Scoliosis - noncompliant

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Hello again SNs! I have a student who is noncompliant with wearing her brace. Meeting with parents soon to talk about a plan. Has anyone dealt with this? Any ideas on how to ensure she is wearing it throughout the day short of having her stop by my office every period for me to verify?

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Specializes in Pediatrics Retired.

Do you have written instructions from the prescribing physician about intervention at school?

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My daughter parked her brace in her locker. When I found out, did not try to involve school personnel because I knew they didn't care enough to even give me lip service. Maybe have someone speak to her from their experience?

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Specializes in Nursing Professional Development.

What does the student say? It seems to me, that is the place to start ... build a trusting relationship (of find someone that has a good relationship with her) and then do a whole lot of listening. What is her understanding of her condition? What is her understanding of what will happen if she doesn't wear it? Why is she not wearing it? Is she prepared for the consequences of not wearing it? etc. What is her development level? Is she capable of grasping the importance of wearing it ... the consequences, etc.?

See it through her eyes, then go from there.

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Specializes in Pediatrics Retired.
Do you have written instructions from the prescribing physician about intervention at school?

I confused myself when I re-read this...let me re-phrase. Do you have a note from the doctor instructing her to wear the brace full time at school?

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I confused myself when I re-read this...let me re-phrase. Do you have a note from the doctor instructing her to wear the brace full time at school?

She has to wear it 21 hours a day, and she takes it off outside of school for about 2 hours for activities/shower, etc. So she's allowed to remove it for an hour at school, usually for gym, but she's keeping it off longer than that, taking it off during other times of day, etc.

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What does the student say? It seems to me, that is the place to start ... build a trusting relationship (of find someone that has a good relationship with her) and then do a whole lot of listening. What is her understanding of her condition? What is her understanding of what will happen if she doesn't wear it? Why is she not wearing it? Is she prepared for the consequences of not wearing it? etc. What is her development level? Is she capable of grasping the importance of wearing it ... the consequences, etc.?

See it through her eyes, then go from there.

Thank you so much for this. I think I will check in with her and do a lot of listening like you said. I needed that reminder so thank you!

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My daughter parked her brace in her locker. When I found out, did not try to involve school personnel because I knew they didn't care enough to even give me lip service. Maybe have someone speak to her from their experience?

Great idea, thank you!

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Specializes in Pediatrics Retired.
She has to wear it 21 hours a day, and she takes it off outside of school for about 2 hours for activities/shower, etc. So she's allowed to remove it for an hour at school, usually for gym, but she's keeping it off longer than that, taking it off during other times of day, etc.

How about this? Tell her the only place she is allowed to store her brace is in your clinic. That way you know it's not on her if you see it there. Also, you can spot check her locker through the course of passing by it throughout your day to ensure compliance.

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Specializes in School nursing.
How about this? Tell her the only place she is allowed to store her brace is in your clinic. That way you know it's not on her if you see it there. Also, you can spot check her locker through the course of passing by it throughout your day to ensure compliance.

You may find she actually prefers this and may be more open to using your office to change in and out of it during that 1 hour of "off" time. She may feel self-conscious.

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Teaching my niece how to put on and take off her brace was one of the best and worst things ever. She's 12 and has had a brace now for about 5 years and she's STILL not quite to the 21 hrs/day requirement. She's close though. I sat her down when she was about 10 and showed her different degrees of scoliosis and what the surgery would require if she continued to not wear her brace. We've had to build her stamina up to the 19 hours she's currently getting in. But getting to that magic "21 hours" goal has been tough!! I also would reward her for meeting the time goals we set for her, increasing each goal after she met the previous one. I really like the idea of sitting your student down and just talking with her about her reasoning behind removing it when she's not supposed to. See where she's coming from and what's leading up to its removal. It's easy for us, not only as adults, but as nurses to see the benefits of wearing the brace but forgetting to explain to the kiddo, in a way they understand and can grasp, the importance of doing so. Maybe try working WITH her to give her more "perceived" control. I hope it all goes smoothly for you though!

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