How to talk to parents..

halohg, RN · Feb 4, 2020

I do not call for every visit. I obviously call for immediate exclusion reasons, and will be rather direct. “ Hello Mrs. X I have little Johnny down here with me he’s complaining of having a sore throat and when I took his temperature it was at 102 ...I know shocking right?” I’ll be a bit Conversational...”so has anyone else been sick in the family or was he ill this morning before coming to school? OK I’ll get him all packed up and ready to be picked up, will it be you or somebody else picking him up?“ for an injury to the face I always do not want to cause alarm so i would say “Hello this is Alex I have a little Johnny down here with me he took a little tumble on the playground and bumped his head now the only reason why I’m calling you is because he does have a slight scratch above his left eye and there’s a little bit of swelling in the area so I do believe when he comes home on the bus that he’s going to have a little remaining Mark there and there may be some residual swelling and maybe even a bruise but everything on the inside looks perfectly good his eyes look great his you know he’s not complaining of any kind of head injury and I’m not concerned at all that there something going on like a concussion the only reason why I’m calling you is because he’s going to come home looking a little differently than the way you sent him this morning.” For an injury requiring follow up... I’ll say most of the above and “ Hello Mrs. acts I have little Johnny down here with me in the health office he bumped heads with another student and actually bit down on his lip and he had a good amount of bleeding about 15 minutes ago but it’s all under control now we put some ice on it and I was able to inspect the area he does have a small little slit in the bottom lip and I do believe that it’s going to need some medical follow up so are you in the area and can you come by and kind of take a look at it and we can determine from there as to what we need to do.“ I also always start with everything is okay, even if it is not. I might recommend for illnesses follow up with a medical practitioner depending on the situation, but not for all situations. But again I do not call for every visit and certainly not if the student was sent by the teacher or if it’s there first visit with light symptoms.

JenTheSchoolRN, BSN, RN · Feb 4, 2020

@halohg said it well above for me.

I work with MS/HS students. My calls home are for they are needed (with a few exceptions for a list of parents I have to call for every little thing - we all have that list): going home due to exclusion-type symptoms or significant injury that needs more immediate care, FYI about injury that is minor but leaves a mark, head injury even if minor, something to FYI about that does mean dismissal but might need monitoring/doctor follow-up.

I also do what I call "check in" calls and I call them that with students. These are for the students that keep visiting and I find no significant medical reason, so I call home as FYI for parent, ask parent how they have been at home, basically open up line of communication with parent. These calls always start: "I don't have any medical reason for your child to not remain at school today, but I wanted to check in and let you know about their day since they have visited me xx times."

tining, BSN, RN · Feb 4, 2020

I do suggest things like for a jammed or strained finger - If that swelling does not go away I would get it checked out. Always call for facial wounds. I give heads up if there is an issue with braces so parent can make an appointment. Bug bites bigger than a quarter with redness and swelling, I'll say - topical doesn't really get to that, you might have to go with something by mouth. I am big for saying "I don't see _____ at this time" As we know things might look different after a few hours.

BrisketRN, BSN, RN · Feb 4, 2020

I call for injuries that leave marks. I try to use words like "collided" "fell" "ran into" for accidental injuries. Parents get less worked up by "Johnny and a friend collided at recess" than "Johnny was hit in the head at recess." When I call I'll say "Hello Mr./Mrs.____, everything is fine, but I just had _____ in my office with an injury from recess." If it is an injury related to bullying/fighting then I have the teachers handle it and they'll transfer the call to me if the parent has questions about the injury.

For illness I am direct "Katie has a fever of 101F. She'll need to be picked up." "Donna vomited. She'll need to be picked up." "Tommy had diarrhea in his pants and will need to be picked up." If they want to know more they'll ask.

k1p1ssk, BSN, RN · Feb 4, 2020

Always stick with facts, and I don't use "baby talk" but I don't use clinical terms either. "Hi this is Nurse Belinda from Arlo Elementary; Not an emergency (unless it is), but Aretha has been complaining of a headache and stomach ache and has a fever, so she needs to be picked up early. Will you or someone else be able to come relatively soon?" or "...Aretha hit her head on the play structure at recess just now, and she is doing ok; She has no signs of concussion, but she does have good sized egg on her forehead. I'm going to continue to monitor her and have her ice it for the next 15-30minutes and let her teacher know what to look out for, and I will call you ASAP if anything changes. If you would feel more comfortable picking her up and monitoring her yourself/take her for evaluation with her pediatrician, you are more than welcome to do so."

tining, BSN, RN · Feb 4, 2020

You could write out a script for the most common things you call for. It will then become routine. If you have to call for something new, write down your thoughts and the most important things to get across.

It will soon become second nature and not so awkward (I remember being awkward as well).

ruby_jane, BSN, RN · Feb 4, 2020

And always recommend that the student be assessed by their PCP (barring the obvious little stuff.)

"I'm calling today out of an overabundance of caution. If it was my kid, this is something I'd want to know. If s/he (insert potential symptoms here) then it's more serious than I think it is and you should speak with his/her doctor."

Nursesusu · Feb 6, 2020

On 2/4/2020 at 9:28 AM, BiscuitRN said:
I call for injuries that leave marks. I try to use words like "collided" "fell" "ran into" for accidental injuries. Parents get less worked up by "Johnny and a friend collided at recess" than "Johnny was hit in the head at recess." When I call I'll say "Hello Mr./Mrs.____, everything is fine, but I just had _____ in my office with an injury from recess." If it is an injury related to bullying/fighting then I have the teachers handle it and they'll transfer the call to me if the parent has questions about the injury.
For illness I am direct "Katie has a fever of 101F. She'll need to be picked up." "Donna vomited. She'll need to be picked up." "Tommy had diarrhea in his pants and will need to be picked up." If they want to know more they'll ask.

This! (I do the same thing)

jnemartin, BSN, RN · Feb 7, 2020

I've learned to ask kids about vomiting vs regurgitation vs spit up (eg "when you threw up, was it clear and frothy or did it look like breakfast," etc). So I will make this distinction with parents: "John said he vomited in the bathroom, but described it as more of a dry heave with some spit up, since he did not eat any breakfast." If I told every parent that their kid "vomited" (because all the kids simply say "I threw up"), it would freak the parents out, often unnecessarily.

For injuries that I do not suspect fracture, I say "John stubbed his toe/shut locker on finger etc. He has full range of motion with a little pain but no swelling or OBVIOUS DEFORMITY that would let me know it's broken" (I love the term "obvious deformity" lol).

If a kid feels sick but doesn't have a fever or obvious s/s, I'll often just call the parents anyways (because otherwise the kid may just call from their phone and arrange their own pick up/make it sound worse than it really is). I'll say: "John is not feeling well and has a HA and general aches. No fever, vomiting or anything that would require me to send him home, but he'd like to go home. It's your call." It's about 50/50 if the parents will come or tell them to stick it out. I used to be a little indignant about parents who wanted to pick up their healthy, faker kids... but now I'm like whatever... it's their call.

jnemartin, BSN, RN · Feb 7, 2020

And I always greet like this: "Hi, Carol, It's Jackie, the nurse over at [School]. NO EMERGENCY, but I'm here with John." And then I let them know my assessment.