peabay
Prolific Pea
Posts: 9,592
Jun 25, 2014 19:50:41 GMT
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Post by peabay on Nov 5, 2015 16:35:39 GMT
If my child was a classmate, I wouldn't want her to watch her classmate die without teachers intervening. I think that would be exceptionally traumatic. What about my child's well-being?
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Post by RiverIsis on Nov 5, 2015 16:37:08 GMT
I think it's pretty black and white. If the state doesn't recognize DNRs for people under 19, the school cannot go against that. The best option would be for mom to keep him home. You can already see the lawsuit and headlines if the school allows it against the law and I can't imagine trying to get insurance for the entire school if they willingly and knowingly break this law. This issue is bigger than one mom and one student.
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calgal08
Pearl Clutcher
Posts: 2,519
Jun 27, 2014 15:43:46 GMT
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Post by calgal08 on Nov 5, 2015 16:37:25 GMT
I cannot imagine the position of the teacher. If the boy goes into cardiac arrest the teacher is supposed to nothing to help him. He's a child, how can you stop yourself from helping a child. Granted, I only read the local article, but it sounds like it's a decision the Mom made, was the boy consulted, are these his wishes too?
This isn't a normal situation. If these are the wishes of the family then they should not put the school in the middle. Home school him.
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Post by RiverIsis on Nov 5, 2015 16:41:35 GMT
I should have mentioned that the mother is a tech in the ER / trauma center. She has seen her share of MIs and cardiac arrests and how we treat those patients. I don't think she wants all of that for her son because she knows the likely outcome for a patient with such extensive history. She is a top-notch person, employee and mother. I think she is well aware that the likelihood of Alex having an issue at school is very, very slim because she is only asking for four hours per week for him to attend and see friends and feel like a teenager for just a little bit. I personally do not think she is asking a lot of the school system if she is there with the child for those four hours. All she is asking for is the right to allow her son to have a natural death should the need arise. meredith Then she is also aware that patients sometimes are kept alive until their DNR is verified.
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Post by rst on Nov 5, 2015 16:44:50 GMT
I think that the argument that it would be traumatic for kids to observe a classmate dying with no attempt to resuscitate is a misguided imagination of what would actually happen. And quite honestly, it would probably be far more traumatic for classmates and teachers to observe full-blown resuscitation-- not that either would likely happen right there in the classroom. In my experience, any child with a health crisis would be moved to the nurse's station, and if for some reason that was not possible, the class would relocate during the medical crisis.
I can't speak to anyone else's situation, but if my son were to experience an episode of escalating ill-health, his aide would immediately and discretely remove him from the classroom to the nurse's station. I would be called ( I live 5 minutes away) as would the ambulance. When the EMS arrived, they would be given the POLST order sheet which clearly indicates which measures are appropriate, and which are not. Because we have hospice care, we would have the option of returning home, or if we considered it more appropriate, we could go to the hospital for treatment.
WE often lament how our society does poorly at end-of-life issues, how ill-equipped we are to deal with our loved ones aging process, how we're emotionally unprepared for loss, how kids are headed off to college unprepared for real life situations after being so sheltered and muffled from any kind of stress. A family who is facing loss, as the family in the news story is, and who has formulated a thoughtful, careful plan for living each day well up until that last day -- this should be a welcomed opportunity to learn some of those real-life (and death) skills. Sure, this child and his mom can't have "normalcy" -- but this is their normal. She's working for quality of life for her child, and quality of life always involves social interactions and connections to the community. His community includes school. Someone up-thread said that school is not a social circle. I'll respectfully disagree. As this child has autism, what do you want to bet that one of his classes is a social skills class or a facilitated social circle? He is part of that community, and has been for years. If he dies during the school year, of course that's deeply sad and painful, but death of a classmate is not something that is uniquely a special needs occurrence. There are high school kids who die in car wrecks, suicides, sports-related injury, overdoses, any number of situations. All are sad and painful losses, and yet nobody is saying that kids at higher risks for that type of death should just stop being included in the school setting.
Obviously, since I live with a parallel situation, it's a topic I've given considerable thought. I'm blessed that we live in a school district that is very welcoming and accommodating to my son and values his contributions and presence.
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peabay
Prolific Pea
Posts: 9,592
Jun 25, 2014 19:50:41 GMT
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Post by peabay on Nov 5, 2015 16:55:21 GMT
I think that the argument that it would be traumatic for kids to observe a classmate dying with no attempt to resuscitate is a misguided imagination of what would actually happen. And quite honestly, it would probably be far more traumatic for classmates and teachers to observe full-blown resuscitation-- not that either would likely happen right there in the classroom. In my experience, any child with a health crisis would be moved to the nurse's station, and if for some reason that was not possible, the class would relocate during the medical crisis. I can't speak to anyone else's situation, but if my son were to experience an episode of escalating ill-health, his aide would immediately and discretely remove him from the classroom to the nurse's station. I would be called ( I live 5 minutes away) as would the ambulance. When the EMS arrived, they would be given the POLST order sheet which clearly indicates which measures are appropriate, and which are not. Because we have hospice care, we would have the option of returning home, or if we considered it more appropriate, we could go to the hospital for treatment. WE often lament how our society does poorly at end-of-life issues, how ill-equipped we are to deal with our loved ones aging process, how we're emotionally unprepared for loss, how kids are headed off to college unprepared for real life situations after being so sheltered and muffled from any kind of stress. A family who is facing loss, as the family in the news story is, and who has formulated a thoughtful, careful plan for living each day well up until that last day -- this should be a welcomed opportunity to learn some of those real-life (and death) skills. Sure, this child and his mom can't have "normalcy" -- but this is their normal. She's working for quality of life for her child, and quality of life always involves social interactions and connections to the community. His community includes school. Someone up-thread said that school is not a social circle. I'll respectfully disagree. As this child has autism, what do you want to bet that one of his classes is a social skills class or a facilitated social circle? He is part of that community, and has been for years. If he dies during the school year, of course that's deeply sad and painful, but death of a classmate is not something that is uniquely a special needs occurrence. There are high school kids who die in car wrecks, suicides, sports-related injury, overdoses, any number of situations. All are sad and painful losses, and yet nobody is saying that kids at higher risks for that type of death should just stop being included in the school setting. Obviously, since I live with a parallel situation, it's a topic I've given considerable thought. I'm blessed that we live in a school district that is very welcoming and accommodating to my son and values his contributions and presence. I don't think at all he shouldn't be in the school setting. I think having all kinds of children benefits all kinds of children. I just don't like the idea of forcing a teacher to make an end of life choice.
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Post by Darcy Collins on Nov 5, 2015 17:04:42 GMT
Thank you for sharing your story rst I agree that those who think a DNR would be traumatic are completely overlooking the fact that seeing a classmate code and attempt for resuscitation is going to be way more traumatic. I would hope that any medical emergency that happened at school whether a medical fragile child or not, the school would have procedures to immediately provide the child with privacy and the classmates wouldn't be standing around watching. And yes, if a child happened to have a medical emergency at school, it's going to be hard on children. To me the obvious solution to both the DNR and the parent being at the school is to provide the boy with a trained medical professional for the few hours he is at school a day. I also believe Alabama's law should be changed allowing DNRs for those under 19.
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Post by rst on Nov 5, 2015 17:11:29 GMT
I don't think the teacher would be taking that role, Peabay. Would the teacher usually be the one doing the chest compressions and charging up the paddles? In my experience, the teacher's actions would be to call for assistance to get the child to the nurse's office and/or to herd other children out of the room to another setting. It's not like nobody would be doing anything at all for the child, and just ignore his dying breaths while they continued to teach. Appropriate care would involve taking him to a quiet and safe space, positioning him comfortably, giving him a blanket or pillow, whatever comfort-based medications and interventions are called for.
Any child with complex medical needs is going to have an extensive medical plan or 504 where all of this is spelled out in exhausting detail.
Probably the core issue in the original story is a funding one. Para hours. The school understandably doesn't want to have to hire a para for the 4 hours a week when it's highly possible that this child will have a high level of absenteeism due to his condition. Some insurance companies will pay for a nurse to go to school with complex kids, but others won't. The mother in offering to be with him (which I know I've done in an attempt to be reasonable and accommodating to the school) just muddies the water.
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Post by RiverIsis on Nov 5, 2015 17:27:09 GMT
I think that the argument that it would be traumatic for kids to observe a classmate dying with no attempt to resuscitate is a misguided imagination of what would actually happen. And quite honestly, it would probably be far more traumatic for classmates and teachers to observe full-blown resuscitation-- not that either would likely happen right there in the classroom. In my experience, any child with a health crisis would be moved to the nurse's station, and if for some reason that was not possible, the class would relocate during the medical crisis. I can't speak to anyone else's situation, but if my son were to experience an episode of escalating ill-health, his aide would immediately and discretely remove him from the classroom to the nurse's station. I would be called ( I live 5 minutes away) as would the ambulance. When the EMS arrived, they would be given the POLST order sheet which clearly indicates which measures are appropriate, and which are not. Because we have hospice care, we would have the option of returning home, or if we considered it more appropriate, we could go to the hospital for treatment. WE often lament how our society does poorly at end-of-life issues, how ill-equipped we are to deal with our loved ones aging process, how we're emotionally unprepared for loss, how kids are headed off to college unprepared for real life situations after being so sheltered and muffled from any kind of stress. A family who is facing loss, as the family in the news story is, and who has formulated a thoughtful, careful plan for living each day well up until that last day -- this should be a welcomed opportunity to learn some of those real-life (and death) skills. Sure, this child and his mom can't have "normalcy" -- but this is their normal. She's working for quality of life for her child, and quality of life always involves social interactions and connections to the community. His community includes school. Someone up-thread said that school is not a social circle. I'll respectfully disagree. As this child has autism, what do you want to bet that one of his classes is a social skills class or a facilitated social circle? He is part of that community, and has been for years. If he dies during the school year, of course that's deeply sad and painful, but death of a classmate is not something that is uniquely a special needs occurrence. There are high school kids who die in car wrecks, suicides, sports-related injury, overdoses, any number of situations. All are sad and painful losses, and yet nobody is saying that kids at higher risks for that type of death should just stop being included in the school setting. Obviously, since I live with a parallel situation, it's a topic I've given considerable thought. I'm blessed that we live in a school district that is very welcoming and accommodating to my son and values his contributions and presence. Since I brought it up. I think the info from the mother perspective leads to the misguidance. The info is shouting do nothing! Let him die! When as you have rightfully pointed out something will be done. Students will be moved either the ill student or the others. Comforts should be given. It just seems like mom is at the end of her tether. Obviously, if she wants her child to attend school it comes with risks, heck I have met the Ambulance at the ER from the school before. Life has risks and difficult choices. Her choice now is that if she wants this 4 hours the risks are that he will have more medical care than she and his own healthcare team advocates. I'm sure the school's insurance isn't going to allow this child to die on campus without any professional medical intervention and unfortunately for mom it doesn't matter if she is president of the AMA, in this case she is mom and she can only keep the DNR on her, on her son's record and hope she is fretting over something that isn't going to happen.
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MerryMom
Pearl Clutcher
Posts: 2,534
Jul 24, 2014 19:51:57 GMT
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Post by MerryMom on Nov 5, 2015 17:34:54 GMT
I should have mentioned that the mother is a tech in the ER / trauma center. She has seen her share of MIs and cardiac arrests and how we treat those patients. I don't think she wants all of that for her son because she knows the likely outcome for a patient with such extensive history. She is a top-notch person, employee and mother. I think she is well aware that the likelihood of Alex having an issue at school is very, very slim because she is only asking for four hours per week for him to attend and see friends and feel like a teenager for just a little bit. I personally do not think she is asking a lot of the school system if she is there with the child for those four hours. All she is asking for is the right to allow her son to have a natural death should the need arise. meredith I am sorry for your friend, but I do not agree with your opinion that non-medical people should make the call whether to contact 911, use an AED, or follow DNR instructions. They are educators, not trained medical staff and such decisions are beyond the scope of their education license. I also do not see where non-medical personnel should be required to follow DNR. As others have posted, DNR orders are for those age 19 and above in your state. If she wants her son to continue to engage in social interactions with his friends, then she should invite them over to her house every day. Again I am sorry for your friend, but I think expending her energy on her effort to "fight for the right to have a DNR followed by the school system her son attends" is misplaced. I think she would be better served focusing her energy on her remaining time with her son and/or organizing her son's social time with his friends.
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flute4peace
Drama Llama
Posts: 6,757
Jul 3, 2014 14:38:35 GMT
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Post by flute4peace on Nov 5, 2015 18:33:21 GMT
So, really, this boils down to the school not permitting the mother to be at the school for four hours a week? What kind of world is it when we can't grant that sort of accommodation to a dying child and his mother? As to the other students, I'd be more concerned about the lessons they are being taught by refusing such a simple accommodation, and the ones they are not - like empathy, kindness and concern for fellow human beings. Thank you for expressing my feelings in a way I couldn't figure out how to say.
This Mom is not asking to drop her son off at school and expect the whole building to take care of him.
Someone please correct me if I'm not interpreting this correctly:
1. Son would not be actually "attending" school, just visiting 4 hours per week with his mother present the whole time.
2. Mother is an ER nurse and fully capable of handling any health issue that should arise during those 4 hours.
3. Due to previous heart surgeries and treatments, performing CPR on the young man would mean certain death.
I can see both sides of the argument, which is why I think blanket laws and policies aren't helpful in this situation. This is clearly a very individual case, and I think it should be treated as such.
I do understand the concerns for the emotions of the teachers, students and staff, and I think it's a valid concern. I also think that could be taken into account when the "plan" is finalized. If the Mom is with him while he's there, she would be the one who would be attending to him if he should happen to code. Definitely still traumatic, but with her taking the lead in how the situation is handled, it could end up being a life lesson for those around them. The young man could have the opportunity to have the peaceful passing that he wishes for, with his Mom there holding his hand, friends able to say goodbye, etc. I would assume that if it did happen they would try to move him to a private area if time allowed anyway.
Any way you slice it, it's just a horribly heartbreaking situation. O/P, please pass along my prayers to your friend and the family.
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flute4peace
Drama Llama
Posts: 6,757
Jul 3, 2014 14:38:35 GMT
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Post by flute4peace on Nov 5, 2015 18:35:08 GMT
I think that the argument that it would be traumatic for kids to observe a classmate dying with no attempt to resuscitate is a misguided imagination of what would actually happen. And quite honestly, it would probably be far more traumatic for classmates and teachers to observe full-blown resuscitation-- not that either would likely happen right there in the classroom. In my experience, any child with a health crisis would be moved to the nurse's station, and if for some reason that was not possible, the class would relocate during the medical crisis. I can't speak to anyone else's situation, but if my son were to experience an episode of escalating ill-health, his aide would immediately and discretely remove him from the classroom to the nurse's station. I would be called ( I live 5 minutes away) as would the ambulance. When the EMS arrived, they would be given the POLST order sheet which clearly indicates which measures are appropriate, and which are not. Because we have hospice care, we would have the option of returning home, or if we considered it more appropriate, we could go to the hospital for treatment. WE often lament how our society does poorly at end-of-life issues, how ill-equipped we are to deal with our loved ones aging process, how we're emotionally unprepared for loss, how kids are headed off to college unprepared for real life situations after being so sheltered and muffled from any kind of stress. A family who is facing loss, as the family in the news story is, and who has formulated a thoughtful, careful plan for living each day well up until that last day -- this should be a welcomed opportunity to learn some of those real-life (and death) skills. Sure, this child and his mom can't have "normalcy" -- but this is their normal. She's working for quality of life for her child, and quality of life always involves social interactions and connections to the community. His community includes school. Someone up-thread said that school is not a social circle. I'll respectfully disagree. As this child has autism, what do you want to bet that one of his classes is a social skills class or a facilitated social circle? He is part of that community, and has been for years. If he dies during the school year, of course that's deeply sad and painful, but death of a classmate is not something that is uniquely a special needs occurrence. There are high school kids who die in car wrecks, suicides, sports-related injury, overdoses, any number of situations. All are sad and painful losses, and yet nobody is saying that kids at higher risks for that type of death should just stop being included in the school setting. Obviously, since I live with a parallel situation, it's a topic I've given considerable thought. I'm blessed that we live in a school district that is very welcoming and accommodating to my son and values his contributions and presence. Very well-said
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flute4peace
Drama Llama
Posts: 6,757
Jul 3, 2014 14:38:35 GMT
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Post by flute4peace on Nov 5, 2015 18:37:30 GMT
I should have mentioned that the mother is a tech in the ER / trauma center. She has seen her share of MIs and cardiac arrests and how we treat those patients. I don't think she wants all of that for her son because she knows the likely outcome for a patient with such extensive history. She is a top-notch person, employee and mother. I think she is well aware that the likelihood of Alex having an issue at school is very, very slim because she is only asking for four hours per week for him to attend and see friends and feel like a teenager for just a little bit. I personally do not think she is asking a lot of the school system if she is there with the child for those four hours. All she is asking for is the right to allow her son to have a natural death should the need arise. meredith I am sorry for your friend, but I do not agree with your opinion that non-medical people should make the call whether to contact 911, use an AED, or follow DNR instructions. They are educators, not trained medical staff and such decisions are beyond the scope of their education license. I also do not see where non-medical personnel should be required to follow DNR. As others have posted, DNR orders are for those age 19 and above in your state. If she wants her son to continue to engage in social interactions with his friends, then she should invite them over to her house every day. Again I am sorry for your friend, but I think expending her energy on her effort to "fight for the right to have a DNR followed by the school system her son attends" is misplaced. I think she would be better served focusing her energy on her remaining time with her son and/or organizing her son's social time with his friends. Again please correct me if I'm wrong, but I understood that the Mom would be there at the school with him the entire time, so it wouldn't be the non-medical personnel making the decisions or attempting treatment. It would be the Mom.
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flute4peace
Drama Llama
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Jul 3, 2014 14:38:35 GMT
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Post by flute4peace on Nov 5, 2015 18:45:32 GMT
If my child was a classmate, I wouldn't want her to watch her classmate die without teachers intervening. I think that would be exceptionally traumatic. What about my child's well-being? I think it depends on how it's handled and who the students are personality-wise.
For my daughter (who is 16 and has a history of anxiety and is deeply affected by trauma), it would be much LESS traumatic for her to witness a peaceful passing according to the patient's wishes, than the chaos that would ensue in someone trying to save his life and therefore, essentially ensuring his death.
Again, assuming that I've interpreted the following correctly:
1. Performing CPR on the young man would cause catastrophic damage due to his prior surgeries
and
2. The mother would be with him and responsible for him the entire time he was at school, so the teacher-intervention concerns are moot.
If we were just discussing a case of a random kid suffering a life-threatening situation in the classroom, then yes absolutely I think teacher intervention would be crucial. I just feel that this case is very different from that.
Sorry for all of the quotes/multiple posts. Apparently I feel strongly about this.
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Post by RiverIsis on Nov 5, 2015 19:55:57 GMT
If my child was a classmate, I wouldn't want her to watch her classmate die without teachers intervening. I think that would be exceptionally traumatic. What about my child's well-being? I think it depends on how it's handled and who the students are personality-wise.
For my daughter (who is 16 and has a history of anxiety and is deeply affected by trauma), it would be much LESS traumatic for her to witness a peaceful passing according to the patient's wishes, than the chaos that would ensue in someone trying to save his life and therefore, essentially ensuring his death.
Again, assuming that I've interpreted the following correctly:
1. Performing CPR on the young man would cause catastrophic damage due to his prior surgeries
and
2. The mother would be with him and responsible for him the entire time he was at school, so the teacher-intervention concerns are moot.
If we were just discussing a case of a random kid suffering a life-threatening situation in the classroom, then yes absolutely I think teacher intervention would be crucial. I just feel that this case is very different from that.
Sorry for all of the quotes/multiple posts. Apparently I feel strongly about this.
I'm sure this is down to the law and insurance. I took it that he was at school not just "visiting". I'm betting that the lawyers have advised the school that the mother can't be his attendant because he isn't 19 and to let a DNR stand isn't legal and let's not get into any ethical issues of not being able to separate being a parent from a healthcare professional.
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flute4peace
Drama Llama
Posts: 6,757
Jul 3, 2014 14:38:35 GMT
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Post by flute4peace on Nov 5, 2015 20:06:42 GMT
I think it depends on how it's handled and who the students are personality-wise.
For my daughter (who is 16 and has a history of anxiety and is deeply affected by trauma), it would be much LESS traumatic for her to witness a peaceful passing according to the patient's wishes, than the chaos that would ensue in someone trying to save his life and therefore, essentially ensuring his death.
Again, assuming that I've interpreted the following correctly:
1. Performing CPR on the young man would cause catastrophic damage due to his prior surgeries
and
2. The mother would be with him and responsible for him the entire time he was at school, so the teacher-intervention concerns are moot.
If we were just discussing a case of a random kid suffering a life-threatening situation in the classroom, then yes absolutely I think teacher intervention would be crucial. I just feel that this case is very different from that.
Sorry for all of the quotes/multiple posts. Apparently I feel strongly about this.
I'm sure this is down to the law and insurance. I took it that he was at school not just "visiting". I'm betting that the lawyers have advised the school that the mother can't be his attendant because he isn't 19 and to let a DNR stand isn't legal and let's not get into any ethical issues of not being able to separate being a parent from a healthcare professional. I'm guessing you're probably right - and if so it really stinks but wouldn't surprise me at all.
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melissa
Pearl Clutcher
Posts: 3,912
Jun 25, 2014 20:45:00 GMT
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Post by melissa on Nov 5, 2015 20:15:05 GMT
Some thoughts on this very difficult situation.
From a medical viewpoint, I am guessing he is not a transplant candidate.
Also from a medical viewpoint, I am thinking he will just get increasing weaker and eventually be too weak to even go to school accompanied by his mother. So, perhaps the concerns about the DNR are not as relevant as one might think. Of course, I don't know his whole story and I am not in cardiology!
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back to *pea*ality
Pearl Clutcher
Not my circus, not my monkeys ~refugee pea #59
Posts: 3,149
Jun 25, 2014 19:51:11 GMT
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Post by back to *pea*ality on Nov 5, 2015 21:07:32 GMT
My first thought was with a child that sick and so fragile, sending him to school, a cesspool of germs would be the last thing this mother would do. I think she expects too much from the school system. I couldn't imagine wasting any precious time fighting with people. I hope instead she finds ways to make the most of the time they have left together.
OP I hope your friend has a support system of family and friends to help her and her son. I cannot imagine how difficult this is for them.
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Post by roxley on Nov 5, 2015 22:08:22 GMT
I don't think the school has a choice when it comes to the DNR. If it isn't legal for a 14 year old, they can't do it. If they have information that CPR would kill him, that is different than a DNR.
As far as mom being at school, I think it would depend on what she is expecting. Is he attending classes? If he is only there 4 hours a week is that reasonable to do without disrupting the class? Is is just going to see friends? If so, can he go for lunch and non academic classes? They obviously aren't looking for an education during this time so I don't think they should disrupt say, a math class every week.
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AmeliaBloomer
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Posts: 6,842
Location: USA
Jun 26, 2014 5:01:45 GMT
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Post by AmeliaBloomer on Nov 5, 2015 22:31:24 GMT
I'm glad we've moved off the theme of teachers providing/not providing medical intervention, and worse, the scenario of a teacher keeping a class full of kids standing around the student and wringing their hands while they watch him die. It doesn't make a lick of sense. This wouldn't happen for ANY student, DNR or not.
And with or without a nurse, 911 would still be called, even with a DNR. And the school nurses would be involved. Do not resuscitate does not mean do not treat.
I'm also puzzled by the assumption that a heart attack will mean immediate death for this child. Maybe it will, but I didn't read that.
Okay. That all said, I would need to know more about the law and more about what class/activity the student wants to attend. My assumption is the school's hands are tied. I know many students who have an individual nurse, but they've all been employed by the school district and follow a pre-approved plan in consultation with the student's physician that conforms to district policy and legal strictures. In this situation, I doubt the district could allow a privately-paid (or volunteer) nurse because of the DNR law.
Outside of the unfortunate DNR entanglement, I have no problem with the student coming to school part-time. It's a really cruddy situation and I hope the family is able to find other socialization outlets for their child.
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Post by RiverIsis on Nov 5, 2015 22:52:52 GMT
I don't think anyone suggested or intimated that a class of students would be stood there gawking during an event. I certainly didn't. However if it happens in the 4 hours class the students are going to see something and they are going to see how their teacher(s) and admin handle it and quite possibly film it too depending on how mixed ability the class is.
Honestly, if mom is set on a certain way her child's death is handled then she has to do that and not demand it of others.
My heart breaks for what they are going through.
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MerryMom
Pearl Clutcher
Posts: 2,534
Jul 24, 2014 19:51:57 GMT
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Post by MerryMom on Nov 6, 2015 0:00:22 GMT
I am sorry for your friend, but I do not agree with your opinion that non-medical people should make the call whether to contact 911, use an AED, or follow DNR instructions. They are educators, not trained medical staff and such decisions are beyond the scope of their education license. I also do not see where non-medical personnel should be required to follow DNR. As others have posted, DNR orders are for those age 19 and above in your state. If she wants her son to continue to engage in social interactions with his friends, then she should invite them over to her house every day. Again I am sorry for your friend, but I think expending her energy on her effort to "fight for the right to have a DNR followed by the school system her son attends" is misplaced. I think she would be better served focusing her energy on her remaining time with her son and/or organizing her son's social time with his friends. Again please correct me if I'm wrong, but I understood that the Mom would be there at the school with him the entire time, so it wouldn't be the non-medical personnel making the decisions or attempting treatment. It would be the Mom. But as it is occurring on school grounds, the school has some liability for not acting. My husband is paramedic and at times, during scene runs, a family friend who is a doctor is there and wants to direct the scope of treatment. Unless the doctor is assuming all care for the patient and rides in the medic with the patient to the hospital, then what doctor says doesn't happen. Again, I am not seeing why the son cannot have visits and social interactions with his friends at his house. That way, the mother gets to call all the shots and can respond as she wishes or not respond if she doesn't wish to any medical situation which might come up with her son. She doesn't have the authority to dictate the terms of the school's response (or non-response in this case) to a life threatening medical emergency.
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AmeliaBloomer
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Jun 26, 2014 5:01:45 GMT
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Post by AmeliaBloomer on Nov 6, 2015 0:17:34 GMT
I don't think anyone suggested or intimated that a class of students would be stood there gawking during an event. I certainly didn't. However if it happens in the 4 hours class the students are going to see something and they are going to see how their teacher(s) and admin handle it and quite possibly film it too depending on how mixed ability the class is. Honestly, if mom is set on a certain way her child's death is handled then she has to do that and not demand it of others. My heart breaks for what they are going through. My experience with seizures and other medical emergencies at schools, including high schools, has always involved successfully clearing students from the area and then adults closing the door or standing in the doorway - or intentionally surrounding the student of in a hallway - so I can't relate to these stories of students who can see, who know the nature of the emergency, who know the standard interventions, and who are noting whether staff or paramedics are employing those interventions. Heck, *I'm* not even sure what's happening - either because I'm herding students or because I can't see. But I'm open to the idea that others have had different experiences with medical emergencies in high schools. If that's true, perhaps the request, if it were within the law, should be denied because of the other students.
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Post by 950nancy on Nov 6, 2015 0:21:54 GMT
I don't know your circumstances so I really can't speak to that situation, but I am a former teacher with 32 straight years of CPR training. We had at least 10 people in our building (elementary school) who were certified to do CPR and use the office AED. All of our buildings have had AED's for years. We had a coach have heart attack on the field and several instances where life saving actions were performed on high school players before the ambulance arrived. All of the coaches were required to have CPR training yearly. I just can't fathom a school system that doesn't have people, even Good Samaritans, who would know what to do. While I know that students do die even with the actions of these people, I don't know of a school system that doesn't have people trained. The rules/laws in place for schools are actually pretty strong. I agree. Our small town district, that's surrounded by farmland, has had AEDs for at least 6-7 years. Our head nurse wrote a grant for them. Staff gets CPR certification annually. My husband was one of the medical personnel at the high school and was very persistent about getting them into all of the schools in our district years before most schools had them.
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AnotherPea
Pearl Clutcher
Posts: 2,968
Jan 4, 2015 1:47:52 GMT
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Post by AnotherPea on Nov 6, 2015 0:33:22 GMT
Couldn't open the link - just posting based on this conversation.
I'm not sure what the mother is hoping to gain by this. I'm assuming the boy is in high school. It can't be education at only four hours per week. Socialization is doubtful between being in class so little and having mom around constantly.
Maybe he's in a self-contained room where he can "hang out" for four hours one day a week? That would be odd in my experience, though, because the parents that send their kids part time to our self contained room do so because they need help caring for their children - they wouldn't attend with them.
I'm wondering what she expects of the non medical school staff. Our nurse is often away from school and we have many schools that do not even have a nurse. I thought DNRs only applied to medical personnel.
My heart breaks for her. I can't imagine that situation.
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Nicole in TX
Pearl Clutcher
Posts: 2,951
Jun 26, 2014 2:00:21 GMT
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Post by Nicole in TX on Nov 6, 2015 0:43:17 GMT
As a nurse, I also think it is unfair to put a school and teachers in that position. It can be tough to follow DNR orders, even for medical professionals and we are trained in these things. I think being a 'lay person' and watching a child have a cardiac arrest and doing nothing is an unfair thing to ask of them....and if the situation does occur, then they will have to live with those memories for the rest of their lives and for some people that could be very traumatic. While I understand the mother's reasoning and wishes for her child, she does not have the right to impact other (non medical) people's lives in this way. Her wishes do not get to supersede everyone else's. If she wants that directive followed and she feels very strongly about it, then she doesn't get to send her child to school, she needs to keep him in an environment where people are in agreement with following that directive. In hospitals we have policies and procedures and as staff we are bound to follow them, agree or not. That's our role. That's not a teacher's role, or another student's or the cleaner, or the cafeteria lady. All she is asking for is the right to allow her son to have a natural death should the need arise. No she's not only asking that. She is asking non medical people to stand and do nothing and watch a child die. Is she taking in account the effect that might have on someone? I've actually been there and done it....and I'm not talking about really old, terminally ill people in severe pain, I mean people who were essentially OK one minute and then having a major episode of some sort (cardiac arrest, stroke etc). It's really awful. I can fully understand how a non medical person could be very traumatised by being forced into such a situation. She doesn't get to put someone else through that. She can choose it for herself, she can make it a directive it for medical personnel, but she doesn't get to do that to teachers or other school workers, or members of the public. That is what I was thinking and could not have said it myself. Many this young man's peers would affected for the rest of their lives by watching a student die in front of them. Parents send their kids to school to learn, not to watch another student die. If this is a very real possibility, then he needs to be on homebound.
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Post by disneypal on Nov 6, 2015 1:06:22 GMT
I am sorry your friend is dealing with this and I can actually understand where she is coming from but...
I do agree with the school, however, to not allow her to stay with her son while he attends class. My reasoning is (a) he may possibly be distracted with his mother there (b) other students may find her presence distracting and (c) if she attends, other parents may want to attend, where do you draw the line?
As far as the DNR, I don't know a lot about the laws surrounding that, but I would think only medical professionals have to abide by that and since teachers and school staff are not medical professionals, then they do not have to honor a DNR.
I can't imagine what she deals with daily, it must be so difficult.
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IPeaFreely
Full Member
Posts: 389
Location: Castle Frankenstein
Jun 26, 2014 8:32:27 GMT
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Post by IPeaFreely on Nov 6, 2015 1:07:16 GMT
Ugh, it's bad from every angle. I see the Mom's wishes, but wouldn't want my kid to be in a classroom where another kid died. I see the Mom's desire to have the boy in some school...to try and be as normal as possible. Plus the kid probably likes school. But OMG, what an awful situation. I would just rather not think about it.
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Post by pjaye on Nov 6, 2015 1:38:02 GMT
I'm also puzzled by the assumption that a heart attack will mean immediate death for this child. Maybe it will, but I didn't read that. Cardiac arrest = heart stops beating (or is in a rhythm that does not pump blood through the body). No beating heart or no blood pumping through the body does mean immediate death...i.e. no more than a few minutes if there is no resuscitation attempt.
It won't be a "heart attack" it will be a cardiac arrest (the article itself says cardiac arrest, a heart attack is not the same thing medically speaking), his heart will just stop, and a minute or two later his breathing will stop, he will turn blue pretty quickly, he'll collapse, fall over or if sitting potentially fall out of his chair. I've seen several, some are quiet some aren't. Some people look like they are about to have a seizure. There will be variables, some people get a sense that something is about to "happen" some get nauseated and vomit just before they collapse. It will be quick and dramatic and if he's in a class room, it won't be a case of calling and ambulance and ushering him quietly to the nurse's office and making him comfortable and then letting the paramedics decide...by the time they get there he'll already have passed away. They won't have time to get the children out of the room before he passes away either.
As for distress at resuscitation, yes that would likely be traumatic as well, but I think people (including children) are better able to understand and process it, when they know it was in an attempt to save or help someone.
I don't disagree with the mother and her overall wishes for her son, I do disagree with anyone expecting others out in the community in non medical roles to follow those wishes. As far as I'm concerned DNR orders are for medical & allied health staff & for hospitals and care facilities (nursing homes etc) only. I don't think anyone can or should have an expectation that they be followed outside of that criteria.
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Post by 950nancy on Nov 6, 2015 1:55:19 GMT
Some thoughts on this very difficult situation. From a medical viewpoint, I am guessing he is not a transplant candidate. Also from a medical viewpoint, I am thinking he will just get increasing weaker and eventually be too weak to even go to school accompanied by his mother. So, perhaps the concerns about the DNR are not as relevant as one might think. Of course, I don't know his whole story and I am not in cardiology! I had a coworker with heart problems. He was in his 30's. He initially joked about having heart problems (he knew he had them), but as the time went on, he became increasingly sick. I swear there were days I would follow him down the hallway slowly just to make sure he made it back to his classroom. He lasted three years, but towards the end, he was not able to work. He didn't come back at the beginning of the school year in August and then passed away in late September. We had a medical plan for him in case something happened when he was at work with a class full of kids. While the classroom would have been cleared, it would still be traumatic for the kids seeing him in distress.
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