Annoyed Parent

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Specializes in ER/School/Rural Nursing/Health Department.

My school situation is a little different than most--I work as the only nurse for three different districts (K-12 in one building) one day a week at each school.  The rest of the time the school doesn't have a nurse.  So teachers are used to bypassing me when I'm here but most give a heads up.

I had a tween age kiddo fall in the gym on an outstretched hand.  He had good grip strength, no bruising or deformity, maybe a little swelling over the wrist.  I gave him age appropriate ibuprofen dose, ice pack, placed his arm on a pillow in a comfortable spot.  He went back to class, mildly complaining, and I got swamped.  I checked on him an hour later at lunch and he was eating and talking, holding his wrist limp, but again--good strength when I asked him to grip, was able to bend and move with mild pain.  I got swamped again--called mom maybe another hour later to fill her in.  Here's where it got tangled a bit.

The teacher didn't let me know that she had called his mom and she had picked him up.  When I called mom I explained what the mechanism of injury was, what I had done, that I had checked on him twice and his wrist was sore but I thought it was likely a mild sprain and suggested an ace or splint if they had one at home or a pcp visit so they could wrap it.  She was annoyed and said, I have him here we had to go to the ER.   Well the teacher had made it sound like the kid was dying so she rushed him to the ER.  Xrays were clean and he has a **mild sprain**. They were given a splint for a week.  No activity restrictions if splint is on. 

I don't know if I just needed to vent or maybe tell me I screwed up or what.  The office staff said that's how she always sounds and not to worry about it.  

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Specializes in school nurse.

Sounds like a tough situation as it relates to staffing- teachers probably have to do a lot of what they wouldn't normally do if there was a full-time nurse on site. I'd maybe (diplomatically) ask that classroom staff always give you a heads up when they're aware of (or pushed for) a student to be a medical early dismissal. At least that way you won't get blindsided like that.

re: the annoyed mom- Some people just have a quota of misery that they have to spread in the world. Take comfort in knowing that you helped her achieve her goal...?

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Specializes in pediatrics, school nursing.

This was certainly weird behavior on the teacher's part - if it was already addressed by a medical professional (I'm assuming the teacher knew that), I don't know what right the teacher has going above your judgement, especially while you were in the building. It would certainly warrant a discussion and clarification of roles. I will say that making a call to a parent about an injury should be a priority, especially if you would recommend a PCP follow up. She may have still taken the kid to the ED (a lot of parents seem to think any non-routine visit HAS to go the ED), but at least you know and can document you recommended PCP eval. Regardless, I don't think you were in the wrong at all here. 

Playing devil's advocate, is there is a chance that the teacher didn't know you were in the building or had a brain fart? Perhaps the kid complained while with her and she didn't realize you had already evaluated? Depending on the age group, I find kids are really good at forgetting what has already been done for them and omit important details. 

And I completely agree that some people are just miserable no matter what; You could have been calling her to let her know she'd won the lottery and she'd complain about how it puts her new tax bracket.

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Specializes in school nursing, ortho, trauma.
On 3/10/2022 at 7:28 AM, Jedrnurse said:

Some people just have a quota of misery that they have to spread in the world. Take comfort in knowing that you helped her achieve her goal...?

that's not just t-shirt worthy... that's throw pillow worthy!!

Seriously - the parent hopefully has an idea of what the nursing services are in their child's school and that you are stretched thin.  It certainly sounds like you did what any of us would have done in the same situation.  I suppose I can see the point of the teacher making a call if she thought you were not in-house, however, I can't believe that there wasn't a bit of a conversation with the student on whether or not they had been seen and followed up with by you.  

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Specializes in Occupational Health Nursing.

It could have been avoided if the teacher advised you that she called the mom, but anyway does the school have any protocol that teachers should not explain anything to the parents? I think that is when everything went downhill. 

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Specializes in oncology.
23 hours ago, RuralMOSchoolRN said:

I gave him age appropriate ibuprofen dose, ice pack, placed his arm on a pillow in a comfortable spot

Where did the teacher think he got the ice pack/pillow?

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Specializes in School Nursing, Home Health.

You didn't mess up.

It was the teacher that overreacted.

Unfortunately since you can't be there all the time this is what teachers probably do all the time

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Specializes in School Nursing, Ambulatory Care, etc..

I wrote this post several years ago, but it still applies today.  I guess I'm sharing so you know you're not alone.  (also, if you ever have a minute, go back to page one of the School Nursing board - you will see that nothing is new) 

 

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Specializes in ICU/community health/school nursing.

Oh my goodness - I have missed you all so much - but NOT THIS!

You documented what you did. I likely wouldn't have done anything differently.  Let the teacher field the ER bill...

 

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