Spinal Screening refusal

JenTheSchoolRN, BSN, RN · Jan 20, 2017

Even though it is ideal to have student remove their shirts, if it is just one layer of shirt (like a gym shirt), I will ask it they will do the screening with their shirt on. I've not have a kid refuse this. For the shoulder blades, I'll ask if I can run my hand along their back. Then I document that student refused to remove their shirt and screening was done with it on. Not ideal, sure, but I have caught things with it and it is better than no screening at all.

This is why I also work with the gym teacher to do screening on gym days when students are wearing less layers. I also do carry a few extra tanks (boys/girls) so that I can give the student to option to change if they desire (especially if girls forget to wear a tank top that day).

Flare, ASN, BSN · Jan 20, 2017

i generally do my screenings in light shirts as well. It not only makes the kids more comfortable, but it speeds up the process. I can do a cattle call type line up. If i find anything unusual, then I call that student to my office for a more private screening with a better view.

KeeperOfTheIceRN, ADN · Jan 20, 2017

Even though it is ideal to have student remove their shirts, if it is just one layer of shirt (like a gym shirt), I will ask it they will do the screening with their shirt on. I've not have a kid refuse this. For the shoulder blades, I'll ask if I can run my hand along their back. Then I document that student refused to remove their shirt and screening was done with it on. Not ideal, sure, but I have caught things with it and it is better than no screening at all.
This is why I also work with the gym teacher to do screening on gym days when students are wearing less layers. I also do carry a few extra tanks (boys/girls) so that I can give the student to option to change if they desire (especially if girls forget to wear a tank top that day).

That's a good idea. I suppose I need to get used to doing what I CAN in the WAYS that I can as opposed to trying to do them the IDEAL way. I'm still trying to get things figured out

As far as the extra tanks, how many do you bring with you and do you let the kids keep them? I had actually talked to one of my campuses about this just the other day, but after talking it over with them, they weren't sure about the whole "re-usable, how many students do you let wear one tank" thing. Which I can totally understand. I love the idea of scheduling them to coincide with gym, but our kids don't change clothes when they go to PE so, that doesn't help at the moment :/ Thank you!!!!

JenTheSchoolRN, BSN, RN · Jan 23, 2017

That's a good idea. I suppose I need to get used to doing what I CAN in the WAYS that I can as opposed to trying to do them the IDEAL way. I'm still trying to get things figured out
As far as the extra tanks, how many do you bring with you and do you let the kids keep them? I had actually talked to one of my campuses about this just the other day, but after talking it over with them, they weren't sure about the whole "re-usable, how many students do you let wear one tank" thing. Which I can totally understand. I love the idea of scheduling them to coincide with gym, but our kids don't change clothes when they go to PE so, that doesn't help at the moment :/ Thank you!!!!

Our kids don't change for gym either; they just wear their gym uniform all day (usually t-shirt and sweatshirt and shorts or sweats depending on time of year).

I have like 10 of them. I don't let kids keep them, but I do wash them before/after screenings. Kids are wearing them for about 1 minute. And to be honest, I don't use them too often. More girls than I thought would rather strip down to their bra vs. wearing an offered tank, but that could be because the kids know me pretty well and I do the screenings privately in my office, 1 student at a time. Plus I screen every year for grades 5-9, so the kids know what's up after the first year :).

cooties_are_real · Jan 23, 2017

I completed my first spinal screening this year. No big issues, but I did have one Little Darling call her mom about the screening. Little Darling proceeded to tell me her mother said she didn't have to remove her shirt and began to get all aggressive about it so I just charted she refused. Will think about the tanks next year.

Farawyn · Jan 23, 2017

No biggie. If they refuse they get a call home and mom can take them to the doc. or not.

scuba nurse, BSN, MSN, RN · Jan 23, 2017

I send a letter home stating the procedure and they need to remove their shirt, so they may want to wear a sports bra, or bathing suit top that day. There is also an "opt out" option for parents to sign and return.

KeeperOfTheIceRN, ADN · Jan 24, 2017

Thanks everyone for your input! I too send out an FYI email letting parents know what I'm doing, when I'm doing it, WHY I'm doing it, and what my findings mean. I also suggest to have their kids, male and female, wear a tank top if they feel they need to. I think I'm going to try some tanks to see if that will help ease the awkwardness too. I also only screen one at a time, but I do have to have another adult in the room with me to, you know, cover my behind :yes: You'd think we'd come up with an easier way to screen for this by now

Amethya · Jan 27, 2017

Actually I did it without them taking off their shirts and did during gym time, all 3 classes in one day.

All I asked was from the coach to put them in line alphabetical order, and one by one I told them to bend the ways I wanted to bend in front of me and checked them and done.

All you got to make sure is they wear their gym clothes or a solid color shirt (Our uniforms are solid red, so I can still see with it on.) You can see their back clearly and it's way easier than calling them one by one.