Should a school nurse diagnose?

[sparklynails23]

The bottom line is without definitive testing one cannot diagnose or rule out an illness, and being a nurse and a mom I will tell you the "Dr. Mom" stuff is mess. My own 2 year old son walked around a week with pneumonia (BTW my husband is a doctor) because he had no fever, he was happy, playful and acting like his normal self. I figured he had the same cold the other 3 had had. Whoops! Nope, he didn't. I have seen parents downplay illnesses and injuries and I have seen them overplay them, too. Just because you "think" something is so doesn't make it so.
.

You and your husband are medical professionals and you let your son walk around a week with pneumonia, but "Dr. Mom's" are a mess?? Okaaaay. There are some great nurses and doctors out there, but there are some really dumb nurses and doctors out there, as well. The same goes for school nurses.

The OP's school nurse has diagnsed her kids incorrectly, twice. How many other kids in the school system have been damaged by her incompetence?

 

[tasha99]

You and your husband are medical professionals and you let your son walk around a week with pneumonia, but "Dr. Mom's" are a mess?? Okaaaay. There are some great nurses and doctors out there, but there are some really dumb nurses and doctors out there, as well. The same goes for school nurses.

The OP's school nurse has diagnsed her kids incorrectly, twice. How many other kids in the school system have been damaged by her incompetence?

 

[mhsjax]

You and your husband are medical professionals and you let your son walk around a week with pneumonia, but "Dr. Mom's" are a mess?? Okaaaay. There are some great nurses and doctors out there, but there are some really dumb nurses and doctors out there, as well. The same goes for school nurses.

The OP's school nurse has diagnsed her kids incorrectly, twice. How many other kids in the school system have been damaged by her incompetence?

Well I do agree with you that Dr mom's aren't always a mess. My pediatrician told us that Drs should always listen to moms. After a brand new Ped, (full of hot air) lectured us about our son and how we shouldn't say things that pertain to his medical condition when we weren't Drs. OUr normal Ped told us that was pretty much new grad BS. and Peds especially should listen to the parents. We were right by the way and our normal Ped knew this as soon as we told her. Anyway, I do disagree with you about the dumb Dr's and nurses comment. It happens. No symptoms, no clue. My mom had pneumonia and she had nothing but a small ache in her back. A good friend is a L & D nurse, on her 3rd baby. Didn't realize she was in labor. Almost didn't make it to the hospital. Things aren't always black and white.

 

[luvmy3]

You and your husband are medical professionals and you let your son walk around a week with pneumonia, but "Dr. Mom's" are a mess?? Okaaaay. There are some great nurses and doctors out there, but there are some really dumb nurses and doctors out there, as well. The same goes for school nurses.

The OP's school nurse has diagnsed her kids incorrectly, twice. How many other kids in the school system have been damaged by her incompetence?

First, the OP's kids weren't damaged.
Second, if a parent decides to take the school nurses "diagnosis" over their doctor's, then they are the ones who "damaged" their kid. If your nurse is telling you "your kid has XYZ", don't blame them because you didn't go get a second opinion from a doctor, to make sure.
If you would take them if the nurse said "it looks like your ds has strep, he should see a doc", then why is it an issue to take them if they say "your ds has strep, they need to see a doc"? If you choose not to see a doc, in either case, its your own fault, not the nurses.

 

[tyniknate]

I've had 3 occasions this year where our school nurse was playing "doctor" and diagnosed incorrectly. First, she told me that my middle son had scoliosis and he needed to be seen by our physician. Took him and paid for an appointment and the doctor said "What? There's not even a hint that he has scoliosis." $140

Youngest son came home with orders that we needed to see his eye doctor because he failed his vision test and he is color blind. Took him to the eye doctor. Not only is his vision 20/20, but he isn't color blind either. $80

Then middle son came home with a note that he needed to see the eye doctor because he failed his vision test. I ignored the note. Then I got a second notice and I ignored it. I then got a phone call. I made the appointment, but I also told her what her diagnosis for the kids had cost me already this year. Sure enough......son's vision is fine. Another $80.

So, here's the recap: One school nurse who believes she is an MD = $300 in extra medical bills.

 

[badblackpug]

You and your husband are medical professionals and you let your son walk around a week with pneumonia, but "Dr. Mom's" are a mess?? Okaaaay. There are some great nurses and doctors out there, but there are some really dumb nurses and doctors out there, as well. The same goes for school nurses.

The OP's school nurse has diagnsed her kids incorrectly, twice. How many other kids in the school system have been damaged by her incompetence?

Yes we did. Because, we, as the parents, "know" our kid. He had the same cold the other 3 had. A little cough, a little runny nose, he was running around playing, same huge appetite. Looked fine, felt fine, acted fine, didn't complain. It's a cold, it will pass. Eh...so...we were wrong. So yes, "Dr. Mom" isn't always right.

...and, as has been pointed out before, no one, including the OP know what her son said to the nurse. One thing we do know is that he was at the nurse twice in a week's time complaining of URI symptoms, and something he said prompted the nurse to look in his throat. She saw what were signs of strep and referred him for medical clearance. That was her job. The OP isn't the only parent in the school, the OP's son isn't the only child. It is the nurse's job to protect the student body, not just cater to one kid and his mother. ...and if a 16 year old kid would come to the nurse for a cough drop, I am pretty sure he would be back again with another "complaint."

No one was "damaged" a 16 year old got a strep swab. Big deal. My 4 year old had one...she didn't cry, I am pretty sure a 16 year old can handle it.

Like I said before, in healthcare people hear what the want to hear and hear the tone they want to hear. I will give you an example, a patient who has cancer and declined traditional treatment, instead, opting for "natural" treatment. Her CT showed some lesions on her liver. She was told, "it could be metastatic cancer, or they could be cysts, you will need further testing to determine that." 3 months later comes back with abdominal pain and has told her cancer has spread to her liver. Her response? "That's impossible, because 3 months ago I was told I only had cysts in my liver."

The OP was annoyed and frustrated that she had to pick her son up from school, she was annoyed that he was missing class and the she may, potentially, have had to take off work to take him to a doctor's appointment she deemed unnecessary. In her anger and frustration she may have projected her attitude and feelings onto the nurse and she may has missed the phrase, "he might."

Again, we don't know. We know what the OP heard. We know what her son told her.

...but what we do know is that no one was "damaged." The kid got a medical screening, and got out of class (which was probably his goal, anyway)


HAPPY NURSES WEEK!

...because sometimes even combat pay wouldn't be enough.

 

[ols386]

You and your husband are medical professionals and you let your son walk around a week with pneumonia, but "Dr. Mom's" are a mess?? Okaaaay. There are some great nurses and doctors out there, but there are some really dumb nurses and doctors out there, as well. The same goes for school nurses.

The OP's school nurse has diagnsed her kids incorrectly, twice. How many other kids in the school system have been damaged by her incompetence?

That's quite a dramatic statement.

 

[wilderness01]

Yes we did. Because, we, as the parents, "know" our kid. He had the same cold the other 3 had. A little cough, a little runny nose, he was running around playing, same huge appetite. Looked fine, felt fine, acted fine, didn't complain. It's a cold, it will pass. Eh...so...we were wrong. So yes, "Dr. Mom" isn't always right.

...and, as has been pointed out before, no one, including the OP know what her son said to the nurse. One thing we do know is that he was at the nurse twice in a week's time complaining of URI symptoms, and something he said prompted the nurse to look in his throat. She saw what were signs of strep and referred him for medical clearance. That was her job. The OP isn't the only parent in the school, the OP's son isn't the only child. It is the nurse's job to protect the student body, not just cater to one kid and his mother. ...and if a 16 year old kid would come to the nurse for a cough drop, I am pretty sure he would be back again with another "complaint."

No one was "damaged" a 16 year old got a strep swab. Big deal. My 4 year old had one...she didn't cry, I am pretty sure a 16 year old can handle it.

Like I said before, in healthcare people hear what the want to hear and hear the tone they want to hear. I will give you an example, a patient who has cancer and declined traditional treatment, instead, opting for "natural" treatment. Her CT showed some lesions on her liver. She was told, "it could be metastatic cancer, or they could be cysts, you will need further testing to determine that." 3 months later comes back with abdominal pain and has told her cancer has spread to her liver. Her response? "That's impossible, because 3 months ago I was told I only had cysts in my liver."

The OP was annoyed and frustrated that she had to pick her son up from school, she was annoyed that he was missing class and the she may, potentially, have had to take off work to take him to a doctor's appointment she deemed unnecessary. In her anger and frustration she may have projected her attitude and feelings onto the nurse and she may has missed the phrase, "he might."

Again, we don't know. We know what the OP heard. We know what her son told her.

...but what we do know is that no one was "damaged." The kid got a medical screening, and got out of class (which was probably his goal, anyway)


HAPPY NURSES WEEK!

...because sometimes even combat pay wouldn't be enough.

Happy Nurses week!

 

[tasha99]

I've had 3 occasions this year where our school nurse was playing "doctor" and diagnosed incorrectly. First, she told me that my middle son had scoliosis and he needed to be seen by our physician. Took him and paid for an appointment and the doctor said "What? There's not even a hint that he has scoliosis." $140

Youngest son came home with orders that we needed to see his eye doctor because he failed his vision test and he is color blind. Took him to the eye doctor. Not only is his vision 20/20, but he isn't color blind either. $80

Then middle son came home with a note that he needed to see the eye doctor because he failed his vision test. I ignored the note. Then I got a second notice and I ignored it. I then got a phone call. I made the appointment, but I also told her what her diagnosis for the kids had cost me already this year. Sure enough......son's vision is fine. Another $80.

So, here's the recap: One school nurse who believes she is an MD = $300 in extra medical bills.

Those were vision screenings, not vision tests. They're only as accurate as the info your kids give, and screenings are designed to pick up any kid who might have a vision issue. That's not playing MD (heck, at some schools, volunteers give the screenings).

 

[Coconut36]

You and your husband are medical professionals and you let your son walk around a week with pneumonia, but "Dr. Mom's" are a mess?? Okaaaay. There are some great nurses and doctors out there, but there are some really dumb nurses and doctors out there, as well. The same goes for school nurses.

The OP's school nurse has diagnsed her kids incorrectly, twice. How many other kids in the school system have been damaged by her incompetence?

Clearly you didn't get what she was saying at all. To me her post was an example of how "Dr Mom" can and is wrong. That even when "Dr Mom" and "Dr Dad" are trained medical professionals they can not realize their child is ill or the nature/severity of an illness.

The school nurse never incorrectly diagnosed much less twice. Also what she did was REQUIRE a DR to check the child out and indicate if they were OK or not. She did what she should have done.

You are being ridiculous in making comments about "damaged by her incompetence". The worst she would have done is sent kids to the Dr to be checked out instead of relying on a parent to decide if the kid was healthy or not *gasp* the horror!

 

[tyniknate]

Those were vision screenings, not vision tests. They're only as accurate as the info your kids give, and screenings are designed to pick up any kid who might have a vision issue. That's not playing MD (heck, at some schools, volunteers give the screenings).

That's for my family physician to determine, not the school nurse. Why is the nurse giving vision screenings when it is done by their pediatrician at their yearly physical? Then, if I don't run screaming in a panic to the doctor ten minutes after she sends the letter, I'm in violation of school policy. Stop "screening" my kids! Do your headlice checks and put bandaids on boo-boos and send them home if they are ill, but all this other nonsense is getting really expensive!

 

[Hannathy]

That's for my family physician to determine, not the school nurse. Why is the nurse giving vision screenings when it is done by their pediatrician at their yearly physical? Then, if I don't run screaming in a panic to the doctor ten minutes after she sends the letter, I'm in violation of school policy. Stop "screening" my kids! Do your headlice checks and put bandaids on boo-boos and send them home if they are ill, but all this other nonsense is getting really expensive!

Then call your state because most states have mandated vision screenings at certain ages written into the school regulations.

Believe me the nurse has other things they would much rather do than all the paperwork and hassles of vision screening 500 to 1,000 kids!

Like everyone else has said they are there for the general well being of the school and community.

And do you honestly think that every child in that school gets a thorough yearly exam at a DR's?

You are very insulting to what you think a professional nurses abilities are.

I also would talk to my kids as to why they were fooling around during the screening because something caused them to fail it.

 

[Mickey&Mouse]

Clearly you didn't get what she was saying at all. To me her post was an example of how "Dr Mom" can and is wrong. That even when "Dr Mom" and "Dr Dad" are trained medical professionals they can not realize their child is ill or the nature/severity of an illness.

The school nurse never incorrectly diagnosed much less twice. Also what she did was REQUIRE a DR to check the child out and indicate if they were OK or not. She did what she should have done.

You are being ridiculous in making comments about "damaged by her incompetence". The worst she would have done is sent kids to the Dr to be checked out instead of relying on a parent to decide if the kid was healthy or not *gasp* the horror!

I think the OP in this case was taking these two encounters with the school nurse seriously, which is why she posed the original question, “Should a school nurse diagnose?” Then she went into the specific details of her experience. I agree that this situation was indeed serious, and warranted at a minimum the follow-up comments she made to the nurse.

As I stated before, this should actually be taken up with the school through appropriate channels. The OP can decide if she wants to do that. I will hazard a guess that the school would like to be informed on this matter, seeing as they could be held liable if a child was endangered by the nurse’s actions.

I have to take issue with the statement, “The school nurse never incorrectly diagnosed much less twice”. According to the OP, the nurse DID diagnose both of her children on two different occasions. The time with her daughter demonstrated a high degree of incompetence that would have caused extreme pain and potentially greater damage to the child’s ears if the OP had listened to the nurse. Instead, the OP rightly fell back on her “Dr. Mom” instincts and took her daughter to the doctor whereupon the doctor validated the OP’s “Dr. Mom” instincts and diagnosed an ear infection.

 

[WL Fan]

There's so much I'd like to say... but I'm going to leave it at

Happy Nurses' Week everyone!

 

[tasha99]

That's for my family physician to determine, not the school nurse. Why is the nurse giving vision screenings when it is done by their pediatrician at their yearly physical? Then, if I don't run screaming in a panic to the doctor ten minutes after she sends the letter, I'm in violation of school policy. Stop "screening" my kids! Do your headlice checks and put bandaids on boo-boos and send them home if they are ill, but all this other nonsense is getting really expensive!

Screenings are the responsibility of schools, because poor vision or hearing affects a child's ability to learn. It's not an issue with the nurse but an issue with school regulations. I'm not sure why your kids failed the screening, but I don't think it's fair to blame the nurse.

 

[badblackpug]

That's for my family physician to determine, not the school nurse. Why is the nurse giving vision screenings when it is done by their pediatrician at their yearly physical? Then, if I don't run screaming in a panic to the doctor ten minutes after she sends the letter, I'm in violation of school policy. Stop "screening" my kids! Do your headlice checks and put bandaids on boo-boos and send them home if they are ill, but all this other nonsense is getting really expensive!

That's really quite insulting. I have a college degree and I will assure you that I am qualified to do much more than check for lice and bandage boo-boos.

Vision and hearing screenings are nothing new. I had them in school and that was a "while" ago.

Actually vision and hearing screenings were started in public schools because many children do not have access to opthalmology and audiology. Many insurance plans do not cover either, and these are the only hearing and vision screenings many children get. Obviously if a child cannot hear or see it will impact their education. Our schools even offer dental screening to children whose parents don't have dental coverage.

...and if the school did see a problem why would you NOT follow up on it? I wouldn't want to take the chance, but that's just me. My daughter's teacher mentioned that she squints at the board, I didn't jump all over her and berate her for not having a medical degree. I took my daughter to the eye doctor, and then I bought her some glasses.

...but anyway, in our school you can opt out of the preventative screenings if you have proof that they were done by your physician/dentist. I don't because they are free. The way I look at it is, if they have the screening and it comes up normal, no co-pay. If they have the screening and it comes up abnormal, co-pay. If I take them to the doctor, co-pay every time. It's a 50/50 shot.

 

[Coconut36]

That's for my family physician to determine, not the school nurse. Why is the nurse giving vision screenings when it is done by their pediatrician at their yearly physical? Then, if I don't run screaming in a panic to the doctor ten minutes after she sends the letter, I'm in violation of school policy. Stop "screening" my kids! Do your headlice checks and put bandaids on boo-boos and send them home if they are ill, but all this other nonsense is getting really expensive!

Because they are likely required to do so..some states have laws that state that is one of the roles a school nurse is expected to perform. I am 37 years old and had vision and hearing (and scoliosis) screenings in school so it's not like this is something new. Not all physicians do vision and hearing screenings at well visits either..I just had someone remark in shock that my Ped does them as theirs does not. Also you do realize how many children do NOT have access to a regular family physician/Pediatrician? A lot of them..despite their parents working their behinds off health care is unattainable or too expensive to actually utilize..meaning these kids never get a vision or hearing screen unless it is done in the schools.

If a child is struggling with their vision or hearing they are going to struggle in school as well. It's simply a screening..it flags kids that need a deeper look by a Dr to determine if they have issues that need assistance or correction.

Do you seriously think a school nurse is there only for head lice and "boo boos"? What an insulting and uneducated response.

FYI..

The National Association of School Nurses (NASN) identifies health screenings as one of the seven roles of the school nurse. Screenings provide a unique opportunity for nurses to positively impact the health of students. Consider the potential benefits when deciding which screenings, if any, to include in your normal activities. For example:

-Act as a safety net for children who might not have regular access to primary care
-Prevent medical, psychosocial, and academic consequences of missed diagnoses
-Provide an additional point of contact to develop rapport, educate, and evaluate the overall well-being of students

 

[bellanotte10]

I had vision and hearing screenings when i was younger. if it wasn't for them no one would've known i needed glasses in the 5th grade. My teacher noticed I was squinting, told the screener who checked and basically confirmed I needed glasses, who told my parents, now i've been wearing glasses full time since then.

I didn't talk a lot when i was younger, especially when I was sick or having issues, so it could've gone on for months, with me just blindly (pun intended) accepting my fate, because i didn't want anyone to fuss. They did do them at my dr, and I went for checkups at the eye doctor every 6 months, but the screeners just happened to be the ones who caught it.

 

[Coconut36]

I had vision and hearing screenings when i was younger. if it wasn't for them no one would've known i needed glasses in the 5th grade. My teacher noticed I was squinting, told the screener who checked and basically confirmed I needed glasses, who told my parents, now i've been wearing glasses full time since then.

I didn't talk a lot when i was younger, especially when I was sick or having issues, so it could've gone on for months, with me just blindly (pun intended) accepting my fate, because i didn't want anyone to fuss. They did do them at my dr, and I went for checkups at the eye doctor every 6 months, but the screeners just happened to be the ones who caught it.

Kids also aren't generally aware they are not seeing/hearing properly either. My Mom got glasses at 8 and will tell you she can still remember how amazed she was at the difference and thinking "so that is what things really look like". They are children and they don't realize what they are experiencing is outside the "norm" so screenings help identify kids that need a more in depth look and possible assistance with glasses/hearing aids..etc.

 

[Janepod]

Kids also aren't generally aware they are not seeing/hearing properly either. My Mom got glasses at 8 and will tell you she can still remember how amazed she was at the difference and thinking "so that is what things really look like". They are children and they don't realize what they are experiencing is outside the "norm" so screenings help identify kids that need a more in depth look and possible assistance with glasses/hearing aids..etc.

This was my experience exactly. When I got glasses in third grade was the first time I realized you could see leaves on trees (that they weren't just big green balls) or read the license plates on cars.

These screenings are crucial for kids. Thanks, nurses!