How Far is Too Far?

[guest83140]

I have a special student that comes freq to clinic at a Junior High whose mom is a nurse who is demanding that I do a head to toe on him every time he graces my door, including what I did for him, vitals, symtoms, outcome and email her daily; in order to prove that I'm doing what I need to be doing "every single time". He comes in get his temp checked and then always asks to use the phone and whines forever on it. I then have to ask for him to go back to class and then he refuses. We've had him escorted to the Asst. Principle and this made her mad. I think he was babied at the previous school where the nurse there is best friends with this lady who works within my district 2 miles away. He prob got lots of rest time, lots of OTC and lots of personal calls. He has no doctor orders for this. My boss is aware and is secretly discussing this with the other school nurse because she came over today she said we needed the Nurse Guideline book on our desk while dropping off supplies. That's all she said. Gossiping I know. She will do anything to make a parent happy regardless of the principle of it. In other words, she will back them before she backs you. I don't have time for this and I don't think it is necessary. This child argues with dad/mom on the phone, has ADD, anxiety disorder, Asthma and normal allergies. She wants me to " evaluate him and treat his symtoms properly and then maybe he won't come back". He has tylenol, benadryl prn per her, inhaler prn., and daily add med we give. It seems she wants something given to him each time he comes. When I wrote her back that we know when to give the OTC, she asked how we evaluated it. Yeah right. This was him all last year at another school I was told and I don't see it stopping. She sent a long email criticizing our care, saying I was being paid to do this and that and sent copies to my principle, counselors and my nurse boss. I see about 60 kids a day and she doesn't care, she just wants what's best for Johnny. What are your thoughts about this? She sent this email without calling me first. Disgusted with Nurses trying throw their weight around inappropiately. She emailed me again criticizing my response in a longer email and I decided not to write back. :stone

[Jolie, BSN]

If Johnny is "requiring" this much attention for his health issues, then he needs to be seen by his primary care doctor for re-evaluation of his conditions and treatment plan, then a new IEP meeting should be held including the school psychologist and social worker. I'm betting Mom won't want this to happen because it will require her to put forth effort and take responsibility for her son.

What a piece of work this mother must be. Does she really want her child to become an emotional cripple?

[Keepstanding, ASN, RN]

Hi Glolilly,

This is totally crazy. You should not be this student's first line of health care. Sounds like he is coming in and for the most part wasting your time and getting out of class for fictious reasons. I would doccument very well with this one. His mother needs to come in and have a "sit down" with you , the principal and teachers. Mother needs to be called to pick him up each time he comes to your clinic. After so many pick up's then Mom may be inconvenienced enough to put a stop to this. Your administrators should back you on this. Don't back down.. This is crazy. Sound's like the kid has the parent "wrapped" ! I am so sorry that you are having to deal with this. Hang in there !

:monkeydance:

[edgwow]

I agree with the pick up policy. I would also let the mom know that I need a perscription for any OTC med to be administered, Tylonol for temperature greater than 101 degrees and benadryl for severe allergic reaction with accompanying hives.

Another option could be,let the mom know that you will call the family peditrician every time he "needs a med"to get verbal permission from the physician. After a few phone calls, the MD is going to want to know what is going on. They will probably tell mom that she needs to get him checked. Mom will then be on notice. Make sure to document this on the IEP which I assume he has since he is ADD, anxiety. There is a policy that the student can not call the parent, the nurse must do so and since there is only 1 phone line, I would set an egg timer by the phone and flip it over after you speak with mom and tell the student he has until it runs out to speak to his mother.What about getting school psychologist on your side? Crazy mom for sure, manipulative student for sure.

[KellieNurse06]

Maybe there is something more to this picture.....I mean..the kid is obviously looking for attention if he is in the office constantly......not to say some of his issues aren't real......but this is over the top.......and hello...anxiety?? Maybe mom is making him have the anxiety......who knows.....The mom sounds a few floats short of a parade if she is being this demanding.....If it were me in your place & I got fed up...I'd pretty much tell her..well since she's an RN then she should have no problem doing a head to toe...after all...you do have a whole school of other kids to look after besides her kid...... and everyone else who mentioned things like picking him up everytime he showed up to you and that sort of stuff...Ya I think that's a great idea......and especially telling the MD of his frequent visits......can you print out all his visits to you & reasons why? A nurse who cares for my daughter is actually a school nurse & every visit & reason for that visit is put into the schools computer system so she can just go back into the system & see every visit & when etc up to when the kid first even began at her school because she has K-5th graders there..............well good luck....

[guest83140]

This is an update on the situation. Kid came several more times. Parents got some Doc to give year around script for prns. But today they held mtg w/o me and voted to modify the plans. 1. cant go to counselor unless agitated 2. can't leave class to make personal calls 3. teachers must email parent daily for progress in class 4. must not roam halls Good Luck to all! But I guess it's a step toward up or down, hopefully up. Dad attended not mom. He is the gofer man. He is just 1 out of 4 that I've had deal with this yr.:smiletea:

[nurseklw72]

Mom didn't go to the meeting? Well if she isn't the classic case of passive-aggressive, I don't know what is. I agree with the other nurses who say to document and make phone calls every time this child is in your office. As far as a head to toe assessment, that's ridiculous. If she's such a fantastic nurse, then she should realize that only a focus assessment is necessary at the school setting. If this child requires full head to toe assessments at least once every day, then perhaps he needs to be admitted to the nearest pediatric hospital for a thorough evaluation by a physician. Good luck to you on that one. It definitely sounds to me like mom has some psych issues. This poor kid will probably change schools more than his underwear because mom is probably one of those parents who is never satisfied.

[tencat]

This is all becoming the rule rather than the exception in public schools, I'm afraid. Heaven forbid the kid or the parents have to take some responsibility for the kid's behaviors........:trout:

[guest83140]

Well, things broke loose today! He was put on a strict behavior plan where the behavior was labeled a. attack and he was to A. go to the coun. for 15 to calm B. go to asst prin if A. didn't work C. go to pysch. if B. didn't work D. go to inhouse thing . Well, he kept being sent to me from teachers, walking out of class, couns. office and then he exploded. Team showed up, got physical, had to be carted off. Found out later has hx of CPS re:stepdad or dad abuse? they say unfounded. Big time Pysch. Wow, was I surprised by all this. They are talking prof help I think. It's beyond me. Bipolar. I am emotionally drained today. 3 1/2 mo left to school and counting.