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Student Overdoses

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JenTheSchoolRN is a BSN, RN and specializes in School nursing.

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So, yesterday was just an overall tough day for me.

I had a student overdose on acetaminophen (~25 500 mg tablets taken) in school and on purpose. Revealed to me about a student in my office that visited me and appeared off - VS normal, but fatigued and very much subdued for the student's typical presentation. I had called Mom because something was off, waiting to hear back. Student's friends come in asking to talk to student - this is when one of the friends started crying and told me they came after seeing what their friend did.

Student stable. Called parent and poison control. Parent close, poison control was like you can wait for parent to transport if that is what parent wants.  Principal and counselor brought in after being notified by me. Parent became delayed, ok with my calling an ambulance to transport and meet at hospital - I went with student. Student stable whole time. 

Physically student is doing well. Emergency psych in of course on 48 hour hold right now. 

I've been a school nurse for 7 years, but hadn't quite seen this as first hand before. I was a mess yesterday (held it together and when I got in my car the emotions hit like a ton of bricks of course) and I'm still shakey today.  Not enough to not be professional, but I know I'm affected. This student is very known to me as is the family.  There will be more debriefing to come as there are huge take-aways to be gained from this incident. I know I am lucky to have that at my school. 

I have a fellow nurse colleague (who covered for me when I went to the hospital) who is supportive and fellow teachers that are as well. But I guess I'm coming back to my nurse's station as well. I know there are other nurses here who have likely seen this. Any additional tips for self care? 

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Flare is a ASN, BSN and specializes in school nursing, ortho, trauma.

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I can't say I've had to contend with this.  It sounds like you handled this like a top notch pro.  Of course, you're going to have an emotional reaction to this.  As you stated, you know the student and family well.  But even if it were a less known student to you, no doubt you'd still feel the shock after the moment was over.  Kudos to you for being able to compartmentalize and stay on top of your game in the moment.  

As an aside, thank GOD that the other student came in concerned and let you know the whole scoop.  I am glad to hear that the student has a good friend who wasn't afraid to check on them and bring this to light.  I'm not sure that it'd be so easy to figure out without that, with normal VS and (presumably) a student not willing to share that piece with you themselves. 

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JenTheSchoolRN is a BSN, RN and specializes in School nursing.

2,656 Posts; 24,319 Profile Views

1 minute ago, Flare said:

I can't say I've had to contend with this.  It sounds like you handled this like a top notch pro.  Of course, you're going to have an emotional reaction to this.  As you stated, you know the student and family well.  But even if it were a less known student to you, no doubt you'd still feel the shock after the moment was over.  Kudos to you for being able to compartmentalize and stay on top of your game in the moment.  

As an aside, thank GOD that the other student came in concerned and let you know the whole scoop.  I am glad to hear that the student has a good friend who wasn't afraid to check on them and bring this to light.  I'm not sure that it'd be so easy to figure out without that, with normal VS and (presumably) a student not willing to share that piece with you themselves. 

YES - thank GOD indeed. I might have gotten it out of the student eventually given our history, but it would have taken a LOT more time. This student is very lucky they have friends that care so much about them. 

But those friends were so deeply affected that our counselor had to call both their families and have them picked up. We as a community are planning to support them as well.

Also, there was another sick student in my office - had that student step out during incident, but they knew what was happening. And they were triggered as a family member actually going through the same thing at the same time. It was not a great day. 

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MHDNURSE has 21 years experience as a BSN, MSN, RN, NP and specializes in Pediatrics, Community, and School Health.

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I'm so sorry for all involved and so glad the friend said something- might have saved the student's life.  It sounds like you are in a very supportive environment with services available to staff and students, which is great.  I think it will take time for you to fully process- allow yourself that time and take time for you when you need it.  We build there relationships with our kids and it is not easy to separate when something like this happens- both a blessing and a curse.

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GdBSN has 6 years experience as a RN and specializes in School Nurse.

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<<<Hugs to you>>> Of course you were affected by this situation, you're human and have a relationship with this student. It was great that this other student felt like she could come to you and tell you the whole situation. Take time for yourself to decompress from this situation, and keep doing a great job! (cue OD) BAM!!! Another student saved from the jaws of death by the school nurse!

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ohiobobcat specializes in ED, School Nurse.

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First of all, good job! I'm glad the other student disclosed the "real" issue and that you were able to intervene appropriately and get that student the help they need.

I had a student with a significant mental health history take a bunch of ibuprofen and aspirin along with 3/4 of a bottle of Malibu Rum at school this year. I called Poison Control and eventually 911.  My student was stable as well, but I had the student transported because we could not reach mom.  I took some comfort in the thought that this was a huge cry for help, and that my student (who was admitted to a psych hospital after medical stabilization) was getting the help they needed, and that I was a part of that process.  I was a little shaken afterwards as well. I imagine it is even harder when it is a familiar student. Debriefings are always helpful, and I am glad that is upcoming for you.

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When I was in nursing school, I worked as a float care tech in a large hospital and was frequently floated as a sitter for those who were on suicide watch, most of which attempted by ODing on Tylenol. One day, I was sitting for a 14 year old boy-not much younger than me at the time. Most of the time the people on suicide watch didn't talk, but this particular boy did. Tearfully, he said to me that he tried because he couldn't live with himself because he was gay. This was 20 years ago. I will never forget that moment. It truly was heartbreaking. I wish I could know how he is doing today.

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Cas1in72 has 26 years experience and specializes in school nursing/ maternal/child hospital based.

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3 hours ago, JenTheSchoolRN said:

So, yesterday was just an overall tough day for me.

I had a student overdose on acetaminophen (~25 500 mg tablets taken) in school and on purpose. Revealed to me about a student in my office that visited me and appeared off - VS normal, but fatigued and very much subdued for the student's typical presentation. I had called Mom because something was off, waiting to hear back. Student's friends come in asking to talk to student - this is when one of the friends started crying and told me they came after seeing what their friend did.

Student stable. Called parent and poison control. Parent close, poison control was like you can wait for parent to transport if that is what parent wants.  Principal and counselor brought in after being notified by me. Parent became delayed, ok with my calling an ambulance to transport and meet at hospital - I went with student. Student stable whole time. 

Physically student is doing well. Emergency psych in of course on 48 hour hold right now. 

I've been a school nurse for 7 years, but hadn't quite seen this as first hand before. I was a mess yesterday (held it together and when I got in my car the emotions hit like a ton of bricks of course) and I'm still shakey today.  Not enough to not be professional, but I know I'm affected. This student is very known to me as is the family.  There will be more debriefing to come as there are huge take-aways to be gained from this incident. I know I am lucky to have that at my school. 

I have a fellow nurse colleague (who covered for me when I went to the hospital) who is supportive and fellow teachers that are as well. But I guess I'm coming back to my nurse's station as well. I know there are other nurses here who have likely seen this. Any additional tips for self care? 

I'm so sorry. 3 years ago, I had a similar situation.  I'm sending you my love, support and encouragement.  You saved their life, you were there and thank goodness for that!!!!!! 

I would say, PLEASE PLEASE PLEASE talk this one out.  Go to a crisis counselor ,if you can.  Maybe call your  local police or fire and see who they process their situations with.  I did, and it helped.  Journal about your feelings, just get them out.  We are nurses and handle life and death situations all the time, but We ARE HUMAN.  It hurts, suicides and suicide attempts are all together different from " emergencies or illness"  For me, there was something so terribly sad about a person hurting so much they wanted to end their life.  I took it to my heart and it was tough.   I still have nightmares about it.  In 26 years of nursing, nothing impacted me like that did.  Unfortunately, my school didnt act with any follow up for the students or staff ( SO NOT OK) 

It's Ok to feel like you do,  You will run the gamut on this one.  I would swing from sadness( over her pain) to anger ( that she would do something like that at school and what if she had succeeded) to no confidence/anxiety ( I know I managed to keep her alive this time, but what about the next time) back to anger ( that my school chose to keep it quiet, even though 12 students knew she had taken the pills but didnt report and not make this a serious educational moment on the crisis that is suicide among young people) to being grateful that at that moment, I  found enough calm to do what I needed to do, I was a nurse, I did what I was trained to do. 

I cant send enough love to you right now.  Big hugs.  Please continue to process this.  You are a nurse and thank God for you. 

 

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ruby_jane has 10 years experience as a BSN, RN and specializes in ICU/community health/school nursing.

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My first year as a hs nurse I had a student attempt to slit her wrists with the razor thingy from a pocket pencil sharpener. I was saved by our athletic trainers who pressure wrapped the wrists and then brought her in. Foster kid in a foster mill family. 

I realize yours is not the same. How harmful the acetaminophen would be is dependent on multiple factors over which you have no control (and of course, if the student chooses not to tell you, you cannot control that either). 

The general mental health of our older youth is sliding in a way that scares me greatly.

Do you have an EAP? You may be able to get one solution-focused counseling. Or you can just use us. Hugs to you from the NTX.

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JenTheSchoolRN is a BSN, RN and specializes in School nursing.

2,656 Posts; 24,319 Profile Views

1 hour ago, ruby_jane said:

My first year as a hs nurse I had a student attempt to slit her wrists with the razor thingy from a pocket pencil sharpener. I was saved by our athletic trainers who pressure wrapped the wrists and then brought her in. Foster kid in a foster mill family. 

I realize yours is not the same. How harmful the acetaminophen would be is dependent on multiple factors over which you have no control (and of course, if the student chooses not to tell you, you cannot control that either). 

The general mental health of our older youth is sliding in a way that scares me greatly.

Do you have an EAP? You may be able to get one solution-focused counseling. Or you can just use us. Hugs to you from the NTX.

I do have an EAP and I've been thinking of taking advantage. 

And wow - razor from the pencil sharpener. 

And mental health needs from our youth are skyrocketing. There are zero mental health beds for youth available in my area right now (my counselor looked into yesterday for yet another student) - and I'm actually in an area with a fair number of youth mental health resources.

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SchoolNurseK has 18 years experience as a BSN, RN and specializes in Home Health, School Nurse Newbie.

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I am so sorry.  <hugs>  Make sure to get some sunshine on your face this weekend (hopefully the weather will cooperate with that) and give yourself some time.  That situation is a lot to process.   It sounds like you did exactly the right thing though and that you've created a clinic environment where students feel safe to share tough stuff with you.  You're exactly where you are supposed to be.  

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ARN has 12 years experience and specializes in medsurg/school nurse.

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this is so hard. we have several students who are on my radar right now as potential suicide risks. they have expressed thoughts in the past. self harm. are in counseling and have multiple supports in place. some even have good family support. they are still struggling. 

I also had a student take more of her antidepressant than prescribed last year but thankfully not enough to do any damage. mom was able to pick up and take for evaluation and VS were stable. thanfully she ended up in class crying on the floor in regret so the teacher alerted me. 

coming from the hospital setting as my background I have cared for a young teen who OD'd on ibuprofen I believe it was and had to have emergency dialysis. I don't know what his outcome was but he was very ill. 

I have never really sought EAP for anything work related but I did after my sons type 1 dx. When really its all the burdens that we as nurses carry that add up and affect us in other parts of our lives as well. the scale was tipped enough for me that I needed to release something. It was very helpful. 

I agree, seek out your EAP person. It is good to talk to someone and have that time to process. 

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