It's ok to look at their....

[Jacquipals]

New school nurse in a private school (prek- 8th) after substituting at a public school and I need help. If a student c/o a rash on belly, do you look? If a 5 year old is inc of diahrea everywhere do you change the poor kid or wait til the mom comes? where do you draw the line? The other rn and I have different opinions. Thanks!!

[Nurse_JackieVA, BSN, RN]

If I need a second pair of eyes then I'll grab the teacher or principal and document who/what/when/where.

I always ask if they want me to look at it or if they want to go into the bathroom then tell me what they see (basically is it bleeding - but I'll document that RN was unable to assess due to location). I don't help with bathroom accidents but if I do need to then another set of eyes and document everything.

[AliNajaCat]

OP: If you're going to be dealing with kids, best learn how to spell "diarrhea". You're gonna need it :).

[ComeTogether, LPN]

I literally didn't even *think* of the rationale for not changing a child would be to avoid accusation. How horrible that we have to worry about stuff like that.

Not a school nurse, obviously, but would't the fact that you're a nurse and have to go through rigorous background screenings just to become (and stay, even) licensed make you the most appropriate person for the job? I mean, I just can't see how a nurse changing a diarrhea attack could ever be misconstrued?

[GmaPearl BSN RN]

Oh, my dear, there is nothing these days that can not be misconstrued and litigated… CYA is just a reality in this job. Kind of crazy considering most of our training and experiences, but it is a crazy world

[Farawyn]

I imagine the kid in those long lacrosse shorts, and I will look at anything above and below.

[kidzcare]

I literally didn't even *think* of the rationale for not changing a child would be to avoid accusation. How horrible that we have to worry about stuff like that.

It common practice for a male who is placing a foley or cathing a female pt to have another female in the room. Or for a male OB/GYN to have a female in the room while performing a pelvic exam. Same idea. Can't be too careful and any accusation (no matter how unfounded) can wreck a life or career.

[MrNurse(x2), ADN]

I literally didn't even *think* of the rationale for not changing a child would be to avoid accusation. How horrible that we have to worry about stuff like that.

Not a school nurse, obviously, but would't the fact that you're a nurse and have to go through rigorous background screenings just to become (and stay, even) licensed make you the most appropriate person for the job? I mean, I just can't see how a nurse changing a diarrhea attack could ever be misconstrued?

Check out men in nursing under the general board, major issue, even in acute care. Thinking about the educational environment, seems like teachers, male and female, are falling about once a week for engaging in inappropriate behavior, so the nurses, counselors and even safety officers fall under that umbrella.

[Amethya]

I'm sort of a parent myself (Niece and nephew, mother died, I am guardian). But still, I don't look at anything down below, that can be taken care of because the students are around my boy's age and he can clean himself, so therefore the Kinder can clean themselves. But I don't mind helping them change or anything like that because I'm used to it. But I always have the teacher with me so they can see what I'm doing.

We are a K-8, so I do get older kids coming in. The girls feel okay to show me their chest if it's something pertaining to that, but other things, I let them take care of that.

I had male students sit in my office in shorts because I had to sew their pants up (I give them a blanket to cover up), but that's basically all I had.

[SHGR, MSN, RN, CNS]

You school nurses post a lot and I love your threads! I'm confused about this one. I've worked special rec camp where I straight cathed campers, and family medicine where we cathed and U-bagged kiddos, so that's my frame of reference here (though genital and breast exams get a chaperone for opposite-sex providers). Why, when nurses and CNA's do all kinds of personal care, is it different in a school setting?

[MrNurse(x2), ADN]

You school nurses post a lot and I love your threads! I'm confused about this one. I've worked special rec camp where I straight cathed campers, and family medicine where we cathed and U-bagged kiddos, so that's my frame of reference here (though genital and breast exams get a chaperone for opposite-sex providers). Why, when nurses and CNA's do all kinds of personal care, is it different in a school setting?

You may work a long and eventless career, but you also may be the one accused. You may drive 60 years and never need that seat belt, does that mean you shouldn't wear one? Your nursing may never cause harm by doing just enough to get by, but best practice gives far greater insurance against problems, whether it be acute, chronic or school nursing.

[chasinRT]

I don't look under any area that would be covered by a modest swimsuit. If there was an emergent need to, I would. We call parents for potty accidents if the kid can't do it. However, I would help them if needed if we couldn't reach a parent or emergency contact. I do have a student with spina bifida who self caths with observation, and I do that without a witness and I also help him clean up after BM if needed as he doesn't have sensation and its difficult for him to know where he's cleaning. There is not room in my restroom for a witness. I hope it never bites me in the butt.

[KeeperOfTheIceRN, ADN]

You school nurses post a lot and I love your threads! I'm confused about this one. I've worked special rec camp where I straight cathed campers, and family medicine where we cathed and U-bagged kiddos, so that's my frame of reference here (though genital and breast exams get a chaperone for opposite-sex providers). Why, when nurses and CNA's do all kinds of personal care, is it different in a school setting?

Were the rec camps you worked at an overnight kind of deal? That makes a very big difference as opposed to a school nurse who is only with the child for x amount of hours a day. When you go to the doctor, you expect there to be a full head to toe exam. When you're in the hospital, you expect a full head to toe exam. When you're at school, a full head to toe exam is not necessarily expected. Why? Well simply because you don't go to school to be examined from head to toe. I think it becomes a touchy subject simply because of the setting. When involving the genitals or breasts, I feel most parents would rather take their child to the doctor to have it looked at rather than a school nurse to look at it. Even though when they get to the doctor's office, the office nurse will then look at the area mentioned on their report, it is still a different setting and they are there for that reason and that reason only. I don't think its a question of whether we're CAPABLE of examining the areas mentioned, but rather the fact that we're in a school setting.

I could be way off with my opinion, but I genuinely feel the setting makes a big difference in the eyes of the parents.