What warrants a call home?

Specialties School

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Good morning, all! I'm not completely new to allnurses, but new to this group. I'm a newly licensed LVN working as a nurse in an elementary school.

I've figured out quickly that there is a huge learning curve as far as practicing nursing in a school vs a hospital/clinic. I have children of my own and tend to use a "would this alarm me as a parent?" as my approach to whether or not to call parents.

So on Thursday I had a 3rd grader come to me at the end of the day with a rear ankle scrape. She was NOT bleeding. She had a bandage on in the area already, so I asked her to show me what I was supposed to be looking at, and she pulled down her sock and she pointed to a cut just below the existing bandage. I cleaned it and placed a bandaid over it and sent her back to class to get her backpack since school was out. And just to reiterate, she'd walked downstairs and across the entire school to my office with absolutely no bleeding. So I documented such, waited for my daughter, and left.

The next morning I walk into the front office with the mother standing there, and she proceeds to yell in my face and tell me I'm incompetent, and that she's am MA and even she knew the cut would need stitches (stitches?! What I saw was a typical ankle scrape... It almost looked the way ankles look while breaking in new shoes). And that I was trying to cut corners so I could go home. To which I didn't reply, but was thinking that I never take a lunch breaks and frequently stay late (unpaid) to work while my kids are in after school care. But how would she know that? She just wanted to go with her wild assumptions and berate me. She was shoving a picture in my face to which I couldn't reply honestly as it would have gotten me into trouble. Honestly, I would never have taken my child to the ER for a 1" ankle scrape, but whatever. And as I said before, the girl had managed to walk quite a bit to get to my office without any bleeding, and yet this mother was claiming her daughter had a saturated sock 5 minutes later? The only thing I can think of was that the ridge of her shoe maybe made it worse?It was also the end of the day, and I'd even asked the girl if she went to after school care or was being picked up, and she said her mom was there! I also spoke with her teacher who said that after it happened, she put a bandage on and she continued working on her science project. Her teacher said it had some blood right after, but none post-bandage nor none when the girl returned to get her backpack.

I guess this this is more of a vent than anything, but I was really upset and embarrassed to have someone yelling at me like that in the front office in front of everyone. When I told my district nurse about it, she just rolled her eyes and said that some parents are crazy and just enjoy escalating things, and to not take it personally. Sure hard not to, though!

So originally I thought this in no way warranted a call to parent, but had I been psychic of this girl having a nutty mom, I sure would have called!

Hello, I'm not a LPN yet, , but I can say that if I was and I was in your shoes I would call the child's parent about anything that happens. Why I say that is because my kids school nurse calls me about anything that happens, even if they provided care like you did and everything was fine like you thought. It's better to be safe than sorry and or embarrassed (sorry that happened to you). My kids school nurse even called me one time when my kid had a headache and he gave him an ice pack. I had no problem with him doing so.

Specializes in Complex pedi to LTC/SA & now a manager.
Hello, I'm not a LPN yet, , but I can say that if I was and I was in your shoes I would call the child's parent about anything that happens. Why I say that is because my kids school nurse calls me about anything that happens, even if they provided care like you did and everything was fine like you thought. It's better to be safe than sorry and or embarrassed (sorry that happened to you). My kids school nurse even called me one time when my kid had a headache and he gave him an ice pack. I had no problem with him doing so.

If my son's nurse had the time to call home about every bandaid and little thing she'd be on the phone 24/7. That's ridiculous. A headache in a non-frequent flier then yes. I've seen the crazy things middle schoolers come into her office and raised an eyebrow at the drama (paper cuts have never caused death gals and a bandaid may or may not cure).

OP the clue is the bandaid where you & the district nurse could not look to alleged sutures. How much to bet that there are no sutures and the bandage will remain 7-10 days? We only bandaged sutured wounds if oozing or bleeding. You did fine. Your district nurse agreed. The mom wanted drama.

Specializes in school nursing, ortho, trauma.

oh, you'll learn quickly that the worst thing about this job is the parents. i had a parent yell at me because i didn't know that her daughter got migraines. it was my first day in district, I didn't know anything about anybody at that point. I had a parent scream at me because her daughter mentioned to me (on her way out the door) that she had a mild stomach ache - I told her that since it was the end of the day to follow up at home since that's where she was headed anyway. Mom was mad because she had to take her to the ER at midnight for her appendix. Did the mom expect me to run labs? Did she think that my psychic abilities should have caught this? The best part is that about a year later the same child's brother was sent into school with severe abdominal pains - parents already aware. School nurse spidey senses start tingling that the brother may be having issues with his appendix. I call the parent tell them to pick up right away - an hour later they finally come for this kid, who is in misery and would you know it - out for the rest of the week - had to have his appendix removed. BTW - mom doesn't work, she was home for that hour, Lord only knows what kept her.

Point is, parents are going to criticize. Some parents just don't get that you are one nurse for hundreds of students - not a personal concierge for their child.

Specializes in Pediatrics Retired.

Oh yea, and parents will get mad at you if you send a kid from school for an x-ray and the bone ISN'T broken!!

This parent overreacted. Some always will. There are a few student that I call home for no matter what because I have dealt with their parents before and know that they want a call. It comes with getting to know your local demographic.

The guidelines that I leave for my subs include calling home for:

Anything that excludes them- fever, vomiting, pink eye (obviously)

Any head injury.

Any injury that I tell the student I want to reassess (ie- trouble with ROM, see if it improves). I tell the parents what I saw on initial assessment and tell them I will call back only if there are any changes.

Bee/wasp sting

eye injury

traumatic nosebleed

Any situation that I think the student may dramatize between school and home (ie- collided with another student in PE, carrying on in my office and then laughing with friends in lunch. Gets home, tell parents that they were dizzy and nauseous all day following collision, scared to call home, nurse is so mean)

As always, nursing judgement trumps all. If something feels off-- call. Often I've called and the parent will tell me that their kid is nervous about a test or the family dog just died so while the student may not feel great, they still need to muscle through.

Specializes in School nurse.

Ditto what everyone else is saying. I'd add, IF the child received stitches then she should have an MD note and presumably a gym excuse. I'm guessing she has neither.

Thank you all for your replies and advice. Everything is incredibly appreciated on my end!

So this lady just won't stop. She is now accusing my district nurse and me of "interrogating" her daughter when the DN asked to look at her stitches. And she's threatened to report to my BON as well as my DN's BON. My district nurse said she'll be laughed off the phone since I provided adequate care for what was presented to me, did not delay care in any way (it was the end of the day), nor did I cause harm in any way. I saw the girl earlier and she just has a regular bandaid over it. I also have confirmation from the teacher that she never saw her bleeding...

And a side story- this lady's kindergartner was hit by a car the first week of school. He was not seriously injured, but she was super nonchalant about it. I'm so confused!

Don't let her get you riled. There are some people you will never please. Just keep swimming and let her stew in her own crazy.

I had a parent scream at me because her daughter mentioned to me (on her way out the door) that she had a mild stomach ache - I told her that since it was the end of the day to follow up at home since that's where she was headed anyway. Mom was mad because she had to take her to the ER at midnight for her appendix. Did the mom expect me to run labs? Did she think that my psychic abilities should have caught this?.

This sounds vaguely familiar to my story! I suppose the one thing I could have done differently was call the mom- although the mom was already here seeing as school was already out for the day :\

But instead, I opted to send a non-bleeding, bandaged child to her parent. Guess next time I'll know better!

Beautiful_soul, you will find that calling for anything is nearly impossible when you see 60+ kids per day. Also, if you are going to call for anything, why hire a nurse? We are only 45 days into school and some of my FF's have seen me 40 times. It's our job to decide what is call worthy. Just like we have to make the call if EMS is needed or not. And we do make mistakes. Unlike the hospital, we have no one to call in for a second opinion.

If my son's nurse had the time to call home about every bandaid and little thing she'd be on the phone 24/7. That's ridiculous. A headache in a non-frequent flier then yes.

Yes. I'd be on the phone all day if I called home for every little thing.

I do have one parent that was pissed I didn't call her about her frequent flyer daughter being here with a stomach ache. We agreed that i would call her ANY time her daughter comes in. I call her almost daily now. Last week she said "oh, you don't have to call me for this/that." I told her I am sticking with our plan. I do NOT trust her. She is the type to complain to anyone who will listen about me, the teachers, Aides, etc.

Things I routinely call for:

Head injury that could be serious.

Lacerations

Fever or vomiting (sent home)

Bad headache-Usually to bring in med

Rashes of unknown origin

Bad nosebleed

Potential fractures or serious soft tissue injury like a sprain/strain

Other things, I use my mom judgement. (Would I want to be called?)

Specializes in school nursing, ortho, trauma.

The mom got mad at you "interrogating" her child? I say put up or shut up with proof about getting sutures.

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