dizziness?

[nursex23, BSN, RN]

Hi school nurses! I'm a new school nurse and I've been having an influx of students saying they're dizzy. No other signs or symptoms. They deny hitting their head. Some say they've ate breakfast, some say they haven't. I always offer the snack and most of the time they feel better but lately they're saying it doesn't help.

What do you do for just dizziness? I've called home for 2 different students and one parent told their child to stop trying to get out of school and suddenly he felt better and went back to class. The other parent actually came to pick the student up. I don't know why I was shocked; I was kind of expecting it to go like the first parent. I don't want to dismiss how they're feeling and it's something serious but at the same time I don't want dizziness to be the golden ticket out of class.

How would you guys handle this?

[arlingtonnurse]

check BP, give water, watch them walk. If they are steady on their feet have them run or skip in office then back to class. Call parent after they have left office.

[nursex23, BSN, RN]

1 minute ago, arlingtonnurse said:

Call parent after they have left office.

Interesting. What's the purpose of calling after they leave?

[k1p1ssk, BSN, RN]

3 minutes ago, nursex23 said:

Interesting. What's the purpose of calling after they leave?

To have a frank conversation without hurting the kids feelings or accusing them of "faking" in front of them; I'll often send kids with frequent, but vague complaints and no ONL VS back to class but tell them I'm going to call home to discuss with their parents. When I call home, I let the parents know that I am not finding anything out of the ordinary but LD (little darling, for clarity) is insisting something is wrong, so you may want to get it checked out. I add in that I think they are safe to remain in school for now, but if they'd like to call their PCP, I wouldn't object at all. Then I document the crap out of it.

8x/10 the kid comes back to school and never complains about whatever it was again; 1x/10 it is something like a burgeoning virus; the last kid/10 is milking it for all its worth because they can play their parents like a fiddle and the family will waste a ton of money searching for a medical problem that isn't there!

[JenTheSchoolRN, BSN, RN]

23 minutes ago, nursex23 said:

Interesting. What's the purpose of calling after they leave?

To give them a heads up but also tell the parent that they are able to return to class. I do this all the time for FYI calls - especially if student is a frequent flier that exam reveals no significant medical findings. If you call in front of a student, they want to talk to parent and pick up happens. Also easier to have more honest phone call with parent/guardian.

Of course, when I call home I often tell both student and parent I'm just calling to check in and report my findings if I don't feel the student needs to go home. I do suggest that following up with their doctor if it continues, but always acknowledge with a parent/guardian that they know their kid best :).

Observation is so key. Kid complaining they are dizzy as they walk around my office with normal gait, touch all the things, then plop down to read a yearbook (yes, I have them because I am also the yearbook adviser)? Um, no. Water, snack if they have not eaten, short break 3-5 minutes tops, then back to class.

Winter break -itis is real.

[Flare, ASN, BSN]

If they're stuffy then they may be feeling that and it may be making them a little woozy. I vary on whether or not I call at all and if yes I do call if I call in front of the child. The benefit of calling in front of the child is that they can see that you called and it squashes it when the parent tells then to go back. If the child comes back after the parent squashed it, I have no problem shutting it down immediately. If the parent wants to take the soft approach and pick up, I'm over it. They can live with their choices. I will usually let the parent know that their child is well enough to wait for them in class. Buh bye.

[SaltineQueen]

1 hour ago, arlingtonnurse said:

check BP, give water, watch them walk. If they are steady on their feet have them run or skip in office then back to class. Call parent after they have left office.

Make sure they've been eating, too.

[tining, BSN, RN]

My kids are nauseated, dizzy and "Can't concentrate on work" - as if.

[bsyrn, ASN, RN]

agree with the above posters. Vitals, increase fluids, snacks then call parent.

[BeckyESRN]

I'm in elementary and I've found that "dizzy" means different things to these kiddos. My line of questioning is generally :

What does that mean to you?

Can you show me where you feel dizzy? (I've had head, tummy, throat, and shoulders)

Have you had this feeling before? and when, what helped...

Most of my littles mean that they need a drink and a few minutes to calm down. Lots of sinus related dizziness, occasional ear related dizziness, a few asthma related, and one dizziness that went to full LOC and landed in the ER.

[bitter_betsy, BSN]

The flip side is... are these kids coming from the same place? Is there a weird chemical wafting into the room from the roof or somewhere else that only affects the kids with the sensitive nose that maybe not everyone smells? Have their eyes been checked by an eye doc (and not a chart)? I recently just found out I need glasses but when you put me in front of an eye chart I can see 20/15. I have a tough time transitioning from sitting to walking or from reading a book to the board (it isn't really dizzy but I can't see well and it makes me feel a bit wonky but dizzy may be the easiest way to describe it). Also - if the kid can walk from their classroom to the nurses office - are they really that dizzy or does the dizzy go away when they exit the classroom (ie is the whatever that's bothering them confined to the classroom).

[EnoughWithTheIce]

I have a lot coming in after Athletics / PE. Dehydration and not eating seem to be big culprits.