School Nurses

[daughtersrus]

Who covers the nurse's office at your elementary school when she's on lunch?

Here, they are requiring the office secretaries to cover for lunch but I know that many of them are not comfortable doing that. About 3 weeks ago, there was an incident where a child fell down at recess and came in for a bandage for his knee. He wasn't crying but asked for a bandage. The secretary sprayed some antiseptic on it and put on the bandage and went back to class for the rest of the day. This was on a Friday. Well, Monday the parents come in screaming that their son had broken his wrist when he fell and no one bothered to call them. Of course the secretary was questioned and told that she dropped the ball and didn't handle it properly. Of course, now she's upset because she's being blamed for not finding a broken wrist in a child that wasn't crying or even complaining that his wrist hurt. Not to mention that she has no first aid training and in not a nurse. There are also a few kids that take epilepsy medication as well as several that are diabetic and have to test a few times day. I know that I would not feel comfortable handling these type of situations without training.

 

[Pea-n-Me]

IMO this same scenario could have happened even if the nurse had seen him. But I guess that's besides the point.

I would think that *ideally* there would be nurse coverage for when a nurse goes on break, or in absence of that, that the nurse would be available to come back for emergencies or at the very least, check out any children that were seen in her absence when she returns.

Hold on let me get these school nurse threads never go well.

 

[lsyorke]

Of course, now she's upset because she's being blamed for not finding a broken wrist in a child that wasn't crying or even complaining that his wrist hurt.

If the child didn't complain about pain...how would a nurse have handled it any differently?

 

[piglet too]

I don't think our nurses (at the three different schools my kids go to) are allowed to leave campus for lunch. So even if they are not in their office, they are at the school and will come check on a student brought in with any type of injury.

 

[Cool-Beans]

If the child didn't complain about pain...how would a nurse have handled it any differently?

Nurses think about the stuff everyone knows, but never thinks about. Like when someone falls, they put their hands out to break the fall and so you have to check the hands and wrist.

Wrist fractures are not uncommon with falls.

That isn't even the only thing that is checked.

You'd be surprised about all the stuff nurses keep in mind and are checking that you don't even know they're checking.

It seems obvious when you think about it now. "Yeah, people do put their hands out. A wrist could get broken." But most people wouldn't think twice when the kid falls. Kid doesn't mention pain, so you don't think to look at it unless you've been trained to think of that and check it.

 

[npmommie]

Who covers the nurse's office at your elementary school when she's on lunch?

Here, they are requiring the office secretaries to cover for lunch but I know that many of them are not comfortable doing that. About 3 weeks ago, there was an incident where a child fell down at recess and came in for a bandage for his knee. He wasn't crying but asked for a bandage. The secretary sprayed some antiseptic on it and put on the bandage and went back to class for the rest of the day. This was on a Friday. Well, Monday the parents come in screaming that their son had broken his wrist when he fell and no one bothered to call them. Of course the secretary was questioned and told that she dropped the ball and didn't handle it properly. Of course, now she's upset because she's being blamed for not finding a broken wrist in a child that wasn't crying or even complaining that his wrist hurt. Not to mention that she has no first aid training and in not a nurse. There are also a few kids that take epilepsy medication as well as several that are diabetic and have to test a few times day. I know that I would not feel comfortable handling these type of situations without training.

IMO this same scenario could have happened even if the nurse had seen him. But I guess that's besides the point.

I would think that *ideally* there would be nurse coverage for when a nurse goes on break, or in absence of that, that the nurse would be available to come back for emergencies or at the very least, check out any children that were seen in her absence when she returns.

Hold on let me get these school nurse threads never go well.

I agree with Pea. I think the nurse should be available, and should check out any injury when she returns, she could very well have missed a broken arm too.
I don't think a secretary should be responsible for checking out injuries, i feel like the nurse should be called to the office, i also don't think a secretary should be responsible for giving out meds either.
not to say a secretary is not capable of putting a bandaid on someone, or handing someone their inhaler. but it is a liability imo to have a non medical person handing medications to children.

 

[TEENEE]

If the kid didn't complain about his wrist how was anyone to know he hurt it? As far as school nurses any school that has one on staff should be grateful. Most school around here don't have one. If they do the nurse may only be there a few days a week.

 

[ORMom2Four]

School nurses? They still have those?

Our schools (even elementary) have not had school nurses in YEARS. If anything serious happens, they call 911. Vision/hearing screenings are done by parent volunteers. Band-aids & minor accidents are handled by the receptionist.

This is in one of the best school districts in the state of Oregon!

 

[ozarkmom]

Do you know how many parents have not realized their child had a broken bone? I remember a mom a few years ago that got a call from school she was horrified to find out she had sent her girl to school with a broken wrist.

 

[lsyorke]

Nurses think about the stuff everyone knows, but never thinks about. Like when someone falls, they put their hands out to break the fall and so you have to check the hands and wrist.

Being a nurse for 25 years, if someone isn't complaining of pain or discomfort then injury would not be assumed. My son broke his foot and didn't complain and his mother, yes a nurse , didn't realize something was wrong until the next morning. Nurse don't have any special sense for injury...they act on what is reported by the patient, when nothing is obvious to the naked eye.

 

[mjkacmom]

If the kid didn't complain about his wrist how was anyone to know he hurt it? As far as school nurses any school that has one on staff should be grateful. Most school around here don't have one. If they do the nurse may only be there a few days a week.

I know SO many parents who took up to a week to realize their children broke bones, especially wrists. Our school nurse does check injured kids when she returns. I don't think a replacement should be required - many schools don't even HAVE nurses, never mind one there the whole time. If there is an emergency, call 911. I'm just grateful we have a nurse in our school.

 

[Cool-Beans]

Being a nurse for 25 years, if someone isn't complaining of pain or discomfort then injury would not be assumed. My son broke his foot and didn't complain and his mother, yes a nurse , didn't realize something was wrong until the next morning. Nurse don't have any special sense for injury...they act on what is reported by the patient, when nothing is obvious to the naked eye.

It might depend on where you work, I guess. But I'd think that even in the worst hospital, they'd at the very least call a neurologist for all falls. Please tell me I'm right at least there.

I know some hospitals are better than others, but please tell me that when people fall, you check something!

We would absolutely check the wrists. Part of a standard Fall assessment. Look at it, do ROM, whole bit. Takes all of 10 seconds. But, again, I know it may not be done everywhere.

 

[Pea-n-Me]

My son also walked around on a broken foot for 2 days.

I felt awful, but orthopod assured me it's extremely common, and that it even happened to his own son as well!

A wrist fracture is a funny thing. It's not likely to snap or fracture in the way that a long bone might. It might have had a fracture somewhere in the bone, but that would require an XRay to see. (As opposed to a mishapen leg or swelling, etc.)

I do agree that a school nurse would have most likely more thoroughly assessed the fall. As in, show me how you fell, is anything else hurting, looking for swelling, etc. But a) none of us were there so we don't know exactly what words were exchanged with any of the parties and b) it still may have eluded detection regardless.

I feel badly for any of you who do not have a school nurse.

 

[lsyorke]

It might depend on where you work, I guess. But I'd think that even in the worst hospital, they'd at the very least call a neurologist for all falls. Please tell me I'm right at least there.

A neurologist for a scraped knee? Hmmm, never. If there were symptoms of further neurological injury, ie. loss of consciousness, pain, confusion, yes, scrapes or a random fall, no.

 

[npmommie]

It might depend on where you work, I guess. But I'd think that even in the worst hospital, they'd at the very least call a neurologist for all falls. Please tell me I'm right at least there.

I know some hospitals are better than others, but please tell me that when people fall, you check something!

We would absolutely check the wrists. Part of a standard Fall assessment. Look at it, do ROM, whole bit. Takes all of 10 seconds. But, again, I know it may not be done everywhere.

I agree about nurses and fall assessments, but I have worked at some very large major teaching hospitals and we do not call neuro for EVERY fall.

 

[Pea-n-Me]

But I'd think that even in the worst hospital, they'd at the very least call a neurologist for all falls. Please tell me I'm right at least there.

This would not be something I'd expect to see, either.

And I doubt the neurologists would be happy if the serious cases weren't triaged. They'd be doing nothing but seeing falls.

 

[mjkacmom]

It might depend on where you work, I guess. But I'd think that even in the worst hospital, they'd at the very least call a neurologist for all falls. Please tell me I'm right at least there.

I know some hospitals are better than others, but please tell me that when people fall, you check something!

We would absolutely check the wrists. Part of a standard Fall assessment. Look at it, do ROM, whole bit. Takes all of 10 seconds. But, again, I know it may not be done everywhere.

Years ago, I fell off my bike, banged up my head pretty badly, broke my collarbone. Before that, I fell off a horse, went unconscious, broke my collarbone. Never saw a neurologist. I think it would take a serious head injury, or certain symptoms, for one to be called in.

 

[npmommie]

Years ago, I fell off my bike, banged up my head pretty badly, broke my collarbone. Before that, I fell off a horse, went unconscious, broke my collarbone. Never saw a neurologist. I think it would take a serious head injury, or certain symptoms, for one to be called in.

hmm. a fall off a horse, resulting in LOC, that should trigger neuro in the ED

 

[mjkacmom]

hmm. a fall off a horse, resulting in LOC, that should trigger neuro in the ED

I think what happened was that when I fell, my gf ran for help (yes, we were 11 years old, riding a horse without supervision, the good old days), and I woke up right before she came back, and it took her several minutes to find someone. I bet know one even knew I blacked out, but I remember I kept seeing cats in all of the medical equipment!

 

[lsyorke]

This would not be something I'd expect to see, either.

And I doubt the neurologists would be happy if the serious cases weren't triaged. They'd be doing nothing but seeing falls.

Can you imagine that call for the consult? Oh, that is one I wouldn't make!