Cutting

Specialties School

Published

Hi all,

I am new to school nursing (worked L&D for 18+ years) and find it to be a challenge. I have a student (actually a few students) that exhibit self-harm in the form of cutting. It seems to me that this is "the new black". I had a pediatrician call me and ask if I had reported an incident to CYFD. This seems a little extreme to me. These behaviors are often a release mechanism and the student is enrolled in therapy to learn healthy coping mechanisms. How do you handle these situations? The student is 16 and lives with her adoptive father.

I work in a rural school setting...pre-k-12...380 students. I see 40-60 kids a day!

Thanks for any advise...

OldDude

1 Article; 4,787 Posts

Specializes in Pediatrics Retired.

This is another reason I stick with elementary only. The only thing I would know to tell them would be to "stop it."

Farawyn

12,646 Posts

It may be a "release method" to the child or teen, but it is considered self harm and should be treated seriously each and every time. Escalate it.

Psych should be on board, and together you take the next steps- evaluating for suicidal ideation, calling the parents, therapy, etc.

OldDude

1 Article; 4,787 Posts

Specializes in Pediatrics Retired.

It must be a fairly complex issue. Princess Diana was a cutter and she had everything. Too deep for my shallow mind.

jonie8693

12 Posts

My daughter's best friend who is in 7th grade was cutting herself and my daughter reported it to the counselor they called the mother in and told her she had to be evaluated before returning to school. They admitted her into a mental health facility on Saturday and is still there. I didn't realize how big of a problem this is becoming.

kidzcare

3,393 Posts

It must be a fairly complex issue. Princess Diana was a cutter and she had everything. Too deep for my shallow mind.

Money and privilege do not equate with satisfaction in life. Depression and other psychological conditions manifest at every socioeconomic level.

I'd be willing to bet that Princess Di's issues were related to the pressures on her to marry a man that was chosen for her and her life in the spotlight.

Farawyn

12,646 Posts

Money and privilege do not equate with satisfaction in life. Depression and other psychological conditions manifest at every socioeconomic level.

I'd be willing to bet that Princess Di's issues were related to the pressures on her to marry a man that was chosen for her and her life in the spotlight.

Yes, absolutely. The "awesome" thing about depression? You don't need a reason.

Kids cutting should never be taken lightly. Ever.

Specializes in Psychiatry, Forensics, Addictions.

Realize that it is not a suicidal gesture, but self mutilation. Many young people are involved in this behavior.

Cutting releases endorphins and can help one feel a "release".

ruralSchoolRN

11 Posts

The student's father was notified and was sent to the emergency room for follow-up and has also made appointments with psychologist. She is in therapy and sees a therapist regularly. She has a history of cutting and has been free from cutting for 4 years. She has had recent stressors in her life and states "it just happened". A self-harm contract was signed and a suicide assessment was done. We did not report to CYFD as the family seems very supportive of treatment and involved in ensuring the student has resources available to help her learn healthy self management behaviors.

ruralSchoolRN

11 Posts

I agree...These kids need to learn coping mechanisms and must have support from us all...

Farawyn

12,646 Posts

Realize that it is not a suicidal gesture, but self mutilation. Many young people are involved in this behavior.

Cutting releases endorphins and can help one feel a "release".

It may be or may not be. It is self harm.

And some kids cut too deep.

Do NOT treat it lightly.

DEgalRN

454 Posts

This is such a rough topic. Cutting is not usually an indication of SI. But, they stem from the same area and the same issues. Any time there's self harm you do need to evaluate for SI. If SI is present, you escalate. With no SI, notification of the parents and referral to a current or new therapist is probably what I would do. (And on days that our PT therapist is here, I send them there!)

Can I ask why she ended up in the ER? Unless she was suicidal or there was a medical issue with her cuts, I'm not sure that I would have sent her to the ER. But, I'll admit, I'm new to all of this and am curious as to your though process/policies?

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