The substitute

I got a call from JT’s school yesterday.  JT had been brought to the nurses office by his teacher. This happens quite a bit. He gets “bellyaches” or there is a question about his snack (sometimes JT likes to freak everyone out by claiming he can’t eat something) . They always err on the side of caution, which Chris and I really appreciate. His school nurse and I know each other pretty well at this point!

This time it was a substitute nurse who called because JT was developing a rash on his face. Surprisingly this was the first time that they have ever had to call for a rash, pretty impressive since when we are out “in public” he gets them all the time. The substitute nurse seemed a little nervous about his rash and his allergies in general and said she would feel most comfortable if someone came to get him so we could keep an eye on him at home. We were more comfortable that way too so going to get him was no big deal. When I saw him I knew right away he was fine but was still OK with him coming home, especially with his regular nurse not being available for the day.

The thing that really bothered me, that I am still kind of upset about is that she asked me if he had an epipen. I know it’s not possible for her to know every issue with every student but it is a tiny school and I felt like she should have known that he has an epipen. She said she was looking at the list of his allergies in his file so why wasn’t there a big bright note that said “This kid has an epipen!!”. I thought that part of our health plan was that every employee in the building was to be notified of his allergies. I just looked it up and it specifically says that the school nurse will inform them, and I believe she does/has but I guess I should have clarified what would happen if she wasn’t there. I know realisticly that maybe not every substitutie knows about his epipen but the nurse seems to be the one person who HAS to know, especially when the epipen is not stored in the classroom. It makes me think that if he were having an anaphylactic reaction that he wouldn’t have received his epinephrine immediately, which is so, so important. And then I start thinking about other scenarios like :what if his teacher and the nurse were both absent on the same day”…who would I be counting on to know then? Am I being unreasonable thinking that she should have known?

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9 responses

  1. Ugh, that’s a tough one but I agree with you, the substitute nurse should have known he had an epi-pen, ESPECIALLY because he had been sitting in her office while waiting for you that whole time. Shouldn’t she have seen that in his chart? However I can’t help but think about my doctors who STILL ask me when I go for visits “can we go ahead and give you a flu shot today?” ….and I am deathly allergic to egg (which the flu shot is incubated in) so I tell them “no, you cannot” and try to contain the rolling of my eyes. They are sitting there with my chart literally in their hands and are trying to inject me with my #1 allergy. I think that in an emergency situation, the substitute nurse would have looked at his file and processed that yes he DOES have an epi-pen and needs it. Sometimes I think our medical caretakers get lazy and it’s easier to just ask the patient as opposed to read the chart/file.

    I’m glad your son is okay and it wasn’t an emergency situation! Did you find out what was causing the rash?

      • Poor thing, I know the feeling of “mysterious rashes” all too well! Sometimes they just appear and it feels impossible to track the source!! It can make you feel crazy when you try. Glad he is okay though!

  2. I get that in everyday care a doctor may check always before giving any thing to JT, or anyone for that matter. The difference to me is that she wasn’t checking to see if it was okay to give it to him, she had no knowledge that he even had it. I do believe that she as the nurse, substitute or not, has his file and the first thing that she should learn from reading his file is that he has an epipen….not to say it is her fault, it sounds like the school has done a great job so far, but to prevent this from happening in the future, they should have different protocol so that anyone dealing with JT should know that he has one, ie a bright sticky note affixed to his file! As you said its is the off chance that his teacher and the nurse are out, at a very minimum one or the other for sure needs to know that he has one. You are doing such a great job Mel!

  3. I think it’s great the nurse was cautious and asked you guys to come in. And I certainly can see her worry about that kind of reaction and not knowing if you had an Epi or not. I think she asked all the right questions. Sounds like the sub was great, but the school needs to work on their health communication plan.

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