Teenage bowel training

[Flare, ASN, BSN]

geez - i feel like all my issues on here are bowel related....

anyhoo - next year i will be getting a student with spina bifida into middle school. In talking to his former school nurses in district, the student is a regular ed student, ambulatory and so forth. The biggest issue is bowel and bladder control, or more specifically utter lack thereof. The parents are content to let this child wear a pull-up and change and clean himself as needed. That's all well and good that the kid is independent with that but my concern for next year is him going to a school where he is not in the same classroom of students that have grown up with him and understand that he may occasionally (or realistically often, as reported by my colleagues) smell of urine and feces.

The parents have not done any type of bowel or bladder training program. Their answer is that he can't feel it and that's the end all and be all. That, i suppose, is how he will spend the rest of his life in his parent's eyes. He does not cath himself - rather just dribbles urine all day, bowel movements ad lib and incontinent.

My fear for him is in mixing with many other children that may not be so accepting of his issues and the inevitable self esteem issues that are bound to follow.

I am headed to his IEP meeting this afternoon, where i will again suggest a training program to them. Where i will voice my concerns. Dioes anyone have any suggestions that i may not have thought of? It is difficult when you have parents that you know will not follow through.

My only other thought is to talk to the student himself once he's in my school about initiating a continence program himself.

[Flare, ASN, BSN]

update - i've officially been uninvited to the IEP meeting... they don't want to ovewhelm the parents...:smackingf

[Spidey's mom, ADN, BSN, RN]

Oh my goodness - I'm so sorry you got uninvited.

My niece has spina bifida. She was bowel and bladder trained and learned to cath herself.

There were occasional accidents in early elementary school but she is fully self-sufficient now.

The parents are doing a grave disservice to their son to throw him to the wolves, so to speak, at a new school.

I'm brand new at school nursing - seems like there would be a policy in place that kids must be "potty trained" before they come to school. I know that sounds kinda harsh - but this young man is ambulatory and not in special ed.

He can do it!

[hammergirl5]

I feel awful for this young man. We had a similar situation in my middle school. Once the child started being being bullied and made fun of for smelling of "poop", the parents got on board with figuring out a "program" for the child, which seems to be working for him. I suggest getting your guidance counselors involved, seems to me that this could be a child welfare issue. Good luck!

[Flare, ASN, BSN]

That's my biggest concern - i mean i think we all went to school with that one kid who farted once during gym class and was forever dubbed "Stinky".

I am hoping that if the parents really are that non compliant with wanting to begin a bowel training program, that the child will eventually hit a point where he is willing to do the work himself. I hate to think that this kid will have to reach rock bottom to begin any real interventions for this, but at least i'll be there to catch him.

There is a policy in place that states all children entering kindergarten must be toilet trained. This is how long this battle has been going on. Because of the SB, he qualifies for a 504 which will accomodate him.