Is it ever okay to raise your voice ?

[Keepstanding, ASN, RN]

So I had a 4th grader come to the clinic because she had fallen on the palm of her right hand at recess and was in some pain.

She was thrashing around and screaming at the top of her lungs. Inconsolable and totally spazzing out.

I directed her to sit in a chair and I tried to assess her hand/wrist/arm area. She was very guarded and would not even let me get close to her, all the while she is hollering loudly.

I got an ice pack for her and reassured her that I would take good care of her. I got a cool compress for her forehead to try to calm her down. Nothing.

Now a crowd is starting to gather in my clinic, as it would seem as though I was murdering someone in here.

Talking with her, speaking in a calm and reassuring voice did not work.

After about five minutes of this insanity, I got in her face and yelled, " Calm Down" !!

She looked at me and suddenly gathered her senses and she calmed down right away.

I then spoke directly into her eyes and told her what I was going to do to assess her. She complied. Her breathing became normal again and I was finally able to help her.

Now folks, I have never had to be this blunt with any other student before and I actually shocked myself, but I had to gain control of this situation, and in a hurry.

My question to you School Nurses: Was this okay to do ? Was I wrong ? Please be brutally honest with me. I felt bad after it was all over. The student's parent was called, she went for an xray. Only a sprain. I do believe she was in pain. Let me know how you all feel.

[grammy1]

You did what was needed. I have done the same, but I work in a junior high and the dramatics there are unbelievable.

[OldDude]

You did what was necessary to reset the downward spiraling loss of emotional control. Good assessment skills and intervention!! I think you're hung up over the words you used, "calm down." I'll bet if you asked the kid what words you used she couldn't remember them. You could have used any word, "rainbow" or "stovepipe" or "green hornet." They all would have worked to startle her enough to reset her emotional nosedive. So, don't worry about word choice...good job! Those kids are lucky to have you!!

[peacockblue]

You shouting at her brought her back and kept things from spiraling into a full blown hyperventilating panic attack and ambulance ride. You done good.

[kummerspeck]

Once, when I was a teacher, my principal called me to the office during my break. (She actually sent a note with one of my students that said "See Me ASAP" on a folded piece of paper, the look on his face-well...). Anyway, I went down, and she said, "Miss Speck, you have got to not yell at those kids."

I had to sit there a moment and figure out what she was talking about. And I can imagine the look on my face when I realized when she must have heard me. I very bluntly said, "Ok, that's fine. But the next time my sixth graders use their metal math compasses (supplied by the school) as darts, what would you like me to do?"

(I yelled when one missed a dude's eye by about three inches).

She sent me back to my class and never talked to me about it again.

You got her emotional reaction under control and she was fine.

And on a side note, in nursing school I learned what to do when someone gets stabbed in the eye with something. So now I'm prepared...lol.

[Jedrnurse, BSN, RN]

You averted a total meltdown which would have been catastrophic. As everyone knows, when you mix a meltdown and a special snowflake, all you're left with is a...puddle.

[FolksBtrippin, BSN, RN]

It worked. So yes, it was okay. It was probably just what she needed.

[canoehead, BSN, RN]

It worked. Good job.

I would tend to usher out all the rubber neckers while someone is that emotional. Privacy would be nice, and you can avoid feeding the drama.

[RatherBHiking, BSN, RN]

My honest opinion is yelling at someone to calm down is not nice but we can't always be nice. However, I think there are better ways to handle situations like that so I'd avoid yelling if possible. Think about all the times you've ever been scared or hurt. If someone yelled at you to calm down it probably wouldn't make you feel better. Yelling could make a child feel like you aren't caring how they feel and you don't want that. Also an adult yelling could scare a child and make them cry harder or heaven forbid another student goes home and tells their parent the nurse was yelling at a student when they were hurt. Doesn't make you look good.

Whenever I have a student freaking out I get their attention (it's ok to say "Hey!" or "Listen" loudly if need be because they can't hear you)then say in a low firm voice "you're going to be ok but you need to stop screaming because it's scaring the other kids" (that gets their mind outside of themselves so they can see how they are acting is affecting others around them. I then tell them yes your are bleeding, in pain, or whatever but your arm, leg, hand, whatever hasn't fallen off and it's something that can be fixed or will heal, etc. This way they know I understand what's happening but I've reassured them and helped them see they truly will be ok and the humor breaks the tension a little. This has always worked for me.

My parents were screamers and it always scared us when they yelled. I don't want other kids to feel scared by me. I don't think any harm was done by what you did but just be careful. Also, make the other kids observing leave. Kids will put on a bigger show for their friends. Just some suggestions but in a true emergency just do what works if need be. Good luck!

[Farawyn]

I raise my voice sometimes at the HS level. Funnily enough, during a crisis I tend to calm down myself, focus, and lower my voice. I more raise my voice when kids are running in with blood dripping all down their face from yet another nose bleed and hovering over my turkey chili.

[kidzcare]

I raise my voice sometimes at the HS level. Funnily enough, during a crisis I tend to calm down myself, focus, and lower my voice. I more raise my voice when kids are running in with blood dripping all down their face from yet another nose bleed and hovering over my turkey chili.

I am the same! I am so calm when it's an emergency! At work and at home.