Published May 24, 2016
vikivail26
53 Posts
Does anyone have an autistic unit at your school. I work for an elementary school. We have a small class of autistic students. The staff in the class bring me kids constantly because they do not fell good and want me to call home and have someone pick them up. The majority of the time the student has no fever, no vomiting, no runny nose, and no cough. They seem fine to me in the clinic, but once they return to class the student suddenly is crying, coughing, sneezing, or what ever. The teachers in there get annoyed because I don't feel comfortable making parents come get there kids because they are crying. Does anyone have to deal with this. My opinion is they just don't want germs in the class.. Should i treat these kids like I do the rest of the students.
tining, BSN, RN
1,071 Posts
My unit sends student to check out their skin - these parents are super obsessed that they are getting scrapes/scratches by means other than common childhood clumsiness. I have a student I check out & document every am/pm and as needed for almost always a self-inflicted scratch. Teacher documents every day as well. I will only send home for fever, diarrhea, vomiting, pink eye and my unit knows this. I will call parent and tell them - 'teacher reports blah blah blah, but I am not finding anything to send home for 'at this time.' I encourage the parent to watch them tonight for worsening sx.
Farawyn
12,646 Posts
Yes. And no.
While parameters as far as fever, vomiting etc. should still exist, remember that some of these kids may not be able to communicate the way kids who are not classified can.
They may be sick, they may be anxious, they may have a scratchy tag, they may not like their snack, they may not like their teacher.
This is why good communication needs to be strong between those TAs/teachers and us as nurses.
I do usually give the parents a heads' up if one of the Spec. Ed. kids are brought down. I find that the parents appreciate it.
OldDude
1 Article; 4,787 Posts
We have an elementary life skills class at another elementary school here. That mentality ran rampant and was part of driving the previous nurse away from there. The bottom line was the aides were just lazy and looked for any excuse to get out of doing something. The new nurse came in this year and told the proverbial cows how to eat the proverbial cabbage. Those kids are subject to the same criteria as any other kids in regard to contagious illnesses. She wouldn't budge, One of the aides couldn't stand the pressure and left but everything finally settled down. So don't fall for it, keep a tight reign on your situation, be consistent and firm, and hopefully it'll stabilize.
SchoolNurseTXstyle
566 Posts
I have been dealing with the same thing this year. The TA's are new, young and inexperienced. They bring them in all day long...
Next year, I am going to toughen up though. Give them some stricter parameters for bringing kids. There are 7 adults over there with 11 kids. I on the other hand are working with a 1:1300 ratio.
Jedrnurse, BSN, RN
2,776 Posts
While ASD people may present differently with somatic issues when sick, overall I've found SPED staff very quick on the "send 'em home" trigger. Set your limits, but also listen to their insights. The good staff can pick up on illness through behaviors in some cases. The not-so-good staff jump at the chance to improve the room ratio. (I wonder if they lost paid hours, i.e. had their shifts cut due to kids being dismissed if they'd be so quick to push the nurse to start this process.)
Flare, ASN, BSN
4,431 Posts
i do have an autistic class - 3 actually. I gotta say - the class for the older kids got a new teacher and since my time in dealing with that classroom has plummeted. The others are actually pretty sporifice too. I am fortunate in that my staff recognizes that these children have behaviors that include making themselves vomit - sure not every vomit is a behavior and some of these children eat strange soft diets resulting in consistent soft stools - but when they come to me because their stool is liquid and peeling the paint off the wall, i'm good with sending the kiddos home.
I think we're all in a good place right now.
pixierose, BSN, RN
882 Posts
Yes. And no.While parameters are far as fever, vomiting etc. should still exist, remember that some of these kids may not be able to communicate the way kids who are not classified can.They may be sick, they may be anxious, they may have a scratchy tag, they may not like their snack, they may not like their teacher. This is why good communication needs to be strong between those TAs/teachers and us as nurses.I do usually give the parents a heads' up if one of the Spec. Ed. kids are brought down. I find that the parents appreciate it.
While parameters are far as fever, vomiting etc. should still exist, remember that some of these kids may not be able to communicate the way kids who are not classified can.
^^^ This x100.
Communication is key. The student can indeed be sick. Or, the behavior can be escape-motivated (got the intended reaction before, the staff will now see an increase in that behavior). Or, the behavior can be attention-seeking. You get the idea. It takes a strong team to nix the aberrant behaviors in the bud while addressing the best interests of the student.
I had a non-verbal child with autism (9-years old) that cried for hours. Exhibited self-injurious behavior when given a demand, flopped to the ground, etc. Bam. Two hours later, the child was truly sick; he was exhibiting those behaviors because he really wasn't feeling well. That was his way of telling us. Those behaviors weren't the norm for him. Another kid could exhibit the same behaviors but they were the norm for him -- we plowed through them, he didn't go home. He wasn't sick at all.
Parents always appreciated the heads-up, whatever the case, by either myself or the nurse. They usually had good feedback too.
jesserpie
40 Posts
I have one severely autistic kiddo that is brought to me all the time. The staff do not want to be blamed if he has a bruise or scratch, I understand that. BUT- they send him down for temperature checks constantly because he "feels hot" and are convinced he has a fever when the thermometer says otherwise. They also send him for what I would consider behavior issues...yes, he has allergies, but wiping his boogers on everything is not my problem and not a reason to send him home. And they are in my office daily to use my restroom to change his briefs, so plenty of opportunity to bug me about every tiny thing.
I had a booger wall when I was 3. My parents had to put up paneling when I outgrew it.
Thank you!!!
We are working on it.