Hi! I’m a new school nurse. I’m currently in a long term substitute position for a K-5 school. I've been at this school for 3 weeks now so I've gotten the feel for everything and have my routine down. I have noticed a large problem with students coming to my clinic faking illnesses, especially vomiting. I have at least 5 students a day come and say they threw up in the bathroom. I try my best to follow the “if you didn’t see it happen it probably didn't” rule. 90% of the time this works out for me. Give them some tums and crackers and they are fine and don’t return.
This past Friday I was slammed busy, like every Friday. A teacher sent a student in at lunch saying he vomited in the bathroom. Well this students sister I actually sent home at the very beginning of the school day for strep throat symptoms and fever. He heard wind of his sister being sent home and I’m 99% sure he was faking just trying to go home. The kid was acting completely fine, talking other kids ears off in the clinic and playing around with another student. So I gave him some tums and sent him back to class. No fever or anything. Not even 10 minutes later he comes back and says he doesn’t feel any better and wants to go home. So I decide to call mom, not to send him home but just to talk to her about the situation. No answer but left a voicemail so I sent the student back to class again waiting for a call back. I got a call back about 20 minutes later and I told her the whole situation and she agreed that he is just trying to go home early as he overheard her talking to his sister that morning saying that if she felt worse during the day to go to the nurse. I was about to pick up the phone and call the students teacher and tell her what was said when she walks into the clinic with the student and demands that I send him home. I told her what the mother said and asked if anyone actually witnessed the student vomiting and she said no. I then explained that if it wasn’t witnessed, no fever and he’s acting completely fine there is no reason to send him home. She then goes over my head and asks the principal about it and she said to send him home so I eventually ended up doing so. Mind you it was one hour until school was over. I was so furious. This is why I have so many students coming to the clinic. They see one get away with it and the teacher enables it so they all do it. I want to confront the teacher about it but I’m unsure what to say.
another suggestion I do to keep a record in my head is the next day the kids I sent home I will see if theyre here the next day if thats the case then I know that the next "tummy ache" can be a redirection back to class. also when a kid does the " I threw up in my mouth" I also explain in order to go home for vomiting I need to see a lot of chunks not just spit or in your mouth.
Hi! I’m a new school nurse. I’m currently in a long term substitute position for a K-5 school. I've been at this school for 3 weeks now so I've gotten the feel for everything and have my routine down. I have noticed a large problem with students coming to my clinic faking illnesses, especially vomiting. I have at least 5 students a day come and say they threw up in the bathroom. I try my best to follow the “if you didn’t see it happen it probably didn't” rule. 90% of the time this works out for me. Give them some tums and crackers and they are fine and don’t return.
This past Friday I was slammed busy, like every Friday. A teacher sent a student in at lunch saying he vomited in the bathroom. Well this students sister I actually sent home at the very beginning of the school day for strep throat symptoms and fever. He heard wind of his sister being sent home and I’m 99% sure he was faking just trying to go home. The kid was acting completely fine, talking other kids ears off in the clinic and playing around with another student. So I gave him some tums and sent him back to class. No fever or anything. Not even 10 minutes later he comes back and says he doesn’t feel any better and wants to go home. So I decide to call mom, not to send him home but just to talk to her about the situation. No answer but left a voicemail so I sent the student back to class again waiting for a call back. I got a call back about 20 minutes later and I told her the whole situation and she agreed that he is just trying to go home early as he overheard her talking to his sister that morning saying that if she felt worse during the day to go to the nurse. I was about to pick up the phone and call the students teacher and tell her what was said when she walks into the clinic with the student and demands that I send him home. I told her what the mother said and asked if anyone actually witnessed the student vomiting and she said no. I then explained that if it wasn’t witnessed, no fever and he’s acting completely fine there is no reason to send him home. She then goes over my head and asks the principal about it and she said to send him home so I eventually ended up doing so. Mind you it was one hour until school was over. I was so furious. This is why I have so many students coming to the clinic. They see one get away with it and the teacher enables it so they all do it. I want to confront the teacher about it but I’m unsure what to say.
You are not the police. You are the nurse.
Throughout my long career, I have encountered nurses who think many, many patients are what we used to call "turkeys". A turkey is a pt we think is faking it, exaggerating, or otherwise being less than truthful or making a mountain out of a molehill. (such as a homeless person saying he is suicidal because he knows he has to be admitted for that, but he is no longer suicidal the minute the disability checks come out);
Since I am not a lie detector, I usually set aside thoughts of the pt being a fake or a liar. I just deal with objective information. VS, LOC and orientation, and the like. Might you get suckered? Yes. But who really cares? I know we care about the students' socialization, their learning, and so on. But you can't fight the whole system. I sometimes have a little talk with the student, but not in an accusatory way.
The teacher and principal were out of line in your scenario. If you confront them on it, you will lose unless your own immediate boss backs you up. You don't tell them how to educate, they should not be telling you how to be a nurse. Nevertheless, you are on shaky ground if you buck these people. It's the same with challenging/daring to have a different opinion than Custody personnel if you are a nurse working in a jail or prison.
Just not worth all the hullabaloo.
Next time, when the Principal tells you to send a kid home, ask her respectfully to speak with your Sup - with whom you have spoken about the kid and from who you have gotten agreement that the kid should stay in school. On 2nd thought this is not necessarily a good idea either.
Did the Principal ask you nicely, in a collegial way? Or was it more of an order?
Around these parts, we call that "bigfoot vomit". We're not saying that the episode of vomiting didn't exist, just that no one saw it to confirm. Generally, I have them take in 3 little cups of water (about 9 oz) and rest in my office for about 20-30 minutes. If they can hold down the water then they're deemed OK to go back, although I may give them a mint to settle their stomach before they go if they seem a bit hesitant. The teacher should not be going above your head. I would definitely have a discussion with them. I would discuss your procedure of making a decision with them and the interventions you use. I am certain they will be quick to say "I thought if they threw up, they HAVE to go home." My usual reply to that is "In many cases, yes. However, the student still needs to be assessed to determine the degree and presence of illness. There are a lot of students who come in reporting that they are sick and have vomited, but in reality are fine."
Specializes in NICU, PICU, Transport, L&D, Hospice.
Our elementary schools in the interior of Alaska are experiencing difficulty with pandemic kindergarten students who were not in any sort of organized preschool in 2020. Those kids are struggling with the transition from relatively isolated lives at home into classrooms with 30 five year old students per teacher. There aren't enough teachers or support staff and the school systems aren't funded to increase wages to inspire or attract more workers.
Stressed children sometimes display or fake nausea and vomiting when stressed. All humans will exaggerate discomfort to create an exit opportunity from a situation.
If a kid feels sick or needs a mental health day, they should be able to go home especially if they are making good grades. The school policies these days are borderline authoritarianism and too strict. I feel sorry for kids these days.
Had a girl vomit the other day, took Doxy on an empty tummy. afebrile, nothing else going on. Already had Covid and is vaxxed. She rested, had some crackers, went back to class...mom called to dismiss her later in the AM... This kid is forever getting dismissed. She sniffles and mom has her out of the building.
I don't know what in God's name she's going to do when she graduates and is in college. These kids this year are totally out of control leaving the building. They come in, they go out, and their parents just run right along and pick them up the minute they get a phone call.
Never in my life would I just swing by a school to pick up my kid who called me to say they weren't feeling good, without speaking to an adult, the NURSE! We gave them a lot of flexibility with Covid last year but holy guacamole, it is insane this year.
Has a girl vomit the other day, took Doxy on an empty tummy. afebrile, nothing else going on. Already had Covid and is vaxxed. She rested, had some crackers, went back to class...mom called to dismiss her later in the AM... This kid is forever getting dismissed. She sniffles and mom has her out of the building.
I don't know what in God's name she's going to do when she graduates and is in college. These kids this year are totally out of control leaving the building. They come in, they go out, and their parents just run right along and pick them up the minute they get a phone call.
Never in my life would I just swing by a school to pick up my kid who called me to say they weren't feeling good, without speaking to an adult, the NURSE! We gave them a lot of flexibility with Covid last year but holy guacamole, it is insane this year.
Doesn't mean she doesn't have Covid again. Also, I thought it was policy to stay/send home if a child vomits. It has to be cleared for 24 hrs.
Doesn't mean she doesn't have Covid again. Also, I thought it was policy to stay/send home if a child vomits. It has to be cleared for 24 hrs.
Less than 90 days ago (our state guidelines) and we have flexibility with our vomit policy if there are no other sx, and the cause is probable-(the doxy on an empty stomach).
If a kid feels sick or needs a mental health day, they should be able to go home especially if they are making good grades. The school policies these days are borderline authoritarianism and too strict. I feel sorry for kids these days.
Sometimes? Yes, as a judgement call. As a policy? I disagree. It would with some students be the de facto path of least resistance when something was coming up/happening in school that gave them the least amount of angst.
Our kids are running enough of a resilience deficit as it is...
Who are you to say my kid is not resilient enough? Do you know in particular what families are going through? They are not adults. How do you know there is something coming up for that child? You're assuming too much. How do you know the kid is not really sick? Do you have testing? You just diagnose they are faking it?
Anytime my child complains AND vomits, I better get a call! I'm coming to pick my child up. Do you work when you vomit? How are they suppose to focus on learning?
Lbarba84
20 Posts
another suggestion I do to keep a record in my head is the next day the kids I sent home I will see if theyre here the next day if thats the case then I know that the next "tummy ache" can be a redirection back to class. also when a kid does the " I threw up in my mouth" I also explain in order to go home for vomiting I need to see a lot of chunks not just spit or in your mouth.