Students who have diarrheal issues in their clothes

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What are yall's policies on students who come to the Nurse Office and have diarrhea in their clothes. Are yall required to clean and change them before being picked up? Or do yall contact a parent to pick up and clean them when they get home? I am at a Pre-K/Kinder campus. 

We have always called a parent to pick up and didn't clean or change them. Mostly due to not having the accommodations (cracker box side restroom), viral issues, and liability. We do not have a written policy in place, it has always been just a verbal policy/guidelines that we go by. What are yall's thoughts on this?

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Specializes in pediatrics, school nursing.

We don't have a written policy, but if there was an available change of clothes, I would absolutely clean and change them (especially if it was the result of the kid being sick). Even though they are small children, and may not be fully potty trained, this is a matter of dignity. I truly can't imagine making someone, especially a sick child, sit in soiled clothing longer than they need to. I imagine their parents will put you in their good graces if you do this as well!

Since your setting is PreK/K, I imagine there must be a larger restroom somewhere that you could move to for this particular task... 

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Yall haven't had any kind of liability issues come up regarding having to help clean, etc. the students? This is what was brought to my attention and I just wanted to get some other school nurses perspective on this. Also, so they aren't any worries concerning Covid anymore on this? That was one reason we were told not to change (of course we would if necessary) if the parent was picking up soon. 

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Specializes in Community and Public Health, Addictions Nursing.

I would approach soiled clothing from diarrhea the same that I would approach any other toileting help with a preschool aged child.

When I worked for Head Start, there was written policy in place for how to assist children while they used the bathroom. This policy included standard precautions to protect staff and students from exposure to urine and feces. If anything, we'd want to remove the soiled clothes before the kiddo sits down on a piece of school furniture or touches their hands to the dirty clothes and then touches other objects (or students).

If a staff person didn't help a child and knowingly left them in soiled clothing for any period of time, at my Head Start it would probably/definitely involve a complaint from the parent and possibly a write up for neglecting the student. 

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SKSmith said:

Yall haven't had any kind of liability issues come up regarding having to help clean, etc. the students? This is what was brought to my attention and I just wanted to get some other school nurses perspective on this. Also, so they aren't any worries concerning Covid anymore on this? That was one reason we were told not to change (of course we would if necessary) if the parent was picking up soon. 

'Liability' has been used for all kinds of ways to avoid exerting any effort at all. Now it seems as Covid is being used in the same way. And if risk of Covid exposure/transmission is a concern in cleaning up children that are soiled, there is a way bigger problem there than soiled children. Why would anyone ever, if they had what was needed, not assist a child in that situation regardless of the parent's travel time.

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Specializes in pediatrics, school nursing.
SKSmith said:

Yall haven't had any kind of liability issues come up regarding having to help clean, etc. the students? This is what was brought to my attention and I just wanted to get some other school nurses perspective on this. Also, so they aren't any worries concerning Covid anymore on this? That was one reason we were told not to change (of course we would if necessary) if the parent was picking up soon. 

If the concern is that you could be liable for looking at an unclothed child, then when you call home to report that the kid needs to be picked up due to diarrhea, you can explain on the phone then and there that the student is soiled and you don't want to help clean them without expressed permission, and get verbal consent from the parent. 

This is how I handle things if a student is reporting pain/itching, or other concerns in a private area. I call home, explain what the student is telling me, and tell the parent that I will only visually inspect the student if they want me to, and that I will have another adult be a chaperone in the room (it can even be them if they want to come to the school!). 

And as far as COVID is concerned, as a healthcare professional, if you have a concern for COVID, then gown, glove, and N95 while changing/cleaning them, just like they would do in the hospital. I can't imagine your state has rules against HCPs changing patients because of COVID....

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Specializes in Community and Public Health, Addictions Nursing.
k1p1ssk said:

If the concern is that you could be liable for looking at an unclothed child, then when you call home to report that the kid needs to be picked up due to diarrhea, you can explain on the phone then and there that the student is soiled and you don't want to help clean them without expressed permission, and get verbal consent from the parent. 

 

I totally understand being concerned about being alone with an unclothed child. Thankfully in the preschool/kindergarten age group, most parents understand that toileting is still a work in progress with their kids, and adults will need to help at times. If I wanted to be extra sure, then yes I would contact the parent first to say what's happening and what we're going to do until the child can be picked up. 

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Thank you!! Your comment helps a lot. I am not worried about Covid but it has been brought up to me. Again, thanks!

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