medically fragile children in cold weather

Keepstanding, ASN, RN · Jan 15, 2009

considering the "no child left behind" policy, i do not see why the child cannot come to school. does the bus pick him up right at his front door or does he have to wait extended periods at a bus stop?

praiser :heartbeat

platinum_garb · Jan 15, 2009

Thanks for your response. I could wax poetic regarding no child left behind. BUT...

My concern is not that, it is today and tomorrow with the heinous wind chill and this child's respiratory state which is not good.

If the parent doesn't make the right call, who gets to?

Jolie, BSN · Jan 15, 2009

If the parents wish to send the child to school, I don't think the school can refuse, since there is no issue of infectious disease that poses a risk to other students/staff.

My thoughts are that it is prudent to look at the risk/benefit ratio. Is sending the child to school in this weather risky to his health? Probably. Will he benefit academically or socially from being at school? From the information you provide, probably not.

Is it your call to make? I doubt it.

Bless you for your concern.

SuesquatchRN, BSN, RN · Jan 15, 2009

The mother's not keeping him when she has free babysitting and nursing care provided.

The kid should obviously be home in this weather. But it ain't your call.

luvschoolnursing, LPN · Jan 15, 2009

If the mother wants to send the child to school, I think you have no choice. You can recommend, but depending on the parent, I would tread carefully on that-they can twist your words and say the nurse TOLD them to keep the child home and you are violating their rights... I know, I know I sound cynical...

rn/writer, RN · Jan 15, 2009

My area is locked in just this kind of deep freeze. Our wind chill today (Thursday) has been between -20 and -35 degrees and is expected to be even a little bit lower until Friday afternoon. Nearly every district in an eleven county area has called off school for today. Some made the decision Wednesday evening. Still waiting to hear about tomorrow, but I suspect that with the same or worse conditions expected, many folks will end up with an extended weekend.

If your area is still functioning somewhat normally, I don't know that you have much say in what happens. Perhaps, there should be some discussion with the mom about contingency plans. What happens if the bus should break down? If school is closed during the middle of the day (district decision, loss of power), then what? You could also ask her about any particular vulnerability her child might be prone to--thicker than usual secretions, increased susceptibility to frost bite--just to get her thinking about the seriousness of the situation. You can challenge her in an appropriate way to consider the possibilities.

Hope all goes well for this little one.

LovebugLPN · Jan 15, 2009

I go to school with a child who has some of the same concerns. Parents will send child because as was stated before "free babysitting". I don't agree because of the weather but who am I to say?

Keepstanding, ASN, RN · Jan 16, 2009

how did this situation turn out for this student ? let us know. thanks !

praiser :heartbeat

platinum_garb · Jan 20, 2009

thank you all so much for your suggestions, opinions, etc. I appreciate the fact that I can post on these boards and get such a great cornucopia of experiences and responses. It makes me glad to be a nurse...knowing im in such great company.

For those of you who want to know what happened (and PLEASE...no flaming...)

I took a mental health day. I called off 18 hours in advance with my agency. Im unsure if the mother transported the child to and from on friday because the child did not attend school today.

Thank you all again.

Pediatric Critical Care Columnist · Jan 21, 2009

As the parent of someone with severe handicaps and who lives in a place where -40 on the thermometer is not uncommon, I'd like to comment. If we were to stop the world whenever it got cold here, nothing would ever get done. My son is transported to his day program door to door in a heated van in the company of the driver and two other clients. I have no qualms about sending him to his program on cold days because I trust the driver and the staff of his program. He is dressed appropriately for the weather in layers, a winter jacket, boots, hat, scarf and mittens when he leaves the house. His program will cancel outings on the coldest of days because of the time required to bundle the clients up. For my son, the benefits of attending the program far outweigh the risks of sending him. But if I thought he should stay home on really cold days, he would stay home.

platinum_garb · Jan 27, 2009

Unfortunately, the student I was speaking of does not exactly get door to door pickup and has severe respiratory problems which is why the student is assigned a nurse on the bus. I definitely respect a parent's right to make a decision in these matters, but just because they are allowed to make that decision does not make their's the correct one.

I know we can't live fearfully in the world. If we always said "what if the heat goes out" or "what if the bus breaks down" NO child would ever go to school in the cold weather. However, the issue with the child I was speaking about was not contingent on his severe mentally handicap, but rather his respiratory well being and the way it is observed to be affected in normal "yucky", bitter, cold let alone the -40s of the week in question.