When you can't solve it all...

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Specializes in School nursing.

...and realize you are human. Missed an asthma flare-up today because kid didn't present with chest symptoms, just nasal congestion and sore throat, part of the parade of kids in my office with cold symptoms. Parent emailed me to basically tell me that I don't listen the child's lungs as their child has asthma and needs a full assessment when they arrive in my office, and they were in urgent care receiving neb treatments.

Maybe I should have; this is my first winter with the student as said student is new to me. I'll follow up tomorrow and own it; I'm far from perfect. I'm glad the student is getting treatment and I already emailed the parent to set up a follow-up time tomorrow.

I usually catch this. I think a need a break. Ugh.

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Hugs, Jen-E. We do our best and we are only human. Hope your meeting goes well tomorrow.

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Specializes in ED, School Nurse.

How old is this student? Is he old enough to say "Hey this feels like it might be an asthma flare?" or "Can I use my inhaler?" That would have triggered a listen to lung sounds. If the student is old enough, he or she needs to learn to advocate for themselves as well. It's not all on you to assess a sore throat/nasal symptoms as an asthma flare-up, although I bet you will now with this particular student.

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Specializes in School Nurse.

Hugs to you...we are only human. Talk with the parents and let them know what you will do different in the future. We learn from every unique situation that we are presented with. Just by you posting this, many of us will do a lung assessment in a similar situation.

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Specializes in School nursing.
How old is this student? Is he old enough to say "Hey this feels like it might be an asthma flare?" or "Can I use my inhaler?" That would have triggered a listen to lung sounds. If the student is old enough, he or she needs to learn to advocate for themselves as well. It's not all on you to assess a sore throat/nasal symptoms as an asthma flare-up, although I bet you will now with this particular student.

Student is 12 and yes, old enough to vocalize symptoms. I will be working on this with this student, as I do with all my middle school students. And I will try and foster a good working relationship with the student's parent. I've done that with my other students that can have moderate to severe asthma to the point where the parent will call me and leave me a voicemail if the student has been battling a cold at home to give me a heads up.

I'm tired, folks. The student is in a grade that I see so many kids from, most for emotional related issues. Not an excuse, of course, but a reason for me to perhaps explore my visit log and how to further avoid the same students visiting me 2-4 times a day (for another thread...)

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Specializes in school nursing, ortho, trauma.

I agree with Ohiobobcat - you work with an older population of kids, not littles that can;t necessarily tell you what's going on. Unless there is a reason why this child couldn't properly advocate for themself, or maybe the child is a brand new diagnosis and does not have the experience with the disease to know what a flare up feels like - then maybe i'd go along with it. But, my dear Jen Eliz, don't beat yourself up. Nothing in life is ever "textbook" and thing can turn on a dime - especially when it comes to dealing with those who are too young to buy a lottery ticket.

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Specializes in School nursing.

Thanks, guys, I appreciate it. I love you for letting me talk it out. This is truly our nurse's station.

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Thanks, guys, I appreciate it. I love you for letting me talk it out. This is truly our nurse's station.

It's more than that. It's our nurse's station, our sounding board, our classroom, and our safe place :)

I seldom listen to lungs with the multitude of kids I have coming in with cold symptoms.

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Specializes in kids.
...and realize you are human. Missed an asthma flare-up today because kid didn't present with chest symptoms, just nasal congestion and sore throat, part of the parade of kids in my office with cold symptoms. Parent emailed me to basically tell me that I don't listen the child's lungs as their child has asthma and needs a full assessment when they arrive in my office, and they were in urgent care receiving neb treatments.

Maybe I should have; this is my first winter with the student as said student is new to me. I'll follow up tomorrow and own it; I'm far from perfect. I'm glad the student is getting treatment and I already emailed the parent to set up a follow-up time tomorrow.

I usually catch this. I think a need a break. Ugh.

Hey, we do our best,and sometimes,it is not the best.That stinks and I am sorry the kiddo is not feeling well. It will be a lesson learned and no doubt not repeated!

Try to let it go and enjoy the Thanksgiving break

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Specializes in kids.
Student is 12 and yes, old enough to vocalize symptoms. I will be working on this with this student, as I do with all my middle school students. And I will try and foster a good working relationship with the student's parent. I've done that with my other students that can have moderate to severe asthma to the point where the parent will call me and leave me a voicemail if the student has been battling a cold at home to give me a heads up.

I'm tired, folks. The student is in a grade that I see so many kids from, most for emotional related issues. Not an excuse, of course, but a reason for me to perhaps explore my visit log and how to further avoid the same students visiting me 2-4 times a day (for another thread...)

I have found that owning it outright, and initiating a conversation with parents on how to move forward, is a healthy approach, and goes a long way to repairing any damage done.

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Good luck! It stinks when we feel like we miss something but best to own up to it and move on. You are human! Hugs!!!

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Situations like this are the worst:( You missed it, but you had no reason to suspect it, so it's a no win. This is what the phrase "Moving forward" was invented for! Another reason that an asthma action plan is so important

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