting response until things are under control. But it sounds like in this case the AP hasn’t taken those precautions.

Should be working May 7, 2014 at 1:34 pm

Ok, a silly variation on this theme, but I knew a guy who fainted when he THOUGHT he saw blood on himself but it was only red fuzz from a new item of clothing he had worn. So fainting at the “sight of blood” is just fainting in a possibly unpredictable, and risky way, and in my view should be disclosed.

Momma Gadget May 7, 2014 at 1:43 pm

An extreme case years ago, a groom so nervous bout his vows, fainted at the alter, fell backwards and hit his head hard on the floor . He died a day later in the hospital.

icsamerica May 5, 2014 at 10:57 am

Rematch!

OpinionatedHM May 5, 2014 at 11:01 am

I think you are right to be concerned about the safety of your children in this situation. At best, there would be an emotional toll on your children if she were to faint and your children would have to find help for her. At worst, someone could be seriously injured (most likely the AP, if she were to hit her head on something while fainting) and it could result in a life altering situation for you all. Neither of these situations is acceptable and steps should be taken to prevent them.
The biggest problem for me, and the reason I would initiate rematch, is that your AP does not seem to understand the seriousness of this situation and it’s impact on you and your family. The fact that she seems “annoyed” that you are “making a big deal out of it” is a major problem for me. She does have the right to ignore her own health and to continue behaviors that contribute to her fainting spells. She does not have the right to put your children at risk and to disregard the emotional impact this could have on your family. A mature person who is ready to be responsible for the care of other human beings understands the impact her behavior has on others and takes action accordingly.
I recommend telling your LCC immediately if you haven’t already. Then get started finding an AP who has a mature understanding of the seriousness of her responsibilities to your family.
I’m thankful you were home to help your AP when she fainted, even if she is not. And I applaud you for calling 911 and getting her medical assistance. I recently had to call 911 for a family member and it surprised me how agonizing a decision it was to judge something enough of an emergency to require all the drama associated with an ambulance and ER visit. I wish your AP was more grateful for your support and your time.

Momma Gadget May 5, 2014 at 11:49 am

Great Post!

MetroHostMom May 5, 2014 at 11:22 am

Hi all – OP here. Thanks for all of your thoughts and advice.

Just wanted to say that our LC was the first call I made after 911, but after her check-in the following day we haven’t heard from her. She is not the most involved or supportive so I am not hopeful she can be of much help in this situation unless we decide to rematch.

HRHM May 5, 2014 at 4:03 pm

We’ve had an LCC like this. Every time I communicated with her about our AP, I also cc’d our program director.

You probably should as well, since this SHOULD effect whether she rematches to another family or goes home (the better result IMHO)

Taking a Computer Lunch May 5, 2014 at 6:09 pm

I’d call HQ. Have it documented that the AP fainted and you took her to the ER. You don’t want any countering from the AP if and when you utter “rematch.”

anonmom May 6, 2014 at 4:03 pm

Aside from documenting it for the agency’s HQ, the need to document to HQ also from a liability perspective. If the AP drives, heaven forbid she should have an episode. Not to mention should she faint and hit her head, this could lead to more severe injury.

WarmStateMomma May 5, 2014 at 11:50 am

Does the AP drive? What if she’d been driving your kids when she fainted? What if she hit someone else? My guess is that she didn’t see blood when she fainted that morning at your home because you didn’t mention it, so whatever her situation is, it doesn’t require blood. And you’re taking time off work to take someone to the hospital for something that could have been prevented if she took care of herself.

The risk doesn’t seem worth it to me, especially for someone who isn’t interested in minimizing the risk.

Should be working May 5, 2014 at 11:58 am

Yeah, if she doesn’t think she needs to change her behavior, or be more convincing to you about how she will handle it, she has to rematch. And yeah, if your kids are hurt or god forbid there were a car accident, she would need to be able to handle seeing blood.

Why isn’t “fainting” on the list of ailments for APs?? They have measles on there but no fainting and at least for CCAP no ASTHMA listing.

WarmStateMomma May 5, 2014 at 3:08 pm

“Fainting” doesn’t need to be on the list because APs don’t have any medical history anyway. :)

Dorsi May 5, 2014 at 6:09 pm

Lol. The uselessness of the AP medical forms….

anonmom May 6, 2014 at 4:04 pm

I totally agree with this comment! They are useless, and many AP’s omit pertinent information.

TexasHM May 7, 2014 at 3:20 pm

Totally agreed. Had an AP with medical history of recurring and serious non-recurring events and nothing was disclosed. Imagine our surprise when we heard “yeah Ive had this problem for years and seen several doctors” when the application had clean slate. In fairness, that was our previous big agency. Since we switched to a nonprofit I have seen a lot more medical detail and transparency from the candidates and agency.

Gretchen May 5, 2014 at 12:08 pm

I had this when I was a child and teenager. (Most people grow out of it eventually.) Speaking from experience, not getting enough sleep can definitely be a trigger for this! In our family manual we state there will not be a curfew unless there are issues and after 4 au pairs we have never felt the need to have a curfew. However, it seems to me this would be a case where we would choose to implement a curfew on the nights before she is supposed to work.

Good luck!

ChicagoMom May 5, 2014 at 1:59 pm

Do you require that she gets enough rest the night before she is on duty? We require our AP to be at home 8 hours prior to starting work. My hope is that he spends it sleeping, so at least he has a shot at being well rested for work.

MetroHostMom May 5, 2014 at 2:23 pm

Hi – OP here – we have never had to require that with her or any other au pairs. They have all been very responsible about getting a good night’s sleep before working the next day. Even when she fainted she was in bed at 8 or 9 the night before. The issue was not enough sleep over a few days. Which is why I am afraid a curfew the night before working wouldn’t be effective.

SingleHM May 5, 2014 at 2:27 pm

How does she deal with her period if she can’t deal with blood?

I think this would be a rematch situation. I have similar aged kids, and while they could call 911, I think I would be hard pressed to ever feel relaxed again.

Sorry OP.

Boys Mama May 5, 2014 at 2:36 pm

My first reaction to this was: Would you ever forgive yourself if you ignored this now and one or both of your children came to harm because of it? While I agree the chances are low that serious harm will come from Vasovagal Response… we are talking about the safety of your young children.

I no longer monitor the social lives of our Au Pairs either, but I admit to thoroughly weeding out those who need to regularly stay out all night partying. I don’t trust their overall judgment and maturity. Yours is even more dangerous… it is obviously a threat to the safety of your children and SHE DOESN’T CARE.

I know… we all feel committed and loyal to our APs and the line between family and employee is blurry. The clear line is child safety. Hot summer coming, no intention to curtail party life are problematic enough. If her application had read (as it should have) “Faints immediately at the sight of blood”… she would have been unable to find work with children anywhere. It’s not safe. When your child is bleeding you NEED your AP conscious at the very least!

Seattle Mom May 5, 2014 at 5:22 pm

I agree with the others- the attitude she seems to have where she refuses to take care of herself and does not understand why this is your concern is more concerning to me than the medical problem itself. I think a serious conversation & another email to the LCC, copying the program director, are in order.

My sister has this issue and it was diagnosed because she passed out when an IV was placed in her arm while she was at the hospital for something else. The whole hospital staff freaked out and ordered cat scans and stuff. Nothing was found. But my sister has a history of passing out when she gets an injection, and she has serious needle phobia (I also have a needle phobia but I don’t think i have Vasovagal response- I passed out twice when I was 12, and that’s it). Anyway she has a bunch of other strange medical problems that would make her unfit to be an au pair, so I don’t even think of the vasovagal response as being a big deal. BUT it’s really bad that your au pair isn’t taking the most basic steps to take care of it and seems to be in denial about why her health would be important to you.

Bruna AP2B May 5, 2014 at 8:23 pm

basics: if you don’t take care of yourself, your own health, how could you take care of someone else.. Same here with respect and love!
If she didn’t mind changing her behavior for her own well being and her job.. rematch.

Skny May 5, 2014 at 9:08 pm

I’d rematch

Multitasking Host Mom May 5, 2014 at 10:10 pm

Something similar happened to us a few years ago with one of our au pairs. She had recently arrived to our home, and she fainted one morning before I left for work. It was actually my child who found her though, and he was pretty upset about it for a few days. She ended up needing several stiches on her face, since her head hit a hard floor. Also, she had expensive scans done at the hospital, that insurance never covered, and I don’t think she ever paid for…but that is another issue. It turns out that she was feeling homesick and had stopped eating (except for the one meal at dinner that I was there for, so I hadn’t noticed she wasn’t eating her other meals.) I lucked out that our LCC gave her a big lecture about the need to take care of herself or frankly she would not be fit to be an au pair. It did set her straight. We did finish out the year, and never had a problem again. Though I must admit for awhile there I was constantly making sure she had enough food! Now would I do it again…I don’t know. Luckily we never had another problem, but it did cause me a lot of worry!

MaleAuPairInTexas May 5, 2014 at 10:21 pm

Sorry to say that but you need to rematch, this a very serious situation, don`t wait util something worse happens for you to rematch, even if she does a good job, she is not reliable with other lives not because she is a bad person but because of her condition, she can faint anytime, so for the sack of your own child, rematch. And like other said before, she should have sounded more grateful about the time and worry you had about her, but if she doesnt seem to want to take of herself, imagine taking care of others.

Anna May 5, 2014 at 11:08 pm

19, parties until 4-6 in the morning and attempts to take care of your kids in the morning? Plus has a known fainting condition exacerbated by the partying?
I have a curfew for my au pairs, except the present one. Yours needs one. If you want to consider giving her another chance.
My concern would be driving – there is no way to work around that and fainting

MetroHostMom May 6, 2014 at 8:44 am

OP here – to be clear, she has never stayed out until 4AM or 6AM the night before working – nor would we have allowed that. It has always been a Friday or Saturday night thing. The issue is a cumulative lack of sleep I think. Still not acceptable but not as bad as staying out all night before working the next morning.

exaupair May 6, 2014 at 6:50 am

She should be thankful you took her to ER. I’m sorry, but I would have let her go probably, as good as she might be I’m not sure if she’s able to look after small children when there’s a risk she will faint again.

DCBurbTwinMomma May 6, 2014 at 7:46 am

I think it has all been said but I want to emphasize CHILDREN FIRST and she is not doing that. Rematch.

NBHostMom May 6, 2014 at 8:16 am

Echoing the others, please rematch. It really troubles me that this was never mentioned during the application process, I see it as 1 of 2 options, both of which would send me into rematch:
1. She actively hid it knowing it’d be more difficult to find a host family (immature / deceitful)
2. She doesn’t consider it serious enough to impact her abilities (immature/doesn’t grasp the importance of her job)

It would be a different story if she had been upfront about her condition and actively managed it, but clearly this doesn’t apply to her.

ShenValHM May 6, 2014 at 8:18 am

OP, perhaps I am reading into things (as we all have to do in forums), but the fact that you used “mostly good with our kids” means to me that perhaps the fainting isn’t the only thing that has you on the fence. I didn’t get the impression that she was a ROCK STAR except for that one little thing. I also read between the lines that she was probably hung over on that morning, which is a big no-no. Forgive me if I am wrong or oversimplifying.

OTOH, I’m not an MD, but do work in a situation where vasovagal reflex is a concern. A lot of it has to do with mindset. Just because she faints at the sight of blood probably does NOT mean (but does not guarantee) that she will just suddenly drop out of consciousness while driving. The “child cuts herself” or “dehydrated from partying and tired anyway” scenarios could be a trigger, though.

I think the crux of the issue is the attitude. I agree with the posters that say start a paper trail and pursue aggressive measures toward rematch that could be put on pause with a drastic change in behavior and attitude.

MetroHostMom May 6, 2014 at 8:56 am

Hi ShenValHM – OP here. Thanks for your comments. She definitely was not hung over the morning she fainted – she came home from partying at 6AM the day before and had all day Sunday and all night Sunday night to recover. I think the bigger issue was that she was sick that weekend and ended up being up all night coughing on Sunday night, leaving her exhausted on Monday morning. Obviously still an argument for her NOT going out over the weekend, but not quite as bad as being hungover which is a huge no-no as you say.

Also, my comment about “mostly good with the kids” was meant to be a realistic description of her. Is she as good as our best au pair ever? No. Is she better than some we have had? Definitely. The tiny issues I have with how she deals with the kids to me are part of negotiating a relationship with an au pair and definitely not rematch worthy. So I was just trying to say that she is good enough with the kids for me to want to keep her.

She has administered band aids to my kids when their knees were bloody and did not faint, so it is not just the sight of blood that will cause her to faint, but more the kinds of injuries that you or I might feel a little queasy dealing with, but we deal with anyway. Which is still an issue we need to negotiate because clearly those kinds of injuries could come up.

And yes, I agree that a change in attitude and behavior is needed for this to work out.

CA-TXmom May 6, 2014 at 8:21 am

My husband also has vagovasal synocope (fainting) and it is triggered by dehydration. I trust him completely with the kids. He knows that when he starts feeling the signs of it coming on, he lays down and can stop it from happening. His condition is manageable but this situation with the Au pair is not. She is not mature enough to take it seriously and how to control it. This is certainly a rematch situation.

On another note, we do have a curfew of 11am on work nights and no curfew on days off. She texts us on days off when she gets home and when she stays somewhere else. We don’t care how late she does it but it let’s us know that she is home safe. We also text her when we get back from a scheduled late date too. It has worked out well.

MetroHostMom May 6, 2014 at 9:00 am

Thanks CA-TXmom – OP here. I will say that she has told us she too knows when it is going to happen and we have been very clear with her that if it starts happening she needs to stop everything and do whatever she needs to do so she doesn’t faint. Having said that, clearly her behavior when it is not happening needs to change as well.

We have the same policy re. getting home – generally don’t care when she gets here or if she stays somewhere else but has to notify us. Unless it starts to impact us in some way – which is where we find ourselves.

Angie host mom May 6, 2014 at 6:15 pm

Honestly you should rematch.

CA-TXmom May 6, 2014 at 8:24 am

I mean vasovagal synocope^

CA-TXmom May 6, 2014 at 8:26 am

And 11pm curfew (not 11am). Geez, I should write when I am tired.

Anonamomma May 6, 2014 at 9:11 am

@ OP

Let me just ask you this – what would happen if one of your children fell (badly) and broke an arm or leg?

What if (sorry for the graphics people) the bone actually pierces through the skin (recently happened to my little niece) and child needs comfort(even a hug) until medics arrived.

Is your AP able to deal with this? or would she faint..

With this AP I dread to think what would happen….. imagine child falls down the stairs and AP is in charge AP faint and child has broken limb and can’t reach help..

This AP is not fit for purpose – rematch – and send her home immediately.

Mimi May 6, 2014 at 12:31 pm

Both my FIL and the mister were/are fainters for the same reasons (blood, dehydration, trauma, hunger, etc.). They had to be vigilant about knowing when a faint was coming on. HD has gotten better with blood and smells due to dealing with 3 active boys and a wife who had hyperemesis during every pregnancy for 9 months :) but it’s a constant monitoring thing, especially since one of our twins (5 y/o) got very freaked out the last time HD had a near episode.

If you want to keep her, ask yourself a few questions. If you decide to keep her, can you deal with making some changes around the potential triggers which may mean curfew and other unpleasant things? Will (potentially) limiting her physical activity in the hot summer negatively impact your kids and the level of care you expect her to provide? If her attitude about this doesn’t improve, can you deal with how that is going to make you feel? Are you going to spend too much time worrying about this? And biggest in my mind…if something happens and you’re not there, how will the kids handle it? Will it be a learning opportunity that the kids can handle, or will it be emotionally traumatizing?

I do think her condition is manageable but not with her current attitude. It’s good that this is the first episode she’s had in roughly 5 months (and maybe she won’t have another), but her annoyance regarding your response to the issue speaks volumes. She doesn’t realize the impact this has on your family, especially the impact it could have on the children. If she can’t put that before her personal beliefs about her issue, then no, it’s not ridiculous for you to rematch because this is not really just about her fainting IMO.

Host Mom X May 6, 2014 at 2:22 pm

This has mostly all been said already, but I too, am a fainter / have “vasovagal syncope,” so I speak from experience. The usual triggers (blood, pain, heat, standing for too long) can lead to me fainting, but I have learned over the years to recognize my “auras” and take precautions when I feel them coming on. My vasovagal syncope (and I think most) is also correlated with generally low blood pressure. So – situations that lower blood pressure even more exacerbate the problem, e.g. pregnancy, or in the case of this au pair most likely – drinking all weekend, not getting enough sleep, not getting enough water.

To the posters who fault the AP for not having included this “condition” in her application – don’t. I NEVER would have thought to include such a condition in any job application, and when I was her age I worked in jobs caring for small kids. It just wouldn’t have occurred to me, since at that time (age 19), I didn’t have a scientific name for it (“vasovagal syncope”), and didn’t even know I had a “condition.” I had just fainted several times in my life, like your AP. (And it “ran in the family.”) The first time I ever went to a doctor about this was in my mid-30s, after I had fainted during pregnancy and my midwife insisted that I see a cardiologist to rule out other problems.

But – I do fault her attitude. Now, I assume she is embarrassed and flustered about the whole thing, but she should recognize and acknowledge why this is a serious concern given her job responsibilities. I will say that my husband and I agreed during the last pregnancy when my fainting was exacerbated that I would NOT drive anywhere. He didn’t even want me to take the subway to work, since one of the times I fainted was in the subway. He was even nervous about me carrying the new baby around the house, but I felt enough in control at home to be able to quickly put the new baby down if I felt a faint coming on.

Like others suggest, I would not make this immediate grounds for rematch, but would have a very serious conversation about how – if she cannot work with you to acknowledge and take precautions regarding this condition — you will have to rematch. I think with 5 and 7 year olds, if you think they could handle dealing with her telling them “I need to lie down for ten minutes with my legs up in the air,” when she feels a faint coming on, then it could be okay.

I will also say (and this may not apply to your AP; you’d have to discuss it) – blood is a fainting trigger for me. BUT – when I am in charge and must deal with the blood, I do what needs to be done. Some triggers – like the sight of blood – are mental, and operate differently in different circumstances. For instance, once as a teenager my cousin injured herself horribly when just the two of us were home. Blood, broken bones everywhere. I took charge, got her splinted and bandaged, got her to the hospital – because I needed to. And once the doctors took over, I promptly fainted. I have seen this with other family members who are also frequent swooners; I think this is common. So I wouldn’t necessarily worry that she wouldn’t be able to handle your kids getting injured. In fact, you really don’t know how ANYONE will handle a serious emergency until the time comes. You just have to hope.

Anyway, one of my “triggers” is talking and thinking too much about fainting, so – signing off now because I am getting woozy!

Aussiemum May 6, 2014 at 6:08 pm

Have a mediated meeting with her to develop a management plan, her attitude sounds like embarrassment, she’s not getting it’s not about her .

PhillyMom May 6, 2014 at 9:55 pm

Did they do a drug test in ER? It is an essential part of syncope work-up for a young person :(((((

hp with a similar past issue May 6, 2014 at 11:41 pm

Given her apparent lack of commitment to minimizing triggers I could not risk her driving kids, or caring generally for younger kids. Instant rematch for me.
Most agencies ask medical questions ( at home country interview and in APs written application) covering various angles designed to figure out if theres a safety issue or reliability issue. If she lied/misrepresented in her application or has developed the conditions since, the agencies hq typically will insist she get a fitness for childcare work cert from dr. They may even pay.
Be sure dr has received a note from you explaining your side, what you know and that dr has ER record. Ap may otherwise give dr a sunny version to get a clear cert.

If u rematch dont let the agency leave you out of pocket. The misrepresentation on the application is grounds for prorata refund or credit and grandfathering of any repeat family discounts or waiver of rematch new AP extra supplementary fees.

VirginiaMom May 7, 2014 at 10:47 am

We had a similar situation but it involved severe migraines, that required hospitalization. The aupair did not disclose prior to matching. We went into rematch immediately. The aupair was furious with us that we had ruined her life. I had to make my kids and their safety first priority.

In your situation I think I would either rematch or set some rules about curfews and better care of her health. I would say she needs to get 8 hours of sleep each night and must be home by 1AM. If she does not want to change her lifestyle to minimize the chance of this happening again, then her alternative can be to go into rematch. It sounds like she was probably drinking, out late and dehydrated. If she is too sick to work, she is too sick to go out with friends. She seems a flippant about the situation. Maybe you should have her come up with her plan for how she is going to live a healthier lifestyle and you come up with a plan and see how well they align. If the two plans look very different then that might be your answer.

Momma Gadget May 7, 2014 at 1:36 pm

I have suffered from debilitating migraines for the past 30 years. You were right to rematch. When I get a severe migraines, I can barely see, or put together a coherent sentence. Though there are so many great new meds,those with severe migraines still need to vigilantly monitor all their triggers and take care of themselves. Some triggers you have no control of like weather changes!

Stress is a huge trigger for most Migraine sufferers- I can’t imagine anything more stressful than taking care of someone else’s kids for long hours, in an unfamiliar country. Sleep deprivation, Alcohol, dehydration ( a long with many foods)are also triggers…And hard for young APs wanting to have fun in their new country to keep in check.

Although I am not surprised she didn’t disclose it to you- many migraine suffered don’t realize that those headaches are actually migraines. Some people only get them occasionally so they never really look into managing them.

Should be working May 7, 2014 at 1:32 pm

I know that CCAP used to upload to the website the DOCTOR’s exam form and comments, which I very much appreciated. It included height and weight and, I vaguely recall, other things that aren’t on the new version. The new version is that the AP herself checks off conditions she doesn’t have and adds comments.

An AP that had hospital-grade migraines is inexcusable. I hope the agency sent her home. I wish we had access to a DOCTOR’s assessment of the AP’s health, plus objective data like height/weight (because I want to know if an AP is even a tad UNDERweight, then I won’t take her). I imagine that CCAP stopped doing it because of confidentiality/medical issues, but I don’t know.

TexasHM May 7, 2014 at 3:32 pm

Only trouble is, even if a doctor examined the AP they likely wouldn’t have been able to diagnose this fainting issue or several other pre-existing conditions. If the AP walks in and says she is fit as a fiddle and they don’t see anything on exam there’s nothing they can do than give them a clean bill of health. Would have missed the migraines too. BTW – our last AP got diagnosed with migraines while she was with us thanks to another HM catching it (ER doc) – but same AP listened to the medical advice given and got some over the counter medication in case one started to come on and it was not an issue again the rest of her term because she took it seriously and managed it.

WarmStateMomma May 7, 2014 at 6:08 pm

I agree that an exam would miss too many things to make it an especially reliable tool. It would become useless for APs from countries without meaningful medical care or where the doctors are willing to rubber stamp a form.

Host Mom X May 8, 2014 at 2:42 pm

And with the fainting – unless it happens all the time, most people probably wouldn’t mention it to a doctor because they don’t view it as a “condition.” And “vasovagal syncope” isn’t something you can test for. It just happens. I had a full cardio-workup and nada. I have low blood pressure, but you can have low blood pressure and not be a frequent fainter. I don’t think it would occur to me to mention to a doctor at a checkup that I’m a bit of a fainter.

IT AUPAIR May 7, 2014 at 4:11 pm

Hi OP, I`m a nurse. I hope I won`t offend anybody if I say that a vasovagal response could happen to everyone. I think that what happened to your au pair is a quite common situation (based on my experience). Have also considered that probably she fainted seeing HER blood? It can sound strange but it can make the difference. I have a friend, also a nurse, who did thousand of blood sampling but
one day he fainted when he did himself a little cut. Hahaha We still laught about it!
Surely the lack of sleep doesn`t help but I wouldn`t be too worried about the safety of your kids. As I said before this is a quite common condition, but there are ways to prevent it. I would definitely talk to her and even if a visit to the doctor is not necesseray for her health in my opinion it could be useful to talk and receive advice on how to prevent it.
Good luck!

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