For the Student or for the Teacher

[SchoolNurseLaura]

Let me start out by saying, this is my first official job as an RN, and four years of nursing school could have never lead to me to the correct answer. I have talked to two different people about this situation and both have different opinions. I am a school nurse and I feel that it is my job to care for the student, the student is my number one priority! However, this day was difficult. The student has some severe mental imparements, leading to some anger issues, and severe ADHD. On this day, he patiently waited in line to be next to make his lunch, however when people passed him in line, he became very angry, and threw out his food. I try to have a good relationship with alll the children, be that person that they are able to confide in, with non-biased opinions. It is important in my school to have a good rapport with the students. Anyways, the teachers got mad, and instead of ignoring the issue, they blew up, yelling and screaming, only making the situations worse. I went and talked with the student, who insisted that he would not eat, but I knew was starving. The teachers decided that because he had acted this way he would not be eating lunch today. They insisted that nothing will be served to him, and they will not give into his bad behavior. Ok, so I know you do not want to reward bad behavior, but I ALSO know that you can not use and should not use food as a reward or punishment. So even though the teachers said NO HE WILL NOT EAT, I made him a sandwich just incase he decided to eat. Needless-to-say, the teachers were very upset with me. HOWEVER, my opinion is, I am there for the student, NOT the teacher! The student and I discussed his behavior when he came asking me if he could eat and I gave him his lunch, I also told him to appologize to the teacher, and thank her for being so kind as to still make him something to eat (even though she did not!) When asking a Psychiatrist about this situation I was repromanded for "Splitting" making the teacher look bad...but that was not my intention. My intention was to obide by the law. He is not fed at home, and is mother has already had problems with the state because of her treatment to her children...but as a school it is our job to feed the children, and using food as a punishment is not right....BUT WHAT IS?! Should I have let him go without food or unintentionally split the student and teacher?? I am so confused...its a nurses job, but we are always walking a fine line...and after being told to do my job and only my job...it makes me wonder...PLEASE HELP!!

[retiredlady]

Having dealt with children like this, frustration is why they are doing it. They don't know how to react to different problems and boys usually will act out in these situations. It needs to be dealt with calmly and with no yelling. I would pull him aside in a quiet place, let him calm down and discuss what other ways he could have reacted. I also would have fed him lunch, then have him go back to the teacher to tell her he was sorry. These children get a lot of negative feedback. They need positive feedback and be shown how to correctly act in different situations. A lot of times teachers do not have the skills to deal with these children nor the time and thereby do not help these children. These children if they miss a meal their blood sugars drop and they act worst, just like we would probably.

[DayOhioRn]

Everybody keeps saying that the teachers were wrong to withhold food, but I just re-read the original post & that is NOT what happened. The student was given food, became angry, and threw it out. He CHOSE to refuse the food. It seems to me that all the teacher did was say "OK, you threw away your food, now you have nothing left to eat." Don't we all have to learn to make good choices? Didn't the OP just reinforce that no matter how bad your choice is, we will always make it better for you? Unfortunately, that is not how life works. More often than not, good choices have good results for us and bad choices have bad results for us. A VERY valuable lesson, indeed. No food was ever taken away from him, and 1 skipped meal will not affect growth & development. I think he was deprived of one of life's lessons.

I think there is little value is withholding food from a special needs child because he threw it. Withholding food is NOT a proper punishment for this behavior, especially since he is not receiving proper nutrition at home. He did not choose to refuse the food, he chose to throw it away. You have made and adult conclusion that this child cannot make, that throwing food away is refusing it. You must look at this from the child's point of view. He was wronged, then he had a meltdown, overacted and threw his food out of frustration. You cannot correct his frustration over the situation by withholding his food from him because he threw it. You must respond to the real cause of his frustration and address that behavior, the meltdown. WHY did he melt down....that is the REAL issue here. Withholding food from a child who is melting down emotionally escalates the behavior. He should have been pulled aside away from the other children and allowed to return to eat when he calmed down, and the meltdown subsided. You are not rewarding his behavior, you are taking the time to address the problem, giving him the opportunity to decompress and get into control. Only when the child has regained control and composure do you address the consequences of his actions. The teachers who decided to punish him by refusing to feed him did not solve anything, they just added to the meltdown, and actually exacerbated the situation. As for punishing him for melting down, a time out, detention, or removal from recess would have been acceptable. Food is NEVER a acceptable form of punishment.

[Brainiacster]

This particular teacher was way out of line - as were the other teachers who were yelling (inappropriate way with which to deal with this kind of situation). Also, you indicated this isn't the first time this teacher has lost her cool. Moreover, as others have pointed out, withholding food is NOT appropriate. Also, it appears the child was singled out for punishment, while the other kids weren't. To be blunt, it almost seems as though these teachers are losing their professionalism & taking their anger out on this child. The child obviously has acted out in the past and it appears as though the teachers have pegged him as a problem & they seem to be inappropriately & unprofessionaly unleashing their irritation with his behavior on him. Seems the teachers need a course in anger management. Understandably, they're fed up with the child's repeated BEHAVIOR (as opposed to the child himself), but they need to remember he IS a child and he DOES have problems and THEY are SUPPOSED to be professionals. Bad enough any adults would inappropriately handle a child, worse yet that it's coming from supposed professionals, and adding to that, it sounds like this child has enough problems without "professionals" adding to it. This child also probs with mother & certainly doesn't need teachers piling more probs on. It appears the teachers either don't KNOW how to handle such a child or they're letting their own anger dictate their response to the child's acting out. Totally inappropriate. These teachers are inadvertently creating MORE probs for this child. Not to imply the child should not have to answer for his behavior - he most certainly SHOULD answer for it, but it should be done in a non-angry, professional manner & in such a way that the child's benefits in the sense that his "punishment" should be something that holds him accountable yet also enables him to become a more appropriately-behaved individual, which is important in one's life. Can also understand the teachers need to maintain order in a school, but surely, there are much better ways to maintain control & discipline in a school setting. Lastly, the psychiatrist is "technically" correct in saying you "split" things, BUT that really was NOT the ROOT of the problem. The root is the child DOES have problems AND also the teachers' (all who were out of control) response to it. The shrink sounds like he's totally missing the boat regarding the real problems AND the solutions. The child sounds like he needs some counseling & also probably some limits, but limits should be set in such a way as to not exacerbate this child's problems. Would think a shrink SHOULD be able to handle that, but this one fell short of the mark. In addition, the whole hostile, unprofessional, losing control reaction of those teachers should be addressed and rectified. This is ridiculous. You did the right thing.

In a nutshell, it appears the teachers have had probs with this child and are fed up, so are losing their tempers & taking their anger out on the child rather than APPROPRIATELY setting limits or 'disciplining.' The shrink is adding to it by inadvertently encouraging the teachers. How did this guy get through medical school? (eyeroll) The ADULTS/PROFESSIONALS are acting worse than the child. In addition, it's not helping the child either. In this case, you have to be the child's advocate in whatever form you deem approriate from a professional perspective.

Possibly adding to it: Even though you're working at the school too, most nurses aren't in the "government worker" mindset - basically, meaning government workers almost have a "tradition" of pretty well doing whatever they want to do without fear of losing their jobs. I suspect a lot of teachers are of that mindset since, as a group, teachers are used to having a state govt job. In addition, teachers, in particular, have been somewhat spoiled because they also belong to one of the most powerful unions in the country (NEA). The point is, teachers, in general, get away with a lot in their jobs. BTW, I wouldn't be surprised if the principal does very little. Guessing he/she will take the path of least resistance: basically shutting it up & doing a CYA. On the other hand, the principal may be amenable to your suggestions if that appears to be the best way to protect his/her own job. Either, way, good luck to both you and especially the child.