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!!

[canigraduate]

Seriously, the teacher tried to withhold his food? I don't have kids, so I don't know the protocol, but do something! Report her, write her up, whatever it is that you do.

I think you did the right thing. Starving a child is, well, AWFUL. If there had to be punishment, it should have been by the school's guidelines, not by withholding food. And what punishment did the kids who cut in line get? I'm assuming they were allowed to eat.

This really ****** me off FOR you. As for "splitting", whatever that is, so WHAT? Food is a basic need. Maslow and all that, which the psych should know better than you. Mess with basic needs and you should expect the kid to act out.

Anyway, good luck in the future with these people.

[Sun0408, ASN, RN]

As a mom of a special needs child, I understand where the child is coming from. It was a meltdown as we call them. It comes from the frustrations at home as well as school. He felt he was being mistreated and acted out.

While I understand the child, I know that is not the behavior that can happen at school.. Had someone watched the child and seen the issue it could have been stopped before it happened.. Of course the child should have been allowed to eat AFTER cleaning up the mess he made and calmed down.

From the nurses perspective, of course you did the right thing. Nutrition is a basic need that must be met. A hungry child will be more prone to meltdowns. Some form of disipline should have happened but not withholding a meal.

If you feel some form of abuse is still going on at home and the child is not eating at home, this needs to be reported. I would also speak with the prinicapal about this and maybe have a meeting with the teacher and the Dr.. The teacher may not be sensitive enough to the issues the child deals with and as for the Dr well, my son's pychatricst told me "he was just the mediacine man".. ****we never went back to him after that*****

Maybe I am too close to this because of my own son, but I think it is wrong on so many levels.

[SchoolNurseLaura]

Thank you all for replying. I hope I get more responses! The state has been alerted about the mother, and been fined on several occasions. Splitting is when a nurse gets inbetween both parties and turns them against eachother...which was not my intention. I am just angry, and I dont think psychiatrists get the issue, they think about the manipulation going on, the pills to prescribe, not the care and love that goes into it...and also, that I could be the manipulator if i dont stick to my job and interfere! I am sickened by the thought that if I was not there, that child would not have eaten...I did get a "thank you" from the teacher at the end of it all, which should have been unnecessary...Please keep the advice coming...as much as possible is always always appreciated!! We are all nurses together, working for one goal!

[catshowlady]

I'm not a school nurse, so maybe my opinion isn't worth much, but from my perspective you did the right thing. Food should not be withheld as a punishment, that is a basic need, even more important if the child doesn't get proper nutrition at home. I think splitting would apply more if you had used the opportunity to make the teacher look bad to the student or undermine her authority, which it doesn't sound like you did.

Would it have been acceptable for the school to withhold lunch from other students? I would hope not. So why is OK to withhold food from this child?

:paw:

[crb613, BSN, RN]

You absolutely did the right thing! Makes me sick to think of this child being denied food. There are other ways of handling his behavior.....witholding food is not an option!

[HiHoCherry-O]

I agree. Denying food is not appropriate. Perhaps denying an extra playtime or as one poster mentioned, he is responsible for cleaning up his mess.

Was it witnessed that other kids were cutting in front of him? If so, why was this issue not handled? It sounds as though he made a good effort at following the rules but then was left without support when others did not and took advantage of the situation. I know many adults who would have huge meltdowns if this happened to them!!

[thinkertdm]

You did the right thing by providing a voice for this student when everyone else was hell bent on punishing him for something he really could not control. Did the teachers really think they would "teach him a lesson"?

[Anisettes, BSN, RN]

I think we're all in agreement that discipline is required, but NOT the withholding of food - even if he WAS getting proper nutrition at home. Using food as reward/punishment can lead to a whole other set of issues. Does this school have any kind of committee or other body (even if it's just the teacher, you, and the doc) who could sit down and discuss this to prevent the same from occurring in the future and reach a consensus onthe possible actions that could be taken by all sides to prevent or handle this issue of 'splitting' from occurring again?

[simplie_lovable]

You did the right thing I am not a nurse I am just a nursing student. But, I have worked with kids/the school board for a couple of years now. In the state of Florida it is illegal to deny a child food and it can not be use as a form of punishment. I would like to believe that this law applies to every state.

[SchoolNurseLaura]

Well according to the other school nurse, this has happened on several occasions...SICK! I guess teachers and nurses see things differently. They see a classroom, we see individuals all of which have individual needs. However building/keeping a rapport and splitting are two different things to me. Also it seems better with this child to keep it different from his life at home, to let him know that he is able to go to you to talk, and you will not judge him or belittle him. I think it is important to discuss this with the teacher, who often does talk to him this way. Because of his mother treating him in such a terrible way, having the teacher be so demanding on him, belittle him, and not praise him for the good things, only punish him for the bad things should probably be brought up, since of the close connection. The acting out at times could very likely be related. I want to be a mediator, not a divider. It just bothers me when I try to do what is best, to then be told off for what I think is right and what I am passionate about, makes me question myself...and we all know that feeling...

[shiccy]

For what it's worth it's actually illegal for the school in many states to NOT given a person food if they're willing to and wanting to eat.

They're kids for heavens sake. And a kid with mental disabilities is going to unfortunately act out more frequently than a person w/out.

This all said, however, I will ask the question that maybe this child should not be in a class such as anger management, or other special ed classes that will allow him to learn ways in overcoming his shortcomings and/or encourage him acting more appropriately.

I think you and the teacher need to have a little talk about attitudes towards children, honestly. This is also an issue that should be brought to the attention of the principal or whoever does conduct / evals for the teachers. It's totally acceptable to be upset from a situation, but YOU CANNOT SHOW IT TO THE CHILDREN. If you're going to repremand a child, GREAT. Take them aside, given them a time out, take away a star that they had to earn, etc. This should NOT, however, be something that is done in the heat of the moment, and should NOT be done in front of other students.

Finally you're right. Food shouldn't, psychologically, be used for praise and/or giving demerits for. Losing recess, having to stay over in detention, taking a time out, or just getting a stern talking to should be the go-to.

(also) Finally, the children that were jumping the lines are partially at fault for this behavior as well. They should be following the rules as well, and should equally have been punished for cutting in line and not waiting their turns... even if that punishment is taking them by the hand and making them wait not where they were originally, but allll the way back to the end of the line.