pencil tip in palm....cause for hysteria???

[schoolnursejennie]

ok so this morning a student came in HYSTERICALLY CRYING AND WAILING because she accidentally got the tip of her pencil stuck in her palm. every single hall monitor came running in to console her. i went to assess the site of the pencil point and she wouldn't let me look at it or touch it. when she finally calmed down enough to let me look at it, it was a miniscule piece of graphite just underneath the dermis. so, i wasn't going to even try to remove it because i dont have the proper equipment in the school office, i called her emergency contacts and nobody picked up. so i ended up putting an ice pack on it because that's the only thing the student would allow me to do without becoming hysterical again. all of a sudden amidst about 4 "fakers", a phantom ear ache, stomach ache, an "i vomited but no one saw it", and a girl who needed a band aid, the principal and head of school come running in wanting to know what happened with the pencil point kid. i calmly explained to them what happened and they asked me if i called the girls parents. i said yes and nobody picked up at any number. then they proceed to lecture me on the proper way to handle a multitude of students when i am dealing with an "emergency." ummmmmm that wasn't an emergency. that was a girl acting hysterical over nothing. am i going to send her home? yes. am i going to call 911 or start notifying authorities? ummm NO. so then i had every single hall monitor and the two principals in the office acting hysterical plus 4 fakers. it was just a mess and i really felt like my medical knowledge was usurped by non-medical authorities and random hall monitors. anyway, to all you seasoned school nurses out there (this was only my 3rd day), what would you have done in a situation like this? am i wrong? please be honest.

[schooldistrictnurse]

If you saw this in a movie, it would be hilarious. What you did was fine. Remember the phrase "fake it til you make it" by that I mean remember to project an air of competence and being in charge. It's ok to tell the other adults, "I've got this" unless there is someone else (like a special aide) who is the ONLY one the student can relate to. Just this year we had a kid press too hard on a mechanical pencil and a small piece broke off and flew into his eye. You could see it plain as day in the inner corner but no amount of rinsing would dislodge it. Luckily the kid wasn't in distress. He just sat quietly until someone came to get him. But an emergency? Not really.

Hang in there!

[schoolnursejennie]

the student was emotionally disturbed and that is why she had such a visceral reaction to the pencil in her palm and i understand that. it just really bothered me to have my competence questioned by a group of people that have no medical training. i think because i am young (24) they feel that they are unsure of my ability and my judgment. well, then they shouldn't have hired me i guess. i don't know why they need a school nurse when they are obviously all doctors. /rant

[mc3, ASN, RN]

No, I think you did the right thing. I might have a talk with the principal (in private) to see why she questioned your judgment and ability to prioritize (nicely, of course). Explain what your reasoning was, and that you'd appreciate her confidence in you. You're the one who went to nursing school for Pete's sake! As far as the rest of the staff, unless they are directly involved and have a "need to know" I would (and have) explained that you appreciate their concern but you need to need to keep student info confidential. And always, document document document!

Hang in there! You're doing fine....

Nurse Pat

[schoolnursejennie]

thanks!! i document EVERYTHING that happens in the office. i'm not taking any chances with my license....i worked too hard for it. (haven't we all?) again, thanks for the advice!

[rdsxfnrn]

you did fine. in cases such as this, I usually have the 'hysterical' student go in the bathroom and wash hands and face, and get "theirself together". when they are calm, i check to see what the problem is, and proceed from there. I am unsure this would work in this case. As for the "HELPERS"........ obviously they were NOT helping the situation. Usually the more audience a student has, the louder and longer they go on. and on. and on. :) You need to find a way to separate them from the child...... if you can get them into the b/r... that will work. if not, you need to tell them something along the line of what other posters have mentioned. when i first started, (year 3 for me, right out of nsg school) the same thing happened. you need to do what I did, take that job and MAKE IT YOURS! I have ruffled many feathers along the way, but now all concerned know that I am the medical authority here.

[rdsxfnrn]

question..... why would you send her home? a call to parent would be sufficient, imho :)

[Purple_Scrubs, BSN, RN]

I probably wouldn't even call, a note would suffice, except that I see that this is a student with an emotional disturbance. That does change the game, and I think you did the right thing. If this was a typical student being a drama queen/king, it would be different. Do I remember reading somewhere that you are at a special needs school, OP?

[schoolnursejennie]

yes i am at a special needs school. the student has a severe emotional disturbance as well as a deficit in verbal expression. if this were a "normal" student, i would NEVER have sent them home but in this case she was unable to function in school. also, the head of school and principal basically decided as soon as they arrived that she was going home, as they began calling the student's parents before even speaking with me.

[Spidey's mom, ADN, BSN, RN]

I'm wondering if they were acting under the false impression that this was lead? I still have people freak out over pencil "lead" and think you'll get lead poisoning.

This could be equated to a splinter. Definitely not an emergency.

You did the right thing.

[talaxandra]

Drat you - lead poisoning was goign to be my suggestion!

I get the student's reaction given her status, but WTH's the problem with admin? I've yet to find a situation that's been improved with hysteria. It sounds to me like you did everything perfectly, and have a proper understanding of what constitutes an actual medical emergency!

[schoolnursejennie]

it's funny you guys brought up the idea of lead poisoning because it was the head of the school that assured ME that pencils are made with graphite and told me to make sure i tell the parent it is made of graphite. so, that was obviously not the concern. still don't know what all the hoopla was about but i'm guessing it was because the student was so hysterical and was emotionally disturbed to begin with. anyway thanks for your input!!!