Student Burned At School

[Googlenurse, ASN, BSN, RN]

student was heating up some food in microwave and another student bumped into her. She got second degree burns all over her chest.  I feel so bad. I was told by the students that they can use the microwave because previous nurses let them use it. These are diabetics so thought nothing of them heating snacks up in the microwave. There was no official policy of using the microwave or not using the microwave in the policy and procedure manual. 

This is only like my 6th time here at this school. I was subbing as the school nurse. Never got an orientation. 

This is my first major nursing error with over 25 years of experience. Help!

[Jedrnurse, BSN, RN]

Accidents are not always errors, and common practices don't always make it into policy manuals.

How old were the students? 

[NutmeggeRN, BSN]

This is not your error.We have microwaves in our cafeterias-middle and high school. Sounds like it was in the health office? I would clarify what the regular nurse does and have her follow up w admin as to their preferences

[Googlenurse, ASN, BSN, RN]

On 3/8/2022 at 11:58 AM, Jedrnurse said:

Accidents are not always errors, and common practices don't always make it into policy manuals.

How old were the students? 

12 years old

The principal made it seem it was my fault for letting the diabetic students use the microwave.  I also admit I called 911 25 min after it happened. I immediately called parents first, calmed student and dressed the wounds, then called 911. That is listed in the P and P manual to do it that way. 

I didn’t see it as a 911 thing.  I’m new to school nursing.  I could be wrong though. 

On 3/8/2022 at 12:32 PM, NutmeggeRN said:

This is not your error.We have microwaves in our cafeterias-middle and high school. Sounds like it was in the health office? I would clarify what the regular nurse does and have her follow up w admin as to their preferences

Yes it was in the nurses office. They didn’t have a nurse for a year, which is why they have had nurse subs the whole year. Total student population is 700.  Grades 5-6. 

[Jedrnurse, BSN, RN]

5 minutes ago, Googlenurse said:

  I also admit I called 911 25 min after it happened. I immediately called parents first, calmed student and dressed the wounds, then called 911.

Call the parents THEN give care?? Not too impressed with their P&P manual, particularly when it's a burn...

[NutmeggeRN, BSN]

16 minutes ago, Googlenurse said:

12

The principal made it seem it was my fault for letting the diabetic students use the microwave.  I also admit I called 911 25 min after it happened. I immediately called parents first, calmed student and dressed the wounds, then called 911. That is listed in the P and P manual to do it that way. 
 

I didn’t see it as a 911 thing.  I’m new to school nursing.  I could be wrong though. 

Yes it was in the nurses office. They didn’t have a nurse for a year, which is why they have had nurse subs the whole year. Total student population is 700.  Grades 5-6. 

Ah...makes sense. He is only concerned about exposure. I'm sure the kid uses one at home. I would clarify, for the future, what they do or not want the lids to do. Then they should make a sign as to who can or cannot use the microwave. Not sure who will address the practice of calling parent first...

[Googlenurse, ASN, BSN, RN]

Just now, Jedrnurse said:

Call the parents THEN give care?? Not too impressed with their P&P manual, particularly when it's a burn...

The principle was asking me why I didn’t call 911 immediately. IDK, when I worked in the ER burns were considered urgent, not emergency like MI 

I wonder if the parents decide to sue, who will they sue? Me? 

[Jedrnurse, BSN, RN]

Just now, Googlenurse said:

The principle was asking me why I didn’t call 911 immediately. IDK, when I worked in the ER burns were considered urgent, not emergency like MI 

2nd degree on the chest of a student with diabetes? Schools are community settings, not healthcare, and tend to land on the cautious side. Honestly, it probably could have been almost concurrent- ask the office to call 911 while you're providing burn care. It sounds though like the principal is also looking for extra reasons to be mad and point fingers. 

How was the student?

[Googlenurse, ASN, BSN, RN]

26 minutes ago, Jedrnurse said:

2nd degree on the chest of a student with diabetes? Schools are community settings, not healthcare, and tend to land on the cautious side. Honestly, it probably could have been almost concurrent- ask the office to call 911 while you're providing burn care. It sounds though like the principal is also looking for extra reasons to be mad and point fingers. 

How was the student?

Crying but vss

[RuralMOSchoolRN, ADN, RN]

While schools often tend to err on the side of caution, in events where its shady if 911 is really needed I usually

1. treat the student and get them settled

2. Call the parents and give a fair and detailed assessment (Jack fell on the pavement during recess.  He has a knee laceration that is going to need stitches. I have a dressing on the wound and he is otherwise doing well.  Do you want me to call 911 or would you like to transport him to your clinic/urgent care of choice?)

3. Keep a running detailed note of times and what I did (1005 gave 160mg tylenol, 1007 called parents, etc).  I also call the teacher and find out if the kid has eaten lately and put that time on a note- ate breakfast at 735. 

Once the parents get there, I again explain what happened and what I did and give them a copy of my running note to give to whoever they take the child to.  The eating thing or medications they've been given is particularly helpful if they may need sedation.  

I don't' think the microwave thing is your fault at all.  The principal needs to make a policy and it needs to be posted in the room where the microwave is.  

As for liability, I'm not sure where that would land.  I'm sure the parents would come after the school.  You didn't expressly go against a policy and 12 years old seems age appropriate to use a microwave.  Your care sounds fine as well. 

[John2018]

Don't blame yourself, it's an accident. But what did you do, did you assist the student to the nearest hospital? How was the student?

[beachynurse, ASN, BSN]

On 3/8/2022 at 12:48 PM, Jedrnurse said:

Call the parents THEN give care?? Not too impressed with their P&P manual, particularly when it's a burn...

I totally agree. I give care first. I look at it as this way I can give the parent the whole picture, what the burn looked like, what I did to take care of it. 1 phone call to wrap it up, and the parent call would come after I called 911.