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.
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?
What does vomiting have to do with a mental health day?
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?
I may be reading a little bit of a stern tone with this quote...but this is why I just call parents with any reports of vomiting whether I see it or not. For those that I think are faking, acid reflux, coughing after exercise, mucous etc etc ... I just let the parents decide. I have become hardened as the years go by ?
Eventually it will come to a point where the parent just states "go back to class" because they are tired of the interruptions of their day or the parent/kid will start having truancy issues with all the "leave early" issues.
I may be reading a little bit of a stern tone with this quote...but this is why I just call parents with any reports of vomiting whether I see it or not. For those that I think are faking, acid reflux, coughing after exercise, mucous etc etc ... I just let the parents decide. I have become hardened as the years go by ?
Eventually it will come to a point where the parent just states "go back to class" because they are tired of the interruptions of their day or the parent/kid will start having truancy issues with all the "leave early" issues.
Everyone seems to be getting offended about this. You don’t know how many kids I deal with daily that are repeat offenders. I have some kids that come 2 or 3 times a day everyday. If a kid comes that I rarely ever see and says they threw up I’ll more than likely send them home. My whole point is kids need to stop abusing the nurse visits. So many kids at this school are already having attendance issues. And for my repeat offenders, I can tell when they are they really sick or hurting cause I know their personalities so well. It’s mostly my repeaters that are trying to go home. And I’ll usually observe them for about 20-30 minutes in the clinic after drinking a juice or crackers and see how they feel. So it’s not like I’m this evil person that is going to make a student stay at school if they are vomiting their guts out. If I sent every kid home that says they threw up in the bathroom, half the school would be at home.
Everyone seems to be getting offended about this. You don’t know how many kids I deal with daily that are repeat offenders. I have some kids that come 2 or 3 times a day everyday. If a kid comes that I rarely ever see and says they threw up I’ll more than likely send them home. My whole point is kids need to stop abusing the nurse visits. So many kids at this school are already having attendance issues. And for my repeat offenders, I can tell when they are they really sick or hurting cause I know their personalities so well. It’s mostly my repeaters that are trying to go home. And I’ll usually observe them for about 20-30 minutes in the clinic after drinking a juice or crackers and see how they feel. So it’s not like I’m this evil person that is going to make a student stay at school if they are vomiting their guts out. If I sent every kid home that says they threw up in the bathroom, half the school would be at home.
This! 8 days a week. The child I referenced stated she felt fine after rest and eating and brushing her teeth. But this is a mom who, (in my 28 years of school nursing I have seen more than one of), flies here at the first phone call. If there is one child in a class who is reported to have strep she is picking her kids up out of an abundance of caution. There is nothing in their medical hx that I am aware of that necessitates frequent removal from school.
This! 8 days a week. The child I referenced stated she felt fine after rest and eating and brushing her teeth. But this is a mom who, in my 28 years of school nursing I have seen more than one of), flies here at the first phone call. If there is one child in a class who is reported to have strep she is picking her kids up out of an abundance of caution. There is nothing in their medical hx that I am aware of that necessitates frequent removal from school.
I think we all have a parent like this at one time or another - yes, it gets old and annoying. I try my best at not letting them bother me.
A few years ago we started to code these kids as "Parent taking student home" meaning that there was no medical/school policy on our end for the student going home and it was a parent decision. I will document any reason parent give me also - if a comment was made about strep and they are picking up kids out of abundance of caution - I document just that. If there are any questions about truancy or if they end up in court, the documentation is there for admin to see.
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.
I sometimes get parents who refuse to come get their kids. Or, if they are working, they refuse to help find someone else to come get the student.
I sometimes get parents who refuse to come get their kids. Or, if they are working, they refuse to help find someone else to come get the student.
One of the second grade teachers came to me today and she has a class full of frequent flyers. Today she had enough of it and told them if you are hurting or feeling that bad to go to the nurse, you need to sit out and rest and recess. I haven’t seen one of them since. This may work for elementary kids but not sure what to do for middle and high school.
One of the second grade teachers came to me today and she has a class full of frequent flyers. Today she had enough of it and told them if you are hurting or feeling that bad to go to the nurse, you need to sit out and rest and recess. I haven’t seen one of them since. This may work for elementary kids but not sure what to do for middle and high school.
This is my procedure period, for elementary kids. For the "sick" kids, they are welcome to rest for a bit in my office and follow my no-fun office rest rules, but they HAVE to go to snack/lunch and eat, and then, if they still feel poorly, they need to return to my office for recess and that's when the conversation about potentially going home kicks in. Basically the only time kids get picked up before lunch starts is if they vomit, have a fever, or look clinically unwell. The teachers all know this as well. If they choose to stay out at recess, they get sent right back to class or reminded of the plan by the teachers; This has cut my post-lunch visits down by a LOT.
I work in a small school and I get to know my kids pretty well and can tell when they aren't themselves. I know my frequent flyers, I know who just needs a little extra TLC, and I know who I won't see unless they are really unwell.
Why in the world do all these children want to get out/away from school, esp the ones who are frequent flyers? It sounds like a mass exodus of kids trying to escape the institution. What are they wanting to leave so badly? Why so many?
Jedrnurse, BSN, RN
2,776 Posts
What does vomiting have to do with a mental health day?