parents won't pick up sick kid!

moreoreo · Sep 12, 2017

I have to admit that in my first weeks of school nursing, I was shocked at how our lead nurse would start itching to call EMS when a parent would take a long time to pick up a feverish child. To be fair, we do not give OTC meds without an MD order here/there is no "stock Tylenol." To be more fair, as I have spent more time here I have seen that fevers can continue to rise despite hydration and cool cloths and that a parent who says "I will come" will often forget to add "in one hour" and say "really soon instead." (To be fair to them, I understand not everyone is hanging out at home or working very close to the school.) So nowadays, when a student has a fever and is symptomatic, I let the parent know upfront, if they say it will be a while, that I will call an ambulance if the fever continues to rise or the student's condition warrants it. I have found that even a parent who is completely stuck somewhere will find someone to come when I give them that head's up.

One of my least favorite school nurse situations is when I have two kids come in at the same time, one is clearly more ill than the other, but the perkier child's parents are attentive and available while the sicker child's parents' phones are out of service without any emergency contact. I always feel so sorry for the child who ends up needing to wait all day.

allnurses Guide · Sep 12, 2017

I have never had this happen before, and don't know what to do. The parents and both secondary contacts refuse to come get a sick child from school. They say that none of them can leave work. This child is 8 years old with a 103* fever. I told them they need to find someone to pick up the child, they say they have no one else to call. What else can I do?

Tell them that if they refuse to pick up their sick child you will call department of children's service and report neglect. That's usually gets someone to come pretty quick.

Hppy

kidzcare · Sep 13, 2017

Tell them that if they refuse to pick up their sick child you will call department of children's service and report neglect. That's usually gets someone to come pretty quick.
Hppy

to maintain a good working relationship with families who we will likely be dealing with for years, this is seldom a first, second, or third line defense.

Farawyn · Sep 13, 2017

to maintain a good working relationship with families who we will likely be dealing with for years, this is seldom a first, second, or third line defense.

Nor is calling an ambulance for a fever.

scuba nurse, BSN, MSN, RN · Sep 13, 2017

When this happens, I tell my social worker, and she talks to the parents and threatens with DCF and that usually takes care of the problem!

I know not a popular option, but you have to do what you have to do. We can't have a sick child hanging around the office all day. And this is only in extreme cases.

nursekoll, BSN, RN · Sep 13, 2017

So nowadays, when a student has a fever and is symptomatic, I let the parent know upfront, if they say it will be a while, that I will call an ambulance if the fever continues to rise or the student's condition warrants it.

Do you have a number that fever has to get to before calling EMS? Is that in your school policy?

WineRN · Sep 13, 2017

Do you have a number that fever has to get to before calling EMS? Is that in your school policy?

We have a few steps before EMS.

We have a standing order for tylenol is the fever is over 101.0 and the parent will not be able to come for more than one hour.

If after that hour mark has pasted and the student is become worse despite nursing interventions (med, rest and hydration), the parents are called again and told that they have 30 mins to get someone to the school or EMS will be called.

Now that being said, I don't think any of the nurse's in my district has got to that point. Usually the tylenol helps and the little one falls asleep. Unfortunately my office isn't always the most quiet place in the school, so the quality of the rest isn't great.

I have heard of other nurses using their SROs to go to the house if it is KNOWN the parents are home and just ignoring our calls.

moreoreo · Sep 13, 2017

Do you have a number that fever has to get to before calling EMS? Is that in your school policy?

In my district EMS calls are based on nurse judgment/assessment so there is not a specific number. I have seen plenty of fevers in my first year and have yet to call as parents have arrived before the need but have been told that I should if it gets to that point. Again, we do not have stock meds or a standing order so waiting indefinitely is not always feasible or safe.

Farawyn · Sep 13, 2017

When this happens, I tell my social worker, and she talks to the parents and threatens with DCF and that usually takes care of the problem!
I know not a popular option, but you have to do what you have to do. We can't have a sick child hanging around the office all day. And this is only in extreme cases.

Why can't you have a sick child in the nurse's office?

JenTheSchoolRN, BSN, RN · Sep 13, 2017

In my district EMS calls are based on nurse judgment/assessment so there is not a specific number. I have seen plenty of fevers in my first year and have yet to call as parents have arrived before the need but have been told that I should if it gets to that point. Again, we do not have stock meds or a standing order so waiting indefinitely is not always feasible or safe.

I do have stock meds, but I prefer to take a parent first before medicating a child with a fever.

But ditto to ambulance calls. It is nursing judgement at my school. I won't call unless the child's condition warrants it. It is no fun for child with a fever that can be managed at home to take an ambulance ride either.

I work with the older students and if I'm not getting a response, I'll ask the student to whip out their cell phone and call/text parent/guardian with my permission. Suddenly folks are available!

But I did have one poor sick kid one time. Student was high-functioning autistic and clearly not feeling well (temp over 100), causing a very large sensory overload. Parent - only contact I had - would not answer phone, texts, email, anything. It was not a good idea for this student to go home on the bus, so an admin drove to parent's home, rang the bell, and found parent was at home, not answering the phone.

scuba nurse, BSN, MSN, RN · Sep 13, 2017

Why can't you have a sick child in the nurse's office?

No I can and i do. But we don't want it to be ALL day, (not a babysitting service) (if they can't come for like and hour or 2 , then OK) but not all day, I cannot have kid with a fever walk home or take the bus. If they are sick enough with a fever to go home, that is where they should be.

Farawyn · Sep 13, 2017

No I can and i do. But we don't want it to be ALL day, (not a babysitting service) (if they can't come for like and hour or 2 , then OK) but not all day, I cannot have kid with a fever walk home or take the bus. If they are sick enough with a fever to go home, that is where they should be.

Yes. I agree.

Sometimes I am a babysitting service. :blink: