NOT gas!

Ug, I know that feeling! A couple years ago I had a student who came in from playing outside with pain to his lower leg and after icing it for a bit, he requested to go back outside and I let him. The next day he came in diagnosed with a hairline fracture. I was calling home for every rolled ankle for a month! The mom was not upset so I counted my lucky stars there! This was also a very dramatic student so I took his symptoms with a grain of salt.

I would have done the exact same thing. You assessed him, he still had pain a few hours later, you called mom. It's in her hands after that.

Hindsight is 20/20. Don't beat yourself up.

If it's a non complainer, i may put them through all the normal paces first (bathroom, snack, rest, etc) depending on the situation. but i may also give an FYI call too if it's a kid i never ever see. We are not fortune tellers, we do not have x-ray eyes. We can only do our best. I would be willing to bet that that child's parent would not have rushed him to the hospital at the first glimmer of pain.

Yes, those parents had to know something was up.

Did the intussusception resolve?

He is in surgery as I type this!

He is in surgery as I type this!

It's okay. He'll be fine.

OP, you stated even the child's PCP thought it was gas. We are not doctors, and frankly, even a doctor could miss things after an exam in my office given the limited tools I (and many of us on this board) have.

I had a student once with consist complaints of stomachache. No rebound pain, no increased pain with palpation. No fever. Just general complaint. I felt something was off, called his Mom to only hit VM after VM. Had student go home to advocate for pushing parent/himself to make appointment with PCP. It didn't feel serious, but I figured a closer look couldn't hurt. Kid's appendix burst at home that weekend - luckily he was okay, no one was upset, but I still felt like I missed something. Like you, I reached out because something felt a little off. At the end of the day, I realized, there are some things that are out of our hands.

This is something that isn't taught in nursing school.."going with your gut." - That feeling that something isn't right even though it may appear so. Many years ago in the ER, I was triage, and a mom brought her 13 year old in, about midnight, because he got up to use the restroom and felt dizzy/unsteady on his feet that evening. The only history of activity was he and another kid were playing earlier in the school day and fell into a chain link fence....no pain, no marks, alert, all vitals were WNL...but something started ringing a bell in my mind that I couldn't explain...they registered and sat in the waiting room but I kept an eye on him (amongst the chaff and ER abuse, at our expense, that fills the waiting room)...anyway, later I looked over at the kid and noticed a faint sheen of perspiration had formed on his forehead/he was leaning over on his mom - and then the siren went off in my head. I yanked him up and dragged him to the only room we had open...in the back of the "fast track." A lot of stuff happened at that point but within one hour the kid was in ICU with a ruptured splenic artery. Prior to that, there he was...sitting there in our ER waiting room bleeding to death. After they were able to tamponade the bleed with about a zillion units of blood he was able to go to surgery for repair and ultimately walked out alive. So....you can't predict the future....but as others have shared - listen to that little voice and "go with your gut."

Great catch, OldDude! Little/growing bodies can compensate for a lot of things - that was one thing that stuck with me after getting through peds in nursing school. One second they can be fine, the next...

Get instinct is so important in school nursing. I am still learning that I need to trust it and that it only gets sharper with more experience.