Phone Calls

kidzcare · Feb 21, 2019

I generally call for anything that will leave a mark or that the parents may want to follow up on once the child is home.

If a student was intentionally injured by another student then administration should handle that phone call and transfer to the nurse if the parent wants a more detailed description of the injury.

OldDude · Feb 21, 2019

I call for all injuries if there is any "sign" of injury like swelling, break in the skin, abrasions, etc from the neck up and for "most" other "noticeable" injuries otherwise. I don't call for minor things like a knee/elbow abrasion or minor avulsion from swinging on the monkey bars.

I call for all head injuries regardless of swelling or some other sign.

I have a school cell phone and it is VERY useful and convenient to notify a parent of a particular injury, or other stuff like rashes, and text them a photo of what I'm calling about.

kidzcare · Feb 21, 2019

4 minutes ago, kidzcare said:
I generally call for anything that will leave a mark or that the parents may want to follow up on once the child is home.

I want to add to my own comment that this is dependent on the child's age. At the preschool level, I'll call for an abrasion after a fall on the playground. A fifth grader I won't because, generally, a 10 year old can tell mom and dad what happened.

Another important note- I will call if I think the kid's story will change between my office and home.

For example: Snowflake is a FF who came to my office with a tummy ache right after PE and was pouty after I told him/her that I it's probably related to having snack and then doing the pacer and had him/her return to class after 10 minutes.

For that, I'll call parents and say "I wanted to let you know that I saw Snowflake after the pacer. The class did it right after snack time and that didn't agree with his/her stomach. There's no fever or vomiting after 10 minutes. I'll let you know if Snowflake comes to my office again" BEFORE Snowflake can go home and say "Nurse Kidz is so mean! I felt like I was gonna puke and she didn't even care! She made me go back to class after barely sitting down!"

You'll learn which kids to make a preemptive call for ?

AdobeRN · Feb 22, 2019

I do pretty much same as Old Dude. I probably use email way more than an actual phone call. After you do this awhile you will learn which parents like to get that notice every time their child is injured, the parent that never answers the phone but will respond to emails etc etc etc.....

I wish we had a school cell phone - it would be so much easier to send a text - especially to those parents who never delete their voice mails, set up voice mails or those that just plain ignore all phone calls from the school.

Flare, ASN, BSN · Feb 22, 2019

Second the notion that you learn quickly of who needs the hand hold calls. I generally make a quick call if there is some sort of injury resulting from a fight - but i make it clear that I don't know any details other that what i'm telling them - mechanism of injury (even if i do, such as who else was involved, discipline, etc) that's out of my realm. I generally call for anything that i feel may need follow up, anything that may bruise or may turn into a call, or call for things that just seem like good CYA. Then there's the other ones, I have taken a page out of ODs book and started making calls for a certain breed of platinum level FFs. Sometimes it does inspire the parent into saying "OMG! He's been there 25 times already this year!" and the visits cut off -sometimes it doesn't.

ruby_jane, BSN, RN · Feb 22, 2019

16 hours ago, OldDude said:
I call for all injuries if there is any "sign" of injury like swelling, break in the skin, abrasions, etc from the neck up and for "most" other "noticeable" injuries otherwise. I don't call for minor things like a knee/elbow abrasion or minor avulsion from swinging on the monkey bars.
I call for all head injuries regardless of swelling or some other sign.
I have a school cell phone and it is VERY useful and convenient to notify a parent of a particular injury, or other stuff like rashes, and text them a photo of what I'm calling about.

I learned a really good lesson five years ago. Sweetpea came in stating he "twisted my ankle" on the stairs. My documentation: no swelling or bruising noted, no pain to palpation, full ROM, bearing weight, no gait impairment, with pain to (I cannot remember which) side.

Ice pack given, student DECLINED rest/elevation in clinic, student instructed to RTC in an hour for reassessment.

He never showed up.

Principal comes in my office the next day to show me the text mom sent to her of a grapefruit-sized ankle, when they were up in the ER, and pissed that I did not call her.

I pulled up my documentation and the principal and I agreed that I had more than done my job, AND I'd be calling on anything that might rebound at home moving forward. That's really informed my practice and I continue to do it. Because no parent is ungrateful for a heads up phone call.

Keeperofbandages, LPN · Feb 22, 2019

I always call for anything shoulders up (unless its from a lose tooth). Also if I think the injury needs further evaluation. I always document if I recommended to the parent further evaluation from an MD. I also make sure to document if it is an injury that occurred on campus from PE/recess or if it happened at home.

NutmeggeRN, BSN · Feb 22, 2019

16 hours ago, kidzcare said:
You'll learn which kids to make a preemptive call for ?

Ah yes, the preemptive strike! Has saved my bacon more than once!!

Supernrse01, BSN · Feb 22, 2019

Yes. If the injury is something like you listed, I call. I don't want one of my kiddos to go home with a big fat lip, bruised forehead, etc... and the parents not have any idea what happened. That's an open invitation for my head to roll the next day, when the parents are mad that they weren't notified. Plus, with something like a bump to the head, sx may not present themselves until the student is away from school and with their parent/guardian.

If the injury was a result of an intentional injury by another student, I generally call, but let the parent know just what I can address medically, and explain to them that administration is investigating the details and that they will be contacting them soon with any further information.

OldDude · Feb 22, 2019

47 minutes ago, ruby_jane said:
I learned a really good lesson five years ago. Sweetpea came in stating he "twisted my ankle" on the stairs. My documentation: no swelling or bruising noted, no pain to palpation, full ROM, bearing weight, no gait impairment, with pain to (I cannot remember which) side.
Ice pack given, student DECLINED rest/elevation in clinic, student instructed to RTC in an hour for reassessment.
He never showed up.
Principal comes in my office the next day to show me the text mom sent to her of a grapefruit-sized ankle, when they were up in the ER, and pissed that I did not call her.
I pulled up my documentation and the principal and I agreed that I had more than done my job, AND I'd be calling on anything that might rebound at home moving forward. That's really informed my practice and I continue to do it. Because no parent is ungrateful for a heads up phone call.

Excellent documentation...but I'm not buying it...something is missing. It doesn't add up that the same kid who came to you for twisting his ankle on the stairs, presenting with no sign of injury, wouldn't return if he started to experience increased pain or swelling at school; especially when you told him to come back. Also, if you had called his mom and described your examination, which included no sign of injury, would she have come to pick him up and take him to the ER immediately? Possible but unlikely...Regardless, this mom got to lash out at you and release her vent and that's the real objective of her text to your principal.

Being a parent of 4 boys, it's really difficult for me to remember to call a parent because their LD experienced pain when they pulled a booger out of their nose at school. I know you all can relate.

ruby_jane, BSN, RN · Feb 22, 2019

31 minutes ago, OldDude said:
Being a parent of 4 boys, it's really difficult for me to remember to call a parent because their LD experienced pain when they pulled a booger out of their nose at school. I know you all can relate.

I love the attitudes of parents with multiple kids. Which one is it? He did WHAT? Send him back to class!!!!