it happened!

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I had to call EMS today. Girl was in my office for a headache. She is a major FF, just yesterday she was sent down my a counselor to nap... something we do not normally allow (this is a large high school of 1500, and i only have 2 beds!) so I see her all the time for headaches and minor things. Offered her Oj and crackers and she refused. Let her lay down a period, bell rang, sent her to class.

About 15 mins later I get a phone call from one for the psychologists telling me I need to COME NOW!! (where are you? who is this? lol, then they gave me attitude for not having my crystal ball and magically knowing who was calling). Well today of all days... my health aide had a half day. So i was totally alone. I could not just run out the door, I was already so swamped and had kids here. Called the district NP to come down... no answer. Started kicking the kids out who were here (they did not need to be here and was about to have them leave anyway). The one psychologist comes running in to get the w/c at that time, saying she'll bring the girl down here. So then I wait here. Then a couple mins later I get a call- no we need you come down here!! So... try NP again, no answer. Looking for securities number when they come to my door - someone else had called them. So they watch my office and I "run" up there (i'm 9 months pregnant there isn't a whole lot of running I can do!)

Student on floor in office, face down, unconscious, RR 18, pulse 56. Had one of the psychologists call 911 - this particular one was actually pretty helpful! Meanwhile the NP calls me and says she's on her way. They start asking me questions.. i know this girl and i have nothing on her - no meds, no conditions/alerts in our system, nothing in her health chart. Psychologist mentions that the girl was hospitalized last week (don't say why), hasn't been eating, and is depressed. (Sidenote: This highlights a problem; that the counselors and psychologists do NOT share info with me, especially psych stuff. So then I have to be the one that is called for things and I have NO background info! mental health IS health, please share with me!!)

EMS gets there and long story short, she was hypogylcemic. BG 53. EMS transported her per dad's instructions because he couldn't get a ride. Dad just called me from the hospital, and she was dx with hypoglycemia there.

So exciting day! So swamped, no breaks or lunch today. My aide better never leave me ever again! lol

Flare, ASN, BSN

5 Articles; 4,430 Posts

Specializes in school nursing, ortho, trauma.

i guess she won't be so quick to refuse the juice and crackers next time! Be sure that dad knows that it was offered and she refused. She will need to learn how to take better care of herself. sorry to hear you had such a bonkers day!

mc3, ASN, RN

931 Posts

Has 12 years experience.

I had a first grader come down yesterday c/o stomachache. No fever. Strong ketone odor about him; other sx reported by Mom similar to ketoacidosis. Ketones ++. Long story short, he was seen by MD in ER and diagnosed as dehydrated. I feel kind of silly that I alarmed parent, but I'm still glad I did!

Yep, it was one of those days...and a full moon to boot!

mc3 :cat:

RNlove17

168 Posts

we are having SO much fallout today regarding not having health info on kids that other depts (ie counseling lol) are told. Such a crazy day today too! I'm getting so much push back and some administrators don't want the HO to get the info because of "confidentiality" and told me that my health aide is basically too gossipy and they don't want psych info shared by her. Ugh!! I said listen, I don't need to know their counseling session meeting minutes. I'm just asking to know if they're hospitalized, any meds, and a general dx if possible! And not for nothing, address this issue with the employee (health aide) then, instead of withholding needed info from the nurse!

Specializes in School nursing.

OP, I completely understand your frustration! Good communication between the school nurse and counseling department is key! I am so fortunate to have a counselor and student support department that will share things with me, but they can often get swamped and forget to pass on some key information from time to time.

Do you have a health form where parents can share current medications students are on directly with you? Or perhaps can develop a system where the information is passed from counseling directly to you?

loriangel14, RN

6,925 Posts

Specializes in Acute Care, Rehab, Palliative.

Why didn't they just call 911 right off the bat instead of calling you repeatedly?

Flare, ASN, BSN

5 Articles; 4,430 Posts

Specializes in school nursing, ortho, trauma.

i don't think you're asking for the world, it's simple sharing of basic health information. If she's been depressed, having issues with eating and has been hospitalized, as you've stated, and as they should hopefully now see, these are health issues. I'm sure if you knew she hadn't been eating, you would have pushed harder for her to eat, and maybe have done some teaching about low blood sugar and may have avoided the whole mess earlier this week.

But it is a big issue if the admins believe that there is a potential for a breach of confidentiality via your health aide. I think it's got to be addressed if information is leaving your office via her lips. If it's not true then the rumors that she is gossipy need to be extinguished.

DON2084182

21 Posts

My dog sounds smarter then your school staff. LOC in anybody should be an automatic 9-1-1 call by whoever saw it. Why did they insist on calling you over and over ?

coughdrop.2.go, BSN, RN

1 Article; 709 Posts

Specializes in School Nursing, Public Health Nurse. Has 3 years experience.

I agree with everyone else, Why did no one take it upon themselves to either A) call 911 right away or B) Mention the fact there's an unconscious student on the floor! I'm glad my staff know that if sometime like that happens they call 911 then call me. If I was Admin I would get on the butts of the psychologists for not using their brain and getting on the phone for emergency services :banghead: I would have made them wish they were Schrodinger's cat

RNlove17

168 Posts

thank you! I've been thinking I was crazy. i even was questioned the next day on if EMS really needed to be called (they hate causing a scene, well oh well, the kid needed help!!) Nothing like having your nursing judgement underminded though. The district NP is meeting with that asst. principal today. We'll see what happens. I don't think the aide is gossipy but she IS nosey.

Everyone runs around like a chicken with their head cut off whenever a medical emergency is happening, so I'm really not surprised that they didn't call 911 initially, it's just typical.

This students dad came in the next day with the ED encounter. Dx of self harm (for not eating). It listed some meds... a few of which are antiretrovirals. I'm thinking the psychologists know about this and were trying to hide that info from getting out. But again, my treatment of teh student would be totally different if I knew she was having serious issues in her personal life - chronic illness, eating disorder, etc vs just a kid who wants to get out of class, isn't sleeping at night, etc. I was also questioned by the one admin how it would be different if I knew her history (ARE YOU KIDDING ME, have you ever been to the dr? they ask your health hx don't they??) and if she is a frequent flier when do I think a phone call to a parent is warranted (basically saying well I should be calling home more if I'm so concerned).