Should I talk to principal about this? (long note)

[katynurs22]

There is a kindergarten teacher that in my opinion lacks patience with her students. She has a male student in her classroom that frequently soils his underwear (possible encopresis, he has all the signs and symptoms, but I'm not the doctor , I can't diagnose). I've sent her an e-mail with information on encopresis for educational purposes and to help her understand that it is a complex condition and reprimanding does not work to treat it. I also told her that the counselor was going to see him and she says "the counselor isn't going to do anything, the mom needs to teach him how to clean himself". The counselor told me that the student states "my teacher told me I have to use RR at home not at school". And she still yells at him.

Today she sent him without a clinic pass, so I send him back to class with blank passes and he returns with nothing and "my teacher said she doesn't need any more passes". So i called her, no answer. So I just forget it and treat his finger that was smashed by a door at home 3 days ago and mom claims x-rays ruled out fracture and then I send him back. Then he returns without a note and shows me the bandage has minor oozing of blood because he hurt it again, so I change the bandage wrap and sent him back. Then he returns again without a note because he washed his hands and it got wet, so I change it again. Then he returns without a note, and i'm like now what , he says "it's too tight" when I know I checked that the bandange wasn't too tight before he left, so I write on a blank pass "no treatment necesary, he needs to keep it on, please send students with pass to clinic". Then he returns again with a note finally with complaint "not clean, he smells" and i did smell it now that he was close enough, then he tells me I have clothes in backpack, so I return him back to class and write "he says he has clothes in back pack, he does not need to return to clinic, we do not have wet wipes anyway." and that was the end of that.

Should I talk to principal about her yelling at him and not sending passes multiple times, I don't want to sound like a snitch or complaint. This teacher is really annoying me now, especially because she sends notes with "call mom for ..." , or "he's really sick" and then comes back and asks "did the parent's come and pick him up?" and I'm like "No I didn't need to call, no fever, he rested, and when asked how he feels he said he feels good, he was fine , I sent him to his music class".

[SilentfadesRPA]

i take from your post you are a school nurse.

have you discussed this with his mother and seen that he his being medically/psychologically evaluated ?

i can not imagine not talking to the principle with documented times and interactions of this teacher as well as your observations of the affect she has on him.

i can not nor want to imagine what this child must be going through with the shaming this woman is projecting on him -

if the principle did not resolve the issue then i think his parents need to intervene with this child's teacher.

i am sure if this was your child would you as a mother would want to be informed of how he is is being treated ?

his sense of worth must be getting shot down daily.i remember a case over years ago that i testified in. a little 4year old boy. the "mother" would clip clothes pin his member when he wet - the baby could not even look at me yet he hung so tightly to my neck when we were examining him and taking pictures of his injuries. i remember not only the physical injuries but the shame he seemed to convey and yet the need for love that he so desperately was trying to find and hold on to.

sounds like he trust you and finds comfort in your care with all of the repeated trips he makes to the office.

instead of letting the teacher handle this situation could not the school purchase some wipes for your office to help him?

i would right out tell her if i ever know of her shaming this child again i will call the child protective services and report her for abuse. and i would do it as a health care professional we are mandated reporters and this does not apply only to physical abuse.

this bothers me alot knowing he is only in kindergarten for gods sake

hang in there with him. sounds like he really needs someone like you on his side.

you may want to consider checking out this book as a reference :

recognition of child abuse for the mandated reporter

written by angelo p. giardino, md, phd; and eileen r. giardino, phd, rn, crnp

the specific following chapters may help you decide your role in this situation

3. child neglect and abandonment

4. educational neglect

5. psychological abuse

8. psychological and psychiatric issues

10. the role of the school in child abuse

all the best to both you and him

marc

[Purple_Scrubs, BSN, RN]

As far as her ignoring your policies, I would try talking to the teacher directly first and set your expectations. Let her know that you will not be seeing any students without a pass, except in emergencies (and define an emergency). You'll have to stand your ground, though, and keep sending students back who do not have passes, as many times as it takes. If this does not work, then a sit down with the principal would be my next step. You could also send an email out to all staff as a friendly reminder and copy the principal on it, so when you take it to him/her you can show that you tried both emailing a reminder, and speaking to the teacher directly.

As far as the student, I think a meeting with the parent, yourself, the teacher and counselor is in order to set out a plan that everyone can agree one. I.e. the student will keep a change of clothes (or two) at school at all time, when he soils himself he can change in the regular bathroom (although you might consider allowing him to use your bathroom if privacy and embarassment as issues with him). You can't force the parent to take the child to the doctor, but you can strongly, strongly recommend it. There are careplans out there for encopresis that might help.

Good luck, sometimes it can be very difficult dealing with a teacher like this.

[shellfrmmo, ASN, BSN, MSN, CNA, LPN, LVN, RN]

I am a middle school nurse and had a very similar situation with a para-professional and a student with what I would label encopresis in my humble opinion. She was mean and hurtful and really just horrible to the child. My son has encopresis and it just set me off. Of course, I have learned the techniques for my son so that he doesn't have that issue anymore but I am sure that if we didn't use those techniques he would still have the problem.

So I was very upset with how she handled this situation. I told the teacher she worked with, I also told my boss and the principal and the counselor. I also gave her print outs on encopresis. I also gave one to the parents.

She has been moved to another school- the high school- which- I do feel guilty about. It may not be related at all but it was within 2 months of my complaints.

The kid is a lot better adjusted and actually hasn't had the problem since she left. I don't know if thats related or not or perhaps the parents are using the techniques on the hand out.

You are the student advocate in my opinion. We are here to help the child succeed in this environment in a healthy and caring way. Please continue to be there for him.

I would most certainly let the principal know. Also, when we have "frequent fliers" I call the parents and talk to them about it. Most of the time they are unaware and are able to help. It depends on the parent.

Hope this helps a little.

[mycsm]

Stay on his side throughout this entire process. he needs guidance, care and love: you seem to be the only dishing it out

[Nurse_Ziba]

"The counselor told me that the student states "my teacher told me I have to use RR at home not at school". And she still yells at him."

What is the counselor doing about this? Was he just passing the message and didn't bother to intervene? I think that the teacher's behavior is an obvious sign that she's very frustrated with the student. I find it Ironic that she's acting that way when actually she should be very patient since she's handling younger kids. The fact that the student was able to verbalize about her teacher's remark means that she too is a contributing factor to the problem.

I think it's about time to talk to the principal since you've tried talking to her and endorsing it to the counselor but nothing happened. Even if you intervene further her mind is already set that the only solution is for the mom to teach her child to clean himself. "the counselor isn't going to do anything, the mom needs to teach him how to clean himself". So does that mean it's okay that the student soils himself as long as he knows how to clean himself?

I once had a kinder student who in middle of second semester all of a sudden wound constantly soil himself. The first time he had BM in school, I did the usual assessment and helped cleaned him up which is very minimal because he is very independent. All I needed to do was give him a plastic bag for his soiled clothes, wet wipes, and privacy. I phoned the mom and told her about the toilet accident, my assessment, and asked how he is at home - was he sick or did she notice anything unusual. Mom told me that her child soiled himself a couple of times during the weekend and didn't have any other symptom but never the less decided to take him to the doctor. The doctor couldn't find anything wrong with him and just told the mom to avoid certain food and to watch out for any untoward signs and symptoms. I accompanied the student to his room and spoke to the teacher (I can afford to do this since her room is a few steps from mine).

The next day, he came to the clinic with the same concern. When he was done cleaning up, I did my usual assessment drill and had a chat with him. During our conversation he mentioned that he lately tends to forget to use the RR when he needs to. I asked was he afraid to use the RR and if something is bothering him. He cheerfully said no. I spoke to the teacher and she mentioned that the mom spoke to her and that she's really frustrated and didn't know what to do. I phoned the mom and told her about the conversation I had with his son. And since he mentioned that he tends to forget maybe we could set a temporary routine for him. A few days had gone by and he was fine. Soon we didn't have to remind him.

I agree with SilentfadesRPA, this kid really needs someone like you on his side.