I had to force myself to wait an hour before typing this because I was so angry. This is a vent. A long one. You have been warned!
About 5 minutes before the first bell rang, the secretary got a call from a bus driver saying a 5th grader (we will call her Jane) got on the bus just fine but about 5 minutes into the ride began screaming and crying, saying her arm is broken. The secretary let me know and me, the AP and the guidance counselor went outside and waited for her bus. I didn't ask for them to stay with me but I didn't mind. When she bus arrived the student had walked up from the back of the bus and was already sitting in the seat behind the driver absolutely beside herself, crying and screaming. Obviously in a great deal of pain. She's not a FF and doesn't really complain. She refused to walk or get up so we got everyone else off the bus while I assessed her. She told me she was resting her arm on the seat back and when the bus went over a bump, she lifted off the seat a little and when she came down, her arm landed on the seat back and she felt a pop followed by sharp pain. My immediate thought was dislocation. She was unable to move the arm but had full ROM of her wrist and all digits, capillary refill of
Now the whole time this was happening the AP was sort of hovering over me. I get it, he was worried, he wanted to see what was going on, it's a liability thing, whatever. But he kept interrupting my questions when I was trying to talk to the student. I understand he was concerned, but I needed to do MY job. That's why I am there! It was annoying but I was okay with it. Mom was called and on the way to get the student to the ED.
We get the girl into my office. There is a line of kids when I get back. None of them are critical so I send them all back to class except one daily med student who takes her ADD medication right off the bus. She takes another dose after lunch so it's kind of important she gets the first pill on time. I checked on Jane one more time and there was no change to her NV status. The counselor was sitting and talking to her, we were just waiting for her to be picked up. So I gave the other student her ADD medication. It took about 90 seconds total and off she went. I then sat with Jane, gave her an ice pack and told her what to expect once mom picked her up and drove her to the hospital. Mom came, we helped Jane into the car and off she went.
Afterwards, we are all standing in the office and the AP says to me "When something like that happens, you can't be worrying about the daily med kids. When a student is injured they are your first priority and you need to make sure the injured kid is ok before you do anything else."
I don't know if it's because I haven't been having the best week at work but this made me so mad for some reason. 1) I already made sure the injured kid was ok. I assessed her on the bus and once we got back to my office. A possible dislocation is painful, of course, but it's not an emergency, her NV status was unchanged and mom was already on the way to take her to the ED. 2) If I skip a child's medication dose, I need to document it and explain why. This particular child is dosed twice a day; missing her AM dose would have messed up her entire schedule and a student who is in a lot of pain but otherwise safe is not an acceptable reason to do that.
I don't understand. I would never go into his office and tell him "This is the way you should write up an IEP" or "You need to discipline a student this way" because that's not my job! Everybody thinks they can do my job? Be my guest. Nobody seems to think my position holds any value until some one has a nosebleed, belly ache or is throwing up. Then I'm the A-#1 and expected to save the day and fix everything with a wave of my magic wand. Teachers are so comfortable demanding I medicate students, irate when I don't send them home and annoyed when I don't hand out ice packs for imaginary injuries. What if I went in there and told them all how to do their jobs? It would be ridiculous because that's not my place. But everyone is more than qualified to do my job, allegedly. My BSN, license and 4 years of experience mean nothing to them. My assessment skills and ability to prioritize are totally ignored because everybody seems to think they can do my job better than I can.
If our jobs are so easily delegated, maybe they should see what happens in schools where there is no nurse. An 11 year old arrested at one of the other elementary schools in my district a few weeks ago. The nurse was there performing CPR within 30 seconds, there is a time stamp on the security camera footage showing this. ROSC was achieved and that child is currently in the PICU waiting for a heart transplant. Would the outcome have been the same if a delegated non licensed professional was the one responding? Maybe. Maybe not. But, you know. Any old person in the school can do what we do.
I don't complain about being used as a PCP. I don't complain about the offensively low salary. I don't complain about teachers (that much, anyway) and I try not to complain about the clueless parents. Because I love the kids.
But I have a real problem with the person who told me during my job interview that I'm the one calling the shots when a medical situation arises also telling me how those shots are supposed to be called. I feel devalued and disrespected and, with the week I just had, I really can't wait to get home and forget this place exists for the next two days.
Specializes in med-surg, IMC, school nursing, NICU.
Jersey... No!!!
(Let's Go Mets!)
As a lifelong fan of the Yankees, I am accustomed to these reactions. I was living in Philly for college during the 2009 World Series. You get used to the death threats.
This AP would probably want you to hold the girl's hair if they were throwing up.
Next time this person is in your presence make a big production of what you are assessing. Examples: "you have good circulation, vs normal" "you are able to move your arm in the expected way" "I feel like all we need to do now is to wait on mom" "Now that you are comfortable, I am going to take care of a couple of thing, please get my attention if you are feeling worse." If I don't have others waiting on me I am super attentive. Seriously we are in the same room, steps away from injured person if status changes.
She's venting. Here. With other school nurses. Who understand.
Yea, yea, yea. We are all nurses. We all work with stressed people.
Got it.
Don't tell us what you "would have done" if you aren't in the situation of being the only medical person in the building full of kids. m'kay?
Thank you! Y'all know that is the main reason I left my job as a school nurse. Reading this incident gave me some feelings of nausea as I remembered being treated exactly the same way.
I am a Yankee fan.
We shouldn't be meeting like this.
Too risky.
Go Giants!! (They did a good job against the Doyers this weekend).
Thank you! Y'all know that is the main reason I left my job as a school nurse. Reading this incident gave me some feelings of nausea as I remembered being treated exactly the same way.
I am so thankful my administrators trust my judgement in all things medical. I keep saying it, but you guys keep reinforcing it, I am in paradise here. I don't think I would survive in another school. I feel for all of you with these issues.
Specializes in med-surg, IMC, school nursing, NICU.
I am so thankful my administrators trust my judgement in all things medical. I keep saying it, but you guys keep reinforcing it, I am in paradise here. I don't think I would survive in another school. I feel for all of you with these issues.
I really have very little to complain about, I am usually very content here at my school. This was just a big one because I feel that we as nurses are constantly having our power taken away from us yet are expected to move mountains.
I guess assessing is so natural to us nurses that someone on the outside may not even realize we are doing it and therefore it looks like we did nothing.
YUP! I had a student have a 30 second seizure and then a little post-iptic nap. The other adult who was there (an OT - really? I would have expected more from her than a teacher) just stared at me while I was monitoring her vitals and sitting by her side. Then she asked if I was going to do anything. I said "Yeah, I'm doing it."
No, they don't know how to do our jobs. They don't know squat. But they think they do because of tv shows and google. My admin does the same thing.
We don't have other nurses around us to discuss and support each other like they do in other settings. That's why we're here on AN!
Sometimes, they just don't get that all you can do is monitor. In their mind, we are a fully stocked ER with the capability to diagnose and treat. I WISH!!
Specializes in med-surg, IMC, school nursing, NICU.
Today, I was discussing when to do my annual evaluation with the AP in question in the office and the SLP happened to be in there. She looks at me and says "You need an annual eval?!" and I said "Sure. Why not?" and she replied "Well, how on earth is AP going to know if you're doing your job correctly, he has no medical knowledge!" right in front of him.
NutmeggeRN, BSN
2 Articles; 4,743 Posts
Hmm...Well...it's OK, I still love ya!!