On what planet does it make sense...

Flare, ASN, BSN · Feb 17, 2011

yet another candidate for "Mother of the year"

safarirn · Feb 17, 2011

Wow. Just wow.

Keepstanding, ASN, RN · Feb 17, 2011

just when you think you've heard it all...........there's more ! :lol2:

Purple_Scrubs, BSN, RN · Feb 17, 2011

I would have been sorely tempted to make a CPS referral...medical neglect. I have had a similar situation but it was not an obvious break. The teacher even gave me grief for insisting that he keep ice on it while I tried to contact the parents (had no working numbers, go figure) because it was "distracting to the class". When he showed up the next day in a cast her tone changed.

DaleenMarine · Feb 17, 2011

Pardon my ignorance, but I'm not even an official nursing student yet. However,the OP gave me pause and I wanted to ask some questions about CPS reporting.

Are nurses mandated CPS reporters? (I thought so, but the OP makes me wonder.)

If so, what kinds of situations require reporting?

Is there a certain amount of discretion allowed the nurse for reportable situations?

Are warnings to the guardian required before reporting?

Why would a nurse NOT report a suspected case of abuse/neglect? (I'm asking about the OP but I'm also curious what other kinds of situations would be "iffy" about reporting.)

I'll admit I'm looking at this from my "high horse" perspective, in that even if I were the parent neglecting my child's need for medical care I hope and pray that someone would step in to protect my child from me. I'm sure I'd be angry, but it seems that every intervention that's ever occured in my life has later shown to be for the best.

bergren · Feb 17, 2011

Glad this turned out with the child getting the care he needed. Was Gramma on the call list? Was it her cell phone that she happened to pick up in Florida?

mustlovepoodles, RN · Feb 17, 2011

Glad this turned out with the child getting the care he needed. Was Gramma on the call list? Was it her cell phone that she happened to pick up in Florida?

Yes, Grandma was on the emergency contact list. God knows why. :uhoh3:Her cell phone had a local area code, so i had no idea she was living about 6 hours away. I was just trying to get SOMEBODY to pick up this kid and I hit the mother lode. I guess Big Mama still rules with an iron fist from 400 miles away.

I try to give my parents every opportunity to do the right thing. I know that a lot of them are very young(like 21), most are unmarried, not well educated, working at minimum wage jobs with no benefits, and have a host of social problems. Most of them have hard lives and many have no elder relatives to seek advice or help from. As such, they sometimes make decisions that the rest of us would say "Wha??" Occasionally, i have to spell it out for them. Yes, i know you have to go to work, but you have to take care of your child when he's hurt or sick. It's the law.

That said, I have no problem calling CPS when I think it's necessary. I don't call for frivolous reasons, but if I find injuries which don't seem to match the "story" or if a child tells me out right that someone is harming them, I make the call and let CPS sort it out. I sympathise with the parents--nobody wants CPS on your doorstep. I have had that experience myself when a well-meaning doctor called CPS after my disabled son was injured in a fall. But I also know that the doctor was just doing his job. RNs are mandated reporters. It is not our job to figure out the whole picture. Our job is to report suspicions. Now, if a child tells me that mommy spanked him and he has no bruises or marks of any kind, and he's happy and unafraid to go home, i will usually put that kid on my radar for awhile. But if he comes to me with unusual marks and gives me a vague story, or tells me outright that someone hurt him, then CPS is going to get a report within the hour. And I document EVERYTHING. In 4 years of school nursing I have probably called CPS about a dozen times. Never had to go to court, although i would if I had to. In all cases that went forward, the parents plead guilty to child abuse/neglect/endangerment.

DaleenMarine · Feb 17, 2011

Thanks for taking the time to answer my questions. I am always excited to learn new things.

bergren · Feb 18, 2011

One of the National ssociation of School Nurses legislative priorities is for the Healthy Families Act

The lack of paid sick days has become a public health concern. More than forty million private-sector workers (38%) do not have access to paid, job-protected time off to recover from a common illness like the flu -- and millions more lack paid, job-protected sick time to care for a sick child or close family member. And among workers in the lowest income bracket, 81% do not have a single paid sick day. For children with both common and chronic illnesses, the results can be devastating for health, well-being, and educational success. In a study of mothers, 40% whose children had asthma and 36% whose children had other chronic diseases did not have paid sick days. School nurses know that now is a critical time for making paid sick days a reality, given the rapid spread of flu and other illnesses in schools. The need is clearly essential for the economic survival of families and for obvious public health reasons. School nurse support is needed when the Healthy Families Act is reintroduced in the House and Senate.

http://www.nasn.org/portals/0/legislation/2011_leg_priorities.pdf

jjjoy, LPN · Feb 18, 2011

Even if you have some reserves to afford taking a day off for illness or to take care of family member, the job might not allow the person to take the time unpaid either.

I can see that companies can't very well accomodate employees who end up taking crucial time off even if it is for a very ligitimate reason. Where to draw the line is a sticky dilemma.

However, it sounds like the OP had the impression that this mom simply wasn't all that worried the injury as opposed to feeling forced by circumstance into neglecting her child in the short term for their longer term well-being (keeping her job, keeping insurance, etc). I suppose only the mom can really know what was or wasn't going on her head.

BSNinTX · Feb 20, 2011

How about sending the kid to school with a homemade 'cast.' As in, a sock wrapped in duct tape. Had that recently.