Ugh...feel so inadequate sometimes

  1. Kid hurt his wrist yesterday at recess. I honestly thought it was fine. Minimal, if any, swelling. Good ROM without signs of discomfort. Did not seem tender to palpation. And he was using his other hand to push & hyperflex it all the way down towards his arm! Iced it & called dad & said I couldn't be 100% of course but thought it was OK...just keep an eye on it. Fast forward an hour to end is the day & his teacher says it looked like there was a nice sized bump. Great, he's gone now. Call dad & tell him that according to teacher's description it has more swelling than when I saw it & he might want to get it looked at. Fast forward to this morning...fracture.

    Anyone have any Bazooka Joe wrappers they can send me? I want to save up for some X-ray glasses.
  2. Visit SaltineQueen profile page

    About SaltineQueen, ADN, RN

    Joined: Dec '15; Posts: 568; Likes: 1,729
    School Nurse
    Specialty: School Nurse, past Med Surge

    10 Comments

  3. by   OldDude
    Those xray glasses don't work...you can't even see through clothing with them!!! Why are you "ughing" and feeling inadequate? You took all the appropriate measures and informed the parent. Could you have done anything that would have changed the "fracture" diagnosis?? Now, STOP IT, with that kind of talk!!!
  4. by   ruby_jane
    You did the best you could with what you had at the time.

    Also you followed up on a report from the teacher (but WHYYYYY didn't s/he send the kid back?)

    Even if you had the wayback machine, you wouldn't necessarily have done anything different, and I guarantee you if you had called dad and insisted dad come get kid, that dad would have taken him home because...at the time of the assessment there was no deformity.
  5. by   SaltineQueen
    I know these things. Thank you. I just wish there was more we could do at times. Like...it would be awesome to have an occupational health type clinic that we could send kids to for quick X-rays or strep tests...that type of stuff.

    Sigh. Dare to dream.
  6. by   pedi_nurse
    Quote from SaltineQueen
    I know these things. Thank you. I just wish there was more we could do at times. Like...it would be awesome to have an occupational health type clinic that we could send kids to for quick X-rays or strep tests...that type of stuff.

    Sigh. Dare to dream.
    Our local children's hospital does a telehealth program in over 100 schools in the area (unfortunately not this new district I'm in). They can do video appointments for rashes, earaches, sore throats, etc. They do rapid strep tests in every clinic and flu tests in high volume ones. It's an awesome program, and not nearly as much extra work I thought it was going to be. I wish we had it here. I think every Title I school could benefit from it.
  7. by   Farawyn
    Quote from SaltineQueen
    I know these things. Thank you. I just wish there was more we could do at times. Like...it would be awesome to have an occupational health type clinic that we could send kids to for quick X-rays or strep tests...that type of stuff.

    Sigh. Dare to dream.
    No. NO NO NO> We work in a school, not a hospital. These are not patients. These are students that sometimes hurt themselves or get sick. NO
    You did it all.
    No ughs.
  8. by   BluebellRN
    Same thing happened to me earlier this year. Felt like crap! But it happens and it'll happen again. We can only assess what we see and what the student tells us. Don't be hard on yourself.
  9. by   JenTheSchoolRN
    I remind myself of this: this is school. These students don't have a school nurse at home. School isn't meant to be an urgent care center. Yes, I can catch things because I have more training than most patients medically, but I can only do what I can with the tools I have.

    Do parents sometimes expect more? Yep, they do. But it isn't more. Daycare centers, afterschool care, they don't have urgent care access either. And kids are interesting creatures that compensate well and change quickly later; you can only assess and report what you see at that snapshot in time.

    As for the person upthread that said they wish they had access to more resources with Title I schools. Heck, yeah! I wish I did. But at the end of the day, I can't refer a kid anywhere without parent permission and I also can't usually go with the kid while they get checked out and really need that adult support. Sure, one can argue a teen can do it on their own, but I'd recommend every person, even adults, not have to go to ED by themselves if they have access to a person who can go with them.

    At my school, we have a great staff member that will take students to appointments with parent permission. That person isn't medical, but I love that person and their work is very supportive to me and mostly to the student who needs it, but for some reason, can't have a parent do it.

    Okay, I'm off my soapbox now. SaltineQueen, you are doing the best you can. And most parents know and appreciate that.
  10. by   Amethya
    You tried... :3 At least he got the help he needed and now on the road to recovery!
  11. by   ruby_jane
    Quote from SaltineQueen
    I know these things. Thank you. I just wish there was more we could do at times. Like...it would be awesome to have an occupational health type clinic that we could send kids to for quick X-rays or strep tests...that type of stuff.

    Sigh. Dare to dream.
    I need Davy Do or Julius Seizure to come in here with a picture with the lyrics from "Man of La Mancha" - To dream, the impossible dreeeeeaaaaaammmm....
  12. by   CampyCamp
    Wrists suck. Fingers as well. I tell the kids and the parents that, too. Well, I phrase it more professionally. A couple years ago my daughter broke hers. She told me so but, who can know. I took her to the ER ASAP because she also hit her head and was suddenly sleepy. Otherwise I would not have been as concerned about her wrist. So I got to talking to the ER doc about clinical clues because I use screening tools for ankles and heads at camp. I want to be more proficient with wrists since I got screamed at by a parent once so I pick brains whenever I can. He just shrugged and said "yeah, we just xray everything" Ortho said the same. So I tell parents that now.

    I'd love the tele-health at camp though. It sucks to take a kid out of the fun for a day or overnight while they get checked and then cleared to rejoin. At school, not so much. They still spend 2/3 - 3/4 of the M-F week with family or the caregivers they select. They need to do this stuff again. They need more affordable ways to do it but the problem isn't usually the money as much as the DOING.

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