Faking sick

JenTheSchoolRN, BSN, RN · Nov 3, 2022

On 10/31/2022 at 8:00 AM, beachynurse said:

I am interested in what a Yondr pouch is??

A pouch you place your cell phone into and it locks. It can only be unlocked using a strong magnet. Comedy shows use them sometimes to prevent audience from recording, but schools are now using them to help students break cell phone addictions/focus better on learning.

Simba&NalasMom, LPN · Jan 30, 2023

nursekoll said:

What do you guys say or do when you suspect a high school student is lying about throwing up or being sick? I need help with a good response that sounds professional and caring. Our school policy is to send home for any vomiting, but if it is not witnessed, I can not prove it happened and it gets to be a he-said-she-said thing. Parents will buck if I send these (typically chronically absent) kids home. So what's a nice way to say "Sorry, kid you're going back to class, and if you vomit again make sure a staff member sees it." I have the same issue with diarrhea, these older kids report having diarrhea more than 2 times because they know that's our sick policy. I think they just don't want to be here and need a nice way to say they're staying. They put on the pitiful face, but I'm not fooled.

Pfft. Why are you so worried about a bunch of manipulative little stinkers trying to get the better of you? That's their job. Especially the ADHDers.

You don't gotta be nice to a little *** who's trying to take advantage of your kindness. That in itself would piss me off. I mean you don't have to be a dick, either...

"Sorry, kiddo, you don't have a fever and nobody saw you throw up. Here's some Pepto (if you're even allowed to dispense OTCs to kiddos these days). Back to class with you. Come back if it happens again and somebody sees it."

k1p1ssk, BSN, RN · Jan 30, 2023

Simba&NalasMom said:

Pfft. Why are you so worried about a bunch of manipulative little stinkers trying to get the better of you? That's their job. Especially the ADHDers.

You don't gotta be nice to a little *** who's trying to take advantage of your kindness. That in itself would piss me off. I mean you don't have to be a dick, either...

"Sorry, kiddo, you don't have a fever and nobody saw you throw up. Here's some Pepto (if you're even allowed to dispense OTCs to kiddos these days). Back to class with you. Come back if it happens again and somebody sees it."

I think that it sounds like the administration & parents at that school wouldn't tolerate the "Suck it up, buttercup" style of school nursing and the OP would likely get written up for being unprofessional. In some districts or schools, depending on the culture, it would be just fine, but working in the schools, more often than not, you are a slave to your community values. If your school's community wants every student to treated like royalty, then you better fall in and do it, or you'll face retaliation from admin, parents, and even students.

allnurses Guide · Feb 3, 2023

raebabelvn said:

I work with K-5, so its a little different here. I will often ask them what this throw up looks like, and they give me all kinds of weird descriptions. There are some students that never complain, and I know its legit... but any vomit that is not witnessed or seen by an adult "doesn't count". 90% of the time, kids with the bigfoot vomit (I've started using this term!) keep water and crackers down and head back to class.

My FAVORITE thing to ask my students is "What does that mean to you?". I use this for just about everything - being dizzy, light headed, diarrhea, etc. The majority of the time, the student has no idea what it actually means and gives me another definition. For example, I'll ask the student what dizzy means to them, and they'll respond with "my eyes are tired". As for diarrhea, I'll ask what that term means, sometimes I get the correct response. If I do get the correct response, and it's a frequent flyer, I'll tell them to come use my bathroom the next time they need to so I can see what their poop looks like. I have yet to have a student do this.

While I am not a school nurse I do work with adolescents in the psych setting. Certain abdominal medications (In the psych setting) can make a person feel a little high, or so some kids tell me. So my rule is If you vomit or have loose stools don't flush but get me or the med nurse to see it. We won't treat with anything other than hydration if we don't see it.

Simba&NalasMom, LPN · Feb 3, 2023

hppygr8ful said:

...don't flush but get me or the med nurse to see it. We won't treat with anything other than hydration if we don't see it.

I work in a nursing home with many individuals with dementia and mental health. Same deal. If I or the aides do not see it, they're getting ginger ale and crackers until we do.

Simba&NalasMom said:

NutmeggeRN, BSN · Feb 3, 2023

Simba&NalasMom said:

Pfft. Why are you so worried about a bunch of manipulative little stinkers trying to get the better of you? That's their job. Especially the ADHDers.

You don't gotta be nice to a little *** who's trying to take advantage of your kindness. That in itself would piss me off. I mean you don't have to be a dick, either...

"Sorry, kiddo, you don't have a fever and nobody saw you throw up. Here's some Pepto (if you're even allowed to dispense OTCs to kiddos these days). Back to class with you. Come back if it happens again and somebody sees it."

wow....

Simba&NalasMom, LPN · Feb 3, 2023

k1p1ssk said:

I think that it sounds like the administration & parents at that school wouldn't tolerate the "Suck it up, buttercup" style of school nursing and the OP would likely get written up for being unprofessional. In some districts or schools, depending on the culture, it would be just fine, but working in the schools, more often than not, you are a slave to your community values. If your school's community wants every student to treated like royalty, then you better fall in and do it, or you'll face retaliation from admin, parents, and even students.

Yeah that response was probably mostly my ADHD talking after my meds wore off that day. I am not a mean person and would not literally speak to patients like that. But I would definitely try use some tough love with some of the more frequent flyers.

At the same time I guess it's a good thing I'm not a school nurse because I just can't with these high maintenance people. I'm not here to give you the damn Disney treatment. I'm here to take care of your health.

beachynurse, ASN, BSN · Feb 23, 2023

k1p1ssk said:

This is too bad; I wonder if policy-wise, you could explore if there is a way to distinguish between excused dismissals and unexcused; Excused being nurse dismissal, medical appointments, funerals, really anything that would be an excused absence and unexcused being parent/child decision, essentially anything without RN input or documented necessity? Then when you call, explain that you have no medical reason to exclude them, when the parent says no, they can go home, add in "OK, but since I am not dismissing them, this will be an unexcused dismissal". Part of the policy could be that the unexcused dismissal stands unless the kiddo ends up with an excluding symptom. Because how many show up at school the next day?

Especially at the MS/HS level, I imagine this is a big problem across the board.

I wish I could do that as well. Again, the motto here is "Don't piss off the parents" . That would definitely piss them off, and cause more headaches for me than I need. I would get phone calls complaining all day, my admin would too and then she would make me change it to excused to placate the parents.

Nurse Beverly · Feb 24, 2023

Listen carefully... most teens though not all, eventually give you a clue that they are faking. Also, are they one of your frequent visitors or have a lot of absences?

I keep saltine crackers, peppermints and water in the clinic.

High schoolers unwitnessed vomiting or diarrhea, unless they present with other symptoms/signs, get rested in clinic for 15 minutes--if no V or D, I usually send back to class. Sometimes I may have them eat a saltine cracker and observe; symptoms determine action taken.

I have found middle schoolers to be a little more trickier in determining the real vs fakers. Usually monitor their behavior in the clinic, if reading, on their chrome book, etc.; I usually send back to class. Maybe 1:10 end up coming back due to vomiting in the classroom.

If I am not seeing a reason to send home but they are requesting to go home, I have them call the parent--then it's between the parent and student. Many times this helps to nip faking behavior in the butt, but not all the time. Students who go home on the "call of the parent" require a parent note for their absence.

RatherBHiking, BSN, RN · Feb 28, 2023

Simba&NalasMom said:

I'm not here to give you the damn Disney treatment. I'm here to take care of your health

Haha I love this!?