Asthma issues and sending kids home....

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I'm a new nurse and a new school nurse but I have over 30 years experience in dealing with asthma. Today this child was sent to my office with wheezing. It was audible with out a stethoscope but upon auscultation this kid was tight. I sent him home last week, asking for med orders and albuterol but this family refuses. Today the mother refused to take him home, said he was fine and caused a scene. Luckily my principal is amazing and sent her packing. How do you All handle wheezing kids with no albuterol? Thanks! -mysixlittleones

I am not sure about the school environment, but here in the ED the social worker either comes to talk to them, or may have an outside agency check on them. As it can be a life threatening thing I am wondering if you all do not have a policy for referral to dept health services for kids or something... interesting

Specializes in school nursing, ortho, trauma.

if i have no meds and a parent refuses to pick up and i feel as though a child is in distress, that child is going to the ER

I agree with Flare. If the kid is in distress and the parent refuses to take them home then I would tell the parent that it is fine I will just call 911 and she can pick him up from the ER (and have a bill to pay). I am sure that would work but I have not been in that situation. Ever if there was respiratory distress and the parent isnt available it is a quick trip to the ER. Luckily I have my principals backing too.

Specializes in Maternal - Child Health.

Had something like this happen once. A parent finally picked the child up, but stated he was going to bring her back after lunch. The principal backed me up stating that the child would not be readmitted to school without a doctor's note.

The very p****d-off parent took the child to the doctor that afternoon and apparently told the nurse that they just needed a note and nothing more. Thankfully, the nurse called me and asked for my side of the story....on speaker phone. When the parent heard my desription of the incident at school, attitudes changed.

Botton line, we can't force a provider to write a prescription, nor can we force a parent to provide medication. But we can (with administration back-up) refuse to accept a child into school whom we can not safely care for.

Yup, usually a 911 call will do the trick. Kid's safe, parent's get a wake up call. Gotta protect the little ones, that is why we are there!

Specializes in kids.

Agree with the above, 911, keep my administrator in the loop and DCYF as necessary for medical neglect.....

Specializes in ortho, hospice volunteer, psych,.

Could her refusal to buy her son's meds be because money is an issue? Many families just miss the cutoff for medical assistance or the CHIP program?

When the father of the boys my husband volunteered with for several years finally got a "better" job, they missed qualifying for the Access program that they had been on before, by $10. Ten miserable dollars! Their

dollars available for medical care were essentially unchanged, but they were suddenly expected to pay for all their medical needs. Two out of the three kids were on allergy meds which were OTC, the third kid had asthma and needed meds for her nebulizer, plus an inhaler.

It was easier for their mom to be obnoxious and difficult than to explain their sudden loss of assistance.

Specializes in school nursing, ortho, trauma.

but that's the point... if you explain your circumstances, i'll go to the ends of the earth for you. I'll exhaust my resources and make phonecalls and advocate for you all day long. I know about resources that many people don't think about - so often times i can help. But, if you make a scene and treat me like garbage, then don't expect me to be all sunshine and lollipops back at you... I know how to make a scene too...

Why isn't the PARENT asking about these resources, instead of getting an attitude when the school is informing that their child has a medical emergency. I don't understand. My husband and I have been out of work, we've lived in crappy housing, had to feed the kids peanut butter and crackers for dinner, have had utilities turned off, and all other sorts of economic problems. We still would have been grateful if the school informed us that our child was truly ill.

We used the local branch of our state health dept. and low-cost clinics until we could do better (when I could do better I immediately ditched the low-cost clinic). I don't feel these parents should be excused. This is their child's health.

Specializes in ortho, hospice volunteer, psych,.

I know you'll gladly provide help when asked and that's great, but women like this woman are so used to being told they're useless, lazy, horrible humans and general wastes of protoplasm that it eats away at and erodes

their souls. (I know... bleeding heart liberal.)

So many families in this area have been on assistance programs since FDR's administration and area social workers tend to treat them very differently than they do those people who are only receiving temporary

help for whatever reason.

The being "difficult instead" attitude is immature and unproductive, but it exsists nonetheless.

Thank you for all the wonderful work you do.

Specializes in OB/GYN, Peds, School Nurse, DD.
if i have no meds and a parent refuses to pick up and i feel as though a child is in distress, that child is going to the ER

This is my policy as well. I have had to threaten a few parents with CPS for medical neglect when they refused to pick up. The fact is, if they're having an asthma attack and they don't have a MDI or neb meds, there is nothing I can do to fix it. The only option I have is to call 911 and let the paramedics step in.

Last year, I had a little 7yr old boy come in wheezing like a freight train, retracting 6-7 ribs, lips blue. He wasn't moving air at all. So I called 911 and then tried to get the parents. No answers. I turned that over to the front offic staff so I could pay attention to this little guy. EMS came and took him away. Do you know, it took us 2 HOURS to find the parent? And when we did we uncovered a BIG SECRET: they had moved 2 counties over and this mom was putting her 7 yr old child on a city bus, sending across our huge metropolitan area to a hub, where he picked up another bus that took him to an apt complex(where he knew no one!). The school bus picked him up there and brought him to school. This made a 90 minute trip for him, and he was doing it alone, twice a day. Holy Cow! We finally got mom to go to the hospital(4hrs after he left school); CPS met them in the room. Needless to say, this child was withdrawn from our school IMMEDIATELY.

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