bathroom dilemma

[lvnforschool]

For as long as I have been working this job (5th school year) I've been helping a student with CP to use the restroom. She is a senior this year, and over the course of time we have gotten really close. She is the same age as my own daughter. So I began to notice this year, she is really, almost for lack of a better word, NEEDY. She we started with 2-3 bathroom stops a school day (8hrs). But now we are at 5 times a day. She is handicapped, so it's not like I can tell her No, you can't go to the restroom. But on the other hand, 5 times takes up ALOT of my day just to help her 10+minutes each time. My coworker thinks I should call her parents and tell them maybe she has a bladder issue. I am really just thinking about not doing anything because this is her last year, and I mean we are already 1/2 way through.

I need outside opinion on the situation. What should I do, or say? Her teachers haven't complained she is missing school time.

[amoLucia]

It is really possible that there is a UTI.

Are you comfortable that it should possibly go UNTREATED?

Rule out the OBVIOUS first.

[KKEGS, MSN, RN]

I would mention the increased bathroom breaks to the parents. It gets a conversation started. Could be a UTI but could be something else too that needs to be addressed.

[JenTheSchoolRN, BSN, RN]

I would mention the increased bathroom breaks to the parents. It gets a conversation started. Could be a UTI but could be something else too that needs to be addressed.

This. A call home to update can never hurt - communication is key. You can also see if increased bathroom visits happen at home, which can help determine if a referral to rule out an UTI is needed. If the pattern is different at home, that also tells a story and gives you more data to work with.

[SaltineQueen]

I've never had a parent upset that I made a call. Is she fully emptying her bladder each time? Maybe there was a med change? Call them, let them decide if they think there's something to this.

[ruby_jane, BSN, RN]

You've gotten good advice from previous posters. I'd also suggest that you make the visits less appealing - she may just be coming in to chat because you're a friendly face. She's a good kid and probably you're used to chatting together so the visit may be a high point in her day. Polite, firm, brief is the way to make visiting you less appealing and perhaps reduce the amount of time she spends if indeed it's not a UTI. Even at the high school level I've had to make my office less appealing and I've had to be less chatty and warm and friendly when I think someone is taking advantage of the rest in the clinic.

But you also have the right idea - the year is half over. YAY! Hang in there.

[KKEGS, MSN, RN]

I've never had a parent upset that I made a call. Is she fully emptying her bladder each time? Maybe there was a med change? Call them, let them decide if they think there's something to this.

True. Usually they thank me profusely for taking the time to call them to let them know something no matter how small.

[KKEGS, MSN, RN]

I've never had a parent upset that I made a call. Is she fully emptying her bladder each time? Maybe there was a med change? Call them, let them decide if they think there's something to this.

True. Usually they thank me profusely for taking the time to call them to let them know something no matter how small.

[lvnforschool]

No bladder issues. We had a talk this morning, and are adjusting the times she is coming up. Her teachers have started to question her about being late to class. This is a social/bathroom visit for her. I try to let her vent her frustrations because she has a lot of emotional issues. I told her, we have to change the bathroom times to where she is not missing class time. Of course she wasn't happy to have to come up on her break but sorry that's the time to do it. Thanks everyone for the advice.

[Windchaser22]

You might also consider a referral to a school counselor if she needs to talk. Now that she is a senior she may be worried about what comes next.

[Flare, ASN, BSN]

this is a very valid point. How independent is the student with toileting needs? If not, Does she have the potential of ever being independent? She may be overwhelmed with the prospect of applying to colleges if that is her plan and now wondering how to manage her condition alone in a dorm, college setting.

[Amethya]

I would mention this to her parents, just to be sure. She might have bladder issues and it can be addressed early.