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bathroom accidents

What do y'all do at your schools for students with bathroom accidents? I have a student who very frequently soils his pants and his parents usually take a while to get here to change him. He has trouble cleaning up himself so he has to have someone come help him.

I have the principal, counselors and my nursing supervisor involved and have encouraged parents to have him seen by a doctor numerous times.

The part that I am frustrated with is that he is always sent here to wait in the clinic.

Sometimes it can be over an hour before his mom arrives to change him. There have been many days where I have him in here while I am trying to eat lunch. He is a very active kid and its hard to keep an eye on him when I have many other students coming in for actual medical needs.

My supervisor has told me that he can go back to class and wait; he doesn't need to be missing class time. She said if it is too messy, he can wait in the office. She said there is no reason for a healthy kid to be waiting in the clinic where we have students with flu, strep and stomach virus symptoms. I have her support but it doesn't go over well with his teacher; she gets upset that I send him back to the classroom. I understand her frustration as well, I just wish the parents would step up.

I end up being the one cleaning up after them when they make a mess of my bathroom and I have just had enough.

Any advice?

OldDude

Specializes in Pediatrics.

What grade is this guy in?

I am in the same situation. I've dealt with a preschool student (going to be 6 in June) who has to be changed 3-8 times a day. Parents have been seeking a medical diagnosis (from several doctors including a neurosurgeon) for almost a year. They have since moved onto a psychologist and physical therapist who deals with incontinence.

We actually have a meeting set up tomorrow with several people from our school and the parents. Right now, I help the child get cleaned up because the parents were certain it was a medical issue. My help will be coming to an end so either the parent will be coming in or the child will have to clean himself up.

I am not sure where the child will be waiting so I'm curious to know what kind of advice you get from others on here.

kidzcare

Has 5 years experience.

Am I understanding correctly that this student is sitting in stool for an hour or more? and the principal thinks he should sit in his stool in class?

Have the parents been asked to bring in extra clothes?

In our district we are not able to help students change or clean up at all; the parents have been asked numerous times to bring extra clothes, wet wipes ect. He wipes up the best he can and waits for parents to help clean him up. Mom is aware that we are not able to assist students in the bathroom.

Eleven011

Has 20+ years experience. Specializes in Home Health,Dialysis, MDS, School Nurse.

I am blessed (cursed?) with being keeper of the donated clothes, so if a child has an accident, they come here and I can usually find something for them to change into. If I have a frequent visitor (not daily, but I have a child that has an accident 1-2 times a month) I will keep his soiled clothes, wash them with my other laundry, and then keep them here for him next time. I also had a student earlier this year (he moved) that was in K, but had accidents daily. He was on an hourly bathroom routine, but still had accidents. He could not clean himself and because they too were seeking a medical diagnosis, the principal wanted him to come here. I said I would gladly help clean him up, but I would not be in a room alone with an unclothed school aged child. So if they wanted me to do it, they had to find me a stand by person.

I'm not sure what advice to give other than to try to get extra clothes from parents?

pixierose, BSN, RN

Has 3 years experience. Specializes in ED, psych.

Hold up. This child is waiting in stool for an hour plus?

I don't agree that the student should be heading on back to class, unless it's a skid-type accident. I'm not sure how old your student is, but, depending on type of accident, that's interfering in classroom instruction for the student and his peers. Also, now the teacher has to keep him almost on a 1:1 since he's an active kiddo, which he's not funded for, thereby taking 1:1 time from students who are funded ... and around and around we go.

My suggestion? Have the child wait in the office. That might get administration to step in a little more quickly. Everyone involved is in a no-win situation. Your clinic and the classroom are not the places for him to "wait."

Edited by pixierose

Farawyn

Has 25 years experience.

I'll ask again. How old/what grade is the student?

OldDude

Specializes in Pediatrics.

I'll ask again. How old/what grade is the student?

Calamity?

Farawyn

Has 25 years experience.

Calamity?

I should have quoted your post when I posted that I was asking "again". I meant, it has already been asked.

Sowwey! :blink:

OldDude

Specializes in Pediatrics.

I should have quoted your post when I posted that I was asking "again". I meant, it has already been asked.

Sowwey! :blink:

I get ya, I'm just sayin, Calamity, we're waiting for the answer...

Farawyn

Has 25 years experience.

I get ya, I'm just sayin, Calamity, we're waiting for the answer...

Don't make OldDude wait, he gets very cranky, and the hour of Wheel Of Fortune is drawing nigh!

I'll ask again. How old/what grade is the student?

I'm sorry, he is 6..in kinder

mc3, ASN, RN

Has 12 years experience.

I'm sorry, he is 6..in kinder

I don't send them back if its poop. If they can't really clean themselves properly enough then Mom can either come and finish the job or take them home for a bath if it's a major mess. Otherwise i have them clean up as best they can and they wait in the clinic. Don't want possibly contaminate the other kids or chairs, if you get my drift. I do not clean nooks and crannies either! Yup, the clinic seems to be the place for all things happenin'. Office staff gets very touchy about kids waiting there. Poopy equals medical equals nurse equals I'm not touching it with a 10 foot pole to our administrators. 😷

I need to quit jumping forums. I thought I was looking at a nursing student post for the first little bit.

Farawyn

Has 25 years experience.

The poor kid. Glad he's not 11, was hoping you would say 3.

Something is not right. Try to talk to parents about this. If they are resistant? Meeting time! You, parents, Admin. and SW.

Yeah, I think I'll just have to let him keep staying in the clinic. The problem is, he seems to think it's a treat and he enjoys being in the clinic. He usually has accidents almost the same time everyday. He's not embarrassed at all.

It just gets frustrating to deal with several times a week.

The classrooms have bathrooms as well, I just feel like if parents provided wipes and clothing he could essentially clean up in the classroom bathroom and if it's too messy, mom could be called to help him. He seems to think coming to the clinic everyday is a treat.

pixierose, BSN, RN

Has 3 years experience. Specializes in ED, psych.

You say you have the principal and counselors involved. What are they doing, exactly?

Has this been going on all year, or is this a recent development?

If this has been going on all year, enough is enough. This student must miss so much instructional time. His parents aren't stepping up; it doesn't sound like administration is either. It's time for a team approach; it's meeting time.

Thus, as your supervisor is supportive, the child really should be waiting in the office. For reasons you stated, your clinic isn't an appropriate setting (healthy kid with sick children, can monopolize your time spent with children who are actually sick), nor is the classroom setting. As the child may be sitting in soiled clothes (for over an hour?), this may expedite administration's actions.

Edited to add: just saw your post - he sees this as a treat. Unfortunately, you may be inadvertently positively reinforcing his inappropriate behavior. Fortunately, that can be easily fixed -- by taking you out of the equation.

OldDude

Specializes in Pediatrics.

Yeah, I think I'll just have to let him keep staying in the clinic. The problem is, he seems to think it's a treat and he enjoys being in the clinic. He usually has accidents almost the same time everyday. He's not embarrassed at all.

It just gets frustrating to deal with several times a week.

The classrooms have bathrooms as well, I just feel like if parents provided wipes and clothing he could essentially clean up in the classroom bathroom and if it's too messy, mom could be called to help him. He seems to think coming to the clinic everyday is a treat.

I think you're on track, unless he has some developmental delay he needs to take ownership of this. Try to continue to convey that to the parent to supply the clothes, etc, and push for him to take care of the changing, cleaning, sacking the soiled clothes, putting the soiled clothes in his backpack to take home for replacement, the works. But it's not your responsibility to potty train him, that's still the parent's job. Good luck.

prmenrs, RN

Has 42 years experience. Specializes in NICU, Infection Control.

Does he have an IEP? Can he be assigned classroom aide or a personal aide, whatever it might be called in your district? Someone who is assigned to toilet and clean him? Maybe w/a one to one assistant, they can pick up cues on when he needs to go before he goes? Just a thought.

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