Hi everyone, I am a new school nurse (as of the beginning of the school year) and could use advice. I cover a district in the state of MN where I am responsible for about 1000 students from pre-k up to 12 grade. I am part time (3 days a week) and our administrator has made it very clear that is all the time they are willing to pay me for.
I have a particularly hard case with a 7th grade student who has been suffering from episodes of unconsciousness, dissociate episodes (not having any idea where she is or what is going on), and along with this has had several episodes where her anxiety is to the point of respiratory distress (she also has asthma). I recently called 911 during a particularly bad episode where her respiratory status was quickly worsening. Parents are adamant that this student stay in the regular ed population and have denied any special ed evaluation or services.
During a meeting with her parents and our building principal I was given instructions by the students psychologist stating that "as long as the student is still breathing and her eyes are open" I am not to call EMS, and it is up to the parent's discretion if they want to pick her up or have her stay at school.
This directly contradicts what our district health and emergency response policy is. My administrators have not had something like this come up before and are looking to me to advise them from a medical and legal standpoint what we should do. My other huge concern is what to advise our unlicensed office staff that cover for me on the days I am not at work or when I am at one of the other 3 buildings I cover. Thanks in advance for any guidance you can give.
An added point that you may or may not have seen. A psychologist is someone with a PhD in psychology. A Psychiatrist is medically trained. That psychologist can not insert into medical matters, as they are.
I know this isn't what you're asking, but has anyone considered PANDAS here?? Straight A student to being unable to make it through the day...hmmmmm....
An added point that you may or may not have seen. A psychologist is someone with a PhD in psychology. A Psychiatrist is medically trained. That psychologist can not insert into medical matters, as they are.
Right! My point to the parents exactly! However they are taking this psychologist's word as the only opinion they are willing to hear and are angry with the school for not following the "doctor's orders". Thank you again for all the replies, I stood up to my superintendent and told him I'm calling 911 if it is necessary and I'm not obligated to follow the psychologists recommendations if they put the child in danger.
""During a meeting with her parents and our building principal I was given instructions by the students psychologist stating that "as long as the student is still breathing and her eyes are open" I am not to call EMS, and it is up to the parent's discretion if they want to pick her up or have her stay at school. ""
None of these people trump the Nurse Practice Act which is our "holy grail." What would a prudent nurse do?? CALL 911 for respiratory distress. END.OF.STORY
But again, a PSYCHOLOGIST IS NOT A DOCTOR! If the parents think that, again this person should have a complaint filed against them, because they are IMPERSONATING a physician without appropriate credentials.
Right! My point to the parents exactly! However they are taking this psychologist's word as the only opinion they are willing to hear and are angry with the school for not following the "doctor's orders". Thank you again for all the replies, I stood up to my superintendent and told him I'm calling 911 if it is necessary and I'm not obligated to follow the psychologists recommendations if they put the child in danger.
pappa22v makes a very valid point. I am not one to step on other professional's toes, but this is endangering a life. I would at least call and ask if there is a psychiatrist who could write that order, because you are not allowed under the NPA to follow orders from a non-medical high level. That would keep it respectful (even though they are a midlevel) and get your point across.
I thought about the student all night. We had a similar situation that was a PANDAS case - it was diagnosed just in time to save this child an admission into a psych unit. You may want to suggest the child be tested. As far as I know it's simple throat culture and could save so much heartache. I know of another case locally that wasn't diagnosed in time and the damage became permanent. A formerly straight A student wound up living in a group home .
Searching for PANDAS thread and found this thread, very interesting and worth a review.
I had a student suffering with PANDAS for nearly 6 months before being diagnosed. I honestly didn't even know about PANDAS until the diagnosis. The student had OCD behaviors especially around food eventually progressing to refusing to eat solid food and severe separation anxiety. The student was treated and within six months completely back to normal.
I had a student suffering with PANDAS for nearly 6 months before being diagnosed. I honestly didn't even know about PANDAS until the diagnosis. The student had OCD behaviors especially around food eventually progressing to refusing to eat solid food and severe separation anxiety. The student was treated and within six months completely back to normal.
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MrNurse(x2), ADN
2,558 Posts
An added point that you may or may not have seen. A psychologist is someone with a PhD in psychology. A Psychiatrist is medically trained. That psychologist can not insert into medical matters, as they are.