Missed a break

[Adriennelb]

A student came In today after falling in PE and twisting his ankle. I kept it iced and elevated for 35 min before sending him back to class. No swelling or bruising noted. I told him to come back at the start of his lunch recess (approx 15min later) for more ice. He came back 3min after recess was done. No swelling so he got sent back to class quickly. Told again to come at the start of recess. Teacher called to say he was not a complainer and was crying in class. Brought him back to the office and there's notable swelling and his ankle has started to get discolored. Parents came to pick him up and hour later and took him to the we for X-rays. Hairline fracture to the growth plate.

I hate that I basically dismissed him for the bulk of the day. I don't know what he did on it during his lunch recess, he said he rested. No way to know if it was broken in pe or maybe aggravated at recess. Being a nurse and not a doctor I know I'm not supposed to diagnose but I can't help but think I missed this one. How do you handle this?

[ruby_jane, BSN, RN]

What the what? Nurses don't diagnosis, parent. It is not in our scope of practice. Some parents are just...ugh.

^ Totally that!^

[OldDude]

Thanks for all the support. The kids dad is pissed and questioning my skills at diagnosing. Assumed that because the sock was on when he got there at the end of the day that it had never been off. And assumed it was swollen when he came in. He emailed the teacher all of this.

She supported me and suggested he email me with any problems. Explained to him that there are 600 kids in the school and how are we (the nurse and health aide) supposed to know that his kid is a tough kid that knows hurt vs an injury.

If you stay in school nursing you're going to run across parents like this. Forget about it. You did exactly what you should've done.

[WineRN]

Thanks for all the support. The kids dad is pissed and questioning my skills at diagnosing. Assumed that because the sock was on when he got there at the end of the day that it had never been off. And assumed it was swollen when he came in. He emailed the teacher all of this.

She supported me and suggested he email me with any problems. Explained to him that there are 600 kids in the school and how are we (the nurse and health aide) supposed to know that his kid is a tough kid that knows hurt vs an injury.

Boo to this, He is probably the same kind of parent who would've argued with you if you did call.

[KKEGS, MSN, RN]

You can only do your best. You do not have the gift of xray vision. I've had the opposite experience where all signs pointed to a fracture. Even the ER nurse said she thought for sure it was broken. Xray showed otherwise.

[MrNurse(x2), ADN]

My wife and I, both nurses, dismissed my son's injury for a sprain, nope, fracture. Doctors do it, too. Don't beat yourself up, you dealt with it before he went home.