Students cutting themselves

OhioBPH · Mar 1, 2018

Thisis more common than many people think. Just stay calm, don't make too big of a deal about it, since she is already getting services. Do you you always do, be a calm, safe person at school.

cooties_are_real · Mar 1, 2018

How do you guys deal with this? My school admin know about this and the student is getting the help she needs, but this was the first time I saw her scars and I almost cried, because she's such a sweet girl and her doing this to herself?
How do you keep yourself from breaking apart seeing these sad moments?

Prayer and lots of it. There are days when I have to excuse myself and just cry. I'm a fixer. I like to fix 'em and send then back to class. When I can't fix it, it breaks my heart. I do my best to encourage and make them feel better, but when home is not good, I can't fix that.

JenTheSchoolRN, BSN, RN · Mar 1, 2018

You have to stay calm. It takes practice. It is a part of the job that isn't easy.

I have been the first person a student has talked to about cutting and seen the fresh wounds. It hurts, yes, but I am also very very glad a student has enough trust in me to talk to me about it. That tells me I am doing something right.

I talk with students about infection control. This is important and I lead with it. It is important to let a student know that this is a no-judgement zone, but I am concerned about infection risk and physical safety. I tell them I will always be honest with them and that I will likely have to talk to another adult about it, but that it does not mean they are in trouble. And that they are very mature for coming to see him.

Often a student that is cutting has been referred to the counselor (or I may be the person referring) and may have a self harm contract/plan in place that involves who to go if they are self-harming. It may be me and who I loop in is part of the plan.

Now what do I for me and my self care? Again, remind myself that I am doing something right because this student trusted me. And when I get home, I treat myself to some ice cream and a good comedy or musical on Netflix.

I hate to say it gets "easier," but I have seen this behavior many times, especially in the middle school. I once was part of three separate new self-harm kid evaluations in one school day. That was a tough day, I will say. But a year later? Those students are doing better and I have a great relationship with each of them based on trust and they have come to me when needed after that. That is a win.

Flare, ASN, BSN · Mar 1, 2018

I feel like it's a big part of the job to be level headed in your dealings with students. You are who they look to for answers and while it is one thing to be empathetic to their situation and want to give them someone to cry with, unfortunately, it's not the position you're in. You're there to assess them for safety and be nonjudgemental to their motivations. The first things you should be asking are if they have any suicidal feelings or feelings of self harm. Any feelings of wanting to hurt others. These are tough and uncomfortable questions to ask someone. Particularly a kid. And it makes it worse if you are doing it and are not in control of your own emotions. That part takes practice and restraint

In my district, any student cutting gets sent, usually via parent pick up for a professional safety evaluation after cutting activity is discovered.

JenTheSchoolRN, BSN, RN · Mar 1, 2018

I feel like it's a big part of the job to be level headed in your dealings with students. You are who they look to for answers and while it is one thing to be empathetic to their situation and want to give them someone to cry with, unfortunately, it's not the position you're in. You're there to assess them for safety and be nonjudgemental to their motivations. The first things you should be asking are if they have any suicidal feelings or feelings of self harm. Any feelings of wanting to hurt others. These are tough and uncomfortable questions to ask someone. Particularly a kid. And it makes it worse if you are doing it and are not in control of your own emotions. That part takes practice and restraint In my district, any student cutting gets sent, usually via parent pick up for a professional safety evaluation after cutting activity is discovered.

All of this as well.

Asking a student if they have any suicidal thoughts is never fun. It requires a lot of control of emotions. This is really important for a student to feel they can honest. And having a student say yes and asking them if they have a current plan for harm and hearing yes is hard. The first time it happened was a even harder.

And being the parent to call a parent about it? Even harder. I am lucky my state has a psych team that can come to the school to evaluate a student if I need it. I also have a wonderful counseling team that can take the reins and we work together.

My school also requires a student be evaluated with cutting behavior and cleared to be safe to return to school by a mental health professional. Paperwork has to be hand. We have dismissed students home with parents again because of it. But it also helps some students get help that might not.

Edit: caring for student that cuts? That is really where knowing the plan the student has is important. But also a level head. If I see an old scar, I might inquire and even ask in a professional way (privately - not if my office is full of student) if that is a mark caused by a student themselves just so I am aware (and again office is no judgement zone). Asking without getting emotional actually helps student be more honest. I always tell a student I'll be honest and hope I can expect the same from them. Empathy vs emotional takes practice I feel.

Amethya · Mar 1, 2018

I feel like it's a big part of the job to be level headed in your dealings with students. You are who they look to for answers and while it is one thing to be empathetic to their situation and want to give them someone to cry with, unfortunately, it's not the position you're in. You're there to assess them for safety and be nonjudgemental to their motivations. The first things you should be asking are if they have any suicidal feelings or feelings of self harm. Any feelings of wanting to hurt others. These are tough and uncomfortable questions to ask someone. Particularly a kid. And it makes it worse if you are doing it and are not in control of your own emotions. That part takes practice and restraint In my district, any student cutting gets sent, usually via parent pick up for a professional safety evaluation after cutting activity is discovered.

Yeah, but as I said before, the student has already been cared for, is getting professional help, but it was the first time I saw the scars. I didn't cry or did a big deal, I just told her how to care for her scars, and told her that we love her at school and that if she needs a hug or someone to talk to, she can talk to our AP, a teacher or even me. I gave her a big hug and she went to class.

peacockblue · Mar 1, 2018

I pretty much deal with the medical aspect; infection control, need for stitches. ( thankfully only saw that once) our counselors take it from there and assess the student and call the parent. They then teach healthy coping skills. We see it mostly in middle school and younger high school girls.

Julius Seizure · Mar 2, 2018

Yeah, but as I said before, the student has already been cared for, is getting professional help, but it was the first time I saw the scars. I didn't cry or did a big deal, I just told her how to care for her scars, and told her that we love her at school and that if she needs a hug or someone to talk to, she can talk to our AP, a teacher or even me. I gave her a big hug and she went to class.

It sounds like you did an excellent job.

Beldar_the_Cenobite, CNA · Mar 2, 2018

I've seen some scars and had a look on my face like "what the hell is wrong with you?"

I blame parents. Parents are who kids, from the chute on up to 18, spend the most time with. No other adult. What time they spend in classroom is nowhere near as long as how they spend it with their personal families at home. Teachers won't provide you with breakfast and a warm meal at night and a bed. The parents do. That means that the amount of time they grow and learn how to behave is dependent on how the parent behaves and acts. If the parent likes to be informal and not resourceful, the kid will probably have an expectation that their parent will take care of them until they grow up and can feel good about leaving the house without a worry in the world about how they'll pay their rent. This is not always true. Eventually, the parent will grow tired of the kid thinking that the kid has no direction, but because the parent lacks resourceful information that provides useful for the kid, the parent struggles. Parents who are informal/formal and resourceful will raise kids probably the most effective way to live.

Helicopter parenting is one informal way, but it's not resourceful, therefore, not effective parenting method.

Combine what I said with the country they live in, the USA and its resources for opportunities for growth to other kids in say Philipines and Syria and their resources and opportunities for growth, you'll see how "obliviously spoiled" the self-slicer truly is. Adults are also the same minus the cutting. Obliviously spoiled.

Just a logical observation.

caliotter3 · Mar 2, 2018

Met two individuals who cut. Girl in high school carved name of boy on her lower arm. She was a 'marginal' student who told the school counselor that she was leaving school after tenth grade to marry a sailor. Last we saw of her. Another person in the military said she had kept her cutting behavior a secret when she enlisted because she did not want to be disqualified. She disclosed that, and probably other situations, when she decided she wanted out. Not all cutting is suicidal in nature but it certainly is not the norm. Very good advice given above.

ohiobobcat · Mar 2, 2018

I've seen some scars and had a look on my face like "what the hell is wrong with you?"
I blame parents. Parents are who kids, from the chute on up to 18, spend the most time with. No other adult. What time they spend in classroom is nowhere near as long as how they spend it with their personal families at home. Teachers won't provide you with breakfast and a warm meal at night and a bed. The parents do. That means that the amount of time they grow and learn how to behave is dependent on how the parent behaves and acts. If the parent likes to be informal and not resourceful, the kid will probably have an expectation that their parent will take care of them until they grow up and can feel good about leaving the house without a worry in the world about how they'll pay their rent. This is not always true. Eventually, the parent will grow tired of the kid thinking that the kid has no direction, but because the parent lacks resourceful information that provides useful for the kid, the parent struggles. Parents who are informal/formal and resourceful will raise kids probably the most effective way to live.

Umm, thanks?

My daughter was a cutter. Let me tell you something, it sucks to see your kid hurting so badly, that she feels cutting herself is her only option to feel better. "Obviously spoiled" is not a term that I would use to describe my child, or others that I have encountered who cut.

I am not a teen mother, had her when I was 28 years old in case you were wondering. She always had a warm meal and a bed at home. I am not going to bore you with my life and her life story, but suffice it to say, this type of behavior can happen to anyone, from any walk of life.

I find your response to this type of behavior from students under our care as school nurses very judgmental, and kind of confusing. I don't understand what you mean by a "resourceful" and "informal" parent.

Our job as school nurses is to meet the student where they are emotionally and physically, and be a calm, non-judgmental resource for these students. I don't assume anything about a student who comes to me with cutting behaviors. I physically assess the cuts and treat them, I assess suicidal ideation, and I refer to guidance. Often times guidance will bring these students to me for treatment.