Why do people ask the “why question?” See, right there…I am asking y’all “why” folks ask “why.” This is a simple concept, and I know y’all will get the ah-ha moment very soon…and…knowing how smart y’all are (all school nurses are super-duper smart), y’all probably have gotten it already, but want to keep reading just to see how many times I use “y’all” in my article.
A child arrives in the office with a bump on his noggin, “Nurse Kevin, Jake pushed me down, and I hit my head on the grass really, really super-hard; I almost cried.” Little Timmy is here with a red bump to his forehead and drying tears on his cheeks. A school nurse is able to do two things at once: Begin an assessment on Little Timmy’s head and the goings-on within his little cranium AND ask the “why question.” Wasn’t that what you were thinking right off, too? Why did Little Jake push Little Timmy in the first place? Ahhh, but for us nurses, the “why” isn’t what matters…right now. It’s the what. And we have to see “what” is going on (the main part of the job is to see to the knock to the noggin) and then pursue the “why” that caused the “what.”
Truth be known, the “why” does not matter too much in this situation. I say that as a nurse. But, as a mamma, that “why” is what it’s all about. Your job as a school nurse is to either:
- Eliminate the “why question” all together.
- Have an answer to the “why question” that could be asked.
- Know the person that has the answer to the “why question.”
First and foremost, is Little Timmy A-OK? When everything checks out, the next step is to call mamma while Little Timmy recovers both physically AND emotionally. What’s Mamma’s first question gonna be?
Why do people ask “why?”
The way I see it, 20 years of nursing has taught me one thing: when folks start asking “why questions,” they are looking for an explanation for something that is usually not explainable. There are 6 reasons why folks will ask the school nurse “why.”
- They are accusing you.
- They are “justified by ignorance.”
- They are showing disagreement or disapproval.
- They are leading the witness.
- It is what it is? Rather, “It is, and I want to know the reason.”
- They want to know the answer to the question.
1) They are accusing you.
A mad mamma calls the office to explain her child’s absence for the pending school day and then asks to be transferred to the school nurse, “Why aren’t you doing anything about the head lice problem in your school?”
This “why question” is loaded on so many fronts. What this mother is really wanting the answer to is, “Why did my child get lice?” This mother wants an explanation of how bugs got into her child’s hair and ended up in her home (and likely in her own hair). She is looking for a culprit to blame; someone toward whom her long and accusing finger can reach out to and say, “You did this to me!”
She is fully aware that the school system does not manufacturer head lice and sprinkle it upon little unsuspecting heads. But, she needs validation in the form of a perpetrator. And, by asking the one person in the school who is the unofficial head lice police, she is accusing you of not doing the job she feels you should be doing.
2) They are justified by ignorance
“Why did you let him sleep? He hit his head and could have a concussion!” I remember how mad that mamma was at me. That mamma was as mad as a three-legged dog trying to bury a turd on an ice pond. She stormed out of that school house and right over to the ER to get her dander up even more. She sure did! And when the doctor saw that things “looked like a duck, quacked like a duck, and waddled like a duck,” he put his “mild concussion” stamp on that child’s chart, despite the fact that this child was well-versed in the after-recess “duck-quacking” that would add another 30 minutes to his recess and subsequently his out-of-class time.
Basically, nobody was asking this boy how he knew so much about “the duck” in the first place. My thinking is, this 5th grader knew more about “the duck” than “to duck” when walking under a low-hanging metal playground toy that has been in the same place for the entirety of his elementary enrollment…and here in the 6th year, he “didn’t see it there.”
Now we all know that sleeping after a bump on the head is okay. No mark, no swelling, no loss of consciousness, no nothing other than a child that stayed up too late the night before playing X-box and was starting to zone-out after his lunch and enjoyable recess (note: only told someone after lining up and heading to the classroom). The problem was, mamma was still going off old science — ignorant of new standards of care. She felt justified in asking the “why question” based on her layman’s assumptions and fears rather than the advice and care of a licensed professional.
3) They are showing disagreement or disapproval.
“Why did you buy cheap Band-Aids?” Seems like a simple question, right? This person is not asking about Band-Aids. They are not asking anything at all. They are SAYING, “I don’t agree with your brand selection of bandages.”
Some folks are passive-aggressive…I think we’ve all been accused of being a bit passive-aggressive at some point. On a good day, I may embrace the “why question-er” in a friendly back-and-forward session of idea-sharing and companionship. But, on a bad day…well…I just smile and wave. I just have to keep in mind that there are a lot of folks out there with only one oar in the water.
Seems like a good idea to start by saying, “I have several good reasons for purchasing these bandages and, if you like, you could buy me a cup of coffee, and we could discuss the problems my bandages may be causing you.” Truth be known, this person is not looking for an answer; they are looking for an argument. They want to get you all riled up and get you to push out your bottom lip. Just keep your lip where it’s at and remember to smile and wave.
4) They want to lead the witness.
“Can you give me three good reasons WHY you didn’t call me after my Little Peter threw up yesterday at school?” Peter’s mother’s tone is letting you know that maybe her Little Peter wouldn’t be so ill today if she would have been notified of his illness yesterday.
Poor Little Peter. These kinds of “why questions” usually come from someone who has sat through a sales seminar or attended some sort of multilevel marketing program thing-a-ma-jig. And, why do you need three reasons? Why can’t one reason be sufficient? But, since I don’t like backing down from a good challenge, let’s see: 1) I called you but, “The cell phone subscriber you are trying to call is not accepting calls at this time.” We know what that means, right? 2) I called dad’s number, and after one ring it went to voicemail. 3) This one I love because it sends the “why question” back over to the mother like a volleyball back over the net, “Did you check dad’s phone for the message I left?”
Vomits are a puzzling “event” in a child’s day. Is the child ill? Or, did the child “inhale” his lunch and wash it all down with a chocolate milk just to be first on the playground spinner toy?
5) They can’t accept that “it is what it is.”
The answer to so many “why questions” is simple: “It is what it is.” However, for the one asking the “why questions,” it’s neither this nor is it that. It’s something that they can’t find a reason for, and they are not okay with that. The problem is: There may not be a reason to give. Instead of accepting the cards they were dealt by the universe, they are looking for “It is (and I want you to tell me why it is) what it is.”
“Why did my Little Paula fall and break her arm?” However, while we all feel sad that Little Paula fell and broke her arm…while walking along the level ground…on a nice dry, spring day…there’s just no answer to the question Little Paula’s mother is asking. What she is really asking is this: “Now I have to take off from work again and take her in for a cast and more follow-up visits, and who’s gonna pay for all this?
Offering sympathy and understanding at the added stress in the mother’s already stressful life is the best answer to this kind of “why question.” Making excuses will only take the conversation way into the weeds. Finding a good conversational trail back out of those kinds of weeds is…well…empathy and reassurance…you stay out of them weeds.
6) They want to know the answer to the question.
Some “why questions” are just that…a question of inquiry. They just want to know why something is and are willing to accept an account of the event and a reasonable and logical explanation of the outcome. You know, cause-and-effect. Most parents want to know what caused the effect so they can both emotionally move on and to know beyond any reason or a doubt that you are the best school nurse their child could have.
Why are “why questions” so important?
Anticipating the “why questions” keeps the care momentum moving in a forward direction. Any plan of care needs an ultimate ending point…a place for the “why question” to fit in. We are civil servants with a commission to care for other people’s children. We are going to get plenty of “why questions.”
Engage these parents. Embrace these parents. Anticipating “why questions” is the guiding light to our practice as school nurses. “Why questions” keep us school nurses thinking like they are pieces in a chess game being played on a volleyball court. You, the strategic school nurse, are to practice your skills and anticipate all “why questions” as you volley the “why questions” to the opposing team, until you are no longer being served “why questions.” You’re simply moving the “why question” through its natural process along with other professionals that can actually answer the “why question” and satisfy the person asking the “why question.” It’s not passing the buck, per se. It’s simply finding the correct person who has the correct answer.
This is no way and no how an article about “covering your butt” against liability (though Nurse Kevin, like you, is very much in support of protecting himself against liability). This article is definitely not about dumping responsibility and subsequently pointing fingers at other staff members. Most “why questions” are questions of inquiry about a decision or action we nurses took during any given incident, accident or during an ill-child assessment. These “why questions” always comes after-the-fact when vision is at a perfect 20/20, and the one asking the “why question” is earnestly seeking a reason for the outcome they find themselves dealing with…usually. After all, the choices that “should have been made” are now so crystal clear…but are they? If they were, the “why question” wouldn’t need to be asked in the first place.
Lastly, rest assured. All the answers to your “why questions” are in your nurse’s notes. When you are presented with a “why question” quiz, it’s OPEN-BOOK test! You’ll do great!