Boy/Girl Who Cried WOLF Syndrome

Specialties School

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Hey, does anyone else get a little sloppy sometimes re: complaints of frequent flyers? I find myself going on auto-pilot more and more when being faced with my 99th "I feel like I'm gonna throw up." (Conveniently timed for math class of course)

Sometimes I worry about minimizing the complaints of these snowflakes too much and missing the real deal if it ever happens. Worse, I'm worried about the laissez-faire attitude slipping over to the other kids who may not come often but present with similar chief complaints.

Thoughts?

I just have to ask... why would you force a kid who so obviously HATES (even if it wasn't an allergy) peas to eat them?? Maybe I'm bias because I HATE peas (the thought makes me want to gag too)..

I guess I am just not in favor of forcing a child to eat any one certain food if the hate it.

I get your point, but if I didn't insist that my kids eat things that they claimed they hated, they would never eat a vegetable again :yuck:

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Specializes in Hospice.
I just have to ask... why would you force a kid who so obviously HATES (even if it wasn't an allergy) peas to eat them?? Maybe I'm bias because I HATE peas (the thought makes me want to gag too)..

I guess I am just not in favor of forcing a child to eat any one certain food if the hate it.

I wondered the same thing. When I was a kid, my mom's only rule was that I had to at least try everything.

I wasn't a picky eater (actually liked Brussel's sprouts AND Lima beans!!) but liver made me gag. Not even a full bottle of ketchup poured over it helped.

My parents loved liver, so it was served at least twice a month in our house. [emoji33][emoji33]

Because I had followed the rules, I got steak on those nights. I think it also helped that I liked liver sausage (go figure; mom actually had to insist I eat something other than a liver sausage sandwich for lunch every day in second grade lol).

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Specializes in Pediatrics, research, home care, infusio.

I have a comment and a question. I too have FF that come in for an assortment of imagined ailments. I have a hard time just dismissing all of them so I usually do a cursory exam to be certain there really isn't an injury or illness, and most often there isn't. The other day I had three kids come in separately with thumbs injured at recess. I assessed pulses, NV status, ROM, provided ice and sent them on their way. The one 7th grader who is not a FF returned for more ice. No change in status. Then I get a call at home the next day from administration asking whether I called mom on this kid. No I hadn't didn't think to really since I had been desinsitized all day with the other FF. Turns out thumb was fractured and mom was upset that I hadn't called. I spoke with her and calmed her down. I explained that my assessment was on the fence and I should have called. Now I am calling far more often.

My my question is: do you call home for every injury or potential injury or illness?? Even on the FFs? My principal wants me to. I explained there's not enough time in the day to do that. She now wants the teachers doing screening to weed out the ffs but the teachers don't feel comfortable making those judgements. Any advice on when to call and how to handle this new directive from the principal?

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Specializes in school nurse.

Could you "split the difference" and send health office visit notes? (At least for the ones that you have no on-the-fence or actual serious concerns about.) I have a stack of fill in the blank notes that I can send home in the student's folder for their parents.

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Specializes in IMC, school nursing.

You are a nurse, you are not skilled in diagnosis, and you make the best decision on the info provided. Easy to play Monday morning QB. I have a small population, I let parents know about most non cut/ scrape, minor "ice pack" injuries. Once you get to a large population, that is not possible. Teachers are not nurses, weeding out FF is not really in their scope of knowledge. Teachers are wise to be uncomfortable with this and nurses should evaluate our necessity if we allow it. This is a one time miss, and truly, not a very tragic one, as most phalangeal fractures are not treated. I think your administrator needs to step back, take a deep breath and look at the big picture over a long time period.

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Specializes in kids.
I spoke with her and calmed her down. I explained that my assessment was on the fence and I should have called. Now I am calling far more often.

And sometimes that is all it takes. I have found that if I directly contact the parent and own it, they chill pretty quickly.

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You will always have one that will slip through no matter what. If a student returns complaining of the injury I will always call to let parents know.

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Specializes in IMC, school nursing.
Could you "split the difference" and send health office visit notes? (At least for the ones that you have no on-the-fence or actual serious concerns about.) I have a stack of fill in the blank notes that I can send home in the student's folder for their parents.

I don't trust the notes will be seen. That's a hard call. On one hand, you can state that you made them aware, but that puts the responsibility on a child.

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Specializes in Pediatrics Retired.

MaltyChick...we've all been there. Beat up on yourself for a while and then let it go. The unique thing about school nursing is that you can't do something "all the time." You can't call for every frequent flier - some yes - but not all. You are there to provide individual assessments and interventions based on your critical thinking skills and nursing judgment. Some time you're the windshield and sometime you're the bug. You've identified what you "should" have done under these circumstances to make a parent happy but the fact remains your phone call wasn't going to unfracture the bone; the kid suffered no ill affects inflicted by you; the parent was just wanting to vent. So, I would advise you to not make any sweeping changes, continue to be the school nurse on campus and move on to the next "thing." You can't keep everyone happy all the time.

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I will generally call if there is a visible mark/bump or if I think the story might be embellished between school and home.

And of course if I'm recommending that they be further evaluated

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If I called for every bump, bruise, jammed finger, etc. I would never make it home at night.

In a 2 weeks time span this month - I saw 27 jammed fingers. If they come back the second time, yes I call! Half the times these fingers are not even swollen or discolored. Until I get x-ray vision, there are things I am going to miss.

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Specializes in Pediatrics, research, home care, infusio.

I do the note home for the scrapes and bumps. And give them an I Saw the Nurse sticker on their shirt so mom or dad will hopefully ask why and then the note will be remembered.

We have nearly 1000 kids here, so calling on every kids that I glance at and dismiss is not at all possible.

Thank you for all of your advice and support!!! That's why I love this page! I went home the other night and started looking for jobs due to frustration and fatigue. I also drive an hour each way to work 6 hours for not a great hourly rate:/ Makes days like these harder to handle and makes me want a change. But I do love being able to work with this age group and population. Sigh.

I have a nice nice long weekend to chill and recharge for the last two weeks of school!!

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