bathroom accidents

Specialties School

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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?

If he has accidents around the same time every day, can his teacher make that a designated bathroom break time for him? There was a girl in my middle school who would regularly have accidents because she was too scared to ask to go. It was "fixed" by giving her regular times to go to the bathroom. (And looking back as an adult, I hope a teacher called CPS as a 6th grader shouldn't be too afraid to ask to the bathroom and having accidents instead, but I don't think that's the same issue with your 6 year old.)

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If he has accidents around the same time every day, can his teacher make that a designated bathroom break time for him?

Good idea! Maybe schedule a time about 10 minutes prior to his "normal" time that he can go and sit on the potty :)

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Specializes in med-surg, IMC, school nursing, NICU.

My principal and I just discussed a similar situation yesterday. I have a K kid who has pooped himself 11 times this year. I started calling home after the second episode and sadly the parents don't really seem to get it. "yeah, we can't figure out why he does it either" is the usual response. He's been to a doctor, everything has been medically cleared. It's never diarrhea, either. It's always formed stool so it's not like he is having an explosive episode. I ask him why he keeps having accidents in his pants and he told me "I poop in the potty at home" to which i reply "Well you need to do that at school, too!"

We started a reward system. For every day that he doesn't have an accident, he gets a sticker. 5 stickers equal a prize. So far he has 1 sticker. So we will see.

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Yes, I've had a few situations where it was a treat. We eventually instituted a reward system (No accidents that day rewarded a sticker, pencil, etc). Also make it very, very boring to sit there and wait meaning no books, no coloring etc. No chatting with friends. Keep "work" there to do. I found the fun quickly ran out of being in the clinic when I did those things. Missing fun things in class also helped. All this, of course, is after anything medical had been ruled out.

😎

A reward system you say. I wonder where I heard that before :p

Hopefully your efforts were successful.

(Okay, back to quiet lurking I go)

Dany

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Specializes in ED, psych.

Calamity, since he thinks coming to the clinic is a treat, can he "earn" a visit after using the bathroom at that scheduled time each day with no accidents ...

... maybe after a certain number of times he can trade in for a prize that's in your office?

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Specializes in med-surg, IMC, school nursing, NICU.

My little guy just came in here. Another accident. I guess my pep talk fell on deaf ears. It's funny because he said as soon as he walked in "Now I don't get any stickers or a prize." He knows it wrong, he just does it anyway.

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Thanks for all of the ideas, I will definitely put some of them to use.

8 more weeks of school..:)

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My little guy just came in here. Another accident. I guess my pep talk fell on deaf ears. It's funny because he said as soon as he walked in "Now I don't get any stickers or a prize." He knows it wrong, he just does it anyway.

The pleasure of the poop trumps all!

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How about this? ,if you sew, or know someone that does, make up a bunch of cheap shorts in really ugly colors; hot pink or flowery purple polyester short with elastic or tie waist...those will be his spare shorts that he'll have to wear until parent arrives. Next time there's an "accident" have him change into those right away to wear back to class until parent moseys on in with a better choice. I don't think he'll like what the other kids have to say about it, maybe that will be enough to get him to stop. Try using baby patterns, too. Don't tell him they're babyish, let the other kids do that. If parent or admin complains you can innocently say it's all you had, and surely they'd prefer Johnny be in class learning instead of just sitting doing nothing? The uglier the color or pattern, the better. Youll get in him and out of the clinic in no time! Blue polka dots, anyone?

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Sometimes, too, if you can put it in terms of hours wasted in the clinic that are taken away from instructional time will get admins attention.

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Specializes in Psych (25 years), Medical (15 years).

I think this is on topic.

Years ago, I was out with a couple of friends, who were Therapists from the Community Mental Health Clinic. Although I was married to my second Wife at the time, I couldn't help noticing how attractive they both were, and thought I'd share a little personal information about myself.

Yeah, I know- putting on the dog for a couple of attractive, intelligent, unmarried Women could have weaved a tangled web, but this personal information was also something of an epiphany that I thought they would find insightful and impressive.

I told them that I wore black underwear because it better hid skid marks.

One of the two lovely, intelligent Therapist shared something with me that I never will forget. She said, "Dave- better hygiene will prevent skid marks." Well, those weren't her EXACT words. It was more something like, "If you'd wipe your... better, you wouldn't have skid marks!"

Excuse me. There's something I have to go do.

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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.

I would think at this point, the child needs a plan in place. As part of an IEP. That there is an aide who toilets him every 2 hours and PRN. An occupational therapist. A counselor.

There are kids who don't understand that they need to use the restroom. There are kids who have asked to use the restroom and denied, so they stop asking. There are kids who have public bathroom phobia. There's kids that due to trauma issues attempt to "control" their bodily functions. There are kids who are sexually abused and this is a huge issue.

What strikes me as odd is that it is known that this kid will not use the bathroom. Humiliating for the child for sure. They are then told they have to clean themselves up (punishment even if not intended to be) further humiliated as the child then could be sent back to class soiled.

Does this child have a disability that is undiagnosed? Trauma that the school is unaware of?

I would advocate for a IEP for this child. And a CNA in house to assist with bladder/bowel training. And until such time as it is figured out, pull ups and wipes.

Even if this child seems to "enjoy" hanging in the clinic there is a psych/social component going on here that needs to be addressed. If the child was successfully potty trained and now has started with the accidents, this screams of abuse. CPS needs to be involved, and this kid needs a plan that will work.

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