Parents with poor compliance/lack of follow-up

[MHDNURSE]

I think one of the things I like least about this job is feeling like I am chasing parents down for follow-through on returning forms, bringing in medications, notes from doctors, etc. We have a field trip tomorrow to go apple picking and I have to go b/c we have a couple seizure kids and a few epi-pen kids. One of the epi-pen kids has a bee/wasp allergy. Last year there were a zillion bees and one of the teachers actually got stung. I have been hounding this mom since the beginning of the school year to send in the epi-pen and I called and spoke with her Friday telling her that if I didn't have it by this morning, her son would not be able to go one the field trip. It is the entire First Grade going so if he stays behind, he will have to join a K class for the day which sucks for everyone. He is also not the best behaved kid. It just really makes me mad that this mom won't follow through and her kid has to miss out and the K class has to be inconvenienced. I asked if there was a problem getting the epi-pen and she said in an angry tone "I have it, I just forgot to send it in". She yells at me like she is mad that I don't want her kid to miss the trip.

[BeckyESRN]

Great idea, but for us, our hospital is about 5 blocks away with excellent response time. This is the main reason we couldn't get stock epi-pens until the very end of last year. The main dr. there said there was no need since the ambulance could be here so quickly. Well, that dr. retired and I asked one of the other docs there and he was more than happy to order them for us!

You can still use the EMS response time. You just have to tell them that unless they can get to the school before EMS, EMS will be called.

[RatherBHiking, BSN, RN]

I'm still waiting on a couple due to insurance issues and one for needing a new dr because theirs retired. However, they had 8 weeks to get this in place before school started but once again the first day of school must have been a suprise!

[KKEGS, MSN, RN]

As a brand new school nurse this has been one of the most aggravating aspects of my job as well. I had to do a health records review and a parent interview for a student who is going through an evaluation for SPED services for the first time. I left SIX messages with his mother, emailed, mailed home consent forms and health history forms, etc. Our school social worker had to drive to her home to get her to sign the consent form so I could at least get his health records from his clinic. Then I had to request the records from the clinic THREE times. I didn't want to arrive empty handed with no report for the SPED meeting and felt so stressed out and ended up crying in the social worker's office because I was so frustrated. She was very sweet to me and then I calmed down, called my mentor (who was the nurse at that school last year) and she informed me that I was busting my butt and going well above and beyond what was expected. She told me to make sure I was documenting each attempt and that this happens sometimes. The SPED team tries to find some other way to get the kid the services they need. Well, I had given up when I FINALLY got records from the clinic so I had something to put in my report. Never did get a hold of that darn mom though.

[Buyer beware, BSN]

OP:

As you know, it's not the kids we are treating, it's the parents. Most parents are OK, some are great, but then there are the outliers.

These folks for some stealth reason harbor resentment towards any health care worker. They sometimes speak to you with sarcastic inflection in their voice and say things when you try to educate, explain or express empathetic understanding of whatever difficulties they are experiencing in raising any child, special needs or not.

The dead giveaway when diagnosing this type of parent is definitely uncovered in the event you have have to ask them to sign a consent for treatment or a procedure for their child. What they will often do is give a cursory nod of understanding or agreement and then say in all irony "you're the expert or professional so you must know what you're doing."

But remember when you hear that line "Beware" to say the least they speak with forked tongue.

[Cattz, ADN]

I have found THE most effective technique is to send a note that identifies EMS response time to show how long their child will be suffering without a med. Dramatic, but honest and effective. The worst feeling is knowing what to do and not having the resources to make an effective change.

Thank you MrNurse- I used this idea earlier this week for a kid with a parent-reported seafood allergy (no paperwork, no Epi-Pen.) Mailed that baby home yesterday, can't wait to hear back from it.