Tummy Ache ideas??!?!?

[blackscrubs]

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!!!

[Artistyc1]

It seems that most of the stomachaches I see are due to kids not spending enough time in the bathroom. I always explain to them what I mean- and it is not to take 30 seconds, and only urinate! Many kids have never been told that it isn't just when you feel like you are going to explode that your body is telling you that you need to have a BM, you might need to sit there for awhile! Some are amazed at how much better they feel after expelling the gas from the burritos they had for supper last night. :-)

[SchoolNurseBSN]

I always do a medical referral after 3-4 visits for the same complaint. I also speak with the teacher and get the counselor involved. I agree that many of these kids do have psychosocial problems and that it may take a while for them to open up. But, where do we draw the line? I am at a school where I have not 1 or 2 frequent fliers but 15-20. Most have many tardies, are failing at least one class, have many unexcused absences. I do not feel I am helping them by letting them visit the clinic 5-6 times a day on a daily basis! That is why i get others involved.

AND SOMETIMES, it really is nothing more than the child does not want to be in math class!!!

What happens when you spend all of your time on frequent fliers? I also have diabetics, asthmatics, a child in renal failure, etc. When those kids need me......I must prioritize and tend to their needs. Sorry, but there is ony one of me and i only have so many hours in a day to figure out what your tummy ache is really all about. There ae 2 counselors, 3 administrators, social workers, psychologists. I feel those people are better trained to intervene on that child and let me provide the services that only I AM TRAINED (as the only medical professional in the building) to provide!

[mc3, ASN, RN]

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.

Yup, see above. If no temp, I also give them plain crackers and water while resting. Serves 2 purposes. If they eat it OK and they don't vomit (hey, where did the vomit smiley go?) they're good to go. If the crackers make them sick, or they look green at the thought of them, I'll usually call home after doing the above.

mc3:nurse:

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[MinnieMomRN]

"hey where did the vomit smiley go?"

You know your a school nurse, when you notice the vomit smiley is missing. Too funny :)

[Kim O'Therapy, BSN, RN]

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.

Sometime, I get the school counselor involved with a case like this. So far this year, it has solved the problem in all but one or two cases.