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

cowgirlBSN · Apr 20, 2009

Well, we spoke with the mother after the child did not show up this morning for school. He refused to wear a pull up today. They now wish for him to recieve home bound services. I really don't know what it will take to get this student encouraged to participate in his own well being. It has to be within him to fix his situation. We can all tell him what needs to be done but if he will not cooperate I'm afraid to find out how long he will go on like this. His mom seems to give in to his direction.

SchoolNurseBSN · Apr 20, 2009

Oh goodness..... it seems like you are back to square one. I guess you are going to have to at least pursue the homebound route! Let the mom know that she has to get a physician to sign off on it. I know that in my district - homebound services for this case would probably not be approved ( I am not in Illinois). Keep us posted!

cowgirlBSN · Apr 20, 2009

Right now mom is asking for homework only. She doesn't want a home bound teacher in their house. I'm not sure how they will work all that out. That's totally above me and I'm glad for it!

bergren · Apr 20, 2009

Did the school psychologist ever get involved? If you give into home bound now, not sure you will ever get him back. Perhaps they would agree to another plan. Sorry this did not pan out.

SchoolNurseBSN · Apr 20, 2009

Right now mom is asking for homework only. She doesn't want a home bound teacher in their house. I'm not sure how they will work all that out. That's totally above me and I'm glad for it!

Hmmmmmm........she does not want a homebound teacher in her house? Sounds weird if you ask me. What did the psychologist have to say in the meeting?

cowgirlBSN · Apr 20, 2009

We contacted our psychologist and she was willing to meet with him however, mother refused, of course. She said her son would not talk to her when he won't talk to anyone else who has tried. We tried to explain that perhaps the pshychologist may be able to speak with him where others have failed. That is was their expertise, but she wasn't up for it.

Purple_Scrubs, BSN, RN · Apr 20, 2009

I would think the only option left is to allow the student to miss so much school that they are pursued for truancy. This parent does not seem to want to do any of the reasonable options that have been recommended. A CPS referral might not be a bad idea either.

topsyturvy · May 5, 2009

I have a 196 lb 3rd grader that poops his pants frequently. His mom allows him to wear a diaper. Sometimes it doesn't just have poop in it..it is soaked with urine also. I think the diaper at this age is such a bad idea. I think it promotes laziness especially in this case. Another thing that bothers me about his situation is that it doesn't seem to bother him at all. He often gets sent in by the teachers to clean up because the smell is so awful! He has been to the Dr but I don't think the mom is consistant with the treatment plan. His wt is another issue..how do we discuss this with the parent without stepping on toes. The mom is a huge lady also. I really feel that with a healthy diet and some good parenting at home he could over come this but what do you do?

His mom let him come to school one day with a t-shirt on that said " THIS IS HOW I ROLL" with a picture of a roll of toilet tissue on it! OMG! I think we are fighting a losing battle!

bergren · May 5, 2009

Have you phoned the physician? Done a home visit? Involved the social worker? Is he on a toileting schedule? Has be been evaluated for a delay? What steps have been taken already?

topsyturvy · May 5, 2009

I have not spoke with the physician. Around here if mom doesn't sign a release the Dr. will not discuss his situation with me. I asked mom to do that and she never did. A home visit..no. I do know that there is a older sister in the house with special needs who also wears a diaper. Social worker..we don't have a councilor or a social worker. We have had him on a toileting schedule off an on since kg. When he starts doing better we give him more freedom only for him to return. I have asked for documentation from his dr and never received it. I turned it over to the principal and he called and requested it also...no documentation...

bergren · May 5, 2009

If you have no counselor or social worker in the entire district. I then would get the school pscychologist involved. Has she / he ever been consulted for this child?

I have worked in districts that will not provide treament / services (diapering, toileting) without being able to have a plan that involves a primary care provider's input. That would require a signed release.

Just based on that fact that he is not continent, which indicates a developmental delay, if it was me, I would suggest a full special ed evaluation which would also require a release to speak to the physican for the health history.

I also have worked in a hospital that did call CPS for a child as obese as you are describing. Despite it being a city with horrific child abuse, we were pleased that they took it VERY seriously.

Keep us informed.

topsyturvy · May 5, 2009

We are a small country school. We have a councilor on the high school campus 6 miles away but she doesn't work cases on my campus. Our councilor quit 5 years ago and they never replaced her. Thanks for your suggestions. I will continue to work at this. The obesity is a problem in this family. The mom is approx: 300 lbs..the older sister is very over wt also. How do you handle students that are sent to you with hygiene problems?