Wasn't the School Nurse right?

Nurses General Nursing

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I have a friend who has been teaching about 30 years. She was telling me and a group of friends/relatives this story. It is a little gross/TMI.

My teaching friend (we'll call Mary) had a female student who had a massive diarrhea accident in her class. Most of the accident happened while the student was standing. By the time the accident was mostly finished the student was pretty much covered from waist down. This happened in an 8th grade class with about 30 students to witness the whole event from start to finish.

Mary called the school nurse to see what to do. Neither Mary nor the school nurse felt they could send the student to the nurse's office because by this time not only was her clothes completey ruined from waist down but she was standing in a puddle that was about 12 inches diameter. They felt to send the student to the office ( a long way from the classroom) or even the bathroom down the hall would have caused a health hazard and would have greatly embarrassed an already very embarrassed 14 year old girl. Shortly after the students (some had started to laugh loudly and poke fun) were evacuated the student also lost control of her bladder :crying2:.

The janitors (all available ones were needed) and the school nurse brought clean up equipment to the classroom to clean the student. A teacher was posted at the door so no one unauthorized would walk in and the teacher posted at the door also served to block the window in the door. Mary told us that the only clothes that could be saved were her belt and her bra. Everything else had to be trashed (her shirt was tucked into her pants). Even her shoes and socks were beyond saving.

One of my cousins, an LPN, couldn't believe they did the clean up in the classroom instead of taking the student to the bathroom or the nurse's office. Even though Mary tried to explain that liquid feces would have been tracked almost halfway across the school my cousin didn't care. Mary tried to explain that it would have been horrible for a 14 year old girl to have to walk down the hall with any and everybody witnessing this accident and her soiled clothes, on top of the class seing it as well. For some reason my cousin firmly believed that the clean up should not have taken place in the classroom.

I am asking you all, if you don't mind, who was right? Did the school nurse make the right decision? I hope this all makes since and if I left out important details I will try to provide them. I did not witness the accident, but only have Mary's account of it. Mary told us that the girl's mother was very pleased with how it was handled.

BTW Mary had an in depth conversation with the girl's mother about the accident and the mother could only figure that the new depression meds the girl was on caused her to have a very upset stomach, to say the least.

Good call for the school nurse!! In reference to "bsnanat2" I'm a CHARGE NURSE / LPN and in school I was taught critical thinking and use critical thinking at work everyday all day and to refer to an LPN as an "TECHNICIAN" is so far off its not even funny!!! It doesn't matter if your a LPN or RN it just depends on what kind of "NURSE" you are!!! I will tell ya I had an LPN save my life one time in the hospital cause an RN almost gave me a med that I'm HIGHLY allergic to and the LPN caught it right before the RN gave it to me through my I.V.

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No one, not even the doctor, could explain why there was so much of it. Mary (the student's teacher) said that she has a friend who was lactose intolerant for some time before anyone could figure out what was going on. She witnessed her have some very embarrassing public accidents. She said even those didn't compare to what happened to this student. When Mary was telling us about it, she described it as a "full colon cleansing."

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I'm an RN, and I do feel like I have to address the issue of "Critical Thinking and LPN's." It was wrong of that poster to say what was said. It reveals a misplaced arrogance, and an apology wouldn't be out of place.

I think it would be far more accurate to say that the cousin of the OP was wrong not because she was an LPN, but because of a defect in her own thinking.

So let's not perpetuate defects of thinking any further.

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I wonder if there was anything physical issues with the kid? Or mentally for that matter?

Don't know of physical issues, but she was on depression meds. Sorry, I don't know what kind. According to the student's mother, the student had to start getting counseling for this episode alone. Mary told me that the girl actually got worse because she was refusing those meds and any others. I know nurses on this site talk about people who won't take their meds, but I kind of understand this girl considering what happened.

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I would be wondering about celiac disease and/or food poisoning.

and, yes, I think the school nurse was appropriate..

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I think she did the right thing I don't think she used critical thinking I think it was more like common sense

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Specializes in cardiac, ICU, education.

I am a school nurse and that is exactly what the nurse should have done.

By health code laws in our state, we can't even send a child back to his or her locker if they come to the clinic with a fever. They have to be picked up by a parent and the parent has to go to the locker for them to get the books before they retrieve their child so as not to contaminate the hallways again.

I feel terrible for this girl. 8th grade has got to be the worst time for this to happen, but the nurse was absolutely correct. And shame on that principal!!!!!!

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Specializes in cardiac, ICU, education.
I would be wondering about celiac disease and/or food poisoning.

and, yes, I think the school nurse was appropriate..

I totally second that!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Celiac disease can cause depression, stomach cramps, diarrhea and most importantly lactose intolerance. It is too bad your nurse friend does not have contact with that person anymore. A simple test could determine celiac.

Both my son and daughter have celiac and my daughter had the diarrhea (and a number of other things) and my son had EXTREME fatigue and what I thought was borderline depression. One we figured out the problem and changed their diet, they have done a 180. The diagnosis was the most wonderful that happened to us ironically.

If this girl does have lactose and or celiac, the depression medication could have gluten in it (as many meds do) and make the depression and diarrhea even worse.

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i'm an rn, and i do feel like i have to address the issue of "critical thinking and lpn's." it was wrong of that poster to say what was said. it reveals a misplaced arrogance, and an apology wouldn't be out of place.

i think it would be far more accurate to say that the cousin of the op was wrong not because she was an lpn, but because of a defect in her own thinking.

so let's not perpetuate defects of thinking any further.

not misplaced. not arrogant. just a fact.

while not the focus of this post, my point to the op was that most lpn's are going to focus on tasks and procedures as that is the focus of their training. yes, many lpn's surpass that, but if they do, it is a testament to them as individuals and their being willing to continue to learn. lpn's whose goal is to simply graduate, pass the test and start working are not going to have the same critical thinking skills that an rn is going to have. this is simply not the focus of their one year of training. that is why i've seen an lpn who almost let their patients die because the allergic reaction to an iv medication they were witnessing 'did not follow the steps it usually does in the book' (as a student i had to go get an rn to deal with the situation) and one who gave a patient too much golightly because 'that is what was on the order.' besides not questioning the dosage, what was the other problem? she had gotten a call that the procedure was canceled due to a hospital wide emergency. when i asked why she gave the laxative prep for the procedure when she knew it couldn't be done another lpn interrupted and said basically that 'since the md hadn't removed the order, she should give it anyway.' next day md was bent! the moral of the story is that the training that lpn's get leads to linear thinking. any improvement from that is up to the lpn.

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not misplaced. not arrogant. just a fact.

while not the focus of this post, my point to the op was that most lpn's are going to focus on tasks and procedures as that is the focus of their training. yes, many lpn's surpass that, but if they do, it is a testament to them as individuals and their being willing to continue to learn. lpn's whose goal is to simply graduate, pass the test and start working are not going to have the same critical thinking skills that an rn is going to have. this is simply not the focus of their one year of training. that is why i've seen an lpn who almost let their patients die because the allergic reaction to an iv medication they were witnessing 'did not follow the steps it usually does in the book' (as a student i had to go get an rn to deal with the situation) and one who gave a patient too much golightly because 'that is what was on the order.' besides not questioning the dosage, what was the other problem? she had gotten a call that the procedure was canceled due to a hospital wide emergency. when i asked why she gave the laxative prep for the procedure when she knew it couldn't be done another lpn interrupted and said basically that 'since the md hadn't removed the order, she should give it anyway.' next day md was bent! the moral of the story is that the training that lpn's get leads to linear thinking. any improvement from that is up to the lpn.

i am not taking sides as i don't believe either viewpoint is entirely correct. however, merely relating anecdotal occurrences as fact is not a valid argument for how all lpns are trained. imo, so often everyone is so defensive of "their" certification that they don't look at things logically.

as far as the nurse, i believe she did the most correct thing in the position she faced.

for the previous poster who lamented that "all kids are on medication," i would simply say that isn't the fact. i believe many children are medicated unnecessarily. however, that doesn't mean that children do not need medication. to take one instance and lament the use of medications is entirely unfounded. just as likely as this child being over medicated is that she has serious issues that can perhaps be stabilized with medications while a generation or two ago should would be marginalized. we don't know if either is the truth, but to make a statement about the overuse of medications in children based on this thread is mere projection on your part, imo.

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Poor girl.

Another theory to consider: maybe she has bulimia and was abusing laxatives. She might have taken a very large dose if it were her first time trying laxatives, or if she had a particularly large binge to "make up for".

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Specializes in Intermediate care.

Oh my....that poor girl. That would be devastating for a 14 year old girl. Even now that would be embarrassing but atleast adults understand and kids/teenagers tend to poke fun more often.

Ahh, my heart just aches for her. I really want to hug her right now :)

But i believe the nurse made the right decision. I probably would have brought her some sheets/towels or something to cover up with so she wouldn't be exposed in the classroom despite everyone being gone, its the idea of it especially for a young girl. A young girl should feel safe in her classroom and not have horrible memories. So providing her some privacy would be a must.

We had a girl in our class when i was in middle school that had cancer. She had no hair, and she looked a lot different then we all remember. Before this girl came back to school she had a discussion with the class about what to expect and how we need to respect her and treat her nice. I'm relating this story because maybe "Mary" can have a discussion with the class about the incident, without the young girl there. Have a discussion about what happened and why it happened and that this is a very difficult time for her.

I'm not good with children, so i don't know if that would help...but she really does not need to go back to school and get picked on.

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