We had this child with respiratory problems, and could not breathe. Under protocol, we call parents first and let them know what's going on. Mom didn't answer, so I called grandma. Grandma came, and she could see the kid could not breathe. We finally got a hold of mom, but she would not be here for more than 45 minutes. It was past 30 minutes since the child came to my clinic and I felt it was necessary to call 911, because she was still having difficulty breathing, I had her on the nebulizer and she could not speak to me. I kept urging the grandmother that we need to call 911, because she can't breathe, but she kept insisting to wait for mom and that it's just asthma and because she has this (And she smells like cigarettes) she knows what's up, and to wait.
The principal and I had enough after an hour of this child not able to breathe and we called 911, the grandmother was pissed, but I was so mad, I didn't hold back. I explained to the grandmother, in the most civilized way that her granddaughter is having difficulty breathing, her mother is not here. You are not her guardian, you have no custody of this child. As of right now, she's under my responsibility and I would rather call 911 to make sure she's okay than wait for her mother. I know it's insurance issues, but please cooperate with us. Right when 911 came, mom came. Grabbed daughter and left, didn't need 911 help. Which is fine because the parent was there, but I told my principal we need to make a protocol that if this happens again, and parent is far from child, we need to call 911 after x minutes, because this took too long.
The child is fine, she was diagnosed with asthma and needs an inhaler, so that's established, but I was worried, what if it was worse? And that time frame could of harmed her. My question, how long should we wait? I would say 15 minutes at least if it's an emergency.
Specializes in Cardiology, School Nursing, General.
Thanks. I'll make sure to make a note of this to the meeting and let them know that no matter the consequences, I will call 911, because it can be a life or death issue.
Thanks. I'll make sure to make a note of this to the meeting and let them know that no matter the consequences, I will call 911, because it can be a life or death issue.
Use the word "liability" a lot, that is the word that administration will cue in to. That GM being there and advising different does not lessen culpability, the school is liable. Trust your gut, your role as a CMA gives you that, and don't second guess. Rather be sorry for over treating than under.
I think the same way, but stupid grandmother was like "Insurance this, insurance that." And would keep calling some random person and talking bad about me in front of me and I'm like, really? What I say, goes. So I'm thinking that I'm going to say this to the next safety committee meeting that I don't care what family says, if the child is having an emergency, I will call 911 then call parents.
Really? I'm sorry you dislike your job so much that you need to be so hateful, I'm seeing a pattern here and it is not pleasant.
I had a similar situation where I had an asthmatic with no inhaler at school. Couldn't get in touch with mom, dad was anywhere from 10-30 minutes away. I ended up calling 911 because it just wasn't worth the risk. Everyone here seriously made me feel so much better about that decision, too.
It comes down to knowledge and liability sadly. You made the right call, and making a plan for triggers to call 911 is a great idea.
Specializes in Cardiology, School Nursing, General.
Really? I'm sorry you dislike your job so much that you need to be so hateful, I'm seeing a pattern here and it is not pleasant.
First of all, I love my job. I'm sorry if it's sounding so hateful, but I was angry that this poor girl was not able to breathe and the grandmother was not listening to me at all. The child could not answer back to me, she was literally gasping and coughing for air. And no matter how many times the grandmother kept taking off that mask, she could not answer you. I kept asking her to let me call 911 in the nicest way, but she would say "Wait for the mother. I had asthma for X years and I know that she will be fine." And she kept arguing with me and the principal that we didn't need the ambulance.
I'm trying to do my job but it's hard when they won't listen to me.
You can tell me I'm a horrible person or whatnot for being so mad at her, but ultimately it's my job to take care of these children, and if something happens to them, its not just going to be on me or the school, it's going to be on my conscience that I could of done something but I didn't because the grandmother decides that she knows better.
Thankfully the child is fine, but it could of gone worse and it would of been all my fault.
Specializes in EMT since 92, Paramedic since 97, RN and PHRN 2021.
I don't think the OP was conveying hate of her job more than the irresponsibility of the grandmother not doing what is best in the childs interest (getting emergency care) than thinking purely of financial (not having insurance). No one will ever fault you for calling 911, you were doing what you thought was in the best interest of the child. Parents can throw fits and whatnot. Ive dealt with plenty of parents at the ER (I'm a medic) saying " I didn't authorize this". Good thing about 911, we don't care if you authorize it or not. BUT I can guarantee you that if that child is injured or died because you DIDNT call 911, guess who pays!
Specializes in Cardiology, School Nursing, General.
I kept explaining to her that they will not bill you right there and then. They'll take you to the hospital where all the billing and insurance will work itself out. She kept saying she wanted to wait for the mother because she had the insurance papers, which I understood but I kept explaining they will take care of that at the hospital. I mean people that get in car crashes don't have time to sign for papers and pay for their bills, when they are in the middle of being in intermediate danger, I'm pretty sure they won't do that to a child.
Specializes in Surgery,Critical Care,Transplant,Neuro.
Heck, if I have a diagnosed asthma student with respiratory distress to the point where they cannot speak AND has had no response from their inhaler AND neb? AND mom is 30+ minutes away? Oh, I'm calling 911. Actually I would be calling 911 first, then I'm calling Mom to tell her to meet the ambulance at the hospital instead.
As the parent of an asthmatic child (and an APRN).....YES! If they cannot speak, call 911 and let me know which hospital they are heading to!!
That grandmother sounds insane. My middle child has asthma, I told the school nurse that she knows what is up, if she thinks my kid needs 911 before calling me, do it. We can deal with the ambulance fee, insurance, whatever, later on after my kid is better. I would rather her overreact than underreact.
I'm not a school nurse, but what was your assessment?
1. Was the child wheezing or did she have a "silent chest"?
2. Was the child able to speak in full sentences? 3 word sentences? Unable to speak?
3. What were her vitals? Tachycardic, tachypneic?
4. What was her mental status? AAOx3, unable to stand unassisted, unable to hold her head up?
I did not read thru all the posts but asthma kills children - it is not something to be taken lightly - if the child has signs of resp distress, 911 is the first call you should be making - parents can meet the child at the hospital ER.
Amethya
1,821 Posts
Thanks. I'll make sure to make a note of this to the meeting and let them know that no matter the consequences, I will call 911, because it can be a life or death issue.