Awkward conversation tips! HELP!

[Csn2016, BSN]

So since last week I've had two different teachers approach me about two different students who were 'ahem' I dont even know how to word this on here...lets just say, doing something in class that made them feel good?...Both are female, one is in Kindergarten, the other first grade. Both come from wonderful families where the teachers have no concerns that there is a serious underlying issue....the teachers are just concerned because it is getting to be a distraction in class. Both have repeatedly asked the students to put their hands on their desk (if they noticed it), or ask them if they needed to go to the bathroom, to which the students would always shake their head no. Its come to the point where yesterday the kindergarten student reached for another students pencil and that little boy freaked out because he saw she had her hand up her skirt for a bit and he was carrying on that she had been 'touching her butt'.....

Advice? Notify the parents? Leave it be? The one teacher came to me about it really concerned because she knows the students parents pretty well on a professional level (their husbands work together) and wants to avoid future awkwardness...which I totally understand.

[BeckyESRN]

The teacher should speak with the parents. There is really no reason to involve the nurse at all. This is developmentally appropriate behavior that needs redirected.

[CanIcallmymom, BSN, RN]

I think that is definitely a parent conversation. Do they have to wear skirts or can they wear pants?

1 minute ago, BeckyESRN said:

The teacher should speak with the parents. There is really no reason to involve the nurse at all. This is developmentally appropriate behavior that needs redirected.

Agree, I think if the teacher is uncomfortable speaking with the parent, maybe a counselor or admin can.

[JenTheSchoolRN, BSN, RN]

Masturbation isn't a dirty word - but this is coming from a school nurse that also teaches sex education to MS and HS students ;). (Of course at this age, student likely has no clue what masturbation is, just what touching makes them feel like).

Exploring ones body can be normal, but not during class.

Do you know either of these students or families? I ask because these conversations are awkward for so very many, but become even more awkward when you are delivering it third hand and hasn't witnessed it. This is most definitely a parent conversation. But it may need to come from the teacher that observed vs you.

(But if the teacher 100% couldn't, I'll likely pinch hit. But I'm used to these topics. It is important that the family knows.)

[NutmeggeRN, BSN]

12 minutes ago, JenTheSchoolRN said:

(But if the teacher 100% couldn't, I'll likely pinch hit. But I'm used to these topics. It is important that the family knows.)

Exactly, and they need to know if there is a hygeine problem or maybe a UTI etc?

[Flare, ASN, BSN]

Yes! You certainly see the range in school nursing. I don't have a problem with making the awkward calls, but i also make it clear that I am not with the student 6-7 hours a day and my assessments are usually based on teacher info and my own observed "snapshots". Excessive pants digging may be due to a child exploring their own body - in which case the parent can have the discussion with the student that the middle the class is not the place, or it could be due to a child feeling discomfort - UTI, hygiene issues, as stated by Nutmegge, also yeast infection comes to mind, discomfort from undergarments, eczema, etc... there could be dozens of reasons.

[Csn2016, BSN]

44 minutes ago, JenTheSchoolRN said:

Masturbation isn't a dirty word - but this is coming from a school nurse that also teaches sex education to MS and HS students ;). (Of course at this age, student likely has no clue what masturbation is, just what touching makes them feel like).

Exploring ones body can be normal, but not during class.

Do you know either of these students or families? I ask because these conversations are awkward for so very many, but become even more awkward when you are delivering it third hand and hasn't witnessed it. This is most definitely a parent conversation. But it may need to come from the teacher that observed vs you.

(But if the teacher 100% couldn't, I'll likely pinch hit. But I'm used to these topics. It is important that the family knows.)

I agree entirely with what you are saying (just wasn't sure how others would view the post on here, so was trying to be careful with my words) I was a womens health nurse for several years so anything in this realm does not make me super uncomfortable except with the fact its young kids. The 1st grade teacher did not ask me to bring it to the parents attention but the kdg teacher did (because she is the one who knows the parents on a professional level outside the school setting so I totally understand where she is coming from and I am okay with it...or having guidance reach out.) I did reassure the teacher that its normal for kids to explore their bodies and it can be difficult for them to understand this young that it is something done in private...

[Csn2016, BSN]

54 minutes ago, CanIcallmymom said:

I think that is definitely a parent conversation. Do they have to wear skirts or can they wear pants?

Agree, I think if the teacher is uncomfortable speaking with the parent, maybe a counselor or admin can.

They can wear pants, I think yesterday is when the other student really noticed it because she had her hand up her skirt vs just over her pants and thats when the teacher was like 'yikes' we need to talk to parents. This is also a first year kdg teacher so she is very anxious, she doesnt want to upset anyone and she just has never really had to deal with this before

[JenTheSchoolRN, BSN, RN]

1 minute ago, Csn2016 said:

I agree entirely with what you are saying (just wasn't sure how others would view the post on here, so was trying to be careful with my words) I was a womens health nurse for several years so anything in this realm does not make me super uncomfortable except with the fact its young kids. The 1st grade teacher did not ask me to bring it to the parents attention but the kdg teacher did (because she is the one who knows the parents on a professional level outside the school setting so I totally understand where she is coming from and I am okay with it...or having guidance reach out.) I did reassure the teacher that its normal for kids to explore their bodies and it can be difficult for them to understand this young that it is something done in private...

So I'm guessing the teacher doesn't want to have the conversation?

I'd just call home and tell the parents/guardians that a teacher brought to my attention that their child has been touching near their private area during the class. As that I was making the parent aware as it can be child exploring (which is normal, but not appropriate during class) or may be a sign that the genital area is uncomfortable due to tight clothing or possible infection - if child is reporting discomfort, guardian should follow up with child's doctor (and sooner vs later).

[Csn2016, BSN]

18 minutes ago, JenTheSchoolRN said:

So I'm guessing the teacher doesn't want to have the conversation?

I'd just call home and tell the parents/guardians that a teacher brought to my attention that their child has been touching near their private area during the class. As that I was making the parent aware as it can be child exploring (which is normal, but not appropriate during class) or may be a sign that the genital area is uncomfortable due to tight clothing or possible infection - if child is reporting discomfort, guardian should follow up with child's doctor (and sooner vs later).

Yeah the kdg teacher does not want to have the discussion with the parents. Since this is only year 3 for me and my first time dealing with this I thought I'd see if any of you ever had to approach the situation with parents. Thank you for your input! ?

["nursy", RN]

In my school we try to approach it as a team. We invite the parents in for a meeting, which includes the teacher(s), principal, a counselor and anybody else who has observed the behavior. I think this is too touchy (ha, get it ?) of a subject to just address with a phone call. We reassure the parents that this is not an unusual behavior, and is something children often do unconciously as a stress reliever. A provider visit is suggested to rule out anything physical. And then we come up with alternative behaviors. Sometimes the kids will respond to having a special toy that they can touch and hold. IF they are discovered "engaging" the teacher may just say "OK everybody stand up and stretch." Also wearing clothing that makes it harder to access private areas may be helpful. The parents are encouraged to have a non judgemental discussion with their child about keeping this type of behavior private.

[k1p1ssk, BSN, RN]

I've had that conversation with parents; The teacher was/is young and teaches younger grades, so was not comfortable with initiating the conversation with the parents; I was lucky though, the parents are really chill about everything. I went with something like this, "Hi Ms. Parent, I Just wanted to notify you to an observation Ms. Teacher made to me about Student. It appears that she is engaging in "self-soothing" behavior during class that is reminiscent of masturbation. (side note: I wouldn't call it masturbation because again, i don't think the child knew what she was doing, just that it felt good); I'm not sure if you are aware that she has discovered this, but I think you might want to have a conversation with her, that it is fine to do, but that it is something that needs to be done in private."

In this particular instance, the mom was aware, had already had a convo with the student, and simply thanked me for the information and kindness surrounding it (i.e. not shaming the girl) or drawing much attention to it. The mom must have spoken with her because the behavior stopped for a few months. She started again after winter break, but the teacher just let me know it was happening and she spoke with the mom about it that time. As far as I know, she hasn't continued in school.