What do you do with your "Stomachache" kids?

Jedrnurse, BSN, RN · Jan 10, 2017

I hit my timer on the phone to make sure they actually try the bathroom for more than just 60 seconds. Also, I call my crackers "stomach crackers" (they're getting quite the reputation). A warm pad over the shirt once in a while seems to help. If it's with nausea and seems legit, I give a single peppermint candy, as peppermint oil has gastric calmative properties.

MrNurse(x2), ADN · Jan 10, 2017

Though I do wonder how puke buckets would fly in the middle school and high school....

That is my litmus test if the student (MS) is really nauseated or faking. They are in a portable and far from the restroom. Many a faker wanting to go home has been weeded out by the dreaded puke bucket.

allnurses Guide · Jan 10, 2017

Just curious. I HATE that complaint with a passion and of course, it is the most frequent one. My kids are all K or 1 so usually not trying to get out of class. I always take a temp, ask them when they last had a BM and then send them to the bathroom, regardless of their answer. They always return 3 minutes later saying "it didn't help". I palpate the abdomen, make them jump up and down and hop, sometimes auscultate the abdomen...I don't have saltines here, don;t have tums or pepto here...I actually love when they vomit b/c then I get to just send them home

I had a stomach ache every day in school in K - 1st - 2nd grade - one of the Nuns final figured out I was lactose intolerant. Problem solved :)

Hppy

Duncan6 · Jan 10, 2017

Love the idea of the yucky bucket! Usually they send the kids down with their huge classroom garbage cans. I appreciate that they're not trailing vomit down the hall, but sometimes the cans are as big as the kids. And then you run into the hassle of getting them returned.

foggnm · Jan 14, 2017

I'm working as a school nurse now. And except for my medically fragile population, I don't do a lot of assessment on small complaints like stomach aches, headaches, dizziness, etc. I'm not a provider (but you are, so your circumstance is different) so I try to keep my assessments purely visual in nature. I certainly don't touch (palpate) any students. The first thing I ask is "what do you want to do?" For middle schoolers it is great because it makes them think about what they want to do to solve the problem (probably not good for younger kids). I further say "do you want to go home, rest for 5 minutes, drink water, use the bathroom, eat something, etc?" If their stomach issue isn't accompanied by fever, diarrhea, or vomiting I just generally let them rest for 15 minutes and send them back to class. They also have to call their parents. And if you 'hate the complaint with a passion' why are you working as a school nurse? Almost all complaints in the school setting are minor. Playing games like asking kids to jump up and down also doesn't seem very professional on your part. And saying you're glad when they throw up isn't particularly endearing, either.

Buyer beware, BSN · Jan 16, 2017

OP,

In the olden days before the advent of intellectual vapor lock and the abdication of common sense the usual encounter between the nurse and the young person complaining of "my tummy hurts" would usually begin and end with the nurse's pointed question inquiring into when the afflicted last had a bowel movement.

For younger children the word "poop" might be substituted for BM.

A flatplate abdominal xray would no doubt confirm this common complaint for the evidenced based needy and indecisive but this would be more of an academic exercise exposing the child to needless radiation only to once again confirm FOS.

Those parents with young children may know and those with older children may remember that aside from some pathological conditions that may impair daily evacuation many children can be somewhat anal retentive coupled with the concommittent fear of using public facilities.

With this said, if a child is first afforded a secured private bathroom to attempt to "do his business" this may curtail the need to jump to exploratory surgery and provide the simple fix.

Kind-hearted · Jan 17, 2017

Waste baskets double as yucky buckets here in this K-8 school :)

ohiobobcat · Jan 17, 2017

I'm working as a school nurse now. And except for my medically fragile population, I don't do a lot of assessment on small complaints like stomach aches, headaches, dizziness, etc. I'm not a provider (but you are, so your circumstance is different) so I try to keep my assessments purely visual in nature. I certainly don't touch (palpate) any students. The first thing I ask is "what do you want to do?" For middle schoolers it is great because it makes them think about what they want to do to solve the problem (probably not good for younger kids). I further say "do you want to go home, rest for 5 minutes, drink water, use the bathroom, eat something, etc?" If their stomach issue isn't accompanied by fever, diarrhea, or vomiting I just generally let them rest for 15 minutes and send them back to class. They also have to call their parents. And if you 'hate the complaint with a passion' why are you working as a school nurse? Almost all complaints in the school setting are minor. Playing games like asking kids to jump up and down also doesn't seem very professional on your part. And saying you're glad when they throw up isn't particularly endearing, either.

I think, if I am interpreting the OP's point of view correctly, that stomach aches are hard to evaluate in a (non-medically fragile) school-aged population. I get that she "likes" when students vomit. Not that she's happy the student is sick, but that vomit is something tangible, as is a fever and diarrhea. Is it really a stomach ache, or is Sally trying to get out her math test?

We do come here to vent and use each other as sounding boards. I can hate a particular complaint that I see day in and day out all day every day, and I can come here to complain about it to like-minded people in hopes that someone may commiserate with me. That does not mean that I shouldn't be a school nurse, or that I'm not a darn good school nurse.

I get that most complaints in the school setting are minor. Until that frequent flier I sent back to class for the 32nd time this semester has appendicitis, and I missed it because he has complained of a stomach ache at lease 2 x per week since school has started and I blew him off yet again. Which is why I am going to evaluate most abdominal complaints at least with a temp check, brief history, last BM, where exactly is the pain, along with a more detailed assessment as I see fit.

I have used the jumping up and down trick a few times, even on my high school kids. If a kid can jump up and down, chances are good they don't have an appendix that is ready to burst. We used this evaluation technique all the time when I worked in the ER, especially on younger ones. So that's not really a game, it's an assessment technique. I also ask how the bur ride in to school was, as we live in pot hole heaven right now. If a student tells me they were absolutely miserable every time the bus went over a bump, I am calling to have that kids evaluated ASAP.

SchoolNurseTXstyle · Jan 17, 2017

Love the idea of the yucky bucket! Usually they send the kids down with their huge classroom garbage cans. I appreciate that they're not trailing vomit down the hall, but sometimes the cans are as big as the kids. And then you run into the hassle of getting them returned.

I stopped trying to return trash cans. It seems the bigger the trash can, the less likely student is to hurl.

If a teacher wants it back, they know where they sent it............

Flare, ASN, BSN · Jan 18, 2017

i do the same thing. If a teacher doesn't retrieve it, I don't go out to return it. I have enough to do. There are times that it looks like a garbage can store in here. i have taken a Sharpie and marked all of my trash cans. I advise the teacher to do the same, as the custodians *might* return their cans to them in the night shift.

I get a lot of teachers that expect that i will clean out and immediately return a pristine can right back to them as soon as their student leaves. Uh - no. The best i'm going to do is toss on a glove pull out the bag and throw that away (, and maybe spray the can down with some sanitex. I make no deliveries. and there are no delusions of me rinsing the thing out. Where on earth would i go to do that?

BunnyBunnyBSNRN, ASN, BSN · Jan 19, 2017

We do come here to vent and use each other as sounding boards. I can hate a particular complaint that I see day in and day out all day every day, and I can come here to complain about it to like-minded people in hopes that someone may commiserate with me. That does not mean that I shouldn't be a school nurse, or that I'm not a darn good school nurse.
I have used the jumping up and down trick a few times, even on my high school kids. If a kid can jump up and down, chances are good they don't have an appendix that is ready to burst. We used this evaluation technique all the time when I worked in the ER, especially on younger ones. So that's not really a game, it's an assessment technique. I also ask how the bur ride in to school was, as we live in pot hole heaven right now. If a student tells me they were absolutely miserable every time the bus went over a bump, I am calling to have that kids evaluated ASAP.

Thank you for wording this better than I could have (or wanted to!)

Abigail Dreilinger · Feb 5

hi I am a nurse and most of my kids have a fever