I need your help!!

[Amg563]

Hello everyone!! I am in desperate need of help. I am a school nurse at an elementary school for grades 2nd and 3rd. We have roughly 475 kiddos. I have been doing this job for 8 months and still learning everyday. I do love it!

I need suggestions/advice/opinions on chronic toileting problems with 3 students. Only one has medical documentation from 2013 for encopresis, and the parents/child were terminated by the ped office due to excessive no shows and non-compliance. The other 2 have no medical documentation. They are all 3 SPED, but not full time.

I know this is said often, and I have tried researching and reading previous threads.

What do I do?? I have a very limited amount of clothing, before I arrived in this position the previous nurse would wash the chronic children's clothes and make them return at the end of the day to change back into their clothes. We have a huge issue with parents not returning the clothing. It is a lower income area.

I call the parents to inform them of their child's accident, they refuse to bring in extra set of clothes, wipes or they have disconnected phone numbers, do not answer, no voice-mail set up, the list goes on...

It is not that I mind doing the laundry, I just feel like there is an underlying problem as this is NOT normal at this age. We are talking 1-2 accidents a day. I don't want to enable this behavior of the parents, but do not want the child to sit in soiled clothes all day. I am worried about the children. As a medical professional, I feel this is not of the norm and I question how sanitary it is to wash multiple children's soiled clothes in 1 washer/dryer. Are there any articles regarding this?

I wanted to try and write up an expectation of our school, the nurse, the parents and the students and eventually try to enforce it as policy, does anyone else have any policies regarding this?

What do YOU guys do with chronic children and families that will not help and basically leaves you with your hands tied.

I feel too busy with caring for the other 472 kids to monitor and remember to wash/turn over or fold their clothes. I hope I am not sounding shallow, I am just ultimately concerned that we are enabling and looking over a possible medical condition. I want to advocate for these children and do the best I can for them.

Thank you so much for reading and helping!

[Wave Watcher]

Call DCS? Physical/Medical neglect maybe? If they won't show up for a physician they won't show up for you. Looks like you are going to have your hands full this year. Maybe get your VP or P to call parents and set the record straight on what they WILL be required to do. #1 is keep a working phone number or at least a # that someone else can reach them. If we have an issue and a parent is non-compliant and we can't reach them due to number being disconnected....we send the police out for a well check. Most of the times that solves the issue real quick and we don't have much of a problem reaching them anymore.

[Amg563]

Thank you!

[OldDude]

Yes you are enabling those parents......do what WaveWatcher suggests...and stop washing clothes.

[Amg563]

Thank you, OldDude!

[GmaPearl BSN RN]

Yes! Call Child Protective Services!!! This is definitely neglect. Poor kids. Make sure the ones on an IEP have parent expectations written in. The encopretic kid as you know will never kick it until parents have 100 % bought in and consistent with the treatment program. The only thing you should be doing is providing a place for toilet sitting after the child eats lunch. But no laundry… never laundry! Sorry if I sound harsh, but seriously….

[ohiobobcat]

I am avidly reading these responses because I know of an 8th grader with these same issues who will be starting in my high school next year.

[CalNevaMimi, LPN, LVN]

Parents either provide clothing or pick-up the child...or it's reported, period. In order for the situation to improve, there needs to be a consequence for the parent(s). Informing the parent over the phone or on VM that CPS will be called if this becomes a problem most likely will result in quick action from the parent. Otherwise, it gets taken to the next level. There is no way I would be taking home soiled clothing!