Bathroom accidents...

[Supernrse01]

... are they really a nursing issue?

I'm not talking about the kiddos that are legit sick with something acute or even chronic. I'm talking about the kids that just don't ask to go to the bathroom or are consistently presenting with behavior issues or looking for a reason to get out of class.

Just wondering your thoughts on this and figured I'd bring a little Coffee Talk to our table. "Talk amongst yourselves"

[KeeperOfTheIceRN, ADN]

The way I see it, if it involves a bodily fluid, it's clearly a nurse thing because we deal with body fluids. Now, with that being said, I fully expected to have all the potty accidents come to me this year when we added Kinder-2nd to our melting pot but NOPE!!! Imagine my surprise (and my admin assistant's!) when I said "I'm surprised we don't have any accidents here. I'm really impressed!". Turns out they've just been handling them without my help! WOOT WOOT!! Not sure how I dodged that bullet, but I'm not gonna rock the boat on it

Side note: if I learned anything from my hospital days, its that I will touch just about anything as long as I have gloves on!!

[MrNurse(x2), ADN]

Side note: if I learned anything from my hospital days, its that I will touch just about anything as long as I have gloves on!!

I started back in the days of only blood got gloves, they were too expensive for every contact.

[SchoolNurseTXstyle]

I can understand it being a nurse issue if you assist with cleaning it up. However, if it is just a phone call home to the parents - is a nursing license absolutely necessary?

I am sure that other adults in the building have been trained in how to utilize the phone!

What if the nurse is dealing with an asthma attack? Does poopoo / peepee kid just sit there stewing in their own juices for 30 minutes until the nurse is free to pick up and dial a phone????

Sorry if I sound snarky!! I don't mind assisting any student with any task if am not busy. I have helped track down band instruments and delivered homework assignments, etc. However,ill and injured students get my attention first and that should not delay an uncomfortable child from being assisted by someone who is a the time available.

[tining, BSN, RN]

Unfortunately I have an encopresis 4th grade student; new to us this year, that is driving everyone crazy. More psychological as per parents "had no accidents over holiday break." Student also does not do school work, claims to not know how to wipe correctly, and is motivated by nothing (school rewards). He comes to me on a schedule, but will have an accident when asked to complete something or there is a test. Removed from 4th grade bathroom privileges for acting weird to other students and we suspected was the culprit for smearing feces in the BR (since he lost his privileges there have been no more feces-BR incidents). Now he comes to me with a time left, time arrived folder. He was spending 30 minutes to change and leaving my bathroom uninhabitable, but now I monitor him in the bathroom across from my office where I can watch the feet and bark instuctions. He leaves to class and returns 10 minutes later (with a grin on his face) because he smells like poo. He has missed 14 hours of instruction time in 25 school days. I am going to suggest he earn his home XBox time by completing school work he can get 2 hours. Being honest about soiling and cleaning properly +1 more hour. Teacher and VP want pull-ups, but that won't help anything. Thanks for letting me vent .

[ruby_jane, BSN, RN]

Thanks for letting me vent .

All the love to you, tining. Not much you can do if there's no motivation.

I take it back - the kid is getting *something* out of this. Just because you and I don't understand what the *something* is, does not mean it doesn't motivate him. What does his private psychologist say? Because...yeah, this needs a specialist, given what you've said!

Hang in there.

[tining, BSN, RN]

Parents referred, but did not bring pay stubs to verify income . . . sigh

BTW - our counselor states this is "above him" he has not pulled this child out for his social isolation, poor motivation, and dishonesty.

I agree with Ruby Jane the child IS getting something out of this, but I will never let him know that.

[Flare, ASN, BSN]

Tining, just wondering - when this kid leaves your bathroom a wreck (assuming this is what you mean), do you make him accountable for it? I understand you can't have him cleaning with Sanitex or anything hardcore, but even if he were to wipe the seat down with a damp papertowel or babywipe and bag it up, it should be safe enough and make him realize that his mess is his to own.

[tining, BSN, RN]

Yes Flare, if there are smears he will wipe them up. It is the lingering odor and the thought that there are things I can't see. My personal response plus I would not send another child into a bathroom I would not go into. Luckily there are restrooms across the hall.

[ruby_jane, BSN, RN]

Ok so....is this a case of medical neglect? Not saying it is or it isn't. I don't know the parents. Encopresis in a fourth grader with no medical cause is a psych issue.

I also call patooey on the counselor. You named three issues the counselor could be working on unrelated to the encopresis.

[WineRN]

Teacher and VP want pull-ups, but that won't help anything. .

NOPE. Pull ups just justify the behavior in my opinion.

Our district requires a doctor to provide the dx of encopresis. If the family refuses, after so many accidents the student is excluded because our district requires all students to be potty trained or have documentation on why they are behind/can't be.

It takes up too much instruction time for that to be handled.

[Flare, ASN, BSN]

Yes Flare, if there are smears he will wipe them up. It is the lingering odor and the thought that there are things I can't see. My personal response plus I would not send another child into a bathroom I would not go into. Luckily there are restrooms across the hall.

i figured as much. I have a student with spina bifida and while a mess is usually not left, it's the odors of pulls up left that often cause objection. In my own bathroom i found a deodorizing device that helps, but does not solve entirely. And ultimately the child was moved to using a bathroom closer to their classroom with more room for supplies so i am not quite as enmeshed in the issue as i was before. I am thinking i will order another deodorizing device for the other bathroom in next year's budget.

[aprilmoss]

I've not had to worry about it since I left the elementary school. In the odd case of accidents at the MS/HS level, I just give the kid a package of wipes and tell them to take care of themselves and offer to call the parent for a change of clothes. The SpecialEd have their own paras for this.