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

bergren · May 5, 2009

Get someone (Walgreens, PTA, hospital auxillary?) to donate hygeine supllies and teach the whole class. Perhaps others can suggest soem hygeine lesson plans. But that is why a home visit helps (do not go alone, I have done some with principals).

Read the story about Daniel Scruggs. Daniel had soiling and hygeine issues. After he committed suicide, they found out Daniel's mom was a "hoarder" and the tub and showers were full of "stuff".

Suicide in a 12 year old

http://www.cbsnews.com/stories/2003/10/28/60II/main580507.shtml

Who failed Daniel Scruggs?

http://www.ctpta.org/legislative/RJ-Scruggs-5-4-2002.pdf

topsyturvy · May 6, 2009

When you make the home visits how do you discuss this with the family? I have found in the past that talking to the student does no good. It may work for a bit but right back to the same habits they are used to at home. I have had parents come to school mad because I spoke with with their child about this issue. Some people are just not as clean as others and I don't think we can change the way they live. When teachers want me to do the dirty work I ask that they help with it also..teach them like they would their own child and tell them straight out. I don't think that it should be left up to the school nurse only to talk to the students...also..I had a teacher yesterday wanted me to talk to her 1st grader or the mom about him smelling and being very dirty..I checked him out and to me he wasn't the most well kept but by far not dirty or smelly. I was shocked!

SchoolNurseBSN · May 6, 2009

That poor child. I say he was let down by everybody in his life. The story bothered me on so many levels. Why did the school not do more? But most of all, why did the parent decide that her child was completely the school's responsiblity and not hers at all?

Have we decided as a society that it is the school's job to raise our children instead of the parents? Sometimes I feel like I advocate until I am blue in the face but the parents never follow up on their end. Then, when something happens - it's the school's fault??

I have a school based health clinic in the parking lot of my school. I have sent my psychologist out to do home visits to get a parent signature for counseling because I cannot reach the parent. I have made arrangements to walk said student to the clinic during school hours. What happens? They don't sign or student is absent on day of appointment.

I have student's who have self disclosed drug use. I have spent hours setting up a place for them to get help. They don't show, don't answer their phone, then the kid show s up back at school a week or 2 later. Then, maybe you do a CPS report and set up counseling through school. I start keeping a close eye on the student, keep talking to the parent (try to remove hurdles - try to understand why the parent is acting the way they act, etc). But, if they kid dies of a drug overdose - mom is on TV spouting how the school did nothing!!

bergren · May 6, 2009

To be honest, if it gets to the point of a home visit, the approach is going to be individualized based on what you find. Much of the point of making the home visit is to get a better handle on the dynamics and to do a more thorough assessment. Ask the paprents's perception of the issue? Do they have a working washer and dryer? Does the mother have 2 jobs and the father 3, and the children are being careed for by the 93 year old great grandmother or the 10 year old sibling.

If the nurse and principal or social worker had conducted a home visit on Daniel Scruggs, they would have instantly known that the mother had a mental health issue, and no instruction, free soap, whatever, would address the problem, because the problem was not knowledge or supplies.

SchoolNurseBSN · May 6, 2009

To be honest, if it gets to the point of a home visit, the approach is going to be individualized based on what you find. Much of the point of making the home visit is to get a better handle on the dynamics and to do a more thorough assessment. Ask the paprents's perception of the issue? Do they have a working washer and dryer? Does the mother have 2 jobs and the father 3, and the children are being careed for by the 93 year old great grandmother or the 10 year old sibling.
If the nurse and principal or social worker had conducted a home visit on Daniel Scruggs, they would have instantly known that the mother had a mental health issue, and no instruction, free soap, whatever, would address the problem, because the problem was not knowledge or supplies.

I agree. My Psychologist tries to get an overall picture of the home life and we work together to try to figure out how to proceed. In the case o Daniel Scruggs - I think one look at the household would warrant a referral to Child Protective Services. Now, say CPS did their investigation and found the family did not require any services because mom was just a bad housekeeper. What else could the school have done? I would never ever want to give up on any child. But, I have no authority to overstep CPS or the police.

bergren · May 9, 2009

I am catching up on my journals on this cloudy Saturday, and the April 2009 issue of the Journal of School Nursing has an article on dysfunctional elimination behaviors.

Kistner, M. (2009). Dysfunctional elimination behaviors in associated complications in school-age children, Journal of School Nursing, 25, 108 - 116.