CPS call?

[MrNurse(x2)]

Our school has a family that appears to be practicing a bit of Munchausen. This child has not been in school for three weeks straight due to severe anxiety. This child came to me one day and begged to call mom to pick him up, crying before call and instant smile when she said yes. According to counselors I have discussed with, this is manipulation, not anxiety. The mother constantly posts on social media how she has a disabled son, it is how she identifies herself, despite the lack of any documented disability. The school has requested medical records of same so we may assist him in any way we can. Is this a CPS issue? He has essentially missed 75% of school days this year. I have brought up truancy issues to admin because we don't really have a medical reason for the absences.

[kidzcare]

$25 co-pay for three kids gets expensive when they all share their germs.

No joke! Between my kids and I with office visits and ABT/steroids, I have spent almost $200 trying to get bronchitis out of my house! And I have incredible insurance.

[Farawyn]

Sully, I like your plan.

What are you gonna do, MNX2?

[OrganizedChaos, LVN]

In Texas unexcused absenteeism is considered neglect and is investigated by CPS, so we would report in such an instance if a truancy meeting wasn't successful.

This. I was about to say something to this extent.

[hppygr8ful, ASN, RN, EMT-I]

In most US State if you are a mandated reporter you have both a duty and responsibility to report "Reasonably Suspected Abuse or Neglect of a minor child under your supervision or care." A simple call to the CPS agency is all it takes to open a case - the agency will then investigate and determine if abuse or neglect exists. If the answer is yes they will take action to assist the parent and/or child as needed. If they find the case to be unwarranted they will close the case - no harm no foul. You however will have done your duty and your conscience will be clear.

Hppy

[MrNurse(x2), ADN]

Sorry, half day Friday and I left for vacay right after. I really can only recommend to my administrators. I feel like I am only getting part of the story. We will see Tuesday, I suppose.

[foggnm]

It would still be a truancy issue first. Then if the child has a legitimate medical problem they will at some point have to work with the school to make accommodations and/or get absences excused. I don't think it would be a CPS issue unless you suspect abuse or neglect then it would need to be reported.

[Nancy54]

When I was in the school system, we had PPW, a pupil personnel worker. They were involved in all situations outside of the school, that impacted attendance at the school. In our school system, boundary issues were big because families would fabricate documents that indicated a child resided within one school district or another and they would try to establish the actual address. But absenteeism to the extent you indicated was definitely another area they were involved in.

I haven't read all the responses, but I definitely agree that an immediate team meeting including the mother (if she attends) is in order and could be justified by the impact these absences are having on the child's learning. While at the meeting discuss the school's need to be prepared to meet the child's health care requirements while in school and get a release of info signed for the pediatrician. If the child does not have a primary care doctor, work to meet that need etc. Also.. if the child has a met a certain number of absences, is there a home/school requirement that kicks in? If so, the mother may be freaked by having someone come into her home and may be more helpful. Re CPS, we were always told that as mandated reporters, we don't screen our calls. We call if we have a concern re neglect, abuse, whatever and the agency does the screening. ie, there is no bad call. I also always like to think of the CPS call as finding another avenue to help get the family the resources they need to deal with the situation that's causing the family distress. The county/state/school has resources available that as a school nurse you may not be aware of or know how to plug the family into. I've also made conversational calls to CPS, just to get their thoughts. Perhaps there's some sort of a county program that could be recommended to this mother since her child "has" so many chronic illnesses (etc) ostensibly to help her deal with the health care system but maybe to assess what's going on and help organize the family into a healthier level of functioning. . I also worked in inpatient pediatric psych so we did a lot of followup and trying to engage community systems. And you know.. although I haven't been part of the school system for a few years, when I was, it was with a very needy community with significant barriers of every kind including language. I sometimes found the offices of health care folks I reached out to were willing be a little flexible with the intent of helping the child and family. Good Luck!