Illinois School Nurses...I need your help!!!

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I have a student in 5th grade who repetedly urinates in his pants and then remains in it for the rest of the day. He will not tell anyone he has urinated and he will not go change his clothes on his own. Administration and I have worked with him and his mom for a couple years now trying different accomodations. Is there any Illinois law saying that this child HAS to change his clothes after he has urinated in his pants? Mom is telling us that his doctor says he should not be made to change clothes because of the social imbarrasment of the situation. I can't help but think it is law that this child cannot go around in soiled clothing risking the other children to come into contact with it??? Pleas help!!:bugeyes:

Consider canceling the meeting if the school psychologist cannot attend. What if the plan the team designs does not meet the standard of practice for behavioral plans?

Expect success. You can have a successful outcome tomorrow. Expect it. As long as everyone can sound sympathetic and non judgmental, and and you are offering help as opposed to discipline, you should be successful. Don't focus on the agreements she has renegged on. If people on the team are so upset they cannot bring themselves to sound sympathetic and appeasing, tell them to be quiet.

You do not need a plan for if she does not agree. See how the meeting goes and if no consensus is reached whoever is in charge of the meeting can state that the current state of affairs is not acceptable and that the district will be getting in touch with mom regarding what will result.

I would not utter any ultimatuums / consequences without the input of the district's legal counsel. Avoid a 504 hearing with OCR. Even if the school is vindicated, they are very costly.

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Specializes in School, Hospice, Triage.

I am on the Student Assistant Team here in my very inner-city school. We never have a 504 without the psych or social worker. Most importantly- he may not qualify for a 504. You don't want to make one unless he neets it!! We often start with a behavior plan. Your psychologist or social worker along with your administrator evaluate that need. You are vital in that decision as well. This is a health issue, that is you! If mom won't agree then you need to seek advice from your district. The issue stays the same even with a behavior plan or a 504. He can't stay in soiled clothing. You call mom and send him home or have her change his clothes if he won't change himself. It's really quite simple. No ultimatum. This happens and this is the consequence. I wouldn't let a child stay here during an asthma attack without an inhaler. Skin breakdown and hygiene are huge parts of the Nursing Process. You have all the knowlege you need! Again, let us know.

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Specializes in school nursing.

I agree with bergren. Do not have the meeting without the psychologist. He / she is crucial in this process. Also, remember- you are crucial too because you are the health expert in the building. Be empathetic. knowledgeable, and professional. Give mom some choices (within reason - of course).

Involve the student at this meeting!!!!!! How does the child feel about the situation?

I would start the meeting with " Mom, what can WE do to help ____________be successful and comfortable while here at school." Then, listen quietly while mom gets everythng off her chest (even if she is upset and yelling) and then move forward. Sometimes, parents will have a complete change in attitude if they know they are being heard.

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You all have been so helpful. I really don't know what I would have done without your excellent advice. I am so completely greatful!

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I just saw the comment above about recording the meeting. Illinois does allow recording, but mom will be allowed to request a copy. IL also allows mom to record the meeting.

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Specializes in School, ICU, CCU, ED, Burn, Tele, Trauma.

Also, Does your district have ahealth coordinator who is in charge of all the nurses in the district or someone who overasees the nurses in the district??? If so this person can be a valuable resource with district policy and procedure...ask them to sttend the meeting...If not, you have ll of us here online and we are always glad to help!! The school is lucky to finally have a caring nurse onboard and although it may not always be easy, you are making apositive impact on the lives of many children, whether you see them in your office or not! Good luck today!!:prdnrs:

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Unfortunately I am the one and only here! Our school is a Pre-K through 12 grade. All in one building! We run around 750-800 students. A very small community, but nice. That is also a setback. There was not a knowlegable nurse before me and I am trying to pick up many pieces here. This is my 3rd year here and I soak up everything I can about policys, guidlines, etc. from anyone I can. This school being so small is used to running things without any nursing help so I'm trying to make my way into the school system where I can be a useful resource!

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Are you Illinois certified? If not, when this storm has passed, think about that. All of that we discussed here and more is part of the Master's level scchool nurse certification curriculum.

  • UIC has an online certification program.
  • National Louis University has a mixed online f2f
  • SIU has a f2f program.

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I am not. I have been interested in doing so, however it is costly and my district will not pay for it. I've asked. Plus there is no incentive for me doing so, no pay raise etc. I've done quite a bit of research on getting certified but I'm confused what f2f means? The online program would be wonderful as extremely busy as I am. I wish the school would put a value on it. I know it would be helpful. I just don't get paid enough to pay for it myself.

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f2f = face to face

I would not encourage that you do it for the money. I would encourage that you do it to enhance understanding of the federal and state laws and school nursing standards of practice.

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Ok, So here is an update since the meeting friday afternoon. Mom seemed to be in agreement with our request (as she has been in the past when we've meet with here face to face and then changed her mind afterward...). We also had the NP that handles our student's medical issues. We started off saying that we understood his medical condition and we were willing to do anything possible to keep him in school in a healthy enviroment for everyone. That temporarily, while the doctors are still trying to line him out, our school would require a pull up for everyone's protection. The NP and mom agree'd that was a logical and reasonable request. I questioned the NP about Hershprungs, which I had never heard of before until Bergren suggested it. The NP said they never considered that since she was only aware of his urinary issues, although mother said he has had bowel incontenance since birth several times a week as well. So she suggested a doctor referal to a gastroenterologist as well. I can't help but to be a little aggrivated with the medical proffesionals to not try to rule all possible physical problems first. So we made a "behaivor plan" for everyone to follow. Kind of like we expect this, if it doesn't happen then we will go here, and so on. So for now we are requiring a pull up. If he does well for a week then the next week no pull up, if he has a problem then we'll go back to a pull up for a week and try again.

So, the big kicker, here it is Monday morning, mother promised he would be here with a pull up on and guess what....no student! Sigh.......:bugeyes:

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I am so glad it went well!!

Thanks so much for letting us know. Keep us in the loop - we are interested.

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