We have a story up on the Talk of the Sound in New Rochelle which is both sad and disturbing. I thought it worth sharing here.
Last fall, a Latino student in evident pain was brought to the nurse’s office by a fellow seventh grader at a local middle school in New Rochelle, NY. The boy told the school nurse he had slipped with his arms outstretched onto a concrete surface and was in severe pain. The nurse handed the boy a bag of ice and called the boy’s mother to come pick him up from school. The mother, although a legal resident, does not speak English well. The nurse did not speak spanish. When the mother tried to ask the nurse to call for an ambulance. the nurse refused and hung up. At the school, the mother asked again for an ambulance. The nurse demanded the mother leave and, according to the mother, threatened to call Child Protective Services on the mother for - get this - failing to get her child medical treatment. It turns out the child had multiple fractures - both arms, from the wrist to the elbow. When the mother called the next day to notify the school that her son would be unable to return to school due to two broken arms the district shifted into damage control mode. The boy was absent from school for more than two months and only recently returned.
You can read about the whole sorry mess at Talk of the Sound. KTM readers will recall the name Anthony Bongo as the school principal and serial violator of the New York Indoor Clean Air Act who allegedly looked the other way when a white supervisor hung a stuffed monkey on a noose as a "joke" to the school's black employees.
I'm sorry the boy was injured, and it sounds like the school isn't the most warm and fuzzy place on earth, but calling an ambulance would not have been appropriate for broken arms. There wasn't much more the nurse could have done, although immobilization would have helped.
ReplyDeleteI'd like to hear the school's side of the story before passing judgment.
Whether or not an ambulance was appropriate was not the nurses call. Furthermore, it would be common decency to have called an ambulance on behalf of the boy's mother once requested to do so. To have chosen not to do so while a child's comfort and safety was hanging in the balance is irresponsible given the nature of her job responsibilities-- people who work in schools are supposed to care about children. This child was injured. He was in pain. Calling an ambulance requires a minimum of inconvenience to her personally. I can't imagine any reasoning that would make me feel otherwise.
ReplyDeleteOf course the nurse can make a judgment about whether the child was medically stable or not. A medically stable child with broken arms does not need a ride in an ambulance. I would be much more outraged at the school had they called an ambulance and the family received an unexpected bill for $1000. It would have been much more appropriate to call a cab, if the mother didn't have transportation.
ReplyDeleteI'd like to hear the school's side of the story before passing judgment.
ReplyDeleteNot me.
The school nurse and the school administration have failed in their duty to keep this child safe.
End of story.
it sounds like the school isn't the most warm and fuzzy place on earth
ReplyDeleteyou can say that again
I have a number of problems with my district, and this isn't one of them.
ReplyDeleteAnd, btw, schools certainly do call ambulances.
ReplyDeleteOur high school called an ambulance for my eldest son when he suffered a seizure in class.
A person with a broken arm needs to go to the hospital.
ReplyDeleteA nurse knows that.
The nurse's job was to get this child the care he needed. The instant she realized there was a language barrier she needed to find a translator.
Failing that, she should have asked the student - who clearly did speak English - whether his mother would be able to transport him to the hospital.
If he was in such good shape the nurse wasn't worried enough to call an ambulance or to ask her boss whether he thought she should call an ambulance, she should have asked the student to translate for her.
"Failing that, she should have asked the student - who clearly did speak English - whether his mother would be able to transport him to the hospital."
ReplyDeleteHow do you know she didn't?
"And, btw, schools certainly do call ambulances.
Our high school called an ambulance for my eldest son when he suffered a seizure in class."
Did I say they didn't? Of course they do, and they should, when there is an emergency. A seizure is a medical emergency. A broken arm, even two broken arms, is not.
For a stable patient, an ambulance provides a ride to the hospital, nothing more. A very, very, expensive ride. There is nothing magical about it. They rarely give pain medicine, at least not where I work. They would do an assessment to see if he's stable which the nurse almost certainly had already done. They would have immobilized his arms, which the nurse probably should have done. That's the only thing that would have made it different than a taxi ride. Arriving in an ambulance doesn't necessarily get the patient seen any faster.
The boy and his mother could probably have been treated more kindly. But from a medical standpoint, they didn't do anything wrong.
Years ago my daughter suffered a terrible break (her finger was crushed). My husband was freaked out to the point of incapacitation. He really couldn't be of any help and he wasn't going to be able to drive us to the hospital without placing us in danger due his lack of focus. He couldn't bear seeing our child in so much pain.
ReplyDeleteNow--imagine not speaking a language well enough to express yourself while you're watching your child suffer. That child was entitled to access to medical treatment, the mother was entitled to have someone call an ambulance, and the law entitles her to medical treatment for her son in a language she could understand and be able to make informed decisions about.
This was criminal. I with Catherine. The school failed in their duty to keep this child safe.
As for my daughter's story. We called 911. They insisted on an ambulance. The emergency crew, upon my profuse apologies for bothering them and not driving ourselves, insisted they wouldn't have it any other way. They not only felt a duty to care for my child, they felt morally obligated. I don't imagine it would have been different in the case of this boy either.
The bottom line for me is that this is another instance, albeit extreme, of schools disregarding a parent's explicit wishes. A parent communicated what she wanted/needed for her child, what she believed to be in the child's best interest and instead, the school not only refuses but threatens to call CPS.
ReplyDeleteThis is what happens when schools believe with religious zeal that they know what a child needs better than the parent does.
They do what they do.
I have worked in ERs. People routinely use the ambulance as a taxi. You will get a very different perspective on this from people who actually work in a hospital.
ReplyDeleteYou might feel differently if you are having a heart attack, but you have to wait half an hour because all the ambulances are out transporting patients with broken arms. And it absolutely does happen. Maybe not in New Rochelle though.
Next time you bitch about the outrageous cost of health care, think about how many $1000 ambulance rides could have ridden to the hospital for $5 in a cab.
CJ,
ReplyDeleteI don't think there are "people" here are defending the actions of the nurse. What I see here is ONE anonymous loon who had posted 4 times here and once on Talk of the Sound to make the same point over and over. This person CLAIMS to have some sort of informed perspective: "I worked in an ER".
Really, as what? A janitor?
Guess what? No one cares what you think because you are just an anonymous pimple on the internet's butt. If you want to CLAIM some medical knowledge then back it up by disclosing your identity and provide a way to independently verify your identity and your credentials. Otherwise, bugger off.
Still, to show what a sport I am, I will go up to the Sound Shore Medical Center ER tomorrow and ask the paramedics their view of the situation. Anon, you are welcome to meet me there.
Bring your mop.
Robert Cox,
ReplyDeleteYou are an asshole. Censor that, but it won't matter because it is evident. Allowing him to post on your site decreases your credibility. Be with whom you associate your name and agenda.
That should have said be careful with whom you associate your name and agenda.
ReplyDeleteA broken arm, even two broken arms, is not.
ReplyDeletephooey
I was in a car crash 12 years ago & I suffered a badly broken wrist. My 2-year old son was with me; he had no apparent injuries.
A person on the scene called my husband, who sprinted over -- which meant I had an English-speaking spouse there on the scene, able to get a car or a taxi to take me to the hospital.
The police loaded us all into an ambulance.
Josh:
ReplyDeleteWe don't call names on this site.
Since you don't know the tacit rules, I'll allow your comment to stand.
But please refrain from such language in the future.
Be with whom you associate your name and agenda.
My choice is clear.
I will associate my name with anyone willing to publicize incidents like this one.
No one cares what you think because you are just an anonymous pimple on the internet's butt.
ReplyDeleteuh.....equal time:
We have a general rule here at ktm about not calling folks a pimple on the internet's butt!
I wonder if I should put that in the "About ktm"?
The bottom line for me is that this is another instance, albeit extreme, of schools disregarding a parent's explicit wishes. A parent communicated what she wanted/needed for her child, what she believed to be in the child's best interest and instead, the school not only refuses but threatens to call CPS.
ReplyDeleteExactly.
Great post. I am less concerned about the nurse's failure to call an ambulance, which I can see as an honest mistake, than about the threat to call CPS. That's a lot like pulling a gun and threatening to shoot. The child really could have been taken away from the mom. In The Fortune Cookie Chronicles a Chinese girl used this tactic (call CPS) to retaliate against her parents, who spoke little English. It worked. Caused a huge amount of grief.
ReplyDeleteYou could knock yourselves out trying to analysis the right decision from the wrong one in this situation but what's really troubling is how we've come to accept such inferior treatment by professionals in our schools. Imagine you're the nurse; a boy is injured and needs medical attention. Your first instinct as a professional who makes a living working with students is to "get resolution and inform the parents." So, you call the mother and keep watch over the medical situation. Perhaps an ambulance is not medically necessary and there is a ready, waiting and clear-headed driver to take the boy to the hospital so you go that route instead. Or, perhaps there isn't an immediate safe ride available and there is a language barrier as well, so you decide that in the best interest of the boy you should call an ambulance in order to ensure timely medical care and avoiding further injury. Either way, you're making a spontaneous decision in the best interest of the student based on the available resources. You aren't thinking about the rules so much as you're thinking about an injured young person -- someone who is officially in your care. The whole message here and it's a message I find pervasive in our schools is "well, we've done what we consider right and that's all there is to it." That's not all there is to it -- there's responsibility, empathy, mature judgment and most of all, an understanding that your work is to seek out and implement the best possible outcomes for your students.
ReplyDeleteFirst, many broken arms are not medical emergencies. That said, the categorical, "A broken arm, even two broken arms, is not", is wildly overstated. There are certainly breaks that are medical emergencies (pretty much all compound fractures, for instance).
ReplyDeleteFrom the article, what we know is that, "both her son’s arms were severely fractured between the wrists and the elbows." To me (IANAD), that sounds like cominuted fractures of both arms, which can present a risk for arterial or venous lacerations. The magnitude of that risk, at least when a medical disaster requiring triage isn't ongoing, is a matter for the patient (or guardian) to judge.
But that's not really the issue here. When the legal guardian of the child requested an ambulance, the nurse chose to ignore that request. That is entirely inappropriate; it was no longer her decision.
Had she said something like, "I'd recommend that you just drive him to the ER; in my judgment, there's really no need for an ambulance", but then called the ambulance when the parent insisted, we wouldn't be having this discussion. But she didn't do that. She refused to make a telephone call and threatened the parent with law enforcement action.
That's unconscionable.
Hi, Seth!
ReplyDeleteFrom the article, what we know is that, "both her son’s arms were severely fractured between the wrists and the elbows." To me (IANAD), that sounds like cominuted fractures of both arms, which can present a risk for arterial or venous lacerations.
ReplyDeleteHi, Doug!
What is a "cominuted fracture"? (I realize I could look it up.)
One thing I discovered, when I had a badly broken wrist as an adult, is that it is fantastically painful -- so bad that later on in the day, when the painkillers wore off, I was shaking & going into shock.
Immediately after the accident, I was barely able to speak to the people on the scene, who were trying to get Andrew (then undiagnosed) out of the car.
The suffering of a person with a severe break isn't subtle.
One last thing: I broke my wrist badly as a child and barely felt a thing, which apparently has to do with a thin sheet of tissue that eventually grows over your bones. I gather that the rip in that tissue is what hurts.
I don't know at what age broken limbs become excruciating.
As for my daughter's story. We called 911. They insisted on an ambulance. The emergency crew, upon my profuse apologies for bothering them and not driving ourselves, insisted they wouldn't have it any other way. They not only felt a duty to care for my child, they felt morally obligated.
ReplyDeleteoh, boy, what a trauma ---- it is incredibly difficult to see a child in pain
when Jimmy had his first seizure, I drove him to the hospital myself.
that was kind of a Midwest farmer thing; I didn't think I should make a fuss
The high school nurse was the one who explained to me how boneheaded that was (in a very nice way -- )
I had no idea that when you've had a seizure you're at high risk over the next few hours of having another one -- which would have meant Jimmy was seizing while I was driving. I also had no idea that a seizure itself can be dangerous, etc.
The nurse (and, later, our pediatrician) explained to me that you always call an ambulance for a seizure. Period.
Hi, Adele!
ReplyDeleteEXACTLY.
This part, especially:
Or, perhaps there isn't an immediate safe ride available and there is a language barrier as well, so you decide that in the best interest of the boy you should call an ambulance in order to ensure timely medical care and avoiding further injury. Either way, you're making a spontaneous decision in the best interest of the student based on the available resources. You aren't thinking about the rules so much as you're thinking about an injured young person -- someone who is officially in your care. The whole message here and it's a message I find pervasive in our schools is "well, we've done what we consider right and that's all there is to it." That's not all there is to it -- there's responsibility, empathy, mature judgment and most of all, an understanding that your work is to seek out and implement the best possible outcomes for your students.
The rule-mongering that seems to go on in a lot of our institutions is awful - and it's dangerous.
It breeds distrust, too.
oh, boy, what a trauma ---- it is incredibly difficult to see a child in pain
ReplyDeleteIt was traumatic. Strangely enough I remained quite calm. If I wasn't worried about keeping my then two-year old child calm, stopping the bleeding without further damaging the break, keeping my husband from fainting at the sight of blood thereby panicking my injured child even more than she already was, AND attending to my newborn son I would have driven to the hospital myself.
The 911 operator was right. Sending emergency transport was the wisest choice for us at that moment in time.
Bob Cox is a complete phony who has been fired from every job he's ever held and is angry at everyone around him. He is attempting to bring down the establishment in an attept to make his own self worth meaningful and point and put the blame on others. He wants to show his family it wasn't his fault he was fired and he's a failure. I'd probably do the same thing instead of just moving on.
ReplyDelete