Special Needs Child Being Bullied: How can I keep my patient safe? - page 3
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... Read More
Oct 16, '12 by nursel56 GuideI 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.Last edit by nursel56 on Oct 16, '12
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.
Oct 18, '12 by CrunchRNYou 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.
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.
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.
Oct 18, '12 by NutmeggeRN, BSN, RNQuote from LovewhatidointxUpdate...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.
Oct 18, '12 by nursel56 GuideYou 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.
Quote from LovewhatidointxBasically 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)I have been extremely careful not to divulge any names. I don't know anything about FERPA.
@ Nhnursie...all of the support from my fellow nurses have given me the courage, information, & support to do what I knew needed to be done. I'm blessed to have each & every one of you.@Justbeachynurse...Thank you! I was hoping that FERPA didn't have some crazy law that would hang me later.@ Nursel56...I am so sorry your niece experienced abuse at school. I hope she hasn't had any long term psychological problems from her experience. That's my biggest fear for these children. I must be naive to think it is their duty to report things like this to parents. Don't they have a right to know without the aggressor's name being disclosed? Is there something in FERPA that excludes them from reporting these incidents? My son's school sent me a note for everything. Of course, we had a preacher's wife in kindergarten & a grandmother in 1st. Unlike this school, his school encouraged parent involvement in the classroom. I spent 2 winter breaks while in nursing school in his classroom doing projects with the kids & helping the teacher.
While they cannot name specific students involved, a public school can notify you of an incident and limited details. Generally you cannot name names of other students, especially if they are special needs. They won't even say if disciplinary action was taken because it varies depending on the student and their individual education plan/504 plan. There are different disciplinary procedures for a child with a known disability (such as a behavioral disability or diagnosis). Parent may be notified that their child has been changed classrooms if that is the decision but usually no information can be sent home regarding the other student.
So saying Mrs X, student Y hit your child today would be a violation. But Mrs. X, there was an incident today between your child and another student. Your child has a bruise, no injury, whatever. And we wanted you to be aware. You cannot name the other child, nor can you tell the victim's parent what type of disciplinary action was taken, if any. The school cannot tell the aggressor the details about the victim(s) such as "Mrs. X there was an incident in school today and your child hit and injured another student. This is how we are going to handle the situation regarding your child." They cannot say the name or any other details about the victim. (Though parents talk and some students talk it is not the position of the school, nurse, administrator or other staff member to reveal such details. )
The only information that would be shared is if it was an absolute zero tolerance (such as a gun or knife was involved in the incident and local police were involved) that local law enforcement or child protective services were involved. And even in that case, it's likely that you'll be told that Officer X or Ms. J from CPS will be contacting you with more information.
JustBeachyNurse...I thought that's how it was supposed to be. Wouldn't that have been easier to tell parents instead of them finding out through anonymous sources that their children are being hit? Now, the parents are furious because they had no idea anything was happening. Since its a new school yr, many of them thought their children were still experiencing separation anxiety with the exception of one child. His mother knew by his behavior that something wasn't right but was lied to when she asked. Glad to see there are nurses like you who know the rules & still advocate. Wish this school had a nurse like you :-)