Should I have checked?

JenTheSchoolRN, BSN, RN · Sep 3, 2015

Nope, nope, nope - your instinct was on the money. I do not check any area that pants/underwear covers in a male or female student. It is just me, no other witness. Nope, nope, nope.

I ask a series of questions like you did and then I call the parent. If I feel the student needs a true examination by a health care professional based on this questioning (i.e. when I suspect it is something else other than a student's first MP), I will tell the parent they do and urge them to make an appointment with the student's doctor. (For HS students, I have had a student call the doctor themselves, especially if it may be pregnancy-related - know your states guidelines there). If I have been asked if I conducted an exam, I simply say "I am not equipped to perform such an exam in my office nor can I diagnose the issue. You need to make an appointment with your child's doctor."

And I document this. Document, document, document.

SnowyJ, RN · Sep 3, 2015

So the parent is mad at you because the child had a little blood from being constipated?

And this is your fault because???

You did your job...You called to let mom know. If she was so concerned, she could have picked her child up herself.

It's a slippery slope when anyone would expect us to examine the genital area. I would only do it if I was concerned about serious trauma, and WITH another adult present and notification of the parent.

OldDude · Sep 3, 2015

Nope, nope, nope - your instinct was on the money. I do not check any area that pants/underwear clothes in a male or female student. It is just me, no other witness. Nope, nope, nope.
I ask a series of questions like you did and then I call the parent. If I feel the student needs a true examination by a health care professional based on this questioning (i.e. when I suspect it is something else other than a student's first MP), I will tell the parent they do and urge them to make an appointment with the student's doctor. (For HS students, I have had a student call the doctor themselves, especially if it may be pregnancy-related - know your states guidelines there). If I have been asked if I conducted an exam, I simply say "I am not equipped to perform such an exam in my office nor can I diagnose the issue. You need to make an appointment with your child's doctor."
And I document this. Document, document, document.

Absolutely!! You shouldn't feel terrible; you should be proud that your instinct was right on target.

JustBeachyNurse, LPN · Sep 3, 2015

You were right. There was no reason whatsoever to perform a peri-area exam. There was nothing you could do or say. Offer a sanitary pad if you suspected menarche and call the parent.

Glad I have a son!

Oedgar · Sep 4, 2015

Nope no way! I work in an OB/gyn office.. and we rarely look down below for preteens/young teens. Even if they come in with problem periods we just put them on the pill. You could have been in a bad situation if you had checked and then the mother got angry.

We've had a few young teens who needed an exam.. and my doc is a female. She was young and brand new.. and did not call me into room to chaperone. I told her with the young kids she still needs a witness.

You did the right thing.

ohiobobcat · Sep 4, 2015

Nope, nope, nopity nope. I would not have gone "there".

You handled it exactly as I would have. Why is mom still harping on this a week later? Have Susie eat more fiber and move on!!!

AdobeRN · Sep 4, 2015

Agree with the others - you did the right thing. I don't check - I call parents of all kids that report bleeding, pain with urination, "private area hurts" etc. I did have a KInder student fall onto a balance beam structure on our playground, landed on groin area - huge laceration in the perinium - bleeding like crazy - that has been the only time I have examined and it was due to an injury - I did have the AP in with me.

NanaPoo · Sep 4, 2015

Oh my...yes, I would have checked the perineal laceration but that's a special situation for sure!

I had a 5th grader complain of "butt pain" yesterday when he landed hard on the gym floor after a Tug of War battle in PE. This kid has a history of dramatic complaints and situations and described "busted blood vessels" on his posterior. Trust me, I did not do a hiney assessment on this kid.

kidzcare · Sep 4, 2015

Oh my...yes, I would have checked the perineal laceration but that's a special situation for sure!
I had a 5th grader complain of "butt pain" yesterday when he landed hard on the gym floor after a Tug of War battle in PE. This kid has a history of dramatic complaints and situations and described "busted blood vessels" on his posterior. Trust me, I did not do a hiney assessment on this kid.

Agreed. I would check a traumatic injury. I had a similar situation with a drama loving kid who came up with the most obscure complaints. He came in and whispered to me "My thing hurts really bad. You know.... My thing" and indicates his crotch. I told him to let his parents know. After he left my office I called the mom who also sighed dramatically and said he was "probably pulling on it too much" :blink:

JenTheSchoolRN, BSN, RN · Sep 4, 2015

Oh my...yes, I would have checked the perineal laceration but that's a special situation for sure!
I had a 5th grader complain of "butt pain" yesterday when he landed hard on the gym floor after a Tug of War battle in PE. This kid has a history of dramatic complaints and situations and described "busted blood vessels" on his posterior. Trust me, I did not do a hiney assessment on this kid.

Okay, now I feel the need to use the words "hiney assessment" at some point in my life. :roflmao:

Farawyn · Sep 4, 2015

Agreed. I would check a traumatic injury. I had a similar situation with a drama loving kid who came up with the most obscure complaints. He came in and whispered to me "My thing hurts really bad. You know.... My thing" and indicates his crotch. I told him to let his parents know. After he left my office I called the mom who also sighed dramatically and said he was "probably pulling on it too much"

hahahhahahahahahhaa!!!