When parents are barriers to care

[MHDNURSE]

I have a new job in a new school district this year. I am doing case management and essentially managing chronically ill/medically high needs kids and helping coordinate their care, paperwork, IEP/504's, etc. So think along the lines of those families that have so much going on and you get swamped with all the chasing paperwork, calling providers, talking with teachers, etc. I take those kids off the school nurses' plates and manage them instead. So I am realizing how some parents claim to be their child's "biggest advocate" and do everything they can to "fight" for what their kid needs/deserves, yet do everything they can to make getting those services difficult.

I have two cases in particular and the mothers are the reason we are having issues in the first place. One mother (who I am convinced has borderline personality disorder with schitzoid tendencies) has made all of these requests for accommodations for her kid. We all meet and she is hostile the entire meeting. I write down all of her demands and call the specialty clinic for his condition to speak with the nurse. The nurse agrees to essentially write a 504 with all accommodations which we can roll into his IEP. So nice of the nurse. So I am thinking great, all set. Nope! Mom gets the 504 from clinic and is upset that it doesn't have all her requested accommodations and tells the clinic they do not have permission to share it with me. Tells me that until they "fix it" we can't have it. The medical component is the only thing standing in the way of a completed IEP for this kid. I told mom that. But at the same time she is fighting with us that we haven't competed the IEP but she is the reason why ? She asks for all these things but doesn't give us anything in return. Still hasn't brought in a copy of his physical (they are new to our district), still hasn't signed consents for meds at school (but demands he self carry and self administer), etc. ARGH!!!!!!

My other case is an overly involved mother of a very complicated little one who is in a school out of district. Our district provides her 1:1 nurse (district policy). Mom and nurse do not get a long very well, but nurse is competent and providing good nursing care. Mom emailing to complain about every little issue, asks for things, etc. I email her back in response to her "urgent" requests and tell her we are still waiting for doctor's orders, still waiting for her to supply a medication list, still waiting for other things...crickets. So she wants us to provide all these things but doesn't turn in any of the things we need to be able to provide safe nursing care for her.

I just don't get why these parents are the biggest barriers to their child getting the care they need, yet acting as if we are the ones not doing our part. I know I am preaching to the choir here. Just a vent more than anything.

[BunnyBunnyBSNRN, ASN, BSN]

Wow! I think this is something we've all run into - parents that want us to do (fill in the blank) without providing the needed documentation, meds, etc. - but maybe not on the scale you are dealing with.

Regarding the parent that is blocking the IEP, I don't think I have any advice other than the usual, "document, document, document".

1 day and some hours to Thanksgiving break! Hang in there!

[Flare, ASN, BSN]

ugh - the worst! Do you have any teeth to put pressure back on either of these parents such as excluding for no physical (in my state we can after 30 days)? can't believe these parents that expect the world and complain about how hard it is, when in reality, they are the ones making it hard.

12 minutes ago, Flare said:

Do you have any teeth to put pressure back on either of these parents such as excluding for no physical

It's a little tricky b/c we have a zillion notes from random providers since he is followed for a chronic illness. Here's another kicker with him- mom is desperately afraid he will "catch" something from a sick student, yet he is unimmunized due to "religious beliefs" . This is what I am dealing with- crazy!

[bluebonnetrn, BSN, RN]

Yup - I have had many of those parents. It's frustrating. I feel your pain. I feel like they are everywhere but also there seems to be more and more of them. Like someone else already said: DOCUMENT, DOCUMENT, DOCUMENT! And hold your ground as much as possible. As soon as you given them an inch you've lost.

[tining, BSN, RN]

Deja vu for the first case. However my mom is narcissistic, making the ARD all about her and everyone there got a dose of her anger. She would throw her arms up, act flustered and when no one reacted she straitened up.

Black hole for demands and energy sucking Nosferatu.

[EnoughWithTheIce]

These kind of situations are what has me considering leaving nursing in general. It just sucks the life out of you when it is a daily struggle for parents, staff, kids to follow the rules and give you what you need in order to do your job effectively.

[NutmeggeRN, BSN]

Oye...thats all I got!

[ruby_jane, BSN, RN]

Sweet baby Moses.

Whelp, one thing I learned this year is that while parents can make all the demands they want, with both 504 and SPED, we need doctor's orders for anything out-of-the-way medical. I cannot help what admin does in the way of personal care services but if it gets to nitty-gritty medical admin seems to acknowledge me as the expert.

And that schizoid mom....has this risen to a level where you are concerned for the health and welfare of the child? I know you're documenting the pants offa this.

I found that a simple "I'll be happy to consider all your requests when I have documentation from sweet baby's provider. Here's a consent form for me to chat with him/her - please sign it and I'll get right on it" seems to help.

Hang in there. It's real and for whatever reason it seems to be worse here this year.

[bluebonnetrn, BSN, RN]

23 hours ago, tining said:

Black hole for demands and energy sucking Nosferatu.

what does Nosferatu mean?

[BeckyESRN]

4 minutes ago, bluebonnetrn said:

what does Nosferatu mean?

synonymous with vampire, it's a 1920 horror movie.

[bluebonnetrn, BSN, RN]

Aha! Thanks ?