Hygiene

  1. 0 This isn't the first time I've had this issue with kids in my 2 years as a district nurse. But got this in my email today. What would you say to this teacher?


    "[FONT=eras medium itc]I have a student with very poor hygiene. He is from a very low socio-economic household and I am not sure what resources they have. I have been to the house, but not inside several times. Is there a procedure for approaching this situation? "

    I don't know of any written "procedures". Do you?
  2. Visit  Spidey's mom profile page

    About Spidey's mom, ADN, BSN, RN

    Spidey's mom has '17 years' year(s) of experience and specializes in 'ER/L&D/Hospice/School Nurse'. From 'In the mountains'; 58 Years Old; Joined Dec '02; Posts: 38,324; Likes: 35,372.

    12 Comments so far...

  3. Visit  DC Collins profile page
    0
    How old are the kids? If the school has an athletics program, encourage the kids to join = free showers?

    DC :-)
  4. Visit  mariebailey profile page
    2
    If the children are young & have consistently poor hygiene, that is a sign of neglect. That could potentially be more of a social services issue.
    amoLucia and brillohead like this.
  5. Visit  Flare profile page
    3
    I always hate getting this request. Nothing makes a kid feel better than getting sent to the nurse to be told they stink. 9 times out of ten it's a kid that we hardly ever see so it's not like it's a kid we have a relationship with, but it's part of the job, so i grit through it. No, there are typically no procedures in place for this. If the teacher thinks it's a case of neglect then the teacher is obliged to call DYFS, but if it's just a case of a kid neglecting their own hygiene, which is most often the case, then the kid needs to be reminded to shower daily, wash their hair, change and wash their clothing and use deodorant.
    NutmeggeRN, mandm97, and Spidey's mom like this.
  6. Visit  Spidey's mom profile page
    0
    Got a nice note from my mentor, who stated - "I tried not to get in the position of being the only one who would deal with poor hygiene. I don't believe it always requires the expertise of the nurse. A teacher can use compassion and honesty and often is able to help in the resolution of the situation."

    She also mentioned that some lower socio-economic families have that "smell of poverty" that is universal and permeates everything. I've come across this as a hospice nurse.

    I'm going to encourage the teacher to try to contact the family with compassion and honesty. I don't think this is necessarily a sign of neglect as this is a high school kid who actually has some mental issues. Our local CPS rep states responding to hygiene issues isn't necessarily something they think is important. I know as a hospice nurse, I see families living in filth and besides making sure things are safe, we can't tell them to wash their dishes or clean their toilets.

    This is a tough issue.

    Thanks for the responses.
  7. Visit  tictac profile page
    3
    I get those requests every now and then as well, and it seems that teachers automatically want to send them to me. Like Flare said, it's usually someone I don't know well. I feel that the teacher has a closer relationship with the student and the student will be less embarrassed if it is handled by the teacher. Now if they've already had the talk, and nothing was resolved, then I understand having me step in, but I don't feel like I have any special expertise in handling this topic.
    mandm97, Tina, RN, and Spidey's mom like this.
  8. Visit  squidbilly profile page
    0
    I have a 4th grade student with very poor hygiene, and I have been pondering how to approach the potentially touchy subject. I see the student often, so I think it would be just as appropriate for me to start the discussion as it would be for his teacher to (although his teacher has never voiced any concern). The student is usually visibly dirty. He will have marker ink on his hands for days and always have dirt under his nails, which to me indicates a lack of hand hygiene. I always have him wash his hands when in my office. And as for the "smell of poverty".. yup! I know boys get dirty, but they should not stay dirty. I would love tips as to how I can approach this subject in a sensitive manner.
  9. Visit  Cherry Ames Peds RN profile page
    3
    I also am reluctant to call parents regarding children's hygiene issues. When I do make those calls I acknowledge to the parent that this is a sensitive topic. I also make sure the family has access to running water, washing machine etc. I recently spoke with a second grader about hygiene and she told me they don't have soap at their house.

    When I speak to the parent, I do try to frame hygiene as an educational issue: other children don't want to sit by the child if she smells, it makes group projects difficult, the child may be teased, etc.

    In the past, I have done a brief hygiene lesson for the fourth grade. I used a poem called "The Dirtiest Kid in the World" from this site: DirtyKid Then we talked about what that kid could do to clean up his act. I also had a hidden word find puzzle with hygiene-related words and a hidden message with the left-over letters. The kids loved it and got a hygiene-related prize like a toothbrush or deodorant when they completed the puzzle. The benefit of group instruction is that an individual child is not singled out.
    amoLucia, mariebailey, and Spidey's mom like this.
  10. Visit  NutmeggeRN profile page
    1
    Ugh... Had to do this again the other day with a 15 year old girl...sad...she smelled, her clothes are dirty and she is now placed with a cousin who is barely able to care of her self. I have found over the years a direct approach is the best...I just say that it came to my attention that some folks were concerned about you and why. I have a shower in my office so I just tell them to pop in when ever they need to, it is always here for them, as I am. Some times I really need to direct them and say directly "You need to get in the shower now" firmly but gently. In the beginning it was NOT easy and rarely is it ever comfortble for the kid (or me) but in the long run it IS what's best for them and usually works out ok.
    Flare likes this.
  11. Visit  Flare profile page
    0
    NHnursie is right - when it boils down to it and you have to confront a student, direct, non-judgmental and matter of fact is the best
  12. Visit  brillohead profile page
    1
    As part of my community nursing rotation, I had to give a presentation on hygiene to a class of 1st graders. During the course of the presentation, one little girl commented that she didn't have a toothbrush at her house, and she didn't think there was toothpaste either.

    I later discussed this with the school nurse, and she was aware of some of the social problems within that particular family. The nurse had little "hygiene kits" in her office for situations like this, and she later (away from the other kids) gave one to the little girl and told her it was hers to take home and use every day.

    Sadly, soap, toothpaste, toothbrushes, deodorant, and laundry detergent can't be purchased with food stamp benefits, so many times families just go without.

    For students who have access to hygiene items but just don't bother to use them, perhaps work out some sort of sticker chart / reward system with their teacher? Come to school clean (body, hands, teeth, and clothes) every day for a week and get a prize/reward of some sort?
    Spidey's mom likes this.
  13. Visit  Spidey's mom profile page
    0
    Quote from brillohead
    As part of my community nursing rotation, I had to give a presentation on hygiene to a class of 1st graders. During the course of the presentation, one little girl commented that she didn't have a toothbrush at her house, and she didn't think there was toothpaste either.

    I later discussed this with the school nurse, and she was aware of some of the social problems within that particular family. The nurse had little "hygiene kits" in her office for situations like this, and she later (away from the other kids) gave one to the little girl and told her it was hers to take home and use every day.

    Sadly, soap, toothpaste, toothbrushes, deodorant, and laundry detergent can't be purchased with food stamp benefits, so many times families just go without.

    For students who have access to hygiene items but just don't bother to use them, perhaps work out some sort of sticker chart / reward system with their teacher? Come to school clean (body, hands, teeth, and clothes) every day for a week and get a prize/reward of some sort?
    That would work well with young kids - I do have one child who was sent to me last week after classmates complained. To be honest, I did not smell anything. I asked a couple of adults - they also did not smell anything. Maybe she's passing gas??

    As to the reward system, the original student is a teenager and has special needs . . I doubt he'd have anything to do with a sticker/reward system.

    I haven't heard from the teacher after sending him an email.
  14. Visit  brillohead profile page
    1
    Quote from Spidey's mom
    As to the reward system, the original student is a teenager and has special needs . . I doubt he'd have anything to do with a sticker/reward system.
    Probably not, with an older kid. Unless you could find the "right" reward to motivate him? Like a "no homework" pass for one class for one day or something (with teacher's permission, obviously). Hard to know, though, with a teen with special needs -- what would motivate us may not even register with him!

    Oh well, you could always just take him outside and spray him off with a garden hose!
    Spidey's mom likes this.


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