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.
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.
1. Wheezing. She was coughing quite a lot and gasping for air.
2. Unable to speak, couldn't utter 3 words.
3. Tachycardia
4. Unable to hold her head up, seemed to be falling asleep. Eyes were starting to be glossy.
And this wasn't all at once, this happened little by little, as the grandmother kept telling me not to call 911 and wait for mom. To me, that was something distressful but we were told to call parents first, because I thought it was something that would blow over. She doesn't have a history of asthma, and this is a pretty athletic kid. So when she had this in the beginning, I thought she just couldn't catch her breathe, so I called grandmother to maybe take her to the doctor. I tried to see if she could breathe, but she wasn't still able to. I was going to to tell the principal that I was going to call 911, when grandmother comes in and tells me no. That's when the problem started.
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.
In our district, the nurse's decision to call 911 is respected. A call to parents follows immediately. If the parents arrive before the child is transported by EMS, they can interveve and decline the transport, assuming responsibility themselves. Unless documentation is in place in advance, grandparents can't do that. Granny's job should have been to comfort & calm the child. If she wasn't doing that, I would have sent her out of the office so I could focus my attention on the child.
But I'm the only medical aide here, so I'm the only one to do the assessments on this.
You are in a unique position. Your school has decided to do the CMA route to save costs, apparently. It puts you, specifically, in a hard place as you have found by the need to hear condescending remarks and a justifiable knowledge deficit as you are not a nurse. This isn't your fault at all. I applaud your decision to come here and use us for a sounding board and resource. Your learning curve is not unlike the nurses on here. Stick with it and never hesitate to consult on here. You have always been upfront about your experience and certification here and it seems at your school. Keep up the good work, you seem to be doing what you should.
Specializes in Cardiology, School Nursing, General.
You are in a unique position. Your school has decided to do the CMA route to save costs, apparently. It puts you, specifically, in a hard place as you have found by the need to hear condescending remarks and a justifiable knowledge deficit as you are not a nurse. This isn't your fault at all. I applaud your decision to come here and use us for a sounding board and resource. Your learning curve is not unlike the nurses on here. Stick with it and never hesitate to consult on here. You have always been upfront about your experience and certification here and it seems at your school. Keep up the good work, you seem to be doing what you should.
Thank you for that. I will keep doing what I'm suppose to be doing and hopefully things end up well here.
You are in a unique position. Your school has decided to do the CMA route to save costs, apparently. It puts you, specifically, in a hard place as you have found by the need to hear condescending remarks and a justifiable knowledge deficit as you are not a nurse. This isn't your fault at all. I applaud your decision to come here and use us for a sounding board and resource. Your learning curve is not unlike the nurses on here. Stick with it and never hesitate to consult on here. You have always been upfront about your experience and certification here and it seems at your school. Keep up the good work, you seem to be doing what you should.
I agree, never hesitate to ask or vent here. The rude and condescending remarks have really irritated me. Some people just aren't nice.
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
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.
If that child had died, Tobacco Granny would have had no qualms talking bad about you on the witness stand. She would tell the press she begged you to call 911 while you callously stood there. You wouldn't be able to publicly clear yourself because of HIPAA.
OK, that's a worst-case scenario. Policy or no policy, when you start to feel acutely uncomfortable about 911 not being called, you call them.
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
And I agree with others, don't hesitate to come here with your concerns. There are always those who will chide you for your lack of compassion, or you must hate your job, etc etc. But hopefully you've found a lot of good expertise and support. We're here for you.
My oldest son has asthma, that gets particularly bad in winter. I set up a personal protocol with his school nurse in order to prevent any confusion during an attack, or worse. I should mention that the first severe attack he had at school the nurse called 911 FIRST then informed me, she apologized so many times i can not count. I assured her she did her job and did it well. I would never want something horrible to happen to my child because someone felt as though they could not call 911. I would recommend speaking with your school board about putting personal plans in place for known students with asthma and another one for breathing difficulty with no diagnosed problems. But agree with many posters here, if a child can not speak then 911 should NEVER wait. Children can only compensate for so long and when they tank they usually tank fast.
Amethya
1,821 Posts
1. Wheezing. She was coughing quite a lot and gasping for air.
2. Unable to speak, couldn't utter 3 words.
3. Tachycardia
4. Unable to hold her head up, seemed to be falling asleep. Eyes were starting to be glossy.
And this wasn't all at once, this happened little by little, as the grandmother kept telling me not to call 911 and wait for mom. To me, that was something distressful but we were told to call parents first, because I thought it was something that would blow over. She doesn't have a history of asthma, and this is a pretty athletic kid. So when she had this in the beginning, I thought she just couldn't catch her breathe, so I called grandmother to maybe take her to the doctor. I tried to see if she could breathe, but she wasn't still able to. I was going to to tell the principal that I was going to call 911, when grandmother comes in and tells me no. That's when the problem started.