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Tummy Ache ideas??!?!?

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by blackscrubs blackscrubs (New Member) New Member

2,214 Visitors; 58 Posts

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OK guys! I need some help form the veteran school nurses. The majority of my kids that come in are complaining of a tummy ache. My rule is: If you vomit, I have to see it. If you flush, it doesn't count! I can tell the sick ones from the fakers. What do you do with the fakers that are coming in 3-4 times a day??? So far, I just have them sip on some water and then go back to class. But then they come right back 30 mins later!!!

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3,661 Visitors; 157 Posts

If they return to my office more than once, I call the parents.I notify them of my assessment findings & the students complaints.

They at that point always ask me what I recommend. I then tell them after a thorough assessment I believe that they are okay to return to class (after rest, water, bathroom, etc). One call to parents that DO NOT WANT TO LEAVE WORK, or come to school to pick up their child is usually all it takes to keep my frequent flyers in class for a while.

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loving2 has 8 years experience.

2,989 Visitors; 70 Posts

I also call the parents. I always ask the parent if I can put them on speaker phone. That way this is NO misunderstanding between what the parent states and what the student tells me. Example, "mom said I can rest her for 1 hour", when in fact, mom said, "Get back to class!" :D

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LACA has 4 years experience and works as a School Nurse.

6,210 Visitors; 371 Posts

Ahh, I've never thought of speaker phone...that's a good idea!! I will have to remember that!

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loving2 has 8 years experience.

2,989 Visitors; 70 Posts

Ahh, I've never thought of speaker phone...that's a good idea!! I will have to remember that!

Ask permission from the parent first. Most say yes, but a few tell me no. Those are the parents that send a red flag. I can hear them yelling on the other end.

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Gampopa has 10 years experience and works as a M/S Nurse.

5,170 Visitors; 163 Posts

Keep in mind that a persistent tummy ache may indicate emotional issuses at home, stress, etc. that may need additional scrutiny. I'm a school nurse in a rural and poor community and when I have a kido coming in for tummy aches there's usually family issues going on. A little TLC, maybe a nap and they are good to go.

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Supernrse01 has 18 years experience and works as a School nurse.

14,996 Visitors; 714 Posts

I have frequent flyers, always with tummy ache...

My rule is, if they vomit, it must have been witnessed. I let them lay on the cot in the clinic for 15/20 minutes and observe. Obviously, if they throw up, I call home. If, after the rest time, they are still asymptomatic, I check a temp and send them back to class. If they end up coming back, I call home, in front of the student and let parent know they have made more than one trip but really seem to be OK enough to make it through the day. If the parent chooses to pick them up, so be it. If not, it's off to class they go. If they continue to come back, I make sure the teacher is aware they are visiting the clinic and we normally speak to the principal and student.

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OB Night Nurse has 19 years experience and works as a School Nurse RN/BSN.

1,549 Visitors; 23 Posts

I also employ the "unseen vomit doesn't count" rule. I allow them to rest a bit and I always check their temp and offer a few saltine crackers. A great majority of my kids with stomach aches say they didn't eat breakfast and/or lunch (I'd have a belly ache, too! Giving them crackers seems to work for a vast majority of them.

Most of my frequent visitors seem to be of the "I need ice for my past sports injury" variety. I'm amazed how many students have severe pain from the game 3 days ago, last week, etc. but it doesn't seem to bother them until 4th period math. It's always math class! And after math class the pain seems to spontaneously vanish!!!

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LACA has 4 years experience and works as a School Nurse.

6,210 Visitors; 371 Posts

I have frequent flyers, always with tummy ache...

My rule is, if they vomit, it must have been witnessed. I let them lay on the cot in the clinic for 15/20 minutes and observe. Obviously, if they throw up, I call home. If, after the rest time, they are still asymptomatic, I check a temp and send them back to class. If they end up coming back, I call home, in front of the student and let parent know they have made more than one trip but really seem to be OK enough to make it through the day. If the parent chooses to pick them up, so be it. If not, it's off to class they go. If they continue to come back, I make sure the teacher is aware they are visiting the clinic and we normally speak to the principal and student.

What she said! haha This is almost exactly what I do every time...If they can sit in the clinic and not vomit in 20 minutes, then I really doubt they did it 6 times before they came up here :)

I understand that there may be emotional issues, home issues, etc...BUT my main job is to make sure they are in class getting an education whenever possible. If I suspect that there is an issue, I will talk to them, ask basic questions (Is there something else bothering you? Did you sleep good last night? Have you mentioned this to Mom/Dad/whoever they live with? How long have you felt yucky? etc), just see what I can get a feel for. If I'm still suspicious after that, I will usually confer with our school counselor and together, we will work to see what issues may be hiding behind the "I'm sick" facade.

I'm not cold hearted, I love these kids dearly...BUT I am not here to play games with them. They are to be in class, that's their job. And I tell them "It's your job to be in class, just like it's my job to make sure you're healthy and taken care of at school. My job is done, so it's time for you to get to work!" They just laugh and skip out!

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bergren works as a registered nurse.

10,814 Visitors; 1,112 Posts

We all know the kids with stomach aches and other somatic symptoms may come 6, 7 8 times before they trust you enough to share that Dad is hitting mom, there is a bully in the rest room, that their brother is on the hospital or that mom lost her job and is crying all the time and they did not get anything to eat last night. The trick if finding the right intervention that addresses the root problem and the anxiety causing the symptoms.

Frequent Visitors: Somatization in School-Age Children and Implications for School Nurse

Journal of School Nursing, June 2010

Frequent Visitors â€" The Journal of School Nursing

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Neveranurseagain has 26 years experience and works as a No longer working as a nurse.

13,683 Visitors; 866 Posts

When students tell me they just had an unwitnessed vomiting, I give them 3 oz of OJ or apple juice. If they really have been vomiting, it will come right back up when the sugar hits their stomach! Only had 2 kids out of 100 that have vomited it right back up.

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308 Visitors; 1 Post

I have a very simple and reliable 5 step plan, cleverly called the "Tummy ache 5"

When a child comes to me complaining for a stomach ache I check the temperature, if > 100 I call the parent and let them decide what the best decision is.

If no fever shows...

1. Try to use the bathroom

Especially in the younger tykes the tummy ache can be caused by constipation and the nurses office is a quite place when they do not feel rushed to do their business. ;)

2. Drink a dixie cup of Water

Another common cause of the tummy ache is just dehydration

3. Eat 3 saltines

Unsettled stomache or hunger goes away!

4. 10 minutes rest on the cott

This is all they get, to lose the interest of the fakers wanting to miss class

5. If Tummy ache is not even a LITTLE bit better, Mom or Dad is called, and they get to make the decision. If tummy ache is even a LITTLE bit better and it is before lunch, we pull the " see how ya feel after lunch," If it is after we try and make it through the day and come back if it gets worse...

WORKS like a charm!

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