Help with a head injury

[nursex23]

Has anyone had experience with students having a hard time returning to school after head injuries? I have a student with many absences due to a head injury that happened early 2019. Most of these absences are due to mom keeping him home for headaches and nausea & vomiting. He's missed about 45 days this school year. He has a 504 but all it says in relation to managing his symptoms is for him to put his head down when he has a headache. I've tried talking to mom to get any updates or maybe if we could talk to the doctor about how to better manage his symptoms but she gets very vague about what's going on. I'm working with the social worker on how to proceed but we're both unsure of what else to do. How would you approach this?

[NutmeggeRN, BSN]

Yikes he may be having issues with visual tracking, has he had an eye exam? I have dealt with some significant head injures. Time for a 504 update meeting. You need to get a release to speak to MD so that you, as the nurse can advocate for the child. And you need to rule out the physical cause, and then start to look at the emotional part. Gotta frame it as non accusatory so as not to alienate the parents. He may well need an IEP, or help with tackling a huge workload perception due to the frequent absences. Sometimes you need to let some of the academic stuff go and work on core concepts. What type of student was he prior to the injury?

Keep us posted!

[JenTheSchoolRN, BSN, RN]

I had a student with concussion on a 504, but it was defined from day 1 as a temp 504 to be reassessed in 3 months. Student had sustained two significant concussions within 1 month of each other.

504 plan was placed in March of one school year, did not continue until the next school year. This student's neurologist appointments were not 6 months apart as well. That really seems odd to me in your case, OP.

504 meeting needs to happen ASAP. Is student seeing a Neurologist? For this 504 to continue, you need documentation and I'd ask for recommendations for the doctor for accommodation needs. And if we are talking a true need for the student have modified work vs accommodated work, then yes, an IEP also may be needed. So much here raises a red flag for me.

What state are you in, OP? Even though we work in schools, health care professionals can talk with each other about a patient they are both caring for as necessary for their health and treatment. Now, I ask parents first all the time. I actually make it a question on my health form they they can check off to make my life easier (99% of parents check yes), but this student needs help and you also may need some clarification on what appears to be a previous doctor recommendation.

[SaltineQueen]

9 minutes ago, JenTheSchoolRN said:

Even though we work in schools, health care professionals can talk with each other about a patient they are both caring for as necessary for their health and treatment.

Yup...but most every doctor office I talk to and mention that to, still says they need parental permission. Makes me nuts but I get they're just covering their a$$es.

https://www.hhs.gov/hipaa/for-professionals/faq/517/does-hipaa-allow-a-health-care-provider-to-disclose-information-to-a-school-nurse/index.html