Annoyed and perhaps a little unsure

Published

Hey all. I'm looking for some reassurance.

Had a first grader get sent to my office yesterday after walking under the monkey bars and subsequently catching a shoe to the face by the other kiddo swinging on said monkey bars. No s/s of injury were seen. PERLA was appropriate. Kiddo says their vision is a little blurry. Had them rinse their eyes out and I placed an icepack on it. Kiddo has icepack on their eye for 10 minutes and I reassess. No changes from initial assessment. Kiddo keeps rubbing their eye and says the blurriness is still there, but "just a little bit". Told kiddo to stop rubbing their eye and to rinse it out again but that I felt they were ok to return to class. Again, there were absolutely no signs of injury at all. Student denied any pain. Made sure to tell LD that if their eye wasn't better, or if it got worse, within a set time frame (i sent a note to the teacher with the time frame of 45 mins-1 hour) to make sure they came back so I could check them out again. Kiddo verbalizes agreement and takes note back to teacher. I don't see kiddo the rest of the day. Teacher says they never complained again.

Today I find out the parent called the teacher super mad yesterday about not being notified and now wants to speak to our principal about it. Now I'm second guessing everything I did yesterday and am stressing out about the whole situation.

Oh. And according to the student, (who has been in class all day with absolutely no complaints) they have an eye appointment today to make sure they haven't lost any vision in their eye.

How badly do you think I messed up?

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Sounds like you did everything right. And if it is so bad and mom is soooo concerned, why the heck is he at school today?????

I have just started making a habit of calling on anything above the shoulders related. It just seems like a good CYA and I am in Middle School!!!

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Specializes in Pediatrics Retired.

This is one of those occurrences where you are simply in the crosshairs and you can't get out of it. Obviously, and I MEAN obviously, you did an excellent assessment. Every decision to do something or not to do something can, and in school nursing, will be second guessed by someone over and over throughout your career. So, I don't think you should have done anything differently other than filing "this" parent away in your mind and if the kid comes back with a hair out of place be sure and call the parent.

I'll add, when I get such complaints of blurred vision I will go ahead and do a vision screening with the wall chart just to say I "did" something.

So, forget about it and move on with your day.

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Specializes in ICU/community health/school nursing.

You documented it all. (I'm sure you did. You're a good nurse).

The parent is suffering status dramaticus. Even if you had pulled out the vision chart, we cannot see into the eye. Even if you'd found vision blurry....the kid was rubbing the eye.

Now you know. Call this one with everything. EVERYTHING. If asked: Wow, I'm sorry that it was communicated to you that this was a serious event. The student was assessed and I found nothing to indicate a doctor's referral was needed, but perhaps things worsened over the day. I sure do wish s/he'd come back to me if things felt worse....like I asked him/her to do. Please do let me know the results of the visit with the doctor.

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5 minutes ago, ruby_jane said:

You documented it all. (I'm sure you did. You're a good nurse).

The parent is suffering status dramaticus. Even if you had pulled out the vision chart, we cannot see into the eye. Even if you'd found vision blurry....the kid was rubbing the eye.

Now you know. Call this one with everything. EVERYTHING. If asked: Wow, I'm sorry that it was communicated to you that this was a serious event. The student was assessed and I found nothing to indicate a doctor's referral was needed, but perhaps things worsened over the day. I sure do wish s/he'd come back to me if things felt worse....like I asked him/her to do. Please do let me know the results of the visit with the doctor.

Thank you everyone for the encouragement!! I hate when I second guess myself!!

Yes, it was all documented. I didn't enter it in until this morning though, but I had made notes for myself because I had a few kiddos in at the same time. And I will for sure be calling for every visit. This parent is a nurse as well, I believe, which may be why I'm surprised at the development of this. I really like your response though. Thank you for that!

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Specializes in Community and Public Health, Addictions Nursing.

I agree with OldDude- a vision screening can help with figuring the "blurriness" issue, but honestly, if the kiddo was a first grader, you probably would have had a 50/50 chance of the screen working.

Where I work, and maybe it's just because I'm pre-K, our policy is to call for anything and everything neck and above. A lot of the time, the injuries that happen aren't serious, but we do it just as a CYA thing.

And like everyone else, super good job on your assessment and follow-up plan!

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Specializes in ICU/community health/school nursing.
1 hour ago, UrbanHealthRN said:

, but we do it just as a CYA thing.

AMEN. Although....when a parent suffers from status dramaticus, often we're "overreacting when you call me for every little thing."

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5 minutes ago, ruby_jane said:

AMEN. Although....when a parent suffers from status dramaticus, often we're "overreacting when you call me for every little thing."

There is a delicate balance of when to call/email/not contact for these parents...we refer to as "informed parents" at my school.

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Specializes in School nurse and geriatrics..
13 minutes ago, ruby_jane said:

AMEN. Although....when a parent suffers from status dramaticus, often we're "overreacting when you call me for every little thing."

We can't win for losing.

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Always call for any face/head injury. I'm in junior high and still do this. It's not worth the headache/stress to not make that 2 minute call. Takes the liability away from you.

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5 hours ago, capecodnurse3 said:

Always call for any face/head injury. I'm in junior high and still do this. It's not worth the headache/stress to not make that 2 minute call. Takes the liability away from you.

It was my plan to call had he returned to my office. With my little guys this year, they all are VERY persistent if they have something that is bothering them (including this one, as this definitely wasn't his first visit). So when he didn't return (after he said the blurriness was clearing up), I figured it had completely cleared up and it wasn't bothering him anymore. I suppose that's what I get for thinking he was going to follow the pattern they had been following all year. ?‍♀️

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I hear ya. From a nurse perspective, you did everything correctly. I just find being in a school environment, they beat to a different drum. Can't tell you how many times I did my "nurse assessment" but then had a parent would be upset for the most ridiculous thing. For peace of mind, I just call and make them aware. If they ask if they need to pick the kid up I'll tell them that I think they can finish they day but will definitely give them a call back if the kid comes back in. It's annoying but then I'm covered and I definitely document everything!

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