Need Opinions!

[NurseBeans, BSN, RN, EMT-B]

I just really need to know if I am crazy or this parent is. The situation:

I saw a student the other day, 2 hours after recess, with ankle pain. No bruising, no swelling, no deformity, student is ambulatory with some limp. Gave ice pack, told her to sit down for a few minutes. She wanted to go back to class so I allowed it, told her to return my ice pack and I would re-assess the ankle. Now, this was 1 hour before dismissal. She stops by with the ice pack about 5 minutes before getting on the bus, no limp. Says it feels better. Now, she had a note from earlier about her visit with me. I do notes for the parents.

Got a call shortly after the busses left from mom, very angry she did not get a phone call. She knows her daughter visited because of the note. Ok...I re-visited the above information, told mom I did not see any issues that needed emergency care. Mom reminds me of a phone conversation about 3 months ago in which she told me the child had ERCP and a pancreatic stent, and about how she needs to know her daughter's health status. IMMEDIATELY. Ok. She knew within an hour after her daughter's visit because of timing, but whatever.

I am struggling to find a connection between ERCP/stent and ankle pain that went away after ice and why mom would need to know immediately of the issue, but clinically I can't think of anything. I never saw the child before this ankle visit, even in the days after her procedure and stent placement. Mom has called the principal and wants to have a meeting about me, and no one has spoken to me about it but I assume I will not come out on top in this situation.

Am I missing something?

[OldDude]

Don't be put on the defensive because you don't have anything to defend. Just tell the mom you will call her upon any and all visits by her daughter to your clinic so you guys can collaborate in regard as to what intervention, if any, needs to occur. You can say you would have notified her immediately if your assessment seemed to have any association with GI, digestive, or glandular involvement because that was the gist of the conversation you guys had about it. You can apologize for not realizing she meant she wanted to be notified immediately for any clinic visit; but that's ok, you're fine with doing that.

That way, the mom will have "won" by getting an apology from you and really that's all it's about. Smile, wave, and move on the the next hysterical, unrealistic, situation...cause there will be more.

[WineRN]

Like OldDude said, I would apologize so that way mom felt like she "won"

My first day, I had a student who was obviously faking a sore throat (she was able to yell to her friends passing my doorway with NO discomfort) so I sent her back to class. When dismissal came, the mom came in with fire in her eyes because I didn't call her to tell her that her baby was sick...

I apologized and agreed to call for every visit. The student was a frequent flier, so after about two weeks of being called almost daily, the student suddenly was cured of all aliments and stopped coming.

I started a little list of parents who *"Need"* to be called and those who only want to be called for fever, vomit or death.

[JenTheSchoolRN, BSN, RN]

Did the parent actually tell you this student has ERCP and a pancreatic stent? Or were you just supposed to know...?

I ask because I've had parents raise their voices to me about not being notified about such and such issue because of a certain medical condition and either: (a) they did not fill out the emergency health card I asked them to at the beginning of the school year; or (b) they did fill out the card and did not choose to share that certain medical condition their child had with me.

[kidzcare]

Did the parent actually tell you this student has ERCP and a pancreatic stent? Or were you just supposed to know...?

I ask because I've had parents raise their voices to me about not being notified about such and such issue because of a certain medical condition and either: (a) they did not fill out the emergency health card I asked them to at the beginning of the school year; or (b) they did fill out the card and did not choose to share that certain medical condition their child had with me.

Yes! I had a family a few years ago that were going through the IEP process and being quite belligerent to my principal about it talking about medical conditions. The principal started to get on my case about why I hadn't followed up on this serious condition and I should have known that they would need an IEP... until I pulled out the yearly health form with every single condition marked "no"

[tining, BSN, RN]

[Amethya]

I tend to call only for fever, vomiting and other things. But I do call parents all the time if the child comes in saying they feel bad or if they come twice for the same thing. I do it so I cover my butt, because I have had children who came in saying they feel bad, they didn't have a fever and they seemed fine, then they go home and cry to mommy that the mean nurse didn't let them call them and I get calls on that.

I had one last week because the child NEVER came in my office about a headache until the last minute before dismissal, I asked the child who's coming to get her, she said mom, I told her that since dismissal is now, she can find her car and tell her mom. I can't do anything about headaches but lay them down. I rather let her go home and get the medicine there than lay 10 minutes with headache, because sometimes that doesn't even help!

Mom called me the next day so angry that I didn't listen to her child, she was feeling bad ALL DAY, that couldn't I given her medication for her headache, because she had a fever when she got in the car, HOW DARE I?! I apologized to the mother and explained my procedures, because it was already dismissal I would rather her go home than stay in my office with a fever, where I can't do anything. I told her I can't give her medications unless its under doctor's orders, so while I wish I could give her some tylenol, I'm not allowed. And also if she was feeling bad since the morning, I would love if she can talk to her about coming to see me, so I can know and call her. If the child comes twice or tells me they aren't feeling well at all, I can call mom so they can know and decide if they want to come get them. I apologized again and she was nice after that and told me she will tell her kid to come see me when she does feel bad.

I always apologize, even if it's not my fault. But after that, I do passively aggressive give my reasons. Just because I apologize doesn't mean I can't defend myself.

[NurseBeans, BSN, RN, EMT-B]

I vaguely remember a phone conversation, and I wrote down the child's name and the procedure(s), but when the child didn't come to see me in the 3 months following, I felt like the issue had passed. I never got any notes from the doctor or anything in writing from mom, and I almost never get those things from any parent. I am just supposed to remember each child's conditions from phone conversations...according to the parents.

Basically I have learned that I need to call parents for everything from now on, and never use my nursing judgement. No one is interested in what the nurse actually thinks; they just want me to act as a pill dispenser and secretary. Fine, I can do that too.

I just really feel like I am doing my best and it is not enough for some people. Depending on how this meeting goes I am telling the principal to start interviewing new candidates because I can't possibly work harder than I am. I was a better OR nurse and I made twice as much money doing that so...makes sense to go back.

[OldDude]

I'm gonna go out on a limb and say there were things about the OR that you didn't like and, likely, played a part in your decision to change jobs. Also, I KNOW you are letting these irritants live rent free in your head. The "few" always take up the majority of school nurse's time. Most of the kids and parents are cooperative and friendly. Your issues are emotionally driven on YOUR part. All of us have felt the same as you verbalized above. Try not to take it to heart. But, you know you, and if leaving school nursing will be your decision, best of luck to ya. Think about me sitting on the beach with a cold Bud Light when you're driving to work at 5:00 am this summer

[Jedrnurse, BSN, RN]

Maybe emailing the parent? (with their okay) Since you're already writing a note, if you write it electronically, the parent will get it in closer to real time.

[NanaPoo]

I have a handful of parents who flip out over EVERY LITTLE THING. We all do and you quickly learn who they are. I agree with you that an ankle really has no relation to ERCP and my first impression wouldn't be to call mom in that particular situation.

2 years ago I had a 1st grader who said she'd scraped her lower back on the playground. Tiny scrape. I cleaned it with Bactine and covered it with a Band-Aid like I do all tiny playground scrapes. The following day I was called into the principal's office with the 3 1st grade teacher's regarding a "bullying incident" and to see a picture of this tiny scrape which had now morphed into a much larger wound on her back. I hadn't even documented the scrape. (If I documented scrapes and imaginary boo-boos I'd never go home.) None of the teachers had witnessed the parent's alleged bullying incident where the child had now apparently been slammed into a piece of playground equipment (this isn't the story she'd given me). The parents were angry that the teachers had been missing this apparent incessant bullying and that I hadn't called home for this horrible wound.

Since then, I've called home every single time that child has stepped into the clinic. Runny nose? I call home to let them know she stopped to get a tissue and blow her nose. Glasses dirty? I call home to let mom know the detailed analysis of the type of cleaner and wipes that I used to clean them. Guess what...not another complaint.

[KKEGS, MSN, RN]

Sounds just like my handful of high maintenance parents. We have a short list of children whose parents must be identified for ANY and ALL clinic visits, literally even if the child just had a papercut and needed a bandaid.

I think what OldDude suggested is perfect. Do it and then move on. You aren't the crazy one here.