Any advice on how to deal with cutters?

Guidance brought me a cutter today- he was already in there for counseling, and needed his arm bandaged (multiple superficial lacs from fingertips to elbow). No cuts on other arms, denied cuts on stomach/legs or other body areas. I did not do any counseling since guidance was already involved and was doing some counseling as well as contacting the parents.

If guidance weren't already involved, of course I'd get them involved right away, but what else should I do? I did teaching on signs and symptoms of infection. I didn't note any other scarring or injuries (burns, no injuries/scars to either wrist that would tell me he's attempted to commit suicide).

Trauma Columnist

traumaRUs, MSN, APRN

165 Articles; 21,214 Posts

Specializes in Nephrology, Cardiology, ER, ICU. Has 31 years experience.

What about notifying the parents?

My husband is a high school teacher who has had to deal with one very very troubled young lady and he stays in close contact with the parents to ensure meds are given, that she hasn't had access to meds on her own (hx of ODs), etc..

Specializes in School Nursing. Has 10 years experience.

aneroo, i am in elementary and i do not see any of these behaviors. i do sympathize with you. let us know how the situation is going.

best wishes to you !

praiser :heartbeat

Aneroo, LPN

1 Article; 1,518 Posts

Specializes in Cath Lab, OR, CPHN/SN, ER.
aneroo, i am in elementary and i do not see any of these behaviors. i do sympathize with you. let us know how the situation is going.

best wishes to you !

praiser :heartbeat

we all have our different things- at least i don't have to deal with lice nearly as much. lol

std's and pregnancy scares? check!

trauma- do you mean contact them on an ongoing basis?

i'm going to touch base with guidance later and see what the results were of what they did and find out what they know. i don't know if this is a new issue for the kid or an ongoing problem.

Aneroo, LPN

1 Article; 1,518 Posts

Specializes in Cath Lab, OR, CPHN/SN, ER.

Update- Guidance still trying to reach parents. Pre-existing psych. condition and already under psych care.

His girlfriend had cut herself, and it made him made, so he decided to cut himself to show her how bad it was. (Screaming WTH!!!! in my head) I asked him how he felt whenever he saw she had cut herself, he said it made him mad, sad, didn't know why she would do that to herself. Asked what he thought his girlfriend would think when she saw his arm- he said she was mad at him as well.

No history of cutting, no other notable scars.

He said he "would never do it again".

Told him if he ever felt like cutting again to come see me first or call. He agreed. Hopefully he will stick to his word and never cut again, but if not, then hopefully we can talk to him before he decides to cut and think of some healthy alternatives to deal with his anger other than self-harm.

Specializes in School Nursing. Has 10 years experience.

sound's like you did a good job with him. hope all will continue to go well. crazy what kids do to themselves. :scrying:

praiser :heartbeat


98 Posts

I also have a cutter in our high school. She has so many problems and they all stem from her terrible home life and upbringing. Every time she comes in for bandaging I will call her counselor. Several times she's had to be admitted. I just support her, clean her wounds, be sympathetic and turn her issues over to her counselor when she arrives. Its a terrible situation.

Aneroo, LPN

1 Article; 1,518 Posts

Specializes in Cath Lab, OR, CPHN/SN, ER.

I'm so glad we have that resource in the school. I tend to forget they are trained to do so much more than make schedules and help with college admissions.

Specializes in OB/GYN, Peds, School Nurse, DD.

I have encountered several cutters in middle school. Mostly girls. I clean them up, bandage it, and send them to the counselor. I also notify their principal (we have 4) and call the student's parent. I dont' fuss at them about it, just deal with it matter of factly, teaching them how to care for the wounds along the way. I figure they'll get enough talk from their counselor and their parents.

My son was a cutter, only I didn't know it. I only wish someone had told me before he made his first suicide attempt. If not for an eagle-eyed student who ratted him out, my son would be dead. I don't blame the teachers or the nurse--he hid it very well. In fact, my son was seriously mentally ill and it even though we were trying to help him, none of us saw this coming.


111 Posts

Specializes in Emergency Medicine, Dr. Office, Psych. Has 18 years experience.

cutters are unique individuals that is no doubt, but they have to be handled with "kid" gloves so to speak, if previous psych history than we have to wonder how long it has been going on? and did you say the g/f was a cutter as well?

guidence ever get ahold of the family? if they know about the cutting they can do somethings to safe guard him , but cutters will find one way or another to cut if they have it in their heads that is the only way they can deal w/ the pain they feel.

my 15 yr old had some issues a few years back (i think he was 12), i was divorced & i guess he took it to heart & thought that cutting himself would help him escape the pain of losing his dad to another women? its really hard to find out where their heads are, we took him out of school for a semester & worked with him at home & with the counseling service that the school had refered us to........... he is great now, no further episodes of cutting in years, but the potential is always there..

you did a great job, don't give up on this kid, they do need & are seeking help believe it or not... and you are on the right track by education..

great job!! keep up the great work:yeah:


200 Posts

Specializes in Med Surg/Tele/Ortho/Psych. Has 13 years experience.

[/color i think the worst thing a person can do is to be rude to someone. i am a nurse in psych and notice some of the health workers are obviously not educated and are just flat mean to these kids. one health worker the other day said "she definately doesn't need positive attention" after the girl had carved into her wrist and was bleeding. i thought this was so cruel. pt obviously has major problems at home and is doing this because something is missing. i think telling them to go to their room and getting in the bed is just cruel. i tried to talk to the pt and get out what is going on.

the individual may or may not be able to express what is going on but at least they know you give a hoot about them. we don't know what kind of life at home they are coming from or what they've been through that they may need to tell you one day. they will never tell you if you are mean to them. it doesn't matter if they are borderline or not.:igtsyt::


381 Posts

Specializes in school nursing. Has 4 years experience.

After three years in middle school...I have seen a few cutters. However, this week was the first time I had a male cutter. I tended to think of this as primarily a female issue. We can't forgot, our boys our facing some of the same issues. It was an eye opener!

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