Parental difficulties. . .

  1. Hi guys! It's been a while. Hope all is going well for you all.
    If a child comes to your office, 3 days in a row on a short 4 day week and complains of the same symptoms (headache and dizziness), what are you doing for the child?
    2/3 days bp is lower and with water intake, comes up.
    I'm checking vitals, history, asking questions about nutrition, stress, medication they take at home. I ask if they've been to the doctor.

    I made the call to the parent to come in and pick up the child on the 3rd day and take them to the doctor. The parent was obviously super pissed off about it. (I will not go into detail on the exact words this parent used towards me).

    I think this warrants further assessment by a doctor.
    Was I wrong?

    Parent was very clear they would be making a complaint.

    I'd like to hear from you guys. Thank you!

    Happy Holiday Break!
  2. Visit JustRNingAlong profile page

    About JustRNingAlong, BSN, RN

    Joined: Nov '16; Posts: 50; Likes: 59

    14 Comments

  3. by   AngelfireRN
    If you'd blown it off and something happened, they'd want to fry your butt, so you did right. Who cares if they're pissed? That's part of being a parent. You gotta take care of the littles.
  4. by   LikeTheDeadSea
    You did what was best for the child. Better to refer and it be nothing than miss something.

    So what if they make a complaint? If admin wants to poo-poo you for it, explain to them that not referring based on the symptoms would put you and the district liable for negligence or something secondary like a head injury.

    If the parent is that agitated, they can take the kid home and not follow up, but you have a paper trail stating that you referred. Inaction is now THEIR problem.


    I often tell people, "I know your time is valuable and I hope it's nothing. On the chance that it is something, you'll be glad you went." I also explain that "Based on the symptoms LD is complaining about the risk for passing out and a head injury is high. It is in LD's best safety interest based on symptoms to have LD evaluated." This is also the response to admin if they criticize.
  5. by   JustRNingAlong
    Thank you guys! Seriously, the best group ever!
  6. by   BunnyBunnyBSNRN
    What are they going to complain about and to who? Seriously, the parent is angry because you advocated for their child's health and well-being. (Eye roll)

    You did the right thing. Trust your instincts.
  7. by   UrbanHealthRN
    When I see a child's symptoms turning into a pattern, I absolutely feel it's important to follow up, figure out what's going on, and make a plan. We're not doctors and we don't diagnose, so following up with the pedi is usually the main piece to figuring out what's going on with the kid. Good for you for doing exactly that! As for the complaint, bring it on. That parent is nuts for wanting to complain, period.
  8. by   halohg
    Dizziness is tricky and could be reason on day one to call. How old is this student? Is the student playing recess and gym without difficulties? Hard to say without more information. But your judgement is your guide and if it guided you to to make your decision than never second guess it. Parents bark all the time because otherwise they have to admit they themselves missed something or they are afraid of what this might be. Fear, anxiety, denial, presents many ways, but being defensive is nearly always present. I always take that position with parents and try to de escalate before they have the opportunity to become the aggressors. I might say something like let's figure this out together, here are my findings...if this was my own child I would consider... if this is something medical or non medical the sooner we bring an answer to this pattern the better. We might be dealing with something as simple as dehydration, etc. GL
  9. by   ruby_jane
    So what was the outcome? I hope that they burned off steam enough to make this a non-issue.

    Just for future reference....I learned to touch base with whichever admin was in charge of me the day that I had the conversation with the parent that I knew was going to end up complaining about me. Just so there was no surprise.
  10. by   EnoughWithTheIce
    Quote from ruby_jane
    So what was the outcome? I hope that they burned off steam enough to make this a non-issue.

    Just for future reference....I learned to touch base with whichever admin was in charge of me the day that I had the conversation with the parent that I knew was going to end up complaining about me. Just so there was no surprise.
    I do this also!!! Admin appreciates being prepared if the parent does complain.

    Also, I have forms called "recommendation for medical attention." I include all of my assessment findings and include a blurb for physician "please advise on at school treatment." I also attach a medication consent form to the referral and make a copy to attach to their medical record.

    In the past, I have sent multiple referrals home (and e-mail and or call parent), Parent either gets sick of me and takes them to the doctor or the symptoms subside. if not, I have a nice paper trail.
  11. by   JustRNingAlong
    Quote from ruby_jane
    So what was the outcome? I hope that they burned off steam enough to make this a non-issue.

    Just for future reference....I learned to touch base with whichever admin was in charge of me the day that I had the conversation with the parent that I knew was going to end up complaining about me. Just so there was no surprise.
    Yes, I had touched base with admin and also with the department in charge of the school nurses in our district.

    Haven't heard anything yet.
  12. by   Flare
    You made an assessment and based on vital signs determined that getting a further evaluation would be the best course of action. If the parent disagrees, they don't have to take him/her to the dr, but you've cya by making the notification you've had to make. If the parent thinks this is the kid malingering (which is unlikely due to the low bp, kinda hard to fake that) then they need to have a talk, or if the parent thinks that this is something that the child can somewhat control (perhaps not taking in any fluids at all or something like that prior to school) again, the parent needs to address with the child. But from the description, I don't gather that is the case. Granted I'm not there, but that's the feeling I get. The parent is out of line to verbally abuse you and I hope that was reported to your supervisor. We are caretakers and educators for these children, not punchingbags.
  13. by   beachynurse
    They complain to the administrators, who come and complain to us.... Couldn't this have waited until after school? We are trying to forge relationships with our parents, we don't want to piss them off you know... , Was it really necessary to send the kid home if you were able to bring their BP up?, and a million other questions from my non-medical professional bosses that make my life so very much fun.....
  14. by   Amethya
    Pssh, they complain and I go, Okay good luck with not helping your kid. "I want to talk to your supervisor!" Okay~! *Hands phone* go for it.

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