Babysiting the "problem children"

[lifelearningrn, BSN, RN]

Do any of you have this issue? This is my first year as a school nurse, and I find my clinic is the default dumping ground for the kids that get kicked out of class. In fact, I'm often the one the teachers call to come remove the child from the room when the administrators are 'busy' doing other things.

I'm told to 'call mom/dad/whoever to come pick him up'... and more often then not, it takes hours to get someone on the phone, and even if they say they're coming, nobody shows until the end of the day. This means I get to babysit (these are kids that wont sit and wait, they are the kids that are ripping things off the walls, hitting other kids, or doing something else equally destructive, and have to be watched and contained closely.) This becomes especially tricky when I have a student come into the clinic with a fever or other complaint and I can't take my eyes off of the behavior issue for even a second (or he's running out the door, or getting into expensive medical equipment).

Because these students usually have an "ADHD" diagnosis- everyone thinks it's my responsibility when the medications aren't working! I literally had a teacher bring a student into my office and say, "He needs to stay in here for 30 minutes until his meds kick in (she had sent him to me earlier that day, 45 minutes too early for his medication. I had just given him his dose 5 minutes prior to her dumping him on me saying he needed to stay with me until it 'kicked' in). I arranged it to where I give this kid both his qam and lunchtime dose of medication so that we KNOW he is getting his meds every day. I really don't think it should be my responsibility that the drugs aren't producing the results they want. ADHD meds aren't a cure for an child who has zero respect for school authorities and rules.

I don't mind helping with these kids, but at what point would you tell the administrators "no". I would like to keep my job.

[peacockblue]

I will see kids who need a "time out" to calm down from anger issues, anxiety, etc. it is NOT your job to babysit ongoing behavior issues. That is a special Ed issue. Your area of expertise is not mental or behavior health. Admin and the special Ed department need to get on board and put a behavior plan in place. I'm always willing to help, but I can not be expected to handle a kid who needs 1:1 care when you can be called into another building I at any time for a medical emergency.

[Eleven011]

I don't have an issue with this at all. If it is a child who is in special ed, their staff handles all behaviors they may have. They are trained for it and know works for the child - I don't. If its a child in a regular classroom, either their aides, principals, counselors or whoever is available will assist. I will be called for medical issues - that its. Only time I supervise is when the special ed kids come to use my bathroom (they don't have their own, and have been getting into trouble in the main one). I am always willling to step in and help, but thank goodness my supervisors understand I can't be the "babysitter" for these kids. If I were you, I would be calling my principal for help every time I was watching a child and needed to assist a true medial issue. She'd get tired of that in quick order.

[JustBeachyNurse, LPN]

If the child needs 1:1 supervision the IEP needs to assign a 1:1 paraprofessional. I'm

guessing your rate is higher than $7-8/hr most paras get paid

[Farawyn]

I don't do 1:1, nor do I call parents to come pick kids up for being disruptive. Not my jurisdiction. A bad day or a bad couple of days? Sure, they can chill out here for a bit, but nothing chronic.

[SnowyJ, RN]

Kids with behavioral problems are sent here only if our counselor or psychologist are not available. We also have a discipline officer and sometimes (but not often) our principal will intervene.

It's more of a dumping ground here for kids who are tired, want to sleep. etc.

My feeling is you are being taken advantage of with regard to kids with behavioral issues being sent o you. Time for a sit down with admin.

[Wave Watcher]

I have never understood why teachers/staff want to send behavioral issues to the clinic. Makes no sense. So, you want a perfectly healthy kid to sit in my clinic next to a kid vomiting, running a temp, or weird rash? Typically, the problem kids are all over the clinic anyways....touching everything...and running around. I have never allowed non-sick kids to sit in my clinic for any length of time.

[NutmeggeRN, BSN]

I try to take the public health approach...that I live in a cesspool and no one should be exposed to the kids illness unnecessarily.....

[zombieghoast]

Nope. If the administrators are busy they have to sit in the office until the child is dealt with (then it is the secretaries who have to babysit them which they shouldn't have to either). Luckily we have a behavioral room for the students. I would not call about the child being disruptive because you are not the one who witnessed it.

[SchoolNurseTXstyle]

Not a medical issue. In fact, a big distraction from the students that do have a valid medical need and need your attention. Sometimes, you just have to put your foot down!

[AdobeRN]

I do not handle these type of behavior issues - they go to AP, Principal or Counselor office. IF they are SPED - our SPED teacher will handle them if needed. The only time I am involved is if there is an injury. We have a "core Team" that handles these type of kids - they are specially trained in holding/restraining etc if needed - so if we have a kid out of control the teacher will use the walkie and someone from the Core Team will be in the room to assist.

I do have a "Quiet room or safe room" in my office if a kid gets out of control but I do not do anything for them unless the AP, Principal, Counselor etc asks me to call the parent for them.

[SnowyJ, RN]

Sometimes we call the counselor's office the "panic room."