Vasovagal syncope as sole reason for nursing school dismissal

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My daughter was diagnosed Thursday with vasovagal syncope.  The attending physician wrote a doctor's note stating that she is cleared to work clinicals with no restrictions.  The school she is attending contacted her that same day.  They will be having a meeting with her on Monday to determine if they will let her continue in the program due solely to the vasovagal syncope diagnosis.  She has this semester and one more and she will graduate with her BSN.  Daughter says her triggers are dehydration and boredom.  What can be done to keep the school from dismissing her from the program?

Thanks for the help, especially to the ones who told me about how to handle syncope to keep it from being an issue.  I also appreciate the comments on what to research before the meeting.  It was good to know that people read the entire message and knew her history of working with the elderly and having not problems in that position.  Anyone who has worked in a nursing home knows that there is a lot of standing around and waiting, either on the resident or for help from another employee.  She was trusted in this position and has requested a letter from her supervisor.  I appreciate all the encouragement.  Keep up the good work!

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Specializes in mental health / psychiatic nursing.

Vasovagal syncope alone is not reason to be dismissed, however multiple episodes in clinicals is very concerning and they may have concerns about her physical health and ability to care for herself while also caring for patients. 

Faculty may want to meet with her to discuss option of medical leave until she gets her symptoms under control vs outright dismissal or withdrawal from program.

It may help if she is able to identify her triggers and speak to how she will address them to keep them from being an issue going forward (probably don't bring up "boredom" as a trigger though, perhaps something about standing for long periods and, assuming it is true, how she can wiggle her legs or knees, bend knees, etc to get some blood flow with out walking to regain her blood pressure when needing to stand for long periods of time).  

(As someone with vasovagal syncope, identifying and mitigating my triggers is huge; I rarely have episodes now). 

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Specializes in Occupational Health.
On 10/2/2021 at 10:47 PM, Mom.6 said:

In 6 semesters she has had 4 episodes.  None of them directly involved a patient

not yet

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Specializes in oncology.

Many decades ago I had a nursing student faint in the OR. She must have been close to the table, because as she fell she pulled out the patient's IV. The staff who could, tried to find out her level of consciousness as she had hit her head. She became alert quickly but complained of foot pain. It turned out that somehow, she had broken her foot. 

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Specializes in retired LTC.

Am curious - how did the faculty meeting go? Should have been yesterday?  

I know this wasn't part of OP's post, but I get the impression that dtr's syncopal episodes are being minimized. At the expense of trying to maintain her school enrollment. I DO NOT want to be nosey. She's gone so far in her educational pathway, no one wants to see her derailed. But episodic vasovagal syncope can be serious.

 

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Specializes in Physiology, CM, consulting, nsg edu, LNC, COB.

There are treatments for this. Perhaps the faculty would be more inclinced to review an adverse decision if she embarked on one or two, rather than relying on just one MD opinion (which may or may not be up to date).

https://www.mayoclinic.org/diseases-conditions/vasovagal-syncope/diagnosis-treatment/drc-20350531

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Specializes in Physiology, CM, consulting, nsg edu, LNC, COB.

There are treatments for this. Perhaps the faculty would be more inclinced to review an adverse decision if she embarked on one or two, rather than relying on just one MD opinion (which may or may not be up to date).

https://www.mayoclinic.org/diseases-conditions/vasovagal-syncope/diagnosis-treatment/drc-20350531

Treatment

In most cases of vasovagal syncope, treatment is unnecessary. Your doctor may help you identify your fainting triggers and discuss ways you might avoid them.

However, if you experience vasovagal syncope often enough to interfere with your quality of life, your doctor may suggest trying one or more of the following remedies:

Medications. A drug called fludrocortisone acetate that's normally used to treat low blood pressure may be helpful in preventing vasovagal syncope. Selective serotonin reuptake inhibitors also may be used.

Therapies. Your doctor may recommend ways to decrease the pooling of blood in your legs. These may include foot exercises, wearing compression stockings or tensing your leg muscles when standing. You may need to increase salt in your diet if you don't usually have high blood pressure. Avoid prolonged standing — especially in hot, crowded places — and drink plenty of fluids.

Surgery. Very rarely, inserting an electrical pacemaker to regulate the heartbeat may help some people with vasovagal syncope who haven't been helped by other treatments.

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Despite the doctor's note saying no restrictions, the meeting informed us of the restrictions the school is putting on our daughter.

What was most interesting is that my daughter had talked to the school faculty, who saw her episodes first-hand, and they were surprised that the school felt a meeting was warranted.  This also leads me to believe that they were not consulted when the school was making its decision.  

Daughter will graduate.  Thank you ADA.

 

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Specializes in retired LTC.

If dtr were a grammar school grader experiencing those episodes, there most surely would be a formal treatment care plan in place with interventions. Multiple parties would be aware of any special needs.

I'm NOT surprised that the school board admin became involved. Dtr could become a personal liability if she herself were injured during an episode. Not to mention any pt injuries were to occur. Don't know how serious her episodes were, but they could be serious serious. Likewise triggers can be ever so simple - like straining to defecate or retching during nasty nausea/dry heaves.

As an adult, dtr needs a comprehensive plan of care, esp as she continues school, her personal life, and then into her professional care.

Glad school will continue for her. Good luck to her.

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I’m glad your daughter is able to continue her education! What kind of restrictions does she have? 

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Specializes in Transitional Nursing.

When you miss more than one clinical day, regardless of the reason - they usually fail you or drop you. 

At least thats how it worked when I went to school.  We could take one class over again, but they didn't come around again for a year. 

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