Question re: bed bugs, etc

[AMcCallRN]

Good Morning,

I have a question for all your School Nurses. Do you consider bed bug infestation neglect? And if you had a student with numerous bites, would you call the parents to inquire if they have a bed bug infestation?

The reason I ask, is I have friends who are very "offended" that the school nurse called her to ask if they have bed bugs because her daughter has many bites on her. They are mosquito bites, but my friend is insulted that a nurse would have the nerve to ask her about bed bugs.

IMO, if something (anything...pest infestation, lice, abuse, neglect) is questionable, then as a nurse, it's our duty to inquire.

Thoughts?

Aimee

[Eleven011]

I would call, but use a more tactful approach. " Johnny is here at my office with lots of little bites on him, did you notice that?" " do you know what they might be from?" That would give them the chance to say they were outside all evening and johnny got bit up by mosquitos (or whatever else it might be). If they are clueless as to what they are, I will take the opportunity to say something like " maybe there are spiders/bed bugs/other creatures in your childs room or bed. Maybe you could check it out?". I would hope they wouldn't be offended!

And no, I wouldn't consider it neglect. An infestation can happen to anyone. Now if nothing is done to remedy the situation, child is continually covered in bites and is scratching open/getting infected areas, that might be different.

[AMcCallRN]

Thank you for your response. I tried to explain to these friends that bed bugs don't mean neglect, nut not sure they are convinced. :)

[linda1959]

Well if it means neglect, I am raising my hand! We just spent 6 weeks dealing with them. The only person in the house who was getting bit was my son - not everyone has a reaction. And before we discovered the the true problem, the pediatrician thought it might be hives and an allergic reaction to Sudafed. And I agree ---it's only neglect if you don't deal with it once it's discovered. But I also get the stigma and what people think . .. it's been a real eye-opener!

[BrisketRN, BSN, RN]

I agree with everyone above. It's not neglect if it's being treated. It can be a process! My sister and I got bed bugs when we lived together in college. We had a fully carpeted apartment and it took 3 full treatments until we were free of bed bugs. Also, leading with bed bugs might not be the best option. I'd go with the "do you know what these bites are from?" and if they aren't sure you could give suggestions.

[UrbanHealthRN, BSN, RN]

There's nothing wrong in asking a question related to a child's health- we're nurses, and (most) parents understand that we just care about kids and want to help. Unless I was VERY sure, though, that a kid had bed bug bites, I'd start the conversation with something general, like "I was asked to check out your child's right arm and noticed some red bumps on her arm", and let the parent take it from there.

As far as neglect- bugs are hell. Lice, scabies, bed bugs...whatever they might be, they creep, they crawl, and they are pain in the patooty to get rid of. As long as I know that a parent is trying to solve the problem, I wouldn't worry. If the parent wasn't doing anything about it, and the kid was getting open skin wounds, couldn't focus due to the itching, etc., well that's not ok. I doubt a parent would like to feel that way, so why would their kid? At that point, some close follow-up, parent conversations, and discussion with the pedi would all happen first, and then maybe I would think about a CPS call if all else failed. But that should be a far-down-the-line move to make.

[OyWithThePoodles, RN]

My kids look like they have an infestation. So much so that I make them wear leggings out lol. Mosquitos flock to them... and me. Hubs was out on the porch for 10 minutes the other day and saw not one mosquito. I come out and was bit three times in just as many minutes.

[KelRN215, BSN, RN]

Not neglect and I doubt such a report would even make it past the screener if anyone tried to call CPS to make such a claim in my state.

Bed bugs can happen to anyone.

[KatiejonD, RN]

Here's what I learned after a city-wide increase in bedbugs in my area a few years back:

my state (NH) does NOT consider bedbugs as "neglect" or anything of concern because there is no evidence that they spread disease.

If a child was in my office routinely complaining that they itched - I would put it back on the parent. Instruct them that they need to purchase something like a calamine lotion, or a hydrocortisone cream and apply it BEFORE school. The school nurse should not be tasked with doing this daily, nor should the student be missing academic time for an issue at home. (Pretty much all parents did follow-through).

If a bedbug was found on the student, or on their backpack - off to home they go. Mom and Dad would need to change their clothing, look them over thoroughly before the child returns to school - and would check in with me before returning to class. Of note: this only happened twice, and one of those times it was an 8th grader who was literally flicking them off his sweatshirt in class.

What I did do was contact my state about what resources these parents had if they were renters (many of my students come from low socioeconomic homes, many of the parents aren't exactly 'go-to'ers'). But I was able to print out my state's laws pertaining to 'who's responsibility is it to treat' for those that rented, as well as a list of contacts that were resources for people. I did not get involved, or offer advice. I simply asked if they would want the info provided by the state to look over. I never had a parent decline.

[Farawyn]

Sensitive Parent Alert!!!