Girls with Cramps

[grammy1]

What do y'all do for the young girls who come in with cramps? If they have no meds in the clinic, our hands are pretty much tied.

Are any of you allowed to use heating pads or warm packs from the microwave? At this time, our health department (who writes our procedures manual), doesn't allow us to use any heat at all. We can calculate and give insulin, but heaven knows we can't be trusted with "HEAT." We might burn someone.

We allow 10-15 minutes to lie down. They can call home for a parent to bring meds, but most are working, and if not working they usually don't have a car so that doesn't usually work. Any other suggestions??

[KKEGS, MSN, RN]

Who writes those manuals?!? I have a heating pad.

[Jolie, BSN]

Are you able to administer parent-provided OTC meds with physician & parent approval? If so, I encourage young ladies & their parents to set this up.

As unappealing as it sounds, exercise can be very effective in minimizing cramps. That's a tough sell when they are feeling so bad, though.

Otherwise, how can you go about requesting changes to your practice manual? It seems absurd to take away effective, no-cost, non-medicinal alternatives.

[grammy1]

We have tried getting the manual changed to no avail. Many of us were using heating pads or microwavable rice packs. Once the health department found out, they put a stop to it quickly. The doc there who oversees it (obviously a male), said that if cramps are bad enough to be in the clinic, then they need to go home. Grrrrrrr......he doesn't have a clue.

We have meds for some of the kids. We don't even need a doctor's note, just written parental consent, but in our area, trying to get parents to bring it is like pulling teeth.

I was just curious what everyone else does, and if I see enough others that use heating pads may start another crusade.

[JenTheSchoolRN, BSN, RN]

We have tried getting the manual changed to no avail. Many of us were using heating pads or microwavable rice packs. Once the health department found out, they put a stop to it quickly. The doc there who oversees it (obviously a male), said that if cramps are bad enough to be in the clinic, then they need to go home. Grrrrrrr......he doesn't have a clue.

Does he want you to send home a large portion of the female population and increase missed instruction time? I wonder if some data on menstrual cramp visits might help, adding in that lost instruction time when students need to lie down.

I use acetaminophen/ibuprofen (if parent has signed off) and microwaveable heat packs. I've had a couple of folks state chamomile tea (or another herbal tea, no caffeine) can help, but that isn't something that I can make easily in my office nor something most kids would try. Exercise can definitely help (which is why I try girls that they should be a more willing participate in gym vs not!), but as someone mentioned upthread, is a tough sell. I wish I were more help...

[Flare, ASN, BSN]

I have a heating pad that the girls are more that welcome to use for as long as they want during recess. For shorter times during academic subjects. I also try to sell exercise, however if they look miserable, I will occasionally write them PE passes but only after they listen to my exercise actually helps cramps speech. If they look like they can't make it, i'll give them a pass and chart it. Those passes are rare.

[SchoolNurseTXstyle]

I have the girls lay on a folded pillow under their abdomen. Often, the applied pressure seems to help.

[OldDude]

Two years ago our district realigned and started keeping 5th grade on the elementary. I seldom had to deal with this subject prior to that move but now it's more common. Uh...er...uhm...let's call your mom!

[DEgalRN]

I'm lucky that I have stock meds. And honestly, I'm sure there are plenty of girls who are bringing in illegal ibuprofen themselves. For the ones I don't have permission for I do use reusable heating pads, talk up exercise, and encourage lots of fluid intake. For super miserable ones I call home and several times I've had mothers collaborate extremely painful menstrual issues and sometimes they do go home. I've been there done that, so I honestly may be biased, lol.

[Eleven011]

I can't use the plug in heating pads here, and I don't keep any other type because I don't have a microwave handy (could go to the lounge, but its against policy to leave a student unattended in the office). So I have been just having them lay down for a few minutes or try to call home for someone to bring the meds. If it happens regularly, I try to get parents to bring in PRN meds to leave here. I do believe there is probably some bootlegging of motrin going on between the HS girls, but that is the least of my problems.

[ohiobobcat]

I have stock meds with standing orders, so as long as I have parental permission, students can come to me for medication. I do have a couple of students who are absolutely miserable on their periods, so when they come to see me, I know to call home for dismissal. I used to be that way before I had my kids, so I can totally relate.

I have a heating pad that I lend out if kids are comfortable with heating their pelvis in class. I have let students rest in my office with a heating pad as well.

I am starting to crack down on students who use my supply of tampons for EVERY SINGLE DAY of their period. Please use my supply if you get caught by surprise and start your period a few days early. But don't come in my office multiple times a day for 7 days to raid my supply of tampons. Be responsible and bring some from home!!

[MrNurse(x2), ADN]

I have prn meds, so they normally come to me for Motrin. I am amazed at how forthcoming most girls are, they come and tell me they are having cramps just like they would tell me they are nauseated. That from a school that teaches no sex ed at all. Good job parents.