Published Oct 29, 2010
BunnyBunnyBSNRN, ASN, BSN
995 Posts
Yesterday I had a student come in c/o SA with nausea and "vomiting" (sorry, sister, if you tell me you threw up in the bathroom without a credible witness it doesn't count!). After asking several questions I figured out that she was having cramps and felt like caca. This is not something I send home for! If I have to be here when I'm bleeding like a stuck pig and having cramps so bad that I'm vomiting, then so do you! In a much kinder way I told the student this. She agreed it was fair and went back to class, (I thought). What she did was went either to the office to use the phone or to use her cell, and called mom. Mom came to pick her up. This morning, mom brought OTC med (per district policy, I can give this with mom's permission for menstrual cramps) and said, "she gets so bad she throws up, that's why I picked her up". Really?! I wish I could go home for 1-2 days a month when I have cramps!
LACA, BSN, LPN, RN
371 Posts
I missed more than a few days of school because of bad cramps and heavy periods. I don't deal with it much here at my school because it's elementary but I have sent a few of the 5th grade girls home before. If they are standing in my office, crying, and absolutely miserable, it doesn't really do them much good to stay at school. They aren't going to get much done. Before I call home, I will try a few different things, but if they are in that much pain, I usually call and see what Mom/Dad wants to do. I've never sent a girl home more than once, the times that I have done it have been different girls. Am I the only one who does this?
momnurse23
46 Posts
I have not had to send home for cramps as I work in K-5 and I don't deal with it that often. I myself missed a few days here and there in middle/high school (even college and went home from work even once when I was younger) because of bad cramps and the headache that goes along with it. It's not a habit but it has happened. l think the previous poster was correct in saying if it's that bad you're not going to get anything out of class. I understand it's important to not make this a habit and if it's so bad she's having to miss each month maybe mom needs to get her the gyn. but pain is pain no matter what is causing it and sometimes you just need a break.
SchoolNurseBSN
381 Posts
I was a middle school nurse before I moved to elementary. I took each complaint of cramps on a case by case basis. i always tried the heating pad first and then went from there. I could tell when the girl felt really bad and would call the parent to make the final decision. If I would see the girl more than once or twice, I would do a medical referral to a gyn.
Neveranurseagain, RN
866 Posts
You need to realize for many of these girls this a huge, new change with their body, and something they need time to get used to. Add to it the fluxuation of hormones, and just compounds the problem. With age, you learn to tough things out, but many of these girls are just 10 years old, and view things from a 10 year mind. A little compassion goes a long way.
tencat
1,350 Posts
I know kids abuse the school nurse to try to get out of school, but unless this gal is constantly pulling this, I think I'd be calling mom and letting her make the decision. Girls that age are certain that every eye is on them and they are desperately worried that everyone will know about their menstrual issues.
HeartsOpenWide, RN
1 Article; 2,889 Posts
I am sorry if this comes off harsh, this one hit a personal nerve; but until you have dysmenorrhea then learn to be empathetic. I missed 1-2 days a month when I was in high school because of it, I had to go on Lorcet it was so bad. I threw up for 1-2 days non-stop and it felt like some one was literally stabbing me with a knife in my uterus an twisting it every 5 mins. I ended up solving the problem after I turned 18 and went on the pill for 11.5 years but still suffered from menstrual migraines. Now that I have been off the pill for 7 months my periods have slowly come back to the way there were when I was a teen, last month they were so bad I doubled over with pain and considered going back on the pill even though my husband and I are trying after 10 years of marriage. I now have a prescription for 800mg IBU to help prevent the cramps and some Ty#3 if it does not work. I am NOT the type to take pills unless I really have to, my Aleve expires before I can use it all. When you have dysmenorrhea you do not just bleed like a stuck pig, you do not just have cramps...
I think I need to clarify...when she walked into my office she said "I threw up". Skin was warm, dry, and normal colour for race. No vomit-like odor to breath (before I started asking "girl problem questions" I took a temp), and when I offered to let her lay down for a bit, she declined. I may have come off as an un-sympathic witch, but I'm not. I have had cramps with vomiting and general fatigue since I was 13, so I get it.
I work in a poor district, keeping these kids in school ensures that they get at least two meals a day (breakfast and lunch) and are in a safe environment. I don't send kids home who I do not find s/sx of genuine illness because education is the one thing that nobody will ever take away from them and for some, it may be the only way out of the ghetto for these kids. I don't allow them to think because their parents will make excuses for them it's okay to abuse the system.
Flame me again if you like, but I'm standing my ground on this one.
You can not concentrate and retain the educational material when you are in that much pain and throwing up. You are not going to keep either of the two meals down when you are in that much pain and throwing up.
enchantmentdis, BSN, RN
521 Posts
I sure am glad that you are not my kids school nurse. Your attitude is terrible for the profession you are in. My own daughter gets severe back/abdominal pain during her periods and at one point got her menses every two weeks and had to be put on birth control to regulate it. I'm sure glad her nurse practitioner didn't have your rotten attitude. When that Mom came to pick the student up she should have told you nothing. I sure wouldn't have. I don't want my child any where near nurses like you, and, thankfully, she is not going anywhere near the nursing profession.
morte, LPN, LVN
7,015 Posts
I think I need to clarify...when she walked into my office she said "I threw up". Skin was warm, dry, and normal colour for race. No vomit-like odor to breath (before I started asking "girl problem questions" I took a temp), and when I offered to let her lay down for a bit, she declined. I may have come off as an un-sympathic witch, but I'm not. I have had cramps with vomiting and general fatigue since I was 13, so I get it. I work in a poor district, keeping these kids in school ensures that they get at least two meals a day (breakfast and lunch) and are in a safe environment. I don't send kids home who I do not find s/sx of genuine illness because education is the one thing that nobody will ever take away from them and for some, it may be the only way out of the ghetto for these kids. I don't allow them to think because their parents will make excuses for them it's okay to abuse the system.Flame me again if you like, but I'm standing my ground on this one.
the added info changes things.....there may be other things they want to do besides be in school....
mustlovepoodles, RN
1,041 Posts
Me too. When I was in the middle school I saw a LOT of cramps and I took it on a case by case basis. There were about 350 girls who just wanted to get out of PE for the day (sorry, no can do.) And there were 3-4 girls whose cramps were so bad they could hardly walk. They'd be vomiting all over the place. For *those* girls, I always called their parents. In fact, I also made medical referrals on 2 of them and their doctors were able give them meds which lessened their discomfort.
I try to give the girls the benefit of the doubt. THese are young girls, not women warriors. THey don't have a lot of experience with this. Personally, I think i need to give them a break sometimes. Not send them home every month, but certainly we can find ways to affirm that what they are feeling is real. Sometimes all they really want is a little sympathy. I didn't have cramps as a girl, but my sister did, back when the only med you could buy OTC was aspirin or Midol. My sister is pretty stoic, but those 1 or 2 days a month she would literally be writhing on her bed and vomiting. It was really awful!