To be furious with the school nurse

[Hedgehog80]

Iam absolutely fuming

Dd2 has various medical conditions, has 1:1 care at school and all going well. Good relationship between us, school and hospital.

The community school nurse paid a visit to school and 'reviewed' all children with medical needs. Fair enough I suppose, didn't think much more of it.
I then got a call from dds hospital as they had been contacted by school nurse with 'concerns'. We cleared it all up and I spoke with the school SENCO who was lovely. Said the nurse had told her 'I don't know much about these conditions but I want copies of this child's records to show my supervisor' the school refused. She them apparently wanted to see dd but they also refused that.

I thought that was the end of it-them I get a GP letter calling us in to discuss these same 'concerns' so I called the GP and explained and then o called the school nurse and told her very bluntly it has nothing to do with her. Dd2 does not have shared care and between us as parents, school and hospital things are fine.

Today I get more correspondence-this nurse is trying to arrange a meeting to discuss her concerns?? It has been addressed twice now and her concerns were the result of a misunderstanding which has been cleared up.
Turns out she is also taking advice from dds old hospital (we left as they made her very ill and gave us wrong advice and treatment) so Iam not happy at all.

She also will not accept that she is not to be involved with dd??? I do not want her interference.

I have written in formally to school banning her from any involvement do why is she persisting ? Iam really angry
Do school nurses have any power at all? I'm thinking of taking this further

Sounds to me like she has further concerns and would like clarity that your DD is being catered for in the best possible way. Maybe these were things she didn't feel it was appropriate to discuss over the phone.

I can understand your frustration OP, but I'd go to the meeting. However annoying she is, her ultimate goal is to ensure that your DD has the best care.

I have t1 diabetes and I find it amazing how little many medical professionals know about insulin pumps. I was in hospital recently and a couple of doctors told me to just take my pump off for a couple of hours when my blood sugar low. I was also told I should be aiming for readings of about 10! This nurse needs to educate herself!

Was going to post but agree with Bluejug completely.

You may not like any 'interference' from another HCP. But obstructing her, if she has genuine concerns, is unlikely to do you any good - more likely to make the nurse even more convinced that something is amiss.

The school is on the nurse's caseload, not dd. the primary contact for questions or to arrange next steps are the parents. That this nurse has asked to have copies of confidential info without parental permission and then asked for the child to be pulled out of lessons so she could see and explore a piece of medical kit for her own curiosity without parental knowledge and consent says a fair bit about her professionality. Well do e to the school for sticking to procedure.

I would now circulate a letter OP, to everyone involved in or relevant to this, particularly the hospital consultants, stating a timeline of events and your responses so far, and state no clear reason for a meeting has been given to you, all information to your knowledge has been given, you are concerned info was requested without parental knowledge or consent, dd's health needs are monitored, supervised and well managed by her team and school, her consultant has not informed you if he/she has concerns to be addressed, and that you do not easily have time to spare from the demands of caring for a child with complex needs for a non urgent matter. Include the nurse's manager in the circulation.

Consultants usually do not appreciate people messing around with their patients' care and I would hope will say so clearly. I think you need to get the medical professionals currently caring for dd to respond to this nurse and be clear that she has no role here, dd is not her patient. The fact that dd has a care plan in a school she is allocated does not automatically make dd her patient, and it is important successful care is not meddled with by someone not involved or experienced or even fully aware of the condition and equipment involved. If she has concerns, fine, let her make a safeguarding referral and a social worker can skim the paperwork, phone dd's consultant and sign it off.

As to 'the nurse needs to learn....' - seriously, the best way of doing that is to tell a child 'come out of class, a total stranger wants to strip you off and explore your insulin pump because she's never seen one before?'

If she wants to learn she can work shadows a nurse at the diabetes clinic for a day, or even contact OP and say would you and dd mind meeting me at school and demonstrating herr pump to me as I would love to see one in use and talk to you about it? There are ways of doing these things that treat the people involved with a bit of respect, and tend to do better at gaining a working relationship.

Ceic-I wonder if the nurse's "concerns" come with a hidden agenda to get your DD back under the old team because that's how the borough/whoever expects it to be done

^^this.

(((((((((((((Hugs)))))))))) OP and DD

I sympathise, Hedgehog. My daughter had a very rare medical condition and her school had a productive relationship with her specialist nurses. The school nurse knew nothing about the condition, failed to turn up to a briefing the nurses organised for the school and then turned up to meetings with us blethering on about nonsense. She was at least only time wasting and frustrating rather than particularly interfering but she could have made life difficult. She wouldn't accept that she didn't understand the condition.

I sincerely hope OP is not 'nice' to the nurse - that will only encourage her to carry on behaving badly.

If a HCP has concerns about a childs care plan or method of treatment where that plan has been made with a consultant and where those concerns are solely based on the HCP's lack of understanding or knowledge the correct route to take is to educate themselves with none case specific information from the team who does things differently to what she expects.

Going about it in the half ased way she has is what usually proceeds some bat shit crazy intervention that actively harms children and is usually instigated by someone who is not qualified enough to make that call or even have an opinion that should be listened to

I don't understand how she managed to get her role without proper knowledge of diabetes

Agree with Frusso amd NeedassockAnnesty. Came back to make the same points.

The OP has already co-operated with the school nurse and given her the information she needed. She hasn't obstructed the nurse in any way.

Papertrail. Not a meeting.

You'd be surprised how little HCP's know about type 1. We have been aghast at some things. A nurse telling us to give dd 'insulin and lunch' when she was having a hypo, GPs asking us to explain the pump to them, the old team refusing to let us carb count dds food....... It's frightening really

Shocking. I was a HCA for a spell before the job I do now and diabetes type 1 and 2 was something that we were very big on. Now I'm a HCP in a hospital and we have yearly diabetes updates. I can understand the pump explanation because they're quite few and far between but a nurse saying give insulin and lunch during a hypo

That was in the first week after diagnosis in hospital I remember saying to dh as she went to get the insulin pen "I'm sorry if this is wrong and I'm not sure but I think we are meant to give her apple juice to treat this not insulin and lunch" I have her the juice and I even doubted myself whether I was doing the right thing. Thank goodness I listened to my instinct - I barely knew anything about diabetes at that point

There's no excuse for things like that. There's even tools we use that direct us. Your daughter should have had a glucose monitoring chart and in the more modern ones they have a red amber green system with instructions on what to do in the event of a hypo.

Should be common knowledge anyway. Did you report them?

Some of the thinly veiled threats about what will happen to the OP if she doesn't bow down to this nurse are really uncalled for. The OPs DD is clearly already in the system and under the care of specialists, if the nurse made a safeguarding referral she would look very stupid indeed. It's a broken system if the OP is being advised to pacify the nurse, even if it is not in her DD's interests.

I am quite about those posters claiming the OP is being "obstructive".

The school, GP and consultant team have told this nurse that her involvement is unnecessary. The OP HAS spoken to the nurse. How on earth is any of this obstructive? What are parents supposed to do - roll over and give in to every ridiculous intrusive and unnecessary demand by over-zealous and misinformed HCPs just to avoid getting a black mark next to their name?

Of course HCPs have a duty of care and there have been cases where serious harm has befallen children because things have been missed. Not quite the same as GP, school AND consultant team all saying the same thing - this child has a robust care plan in place, has a 1:1 and is seen regularly at X hospital by their specialist team.

I think the OP is well advised to make a formal complaint - surely the nurse can find a more pressing case to get her knickers in a twist about!

OP I'm a senior HCP and I would be furious in your situation .

There really does not appear to be any clinical need for this woman to be involved and I really really hope you asset yourself with a complaint to PALS.

OP I'm a senior HCP and I would be furious in your situation .

There really does not appear to be any clinical need for this woman to be involved and I really really hope you asset yourself with a complaint to PALS.

The school nurse has a professional responsibility to all the children within a school under her remit; it's not "nothing to do with her". School Health Teams are commissioned to provide public health services by the NHS. They follow on from Health Visitors and are responsible for the health and wellbeing of children and young people in their area in conjunction with GPs, hospitals, CAMHS, Children's Services and disability services.

The school nurse will be required to ensure she is monitoring and involved in health care plans for children within 'her' schools, if necessary in partnership with primary and secondary care agencies.

However she sounds like she is a bit gung-ho and needs to develop some tact and diplomacy regarding your daughter's care and health needs. I can understand her wanting to understand that the provision for your daughter is appropriate and acceptable, but she should be doing this in a sensitive way. She should be able to liaise with the specialist team and the school shouldn't be overly obstructive. I can understand her wanting to understand about the insulin pump, but she should be doing that via the PDSNs and not directly with the child!

I can't understand why she's getting so involved if your daughter is regularly seen, reviewed and monitored by the specialist team. I would imagine she just needs to be kept in the loop.

(By the way insulin pumps in young children are relatively rare so a school nurse wouldn't necessarily have a lot of knowledge about them. She may be clued up about diabetes in a general way but not in any depth as children with type 1 tend to be managed by paediatric diabetic specialist nurses).

She can do russo but she'd probably have to put it in writing to the commissioner of SHT services. Of course she can choose to decline the involvement of School Health but they can be a valuable source of support in some cases - not this one obviously!

I do understand the OPs frustration and sympathise, but I can also see the other side whereby HCPs have a responsibility to the child by virtue of their role. However they do of course have to behave professionally and appropriately and work within the boundaries of their expertise.