Home injuries: Does the nurse need to know?

  • 29 Jan 2018 10:37 AM
    Reply # 5707223 on 5702175
    Deleted user

    Good to hear we are all in agreement. I sometimes find it difficult in this respect. The nurse must be aware of an injury (or illness) that is more than minor to avoid potential complications. Sometimes I don't feel the cooperation from the teachers e.g. with screenings, follow ups etc. I understand they need to be in class but their health must be maintained at a minimum and illnesses or injuries especially. Some teachers actually act like they know more than I  that a student is ill when I have ruled out any significant problems. Most parents work and I don't feel it respectful to call them over any little thing.

    On the other hand students have actually been ordered out of my office by a teacher for tests or if the teacher thinks they are faking.  Overall I don't think we get the respect that we deserve and need to do a good job. I wish I knew how to remedy this. I do have support from the administration for the most part. 

    Hoping things get better. 

    Last modified: 29 Jan 2018 10:48 AM | Deleted user
  • 26 Jan 2018 7:34 AM
    Reply # 5703107 on 5702175
    Anonymous

    I see some great advice posted within this subject. I agree with everything said to date with relation to the student. With relation to your work peers, I would suggest first speaking with your administrator to gain support, then perhaps approach this with an educational in service.  My thought is that staff often are boxed in mentally to delivering content, and forget to look at the student holistically. When they realize the impact injury can have on the learning process, and what mechanisms may have caused the injury, you should gain the support of most.  I also remind them of liability and the protection that can be gained through consulting with the school nurse. Good luck!

  • 25 Jan 2018 6:47 PM
    Reply # 5702500 on 5702175
    Anonymous
    These issues can be so difficult. My very first thought is that any adult who objects to a student seeing the school nurse doesn’t understand the difference in the role of teacher and school nurse. They also don’t know that RN‘s help to keep students in school and able to learn. School Boards who choose to employ RN’s are demonstrating the community’s concern for the health and wellbeing of students. The School Board is acting “in loco parentis.” And, finally the issue of possible abuse raises its ugly head. I have recently retired, when I worked I refused to give ice, cough drops, etc without seeing the student first. I explained to the teacher that for them to expect for me to treat something I had not assessed would be like me going in and teaching their class because I could. I also had this issue when I first began and I explained the above to the teachers and I also explained that no one at the school could practice nursing unless they were licensed. 


  • 25 Jan 2018 2:57 PM
    Reply # 5702250 on 5702175
    Anonymous

    Posted on behalf of  Haddock, Beth  SAU73

    School nursing is often an extension of home care, and some times we are even the first line of health and wellness that a child has. A nurse is not over stepping by assisting with care at school, it a continuum of care, home to school, school to home. A well child learns best when they are healthy and have needs met and a teacher should realize that a nurse is part of the the collaborative team. It is absolutely imperative that a school nurse know about significant injuries at home, (but some times we are not kept in the loop, usually by the parent). Home injuries often impact learning. What if that student has sustained a concussion? There are state laws about return to play for a student with a concussion. Parents in my district are always grateful for our input as nurses, our assessments, our recommendations. Administration in my district is very good about supporting our role and our decisions. Teachers in my district are excellent about including us with student wellness and concerns and use us as resources. Good luck to you!

  • 25 Jan 2018 2:55 PM
    Reply # 5702248 on 5702175
    Anonymous

    Posted on behalf of Karen McCusker  mccusker@sau83.org

    Wow I am thankful my staff is not like that. They always ask that I check things out like that wish I had a document that could help you. However maybe alerting them that sometimes these injuries can be abuse based and that is why parents wont approach the nurse due to our training at spotting such things. Also remind them that we are all bound by the law to report suspected abuse and having them see you takes some of the weight off of them. Also remind them that injuries can impact the students health and ability to preform.  

  • 25 Jan 2018 2:54 PM
    Reply # 5702246 on 5702175
    Anonymous

    Posted on behalf of Denise Bailey

    It is my feeling that we can not and would not be overstepping our bounds if we evaluated/treated an injury that happened at home. I feel it is my duty as well as in my job description to address any and all injuries and sicknesses that I become aware of with my students. Accommodations may need to be made for the student. Unfortunately students are in some cases abused and parents report the injuries were sustained by accident. In some cases it needs to be reported to guidance as well as to DCYF. I am not saying this is the case in this case. I would err on the side of caution and evaluate with or without a call from the parent. 


    Denise Bailey RN BS M.Ed

    School Nurse
    Salisbury Elementary
    (603)648-2206
    Fax (603)648-2529


  • 25 Jan 2018 2:47 PM
    Reply # 5702239 on 5702175
    Anonymous
    NHSNA Board wrote:

    Posted on behalf of a nurse who wishes to remain anonymous:

    I need your input, I have 2 teachers who are telling me that if a student has an injury at home and the parents are aware of it then the school nurse does not need to know. I had One student who texed the teacher and told her their son fell getting out of the bathtub. The teacher felt that since the injury occurred at home there was not a need for the nurse to know about what happened. The student had requested an ice pack and the teacher sent her para to get the ice. She did not want the student to be evaluated. So I did not see the student until almost lunch time and the student had a significant bruise and swelling around the peri orbit of the eye. The teacher was emphatic that the student go outside for recess. Her thinking if the parent had wanted the nurse to see the student they were in charge and she stated that If it was my child then I would be upset with the nurse overstepping her role as the nurse . I have been with these teachers for 3 years now. There is some feeling that the role of the nurse should not be interfering with the students academic success by taking them away from valuable class time. . There is more to the story but this is the Crux of the issue. As of now I am trying to find in our school policy where the school nurse may be involved with something other than what occurs during the school day . The resources I have here are limited, I plan to talk to HR then approach the teachers with information and get a consensus agreement Thank you for your input.


    I think it is very important that school nurses know about certain injuries.  For instance in the case of a potential head injury, a concussion or bleed could not be symptomatic for some time.  I have not had any issue with parents if I call them when a teacher indicates they had communication with a parent about a home injury.  

    I certainly think that as an RN, you have the medical knowledge to assess any potential complications of an injury more than the teacher.

    Ellen Warecki MS APRN NCSN

  • 25 Jan 2018 2:36 PM
    Reply # 5702235 on 5702175
    Anonymous

    Oh, my goodness. There are quite a few issues going on here.  Firstly, the teacher withholding healthcare or first-aid to a student strikes me as careless at least, possibly criminal at worst  Have you spoken to your administrator about the teacher exercising overreaching control of the student, and nursing?

  • 25 Jan 2018 1:56 PM
    Message # 5702175
    Anonymous

    Posted on behalf of a nurse who wishes to remain anonymous:

    I need your input, I have 2 teachers who are telling me that if a student has an injury at home and the parents are aware of it then the school nurse does not need to know. I had One student who texed the teacher and told her their son fell getting out of the bathtub. The teacher felt that since the injury occurred at home there was not a need for the nurse to know about what happened. The student had requested an ice pack and the teacher sent her para to get the ice. She did not want the student to be evaluated. So I did not see the student until almost lunch time and the student had a significant bruise and swelling around the peri orbit of the eye. The teacher was emphatic that the student go outside for recess. Her thinking if the parent had wanted the nurse to see the student they were in charge and she stated that If it was my child then I would be upset with the nurse overstepping her role as the nurse . I have been with these teachers for 3 years now. There is some feeling that the role of the nurse should not be interfering with the students academic success by taking them away from valuable class time. . There is more to the story but this is the Crux of the issue. As of now I am trying to find in our school policy where the school nurse may be involved with something other than what occurs during the school day . The resources I have here are limited, I plan to talk to HR then approach the teachers with information and get a consensus agreement Thank you for your input.

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