Someone talk me down...

Specialties School

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Specializes in School Nursing.

because I am about to jump (figuratively of course!) Too angry for details right now, but in short a parent is upset with how I handled a fracture. Everyone I have talked to agrees I did everything fine, but she has made a call to admin. What really gets me is that I talked to her this morning to check on the child and she said NOTHING. As soon as my hands stop shaking I will give more details, maybe some of you more experienced school nurses can let me know if I could have done anything different. I just feel like I pour my heart and soul into these kids, and this is what I get. I held that child's hand and stroked her head for almost an hour waiting for her mom to drive in (she works 30+ minutes away), and this is the thanks I get? I really want to quit right now, but I am too smart to do it when I am this emotional. :sniff:

Specializes in School Nursing, Ambulatory Care, etc..

purple,

if you did everything you could do and according to policy, then you shouldn't be upset. sometimes, people (this parent) need someone to blame. maybe she is feeling guilty because she was at work and wasn't able to be the first comfort her child received. maybe she had a bad day and needed someone to be mad at. maybe she's just crazy. anyway around it, don't let one parent, with one ax to grind, ruin your day - or your weekend!

remember, scarlett, tomorrow is another day and wine heals all wounds!

sara

Specializes in School Nurse, Maternal Newborn.

Yes, it is a good idea not to let emotions at such a time put you into a state where you can't think clearly, or have you needlessly move on. It would be a shame for you to leave a job that you obviously love and do well at. And, just plain wrong, when this mother is probably wrong in the first place.

There are always parents like this- and I really don't understand what makes them this way. Some of the most neglected kids in my school are the ones that have the parents that go to the ends of the earth to try to have someone punished when something happens while the child is away from home. This is even if the child is one with behavioral problems that the parent is not following up on, and is doing something that they were not supposed to have been doing when the injury occurred.

The school district I work for is problematic in that it backs down for some of these bullying parents every time, the nurses are unfairly forced to defend themselves.

Did she think that you needed to call an ambulance? Of course, we both know that a fracture, if closed, is not that type of injury, it can wait for the parent to come. Sometimes, though, I have felt forced to call for an ambulance, as some of our parents would probably not take the child to a physician at all, but would then say "she never told me to". I am very careful with those, as you can imagine. (A lot of my kids are in and out of unfit homes, foster care, etc.)

Other than immobilizing the fracture, keeping it raised, putting ice to it, calling the mother, and comforting the child, I am unsure of what else there would be to do?? If this mother has any other suggestions that could help keep a parent from treating the nurse this way, I would love to hear them! I am sure that you did the right thing, but I know that even knowing that doesn't help when you are hurt by allegations of mishandling a fracture- it never helped me, at least!

Specializes in School Nursing.

Don't jump, Purple!! :eek:As long as you acted properly and documented everything, the parent doesn't have a leg to stand on. Sorry you have to deal with this. Some folks are just crazy, no matter what.

Specializes in LTC.

Hang in there Purple. I'm sure everything will turn out find.

Specializes in School Nursing.

It is a new week (and the last week of school) so I am feeling better. Basically the parent was upset because "if I had told her it was broken she would have gotten there faster". How she would have managed that I don't know because she still works 30 min away. What I told her (the child was in earshot, so I did not want to use the word broken or fracture, since she was hysterical already), was that she had what looked like a deformity to the bone in her arm, and she needed to go to the emergency room immediately for an x-ray. Mom still says I should have said "it is broken". I have two problems with that. 1) Do I have a red cape and a big S on my chest. No. So I do not have x-ray vision either. 2) Even if I was 100% sure it was broken, it is not in my scope of practice to diagnose. I have had a parent call me out when I excluded their child for pink eye and grill me for "making a diagnosis", even though I was just recognizing s/s, so I am very careful not to step over my scope.

I don't think anything will come of this. Mom wanted to talk to the principal today and she did not want to talk to my bosses in health services, so I think it will blow over.

Here is one thing I want to ask you all. This kid was tiny tiny, and the smallest pedi cardboard splint was way too big, even with what little padding I had to pad it. She was already holding her arm across her chest, so I put it in a sling rather than a too-big splint. It was still immobilized. I wish I could have splinted it, but with our tiny budget and the supplies I had I did the best I could. Would you have done the same, or what might you have done differently. Mom was not upset about how I handled it, but it has been bugging me since I wish I had a smaller splint.

Thanks everyone as always for the kind words and encouragement. Y'all are the best!

Specializes in School Nursing.

purple, so sorry you are being put through this. it is very un-deserved. you are a good school nurse and you did your best with this child. don't let a "bully" parent kick you around. some parents are real butt heads. don't let it ruin your day. we all support you !!

praiser :heartbeat

Specializes in School Nurse, Maternal Newborn.

With the information you have to work with, unless you do have x-ray vision, no one can state "broken" for sure! Also, I, too, am skittish about "diagnosis", it is not within our scope of practice. Even so, a fracture, while very serious, is not usually life threatening.

As for the splint, I think that the sling probably worked OK. I have, though, on a tiny child, used tongue blades taped together as splints, and it worked well. (for a fractured forearm.)

Specializes in School Nursing, Ambulatory Care, etc..

purple,

i am in agreement with you and everybody else that has posted since; we do not diagnose! if you would have said it was "broken" and it wasn't then she would have been mad b/c of that.

anyway, i keep a couple of old magazines in my office to use as splints. the problem here is, if it looks "professional" the parent won't take the kid in figuring it's already been treated.

hope you have a good week!

s

Specializes in Cath Lab, OR, CPHN/SN, ER.
It is a new week (and the last week of school) so I am feeling better. Basically the parent was upset because "if I had told her it was broken she would have gotten there faster". How she would have managed that I don't know because she still works 30 min away. What I told her (the child was in earshot, so I did not want to use the word broken or fracture, since she was hysterical already), was that she had what looked like a deformity to the bone in her arm, and she needed to go to the emergency room immediately for an x-ray. Mom still says I should have said "it is broken". I have two problems with that. 1) Do I have a red cape and a big S on my chest. No. So I do not have x-ray vision either. 2) Even if I was 100% sure it was broken, it is not in my scope of practice to diagnose. I have had a parent call me out when I excluded their child for pink eye and grill me for "making a diagnosis", even though I was just recognizing s/s, so I am very careful not to step over my scope.

I don't think anything will come of this. Mom wanted to talk to the principal today and she did not want to talk to my bosses in health services, so I think it will blow over.

Here is one thing I want to ask you all. This kid was tiny tiny, and the smallest pedi cardboard splint was way too big, even with what little padding I had to pad it. She was already holding her arm across her chest, so I put it in a sling rather than a too-big splint. It was still immobilized. I wish I could have splinted it, but with our tiny budget and the supplies I had I did the best I could. Would you have done the same, or what might you have done differently. Mom was not upset about how I handled it, but it has been bugging me since I wish I had a smaller splint.

Thanks everyone as always for the kind words and encouragement. Y'all are the best!

You did exactly what you were supposed to, and I would hope your admin. would understand that and back you.

As for splints- a rolled up newspaper is a good splint material. It's thick enough to not bend easily and maintain its form when taped.

Specializes in School Nursing.

THanks for the tips! The newspsper/magazines and tongue blades are great ideas, I will keep that in mind for the inevitable next time.

Specializes in Cath Lab, OR, CPHN/SN, ER.
THanks for the tips! The newspsper/magazines and tongue blades are great ideas, I will keep that in mind for the inevitable next time.

YW! The newspaper is very handy for ankles. Shape it like a U with the sides of the U going up around the malleolus (spelling?) and then wrap it up. Great stabilizer.

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