i'm a float rn, right now filling in at a middle school clinic. it's a very hectic clinic, 6th,7th, 8th graders coming in for all sorts of real and not so real complaints. a boy came in and complained of stomach pain, 'something moving in there', which was atypical of course, so i chalked it up to gas pains and explained that since he had just come from lunch that was probably the cause (after the regular assessment). no, he said, his lunch was taken away, so he had not eaten anything. his affect was grim, depressed, serious. of course i probed about the lunch being taken, and tears spilled from his eyes as he shrugged and said, 'someone took it'. he didn't offer much. he just acted like it wasn't worth explaining. it was like pulling teeth to get information. we walked toward guidance and he was reluctant, saying he didn't want to go. he slumped, literally to the floor. he answered my questions, admitting being bullied but teachers not doing anything, even a dean not doing anything, and the bullying having gotten worse after they found out. he was terrified about being a 'snitch'. he cried and felt the situation was hopeless, he said he was 'just so tired'.
i called his grandmother, with whom he and his mother live (his dad died). his grandmother said that they knew about bullying earlier, that kids had thrown blue kool aid in his face and he had problems on the bus, but that lately he denied any bullying and when they asked him at home he had told them it was all taken care of. this clearly wasn't true. she wondered why he would say that if he was still having problems. i voiced my concerns that he may feel hopeless, that he didn't feel any way of improving the situation and he did not want to go to guidance, or even really tell me what was happening. i told her i was concerned for his psychological safety. (i didn't tell her that last month an eighth grader committed suicide).
i asked her to pick him up instead of ride the bus today and i would keep him the clinic until then due to his state of being so upset.
i bought him pb crackers and let him rest on the cot. going to check on him he pointed to a sort of spot on the wall and said it looked like a person and defined the nose , etc. didn't think too much of that even though i couldnt see what he was talking about, but then he admitted that he sometimes heard voices. (grandmother said this happened once before when he was younger) he didn't want to talk about it, but all he would say was they were mad and yelling but he couldn't understand what they were saying. psychotic break?
school let out, i walked him to find his grandma's car in the car line.
talked to my supervisor, she's aware. apparently he was bullied before, it led to a fight, and the bully and he were suspended, so the dean is aware of the problem.
he seems hopeless. and why wouldn't he? and i have a bad feeling.
Go to administration first thing this morning and arrange a meeting with them, the parents of the boy, the parents of the bullies, and a social worker. Try and get everything out on the table. This child needs to be protected. I wouldn't be against getting the police involved either. If they are committing criminal acts against them they need to be arrested. The victim's parents bringing a lawyer isn't a bad idea either. The child has the right to go to school in a safe environment. This child cannot be left in this situation without help.
Pulling him out and home schooling in the interim isn't a bad idea either. It's a shame that the victim has to be removed versus the bully but it could be a wise move until this is dealt with. He's crying out for help and he seems to have finally found someone concerned enough to deal with it.
Point out one child already died. Do they want a second one?
Specializes in Peds/outpatient FP,derm,allergy/private duty.
Hel l no you are not over-reacting! And, it seems as though it may be bullying, or something unusual enough to you about his behavior that indicated possible psychosis?
Do you know anything more about his academic performance or talked with any of his teachers? The reason I asked is because I went through a situation with my son- he was having difficulties in several areas, and it's hard to separate emotional/social physical problems, learning disabilities or any or all of the above.
They finally convinced me to do a multi-disciplinary evaluation called the SST, and the group includes parents, teachers and the school psychologist. While a Special Ed referral usually causes people to think of delay, it also includes evaluations to uncover the problems he may be having that underpin everything else.
Alot of people freak out at the mention of this, but schools are bureaucracies-they have very strict guidelines in place outlining the process, the rights of everyone involved. When my son was evaluated they had a boatload of different specialists examine him, the cost of which I never could have handled.
Anyway, this may or may not help in this situation, but since this was my experience, thought I'd share. Best wishes. You are very awesome. :)
Here is a link to the procedure they go through. It's pretty general. Your state may differ.
You are not a mandated reporter to CPS on parental neglect regarding bullying. You don't actually know that nothing is being done--from the kid's perspective, nothing has been done--but if he's not reporting it to the proper authorities (ie teachers, principal, guidance counselor, family) and they are unaware of it, there is no neglect. Action may have been taken, but if the bullied kid doesn't provide any feedback as to whether it was helpful or not, how are is the staff supposed to be aware of any issue? At the middle and high school, the kids have a lot more unobserved time, and because of the nature of the middle school organization, teachers and administrators don't sit together at lunch, with time to talk about what is going on with certain students in their classrooms. If they don't witness a pattern of abuse, or it isn't reported to them, how are they supposed to know to take action?
OP, I disagree with you on this : *The last thing I want is to push him into doing something that is going to put him at risk and make him feel like he is powerless to make decisions after he confided in me.*
I think the last thing you want is to read his obituary in the paper. You MUST tell the guidance counselor and principal. You aren't there all the time to develop any kind of therapeutic relationship with the kid, and therefore you can't help manage and monitor his care. You NEED to turn this over to people who can. You must convey to them the seriousness of his mental health issues, reminding them of the fact that initial suicides in that age group can also trigger copy-cat suicide/suicide attempts.
Thank to all. This is a big, nerve-wracking day for me. I appreciate all your viewpoints, I have read each one and taken all into consideration seriously. I hope my actions today will have a good outcome. I will try to get admin's side of the story, as one poster pointed out, to see what, if anything, they have done. The only other thing I can think to to is encourage a school wide assembly on bullying (so as not to individualize this particular victim) with a school resource officer and let these bullies know that they will get legal charges against them if they commit these acts. After all, as I understand it, kool aid in the face is battery. Maybe we can get a school resource officer out to talk about what juvenile detention is like.
I've heard of a situation similar to this where the School Nurse had to go to the School Board before any action was taken. I think you have a duty to keep advocating for this child or to find someone else (CPS) to if you're unable.
OK, it seems to me that a point is being missed. This kid is hearing voices, seeing things, and feels like "something is moving around" inside of him. That alarm bell is much bigger in my head than the bullying. He needs psychiatric help ASAP!
Is the bullying a problem? Absolutely!!! And it must be dealt with. But I think the fact that he seems to be having a psychotic break is more important.
He needs to be evaluated by a psychiatrist/psychologist NOW.
Someone asked how/why bullying is allowed to happen at school. There are a lot of factors. First of all (and the biggest problem, I think) is the prevalent belief that kids will be kids and bullying is just a part of life. It is an attitude that is widespread among school personnel and often among the parents of the bullies. They downplay the actions of their children as just 'kids being kids'. The victim becomes the problem for not being able to 'handle' it. SOOOO wrong. However, it is a societal issue as well. How many adults are bullied in the workplace and expected to 'take' it?
Parents of the bullies sometimes encourage their kids, as is the case with gang banger parents. They want their kids to be tough to take their place in the gangs as they age. Or some parents see their kids' behavior not as bullying, but as 'playing'. Many bullies come from backgrounds where their parents are well-educated and perhaps prominent members of the community. Add these attitudes into the mix and it becomes nearly impossible to stop bullying in the schools. If we could convince the staff and principals that bullying is harmful and wrong, a lot more could be done.
OK, it seems to me that a point is being missed. This kid is hearing voices, seeing things, and feels like "something is moving around" inside of him. That alarm bell is much bigger in my head than the bullying. He needs psychiatric help ASAP!
Is the bullying a problem? Absolutely!!! And it must be dealt with. But I think the fact that he seems to be having a psychotic break is more important.
Agreed. There's an assumption that the bullying is what triggered the psychosis, but there's also a chance that this boy is being picked on because he's displaying the symptoms of a mental illness.
Kids are merciless and pounce on anyone who is different -- visual and auditory hallucinations, talk of things moving inside of him, etc. would make him a natural target. Once the bullying started, it would feed the psychotic behaviors, which in turn would spawn more bullying.
Getting this young man a psych evaluation is critical.
I work with situations like this all of the time (I work for a pediatric psych hospital, formerly as the nursing supervisor)...
Don't be too quick to pin the kid as psychotic - meds don't help situations that are due to external factors. I hate seeing kids on stimulants or antipsychotics because their family is ****** up, or due to bullying. Stress manifests itself in all sorts of ways, and none of these symptoms sound remotely psychotic.
1. For now, the kid should be removed from the situation. Cyber schooling can be a GREAT option if the family can swing it - if both parents work, it might not be.
2. Don't count on the school to do anything. What can they do? If they intervene, the bullying will get worse. Ending bullying requires a cultural shift, not an intervention.
3. Does the patient have any clear strengths? Middle school is a war zone - no one enjoys it. Finding one's niche can make the transition much better. Putting him in touch with the gifted program, or with the drawing club, or anything where he can feel safe would be a huge help.
4. Does he have any obvious anti-social behaviors? Some kids, frankly, have a bullseye tattooed on their forehead. Aspergers kids deal with this all the time. Doesn't make it right, but it explains a lot. By working on those behaviors (usually in a structured, therapeutic setting), the situation may resolve.
You're right to get involved -don't abandon the kid. Having a teacher (or even the school nurse) who has a genuine expressed interest in one's life and one's goals is SUCH a huge influence!
i spoke with the principle and the secretary (i know the secretary does not have alot of power but i wanted a witness to the conversation). the child is spot on - the priciple barely listened. i mean - from across the room while she was doing paperwork. when i started saying things like i had serious concerns about psychological stability, she walked over to me, i think mainly because the secretary was there. i explained his fears of getting beaten up if he went to guidance and she shrugged her shoulders and said "yea that's common". i asked about the school resource officer, and she said he was only there two days a week and 'he is not going to get involved unless there are arrests or something, and that's not likely'. i told her all about the lunch getting stolen, him breaking down, slumping straight to the floor, the fear, the voices in his head, and she said, 'well he just has to go to guidance, cause that's the only way to help'. i explained how hopeless he was that the school would help because he was punished via suspension when he was bullied and fought back. finally, she asked his name. then she ended the conversation. she did not look pleased.
oh, and one more thing, the child who committed suicide last month? well, i happen to kjnow it was a suicide because one of our staff spoke with the mother when she called to say that her son was not coming back to school. and i mentioned it as a suicide and asked my supervisors how to deal with children if they came in asking about their classmate committing suicide. so today when children came to the clinic, off and on i asked them if they knew the boy, just trying to find out if he had been bullied too. i didn't find that out, but what i did find out was that the school told everyone he "died in his sleep", not suicide.
I've been thinking of you and the student all day long. The principal is a moron. She wants to ignore the issue and pray the police aren't called because she doesn't want to deal with any of this. I fear that other little boy commit suicide because of a bully as they pulled him from school. He might have been too afraid to go back. Children aren't stupid. They know little boys and girls that are healthy don't just go die in their sleep.
Can you call his mother? I would urge her to go back to the school with a lawyer. The principal will like this even less than the police. And I would tell the mother to press charges on the bully. Their behavior IS criminal and it needs to stop.
You are a wonderful nurse. I know you must feel so helpless here which is all the sadder because you are an educated adult and the child has no power in this situation.
Batman25
686 Posts
Go to administration first thing this morning and arrange a meeting with them, the parents of the boy, the parents of the bullies, and a social worker. Try and get everything out on the table. This child needs to be protected. I wouldn't be against getting the police involved either. If they are committing criminal acts against them they need to be arrested. The victim's parents bringing a lawyer isn't a bad idea either. The child has the right to go to school in a safe environment. This child cannot be left in this situation without help.
Pulling him out and home schooling in the interim isn't a bad idea either. It's a shame that the victim has to be removed versus the bully but it could be a wise move until this is dealt with. He's crying out for help and he seems to have finally found someone concerned enough to deal with it.
Point out one child already died. Do they want a second one?