I was approached by one of the HS assistant principals regarding a 12th grader who they think looks like she might be pregnant. Thie issue is that they want me to meet with the student and inquire about if she is pregnant or not ( in the manner that the teachers noticed changes and are concerned ). I happen to like this asst. Prinicipal very much but I think it is a little intrusive of the student's privacy especially since she is a senior and is graduating in less than 2 months. Even if the student is pregnant I think it is a violation of HIPPA and FERPA which doesn't require me to share this information with anyone else in the school. I don't see how this student being pregnant is pertinent to the remainder of her senior year.
What are your thoughts?
PS There is already a pregnant 11th grader who is openly pregnant in the school. Also I'm a very experienced nurse in Labor and Delivery.
Yes. And the adult is a student consenting to sex, according to that. So, a 13 year old who has sex, her mom doesn't need to be told? And then what is the school's responsibility toward her, wait until her water breaks and hope for the best?
I'm not being flip, I'm really not. My tone here is not combative, or at least I don't mean it to be.
I worked in a clinic and it was pretty cut and dry. I'm just trying to figure out if that changes in responsibility to a "student" as opposed to a "patient".
It's a good point, but honestly at that point I think I'd be calling CPS before the parents, depending on what the student says. (And again, I'm in elementary, so I have no experience dealing with this - just what my gut says.) As terrible as it is, there are parents out there who abuse their children, and if the student is that young then a CPS visit might be a good thing?
Or maybe a phone call to home saying "your student has been presenting with vague upset stomach complaints, there is XYZ going around the building, she doesn't need to go home at this time but you might want to call her doctor for an appointment to double check she doesn't have a virus."
Really here's what it boils down to for me:
And then what is the school's responsibility toward her(...)?
Sometimes I feel like discussions about teenagers turn into "what is the responsibility toward the parent" instead of toward the teen. (Not saying this one has!) They're tied together, but the teen is the priority. If she's old enough to make those choices, we shouldn't be going behind her back to inform her parents. If she's NOT old enough to make those choices, we should be protecting her, even if we're protecting her from her parents. And where's the magic line between old enough and not old enough?
This is also making me think about pregnant autistic women, and the difficulties they face in being considered competent. But that is way off subject, I've just had this window open 30 minutes (lots of walk ins!) and my brain is firing all over the place.
The other aspect of responsibility, is that we are NOT primary health care offices (although I have heard of some high schools doing that). So is it just our responsibility to refer the student out to their PCP? Like a student with mostly well-controlled asthma, whose parents refuse to bring in any inhalers -- it's potentially life threatening, but we can't take her to the MD ourselves, all we can do is request and refer, unless/until an emergency happens. If a student is pregnant and healthy, does it benefit her for us to interfere?
I also am not trying to be combative, I'm kind of thinking "on the keys" (instead of "out loud" lol). I think I'm going to bring this up with the other nurses in my district and see where their thoughts lie. It's an interesting question.
Yes, kids hide "things," but the "thing" is this case is pregnancy and as I said, it's fairly difficult to hide a pregnant belly for most girls/women. Though sure, we hear cases of teen girls that hid the pregnancy and gave birth in the bathroom at prom, but I seriously have to question what was going on in the home to the point that the parent(s) didn't notice any changes(physical or otherwise) in their child?
Surely, as adults we can hold more than one topic of discussion in our span of attention, right?
I have to wonder exactly how OP broached the subject with the student? I agree that the school counselor would've been a better choice to ask. Also, had the child actually been pregnant, who is to say that the parent wasn't aware? I'm throwing out hypotheticals, obviously.
I was actually thinking of the Prom story...
Yes, and if the child and parent are both aware, shouldn't tell tell the school? They should, but they don't tell us a lot of things. I find out most of my med changes for the special ed kids from the kids themselves. He/she will tell me they are on a new pill. Then I find out either the Special Ed teachers have that info and are sitting on it, or Mom hasn't let anyone know. I try to let them know it would be great if I know so and so's seizure meds have been decreased to better help the child...but I still feel I'm the last to know.
I feel bad for Rnqueens as well as the student. I can't imagine how awkward the conversation must have been.
Surely, as adults we can hold more than one topic of discussion in our span of attention, right?
Historically speaking, allnurses moderators have been very strict about keeping threads on topic. And parenting styles can be a hot topic that get tempers up. I just did not want the thread to get de-railed and/or shut down, that's all.
I spoke with the guidance counselor today and apparently the school lawyer's have stated that the school is to notify the parents if the student is pregnan even if she is 18. So I guess I have to be intrusive.
and i would be waiting for the law suit from that ADULT student, with bated breath.
...Sometimes I think .. .no MANY times I think the school has taken on too much outside of education (and not doing a great job of that as well).
THIS, totally. I feel that a lot of the things I am asked to "look into" as the school nurse, are just plain not my business or the business of the school. It's intrusive! It's like there are no more boundaries.
I'd like to think that I would know if my child was pregnant. I would also be highly offended if my child came home and told me that the school nurse asked such an intrusive question. I really have to question your coworkers as well. A pregnant belly looks very different than general weight gain. Methinks the faculty might be gossiping about the kids too much and creating senseless drama.
Specializes in M/S, LTC, Corrections, PDN & drug rehab.
I feel bad for the student & the nurse. The staff put the nurse in such an awkward position just because they were gossiping & wanted to know if the student was pregnant or not.
Then the poor student. I can't imagine being asked if you're pregnant when you've just gained weight. Poor thing. I know the nurse meant well, but I don't know about the staff. I hope there are no ill repercussions from this!
I spoke with the guidance counselor today and apparently the school lawyer's have stated that the school is to notify the parents if the student is pregnan even if she is 18. So I guess I have to be intrusive.
That would be all the more reason for me to stay the heck away from it. At the end of the day i'd have told the admins to follow themselves if they were all that concerned then just give a little heads up to my union rep about what went down. You can't be forced to violate someone's privacy. Task the lawyer with violating her privacy and see how quick he/she is to actually do it.
Thank you all for your support and thoughts. Like I said before this has definitely been a lesson learned as a new school nurse. All the concerns everyone voiced were my same concerned and made aware to admin. this situation stayed with me the whole weekend because I totally understood how the student felt and it was me who presented to her. I heard the mother came to the school but, I am not putting myself anymore into the situation. As I told the student the staff (not myself) were concerned. Like someone posted earlier I kind of feel like they were probably gossiping about the student but, convinced me due to "safety". Never again!!!. No one has brought it up to me again and I am very happy with that. They wanted to know they deal with the aftermath.
Also the whole look of a pregnant belly versus just a belly was asked by myself and everyone was so sure it was rounded out like a pregnant belly. Which it wasn't once I got a good look at the student ( no I didn't ask her to show me her belly I just observed how her clothes were fitting her). SMH
Thank you all for your support and thoughts. Like I said before this has definitely been a lesson learned as a new school nurse. All the concerns everyone voiced were my same concerned and made aware to admin. this situation stayed with me the whole weekend because I totally understood how the student felt and it was me who presented to her. I heard the mother came to the school but, I am not putting myself anymore into the situation. As I told the student the staff (not myself) were concerned. Like someone posted earlier I kind of feel like they were probably gossiping about the student but, convinced me due to "safety". Never again!!!. No one has brought it up to me again and I am very happy with that. They wanted to know they deal with the aftermath.
Also the whole look of a pregnant belly versus just a belly was asked by myself and everyone was so sure it was rounded out like a pregnant belly. Which it wasn't once I got a good look at the student ( no I didn't ask her to show me her belly I just observed how her clothes were fitting her). SMH
I'm sorry! I can't help but laugh at the silly adults(not you) involved. Because you were the one that spoke with the student, I wouldn't be surprised if mom wants to speak to you. So prepare yourself for that possibility.
Let's just hope that none of the faculty were gossiping within ear range of other students
fetch, BSN, RN
1 Article; 481 Posts
It's a good point, but honestly at that point I think I'd be calling CPS before the parents, depending on what the student says. (And again, I'm in elementary, so I have no experience dealing with this - just what my gut says.) As terrible as it is, there are parents out there who abuse their children, and if the student is that young then a CPS visit might be a good thing?
Or maybe a phone call to home saying "your student has been presenting with vague upset stomach complaints, there is XYZ going around the building, she doesn't need to go home at this time but you might want to call her doctor for an appointment to double check she doesn't have a virus."
Really here's what it boils down to for me:
Sometimes I feel like discussions about teenagers turn into "what is the responsibility toward the parent" instead of toward the teen. (Not saying this one has!) They're tied together, but the teen is the priority. If she's old enough to make those choices, we shouldn't be going behind her back to inform her parents. If she's NOT old enough to make those choices, we should be protecting her, even if we're protecting her from her parents. And where's the magic line between old enough and not old enough?
This is also making me think about pregnant autistic women, and the difficulties they face in being considered competent. But that is way off subject, I've just had this window open 30 minutes (lots of walk ins!) and my brain is firing all over the place.
The other aspect of responsibility, is that we are NOT primary health care offices (although I have heard of some high schools doing that). So is it just our responsibility to refer the student out to their PCP? Like a student with mostly well-controlled asthma, whose parents refuse to bring in any inhalers -- it's potentially life threatening, but we can't take her to the MD ourselves, all we can do is request and refer, unless/until an emergency happens. If a student is pregnant and healthy, does it benefit her for us to interfere?
I also am not trying to be combative, I'm kind of thinking "on the keys" (instead of "out loud" lol). I think I'm going to bring this up with the other nurses in my district and see where their thoughts lie. It's an interesting question.