Staff Hysteria

[Ashizzle]

I'm a school nurse and I'm going crazy! I feel as if some kind of mass hysteria has settled over this school, and it's not the kids. It's the staff! I'd like to hear some thoughts about one of my current situations.

One staff member (we'll call her Becky), was diagnosed with a seizure disorder and does not have it under control at all. My issue is, school has only been in session for a few months and during that time, I've responded to Becky's office roughly ten times. Most of the time, Becky describes an aura and nothing happens. Sometimes she asks me to check her vital signs. What is that going to do?

Generally when Becky has these episodes she'll report to me that she neglected to eat breakfast and lunch. She basically lives off of energy drinks and pop. It eventually came out that she is taking all of her meds PRN, even her long-term medications that take weeks to a month to take effect/ reach therapeutic levels. She ONLY takes her medication when she feels like she's going to have a seizure. I very politely explained to her that the medications needed time to take effect and that wasn't going to work, then it happened: she had a full blown seizure at school. ...then it happened again, and again.

I definitely don't want to be insensitive. I care about all of our staff and students; I want her to be safe. In this instance, I don't feel like she's holding up her part of the bargain. The district is very flexible and supportive, which I think is wonderful, but at what point shouldn't this person take some accountability? This is a grown adult being noncompliant in a situation that has serious consequences. Students are constantly on edge, and I'm constantly having to leave my office to run to the aid of this teacher. I'm glad to help, but I can't help but feel like these situations would be completely avoidable if she would just eat breakfast and take her medicine like the MD ordered.

[BeckyESRN]

Here's my update: I did ask the health director for help and she said she would talk to Becky. Here's what we have: My health office will now be getting siderails for all of our beds in the health office! Really. The director insisted that there's nothing we can do, and we must accommodate her or she could "sue us."

When Becky feels like she's going to have a seizure I ask her to sit on the floor and I put pillows on the floor next to her so if she falls over, her head is protected. This has kept her safe during the seizures she's had in my office. Apparently she doesn't like that and took advantage of the talk time with the director to complain. I'm at a loss for words.

:banghead:Parents need to start complaining because this not a safe learning environment for her students! She cannot be your responsibility and providing special accommodations for her in the nurse's office places it squarely in your lap. She is a grown-a$$ adult and needs to take responsibility for her own health. Administration needs to have a come to Jesus moment with this teacher. What are they going to expect you to do when you have a student with a health emergency and she demands your attention?!

[ruby_jane, BSN, RN]

What are they going to expect you to do when you have a student with a health emergency and she demands your attention?!

This. Because... you can't leave a "seizing" teacher to go to another floor/wing/classroom to wheelchair a student to the clinic, right? Do you have an aide? I'd also suggest (and you may be on it already) that you involve administration in a back up plan for when there's a seizure in your clinic and another emergency far away from you.

Hang in there.

[MelEpiRN]

How awful. I don't work in schools and have nothing insightful to add other than I hope she doesn't drive. I've seen too many people come through my ER that have seizures while driving. Scarrryyyy.

[WineRN]

Here's my update: I did ask the health director for help and she said she would talk to Becky. Here's what we have: My health office will now be getting siderails for all of our beds in the health office! Really. The director insisted that there's nothing we can do, and we must accommodate her or she could "sue us."

When Becky feels like she's going to have a seizure I ask her to sit on the floor and I put pillows on the floor next to her so if she falls over, her head is protected. This has kept her safe during the seizures she's had in my office. Apparently she doesn't like that and took advantage of the talk time with the director to complain. I'm at a loss for words.

She could never sue you guys, She has admitted to being noncompliant with her treatment which is what is causing these issues. Your cots (and all of the supplies in your office) are for STUDENTS, NOT for staff.

Document EVERYTHING she says and does. I would tell your health director that you are uncomfortable being put into a position where you are constantly being taken away from students to help a staff member who isn't following her doctor's treatment plan.

[OldDude]

Here's my update: I did ask the health director for help and she said she would talk to Becky. Here's what we have: My health office will now be getting siderails for all of our beds in the health office! Really. The director insisted that there's nothing we can do, and we must accommodate her or she could "sue us."

When Becky feels like she's going to have a seizure I ask her to sit on the floor and I put pillows on the floor next to her so if she falls over, her head is protected. This has kept her safe during the seizures she's had in my office. Apparently she doesn't like that and took advantage of the talk time with the director to complain. I'm at a loss for words.

This made me LOL!! Hey, if she doesn't like the pillows maybe you could get a football helmet from the coach and have it handy to slip on when a seizure is imminent? I'm really sorry you are stuck in this mire, but it sounds like typical school administration mumbo jumbo word salad.

[Julius Seizure]

OP, if you hit the "quote" button instead of the "reply" button, it will copy the text of the person you are responding to - it makes it a little easier to follow the conversation. Just trying to give a helpful hint!

Secondly, are you calling 911 every time she has a seizure? I don't know if it would help or not, since she might just enjoy the fuss...but maybe she would get tired of the medical bills. And more people would be telling her to take her darn meds. I'm not a school nurse (I just like it here), so my suggestion might not apply. What a frustrating situation!

[TriciaJ, RN]

Oh I agree with you 110%. Her students have told me all the crazy stories she tells them after missing work for a few days. She embellishes a lot and adds on aspects that didn't really happen.

Then this is not a health issue; it really is a performance issue. Auras with no seizures? This person is milking it. The level of disruption she is causing is exceeding the value of her employment. This is an HR problem.

[TriciaJ, RN]

Here's my update: I did ask the health director for help and she said she would talk to Becky. Here's what we have: My health office will now be getting siderails for all of our beds in the health office! Really. The director insisted that there's nothing we can do, and we must accommodate her or she could "sue us."

When Becky feels like she's going to have a seizure I ask her to sit on the floor and I put pillows on the floor next to her so if she falls over, her head is protected. This has kept her safe during the seizures she's had in my office. Apparently she doesn't like that and took advantage of the talk time with the director to complain. I'm at a loss for words.

When I worked corrections, we often had inmates with seizure disorders. When screening them I asked them all if they experienced any prodromal symptoms. Most said no; the seizures happened without warning. The few who experienced auras and such were asked if this gave them any time to call for help, or even just sit down for safety. Every single person said no. The prodromal symptom did not happen soon enough to serve any safety purpose. The seizure was too imminent.

This was my personal study and in no way meets scientific criteria. However, when someone reports they "feel like they're going to have a seizure" I'm mighty skeptical. And I'm not surprised that admin is rolling over for this nonsense. You're going to have to find a way to take the reward out of this, like you would for a student who was constantly grandstanding.

Meanwhile, maybe parents can complain about her other inappropriate behaviours and admin can take action on those grounds. But trust them to throw their performance problem into the nurse's lap.

[TriciaJ, RN]

This. Because... you can't leave a "seizing" teacher to go to another floor/wing/classroom to wheelchair a student to the clinic, right? Do you have an aide? I'd also suggest (and you may be on it already) that you involve administration in a back up plan for when there's a seizure in your clinic and another emergency far away from you.

Hang in there.

Great idea! Maybe all the staff need training on how to keep someone safe while they're having a seizure. Then someone needs to be assigned to attend to the seizure with you, so that someone can stay with the person while you attend to other urgent matters.

Maybe when it becomes everyone's problem admin will change their tune.

[OldDude]

...I'm not a school nurse (I just like it here), so my suggestion might not apply. What a frustrating situation!

And...I'm glad you stop in. I enjoy your comments and perspective.

[Julius Seizure]

And...I'm glad you stop in. I enjoy your comments and perspective.

Aw thanks! (warm fuzzies!)

[JenTheSchoolRN, BSN, RN]

Meanwhile, maybe parents can complain about her other inappropriate behaviours and admin can take action on those grounds. But trust them to throw their performance problem into the nurse's lap.

This. How much class instruction time is this teacher missing due to this issue? Is it affecting her student's ability to learn?

Now, it is not our jobs to answer these questions, but these are questions admins understand and cannot ignore.

Also, I echo poster above about emergency plan if you are attending to this teacher and a student has an emergency...what happens? This needs a plan. And also, the teacher needs a seizure action plan if this going to continue at school. This may mean calling 911 each time, which admin will find old after a few times.