EPIC FAIL

[girlmom]

Brand new school nurse this year and learning a lot. I come from a clinic background so the school setting has been a big adjustment for me. Thankfully this board has helped me out a ton. Until today. I had my first epic fail as a school nurse. I am 1 nurse for 4 schools in our district, so I have to travel around. Today was called to the high school for an 11th grader with "blue, shaky" hands. I drove up to the high school thinking the worst. Got there and sure enough, they were blue. Both sides of both hands up to about her wrists. Everything checked out- vitals, not dyspneic or wheezy. No hx of cardiac issues, but does have asthma. No numbness/ tingling or pain in hands. She appeared nervous, but not really in any distress. Said she felt fine aside from her hands. I was stumped so I called mom to have her brought in for evaluation. Student came back about an hour later- turns out she was wearing brand new dark blue jeans and it had rubbed off on her hands. UGHHH. Glad everything turned out ok but boy do I feel stupid. Next time someone's anything is blue I'll try washing first. TGIF

[CrunchRN, ADN, RN]

Lol. How could you have known? Not even close to an epic fail.

[KKEGS, MSN, RN]

It's makes for a great story from the trenches!

[Cattz, ADN]

Good job. How could you have known. Don't feel bad, you did your assessment and nothing else checked out. Maybe mom will make sure she washes the new jeans next time!

[MrNurse(x2), ADN]

It is probably a good idea for any "blue hand" presentation to assess neurovascular status first, if good CRT then have student wash their hands with warm water to see if it gets better. From a vascular standpoint as well as dye standpoint, it makes sense.

[OldDude]

This story will make you feel better...I work pool in a pediatric urgent care. We had a teenage girl come in with similar presentation, blue hands, onset during the day, O2 sats normal, cap refill 1 second, no loss of sensitivity...I know this because I was doing intake. She was seen by the Urgent Care MD and transferred to the Emergency Room (by private car) where she was, triaged, placed in a room, and subsequently instructed by the ER doctor to wash her hands and was immediately and miraculously cured.

Feel better now?

[MrNurse(x2), ADN]

This story will make you feel better...I work pool in a pediatric urgent care. We had a teenage girl come in with similar presentation, blue hands, onset during the day, O2 sats normal, cap refill 1 second, no loss of sensitivity...I know this because I was doing intake. She was seen by the Urgent Care MD and transferred to the Emergency Room (by private car) where she was, triaged, placed in a room, and subsequently instructed by the ER doctor to wash her hands and was immediately and miraculously cured.

Feel better now?

I have found that the higher the level of care, the easier it is to overlook the basics. My wife was in shock trauma and the nurse said she may have to wait for surgery and have an external fixator because of swelling. I asked why the knee wasn't being iced, the look on her face was priceless. I probably wouldn't have thought about it either, but there was no way I was going to deal with an EF, I think they're gross.

[SunnyPupRN]

I wonder why she was shaky, though? That part doesn't account for the dye, and surely would have thrown you off as you collected the symptoms from the teacher or whoever sent her!

[MrNurse(x2), ADN]

Probably anxiety. Someone told her they need to amputate her hands before seeing you and bam, she's a jittery bundle of nerves.

[SnugglePuggle, MSN, RN]

Stick around on this forum and you will learn about many of the odd things we as School Nurses encounter! Check out my post under "Most off the wall complaint"!

[BeckyESRN]

I wonder why she was shaky, though? That part doesn't account for the dye, and surely would have thrown you off as you collected the symptoms from the teacher or whoever sent her!

Because "I was feeling fine and them my friend said that I looked sick and now my stomach hurts and I think I have a fever" is a complaint that we get a lot!

[Flare, ASN, BSN]

Ah yes... Dr. Bestfriend MD, FACS, PITA is NEVER wrong. Don't you go doubting their skills!!