School officials in Florida’s Volusia County School are insisting that a school nurse was perfectly correct in refusing to give a boy his inhaler during an asthma attack because a medical release form was not signed by a parent. By the time the mother arrived at the school, her son was passed out on the floor. She says that the nurse watched as her son, Michael Rudi, 17, collapsed.
The school dean found the inhaler in its original packaging with the student’s name and directions for its use. He seized the inhaler because of the absence of a form. When the boy began to have trouble breathing the mother was called to come into school. It is not clear why, if they could reach the mother, they could not get telephonic approval. More importantly, with the boy having breathing problems, the school insisted that it was still more important to get a form signed than help the child. Rudi is quoted as saying “[a]s soon as we opened up the door, we saw my son collapsing against the wall on the floor of the nurse’s office while she was standing in the window of the locked door looking down at my son, who was in full-blown asthma attack.”
Faced with this horrific situation, the Director of Student Health Services, Cheryl Selesky, still insists it was the parents’ fault for not being sure a new signed form was on file this year. There may have been a failure in supplying such a form, but that pales in comparison to the callous and irresponsible attitude to this teenager who was in obvious medical need. The school was previously made aware of the boy’s medical condition and yet stood there with an inhaler and an unsigned form in hand . . . but concluded the form was the more pressing matter.
It is also not clear why 911 was not called. The parents have filed child endangerment charges against the nurse. They also may want to consider a civil lawsuit against the school. Since the school appears primarily motivated by legal rather than medical considerations, a torts action may serve to concentrate the mind of officials.
Source: Orlando
I know a wonderful RN who has a flawless history and an impressive resume but she is not allowed to be a school nurse (which she has tried four times to do!) because she was mistakenly arrested by the FBI in 1989, after which they jailed her, unjailed her, apologized and let her go and then she had to pay $12,000 to get the thing straightened out etc. etc. etc. and then, 30 years later, it came back because somewhere like SC or NC or Tennessee or something had thrown her name in a database that had tripped the wire for working in public schools after criminal conduct. THEN she had to hire lawyers and spend another $14,000 to expunge records that were not real criminal records but she couldn’t do it because the criminal records she needed to show that she was improperly arrested were already expunged, leaving her unable to prove anything.
When I see shit like this I think about how SHE would have responded to a kid struggling for breath; she would have moved heaven and earth to save that kid no matter what came own on her later. But she can’t practice in the schools. The corruption in our courts affects almost everything in our lives, one way or another, eventually.
AS to complete information: The simple fact is we have to judge on the information we have. We NEVER have perfect or complete information. Ask any judge. We do the best we can with what we have.
—————————————
Mespo, asking as a Nurse, does the legal system representatives not have a duty to fact find before casting potentially damaging judgements or accusations?
Because it seems to me that the climate that is out there right now has created so much fear that it would take an uber-fool to disagree with the loudest voice, no matter what the truth is….
” Don’t mess with red headed nurses of Scottish and Irish descent. ”
——————————-
that would be me….
Elaine/mespo/Blouise/W=^..^
I think all of this still comes back to what Mike A. said earlier:
“With regard to the Volusia County school matter, the school nurse should have immediately called 911 when it became apparent that the student could not breathe. If she had his prescription inhaler in her possession, she should have administered the specified dosage to him regardless of the absence of a signed permission slip. Had she done so, I believe that she would have been immune to suit under Florida’s Good Samaritan statute. The school should also have a policy in place covering medical emergencies in situations in which a signed parental consent is not on file, and school employees should be familiar with that policy. Instead, it appears as though the nurse suffered some sort of bureaucratic brain freeze and did nothing. This hardly qualifies as a ‘damned if you do and damned if you don’t’ incident.”
That the parents didn’t have all the i’s dotted and the school didn’t have all the t’s crossed does not change that the school and its employee the nurse acted without that all too rare commodity – common sense – in a situation where someone’s life was in danger. This is precisely the kind of situation Good Samaritan laws exist to create a shield against liability for and the schools reaction somewhat shows that it is enamored of its own “power” by genuflecting to their own policies or lack thereof over doing what just about any person finding this child with an inhaler in distress on the street would have done.
re the facts, an anecdote. I helped work with a 10 year old kid when I was in high school. He was misdiagnosed as autistic but aftedr 6 weeks and my exclusive to him attention, he blossomed, Went to take him to state fair. Picked him up at his home and asked mother did she have the bag lunch for him she was asked to make. She got angry. “I have 8 kids, I don’t have time for this kid to do that.”
Without context Wootsy and others are absolutely right. We don;t know what the parents did or did not bring to the situation.
ps; 17 year old TEENAGE boys are not children…they are on the cusp of learning responsibility vs becoming poster children for the FBI….
” That is why I am so surprised that you, like Elaine M.and BLouise, choose to focus on the parents rather than the needs of the child. No matter how you slice it diverting attention from the immediate issue of a possible fatal situation for a child is callous.”~Mespo
————————————————————————
In this instance, Mespo, I have the luxury of being a Nurse and responding to the situation as a Nurse, not a Lawyer. I am responding to a scenRIO on a blog. In my mind, in this forum, I can do more to add to this topic if I look at the situation wholistically and not just as someone looking to find someone to blame. IF I WERE to look for someone to blame, it would certainly not, in this instance ESPECIALLY, be the Nurse ALONE. To effect positive change so that this scenario is not repeated, I would suggest that turning the probably underpaid public servant into some kind of monster or whipping post for overworked, possibly struggling, and perenially guilt angry mothers, is counterproductive when ALL THE FACTS ARE NOT AVAILABLE!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
:p
anon nurse: True dat! The school nurse should be either an RN or LPN, but budget constraints are making schools cut corners whenever they can. All too many administrators see the school nurse as only someone who hands out Band Aids for cuts and scratches and doles out pills if they are on the approved list in approved bottles. My wife was an RN and former Head Nurse (Oncology) and my DiL is a critical care RN. My mom was an RN and former Director of Nurses at a large teaching hospital. Kind of the family business. I have not discussed this incident with my DiL yet, but have a pretty good idea what she is going to say. If this had happened to our daughter, my wife would have been down at the school and metastasized all over both the nurse and principal. Don’t mess with red headed nurses of Scottish and Irish descent. All the stories about fiery tempers are true.
As for forms, there were several instances where the school lost our permission forms, or could not locate the. As for a kid in the middle of an asthma attack, who the hell has time to go look in the filing cabinet for a damn form? Something I learned a long time ago was that middle level bureaucrats never actually make things happen, since the only real power they have is to obstruct and delay.
Glad this “nurse” was not at our daughter’s high school her Senior year when one of her friends collapsed in the corridor. The girl had a heart transplant and her body started to reject it. The school staff reacted quickly and the kid was airlifted out, but died at the hospital the next day. That is about as far outside the bureaucratic box as you can get.
mespo,
If you had read all of my comments, you should have seen that I faulted the school nurse/administration for not having done anything to help the student. I don’t CHOOSE to focus on the parents. I’ve been trying to provide the perspective of someone who worked as a public school educator for more than three decades. In a discussion on this topic, I think it important to address the responsibilities of parents today in regard to their making sure that they provide schools with all the necessary medical information and signed forms to ensure their children’s health. I don’t consider that diverting attention. I think it pertinent to the discussion. If that makes me “callous” in your mind–so be it.
In the area where I live, school nurses go through a rigorous screening process and most are RNs. CNAs should not be working as school “nurses”, though I realize that its a growing trend.
If this school nurse is an RN or LPN, she should be reported to her licensing board for investigation and possible sanctions. If she is only a CNA, I am not sure what sanctions could be imposed on her as a paraprofessional. People who get hired as school nurses should–you know–actually know something about nursing. Given that schools are underfunded, I seriously doubt she is an RN, and probably not even an LPN. The term “warm body” comes to mind.
Woosty:
“I have never been called callous in my entire life and in fact have been told just the opposite…”
*****************
That’s likely true. I didn’t cal you callous as a character trait. I said you were callous to this situation. There’s a big difference. i always find you reasonable and empathetic. That is why I am so surprised that you, like Elaine M.and BLouise, choose to focus on the parents rather than the needs of the child. No matter how you slice it diverting attention from the immediate issue of a possible fatal situation for a child is callous.
AS to complete information: The simple fact is we have to judge on the information we have. We NEVER have perfect or complete information. Ask any judge. We do the best we can with what we have.
Mespo, my mother was in a nursing assistance situation, inpatient, but had signed a number of blank checks that her home health aide(s) filled out and cashed for full week’s salaries.
I tried to get her declared financially incapacitated. The court assigned the psychiatrist who evaluated her. For some reason my 2 sisters were there with her.
The psychiatrist opined that, among other things, my mother had no psychiatric history. Only problem was she was repeatedly hospitalized, had ECT on a number of occasions and hx of psych diagnoses.
This doc may have been assigned by the court but unbiased he was not.
At the end of the day anyone can be bought by anyone, appointed or hired.
mespo727272
1, May 27, 2012 at 8:09 am
Woosty:
I certainly understand your feelings about a justice system in which experts can be paid to say almost anything. I have always advocated court approved experts who render unbiased opinions. Your experience however has made you callous to this situation.
————————————————–
I have never been called callous in my entire life and in fact have been told just the opposite…that my sensibilities have often been a detriment to myself. I don’t agree w/that either…being sensitive often makes others uncomfortable as it heightens ones perception of a situation and including the understanding of others behaviors. It has on occasion made me a target but also made me more compassionate, not less so.
What do you get out of calling someone who disagrees w/you ‘callous’…?
In my situation, The expert wasn’t paid to ‘say almost anything’ he was either misinformed deliberately to effect self serving odds or he was paid to lie….or both.
It’s amazing the damage that mischaracterization will do.The monster law firm decided to ‘cover thier asses’ by attacking me offensively, aggressively and without facts or evidence to support themselves…so they ‘manufactured’ thier argument knowing that time and argument would give them what they wanted….which had nothing to do with anything pertinent to the case. [much like your statement].
Any coward knows that is how to win a ‘fight’ even if you are the only side fighting. [You can ask Iraq about that.]
If the topic of this column were ‘court experts’ your criticism would be appropriate and not at cross purposes with the discussion….
http://www.nlm.nih.gov/medlineplus/news/fullstory_124582.html
Blouise,
You make some good points in your response to Mespo. I was an elementary teacher for more than three decades. There were numerous occasions when our school nurse, secretary, or we classroom teachers had to spend valuable time calling/contacting parents in order to remind them that they needed to return emergency information health forms, field trip permission slips, etc., to the school. There were also instances when we had to contact parents on the morning of a scheduled field trip to “re-remind” them that the school had to get written permission from them or their children wouldn’t be allowed to go on the trips with their classes. Near the end of my teaching career, I found that there were even some parents that I had to “parent.” Fortunately, the great majority of parents were always responsible. It’s the few who aren’t who cause headaches for schools–and sometimes problems for their own children.
That said, if I were a school nurse or administrator, I wouldn’t take a chance with a child who was having an asthmatic attack.
lotta,
If you get a chance, could you go over to the thread from last week “The Lure of Certainty …” and expand on something you wrote:
“The altruism of embracing uncertainty, the big uncertainties and the little ones, is IMO a luxury brought with very good times or very bad times.”
lotta,
The Scouts (Boys and Girls) have assured me that they know what poison ivy looks like and will not be weaving it into my crown.
mespo,
I have never worked for a public or private school system but I have long been a critic of parents who slough responsibility for their child’s health, manners, moral indoctrination, etc onto the employees of the school system. You and I went round and round on this subject years ago agreeing, in the end, to “somewhat” disagree. (To jog your memory, we discussed your father’s experiences and responsibilities in the education field.)
Woosty is simply repeating the fact that, emotionalism aside, we don’t know enough about the situation to determine, with any degree of certainty, why the nurse did or did not take certain actions. We do know that the parents neglected to sign the form that would have guaranteed treatment for their son and thus far, the only people talking are the kid and his mother. Given the nature of their law suit, spinning the facts to their advantage is to be expected. Whether or not that advantage stands up to cross examination is yet to be seen.
That is what impressed me about Woosty’s position and why I took a breath and amended my original stance.
lotta,
I spit on Papal spies … interesting link.
Woosty:
I certainly understand your feelings about a justice system in which experts can be paid to say almost anything. I have always advocated court approved experts who render unbiased opinions. Your experience however has made you callous to this situation.
The parents are NOT responsible here. To make them so elevates form over substance as I’ve said. We ALL have an obligation to assist a child we see in distress regardless of whether the paperwork is there or not. You are not exonerated from responsibility simply because you have a crutch to lean on.
Even in our fractured, illogical society, I cannot imagine a jury penalizing a nurse for acting to fulfill her oath in an extreme situation. Never seen one; never will.