Special Needs Child Being Bullied: How can I keep my patient safe?

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After 4 yrs of staff nursing, I switched to agency nursing. My latest assignment is caring for a special needs child in a public school. I've had this child since the last school yr.

I had to report an aide for slapping a child the first month I was there. The teacher witnessed the event and we discussed it. After realizing the teacher hadn't reported it, I did.

Subsequently, the teacher denied seeing anything and the aide was returned to full duty. The special needs student was slapped for attacking another student. I have witnessed this other child choke, kick, push, hit the smallest children in the class repeatedly.

My supervisor told me not to get involved because it was none of my business.

After witnessing a 3 yr old choked until he turned blue, I went to the principal. She gave me her cell number and told me to call if I witnessed future attacks. I did as she asked twice and she did nothing.

During this school year, numerous events have taken place with potential to harm my child. I can no longer take her out of her wheelchair and allow her to sit on the rug with the other students. The new aide in the class has told other parents of incidents. The principal thinks I divulged the information and asked that I be replaced.

I'm tired of watching children be abused and looking into the faces of their parents and knowing what I know. I don't mind being replaced, but I hate that these children will continue to be abused if nothing is done.

Is there anything I can do without losing my license?

Can I tell the parents their children are being hurt if I don't give the aggressor's name?

Should I write a statement for the compliance officer? His tone initially was "as a parent i can understand why you're so upset about this situation". However, during his return call, his tone was more like a "I'm protecting my relationship with the client & my company & from this point, you're on your own". I am afraid I may be the one left holding the bag.

Specializes in Complex pedi to LTC/SA & now a manager.

Not a school nurse, but consider calling your personal malpractice/liability insurance for advice. Like others said nurses are manditory reporters, regardless of what your agency says. Compliance is likely involved because they know this is the truth. There is one agency that is now under manditory compliance oversight because of failure to address issues such as this (as well as several other unscrupulous business practices). Good luck.

you can check your board of nursing website for information and support regarding manditory reporting of child abuse.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

I think the advice from Just Beachy Nurse is good. Unfortunately neither your agency or the school are going to be interested in anything other than protecting themselves from liability.

I found a couple of websites you might find helpful. Both are ".gov" - the first is from HHS called the Child Welfare Information Gateway. It's very user-friendly. You check a box for the state you live in and check others that apply to your situation, the site will then provide you with the appropriate statutes and other info.

I have some experience with Special Ed through two family members. I know that a great deal of their funding comes from the federal government, and they are very concerned that money is used appropriately and offer information on what to do about abuse and allegations of other types of misconduct. Here:

US Dept of Education Office of Special Education and Rehabilitative Services.

Hope it all works out for the best.

Update...I followed everyone's advice. Reported incidents to the proper authorities. Have to say this has turned into one big mess. My student's mother has hired an attorney to fight for my job after being told there was nothing she could do but accept a new nurse. All of the children's parents were notified by the teacher's aide of the abuse. The secret is out. Saddest part for me is when my supervisor told me "Do you really think you're the only nurse who's seeing things like this? No, you're not! So, why is it that you're the only nurse I'm having a problem with keeping your mouth shut?". I am deeply saddened that my fellow nurses can in good conscience witness children being abuse & choose to ignore it. I didn't become a nurse to sit by quietly & watch any individual be harmed. If this is what being a nurse is, I'm in the wrong field! I became a nurse because I care about people. I want to make a difference in people's lives. I believe we become nurses to positively impact the lives we are trusted with not to give in to corporate policies that care more about profit than people. Correct me if I'm wrong.

Specializes in Clinical Research, Outpt Women's Health.

You went out on a limb advocating for the children and I am just awe struck. I truly hope something wonderful happens for you and I am so proud of you as a nurse and a human being.

So, the agency fired you for reporting this? If so it would be nice to get some publicity about this. There should be absolutely zero tolerance for this kind of abuse in our schools.

Specializes in Complex pedi to LTC/SA & now a manager.

If you have personal malpractice/liability insurance contact them...now they may be able to assist you if you lose your job for doing the right thing and following the law as a mandated reporter. You did the right thing. Clearly your patient's mother understands this as she TOO is fighting for you.

I'll never understand why people keep quiet when others abuse the innocent with no voice. It's up to you how much publicity you want to do, but be wary once you open that bag of worms it can rupture far and wide.

There are huge networks of special needs parents, myself included, who are standing by your side.

@ CrunchRN...Thank you! My grandmother raised me to do the right thing regardless of the consequences. My agency didn't fire me. The Special Needs Nurse Coordinator replaced me with another nurse through my agency. My student's mother was told she had no choice but take another nurse. She may eventually get stuck with another nurse but not without a fight. I was overwhelmed yesterday when the mother told the aide that she wouldn't take another nurse because "'student's name' was a different child before 'my name' came along. It's as if she woke up 'student's name' & brought her to life". This is why I became a nurse not for praise but because one person can make a difference.@ JustBeachyNurse...I'm not sure i want to get out in that spotlight. I'd rather work from behind the scene. If it comes to a point where the only way to get results is for me to go public, then I will. I have been told that some of the parents are discussing going to the media. I've got their back if they need me. As for insurance, I don't have it. I see now why it's so important. I'll be getting some immediately & praying I'll never need it.

Specializes in Complex pedi to LTC/SA & now a manager.

Personal insurance is rather cheap for the high level protection offered. In additon to the consultation services often availed to you if you run into unique situations such as this.

I'd definitely think twice before putting my name out there in the media, perhaps consult with someone in the know such as an attorney or otherwise. While some reports are public information, many regarding children are not. If the parents want to step forward that is one thing as they have the right to make their children's information as public as they so choose. Remember you need to be careful in what you say so as to not reflect poorly on your employer or reveal confidential information about your patient or other students. Some of your knowledge is covered under HIPAA and other information is covered under FERPA (the educational privacy act) since you work in a school system. HIPAA was recently beefed up by the HITECH laws that increased fines and punishments for releasing confidential medical information without consent. Certain medical information obtained in a school setting falls under FERPA since there is not a total provider client relationship and insurance billing is not part of the equation. Common sense is not so common.

I'm always amazed at individuals who are constantly afraid of intervening when witnessing bad acts. Don't risk your own safety (such as stepping out to help in the middle of a gang fight (extreme example) but you can call the authorities to intevene (whether child protective services for institutional abuse or the police).

Feel good that the mother's clearly sees that you have made a difference in her child. It's entirely possible that the school district requested another nurse be assigned and not solely your agency's decision. Mom can find out her rights in this situation as several states have decided that parents have the right to choose their nursing agency & service provider is used for their child in the school setting within certain guidelines.

Specializes in kids.
Update...I followed everyone's advice. Reported incidents to the proper authorities. Have to say this has turned into one big mess. My student's mother has hired an attorney to fight for my job after being told there was nothing she could do but accept a new nurse. All of the children's parents were notified by the teacher's aide of the abuse. The secret is out. Saddest part for me is when my supervisor told me "Do you really think you're the only nurse who's seeing things like this? No, you're not! So, why is it that you're the only nurse I'm having a problem with keeping your mouth shut?". I am deeply saddened that my fellow nurses can in good conscience witness children being abuse & choose to ignore it. I didn't become a nurse to sit by quietly & watch any individual be harmed. If this is what being a nurse is, I'm in the wrong field! I became a nurse because I care about people. I want to make a difference in people's lives. I believe we become nurses to positively impact the lives we are trusted with not to give in to corporate policies that care more about profit than people. Correct me if I'm wrong.

No you are NOT in the wrong field, the person who fired you is!!!!!!!!!! And this should now hopefully bring some systemic change for the organization. We are all here for you!

I have been extremely careful not to divulge any names. I don't know anything about FERPA.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

You did good. My niece was abused by an older boy in her Special Ed class when she was 11 years old. The school never informed my brother when they knew all along what was going on. Your actions are helping raise the bar for her, and all the victimized children in what appears to be a sick, "go along to get along" environment. ((Lovewhatidointx)) Thank you.

Specializes in Complex pedi to LTC/SA & now a manager.
I have been extremely careful not to divulge any names. I don't know anything about FERPA.

Basically if you follow HIPAA and basic confidentiality rights you will be fine. FERPA only can remove federal funding from schools if they divulge confidential student information. HIPAA is stronger than FERPA: Family Educational Rights and Privacy Act (FERPA)

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