Hello felllow nurses,

So it appears more and more school districts are taking up the new policies on lice. Our district is going to live out the remainder of the school year still sending home kids with live lice. But I hear CDC changed some policies and starting next year we are no longer allowed to send students home with live lice. How do ya'll feel about this? I live at a low-income school in a poverty stricken area. Every classroom has atleast 2-3 students with active lice, despite my best erfforts of speaking with parents, sending the student home multiple times, getting the social worker involved, ect. I can't imagine how badly infested my school will become next year. One of our preK classes had 7 students with active lice out of 16 kids. I just don't know how I feel about this....

Well, you being from Texas, you know the state health department took head lice OFF of the list of conditions by which to exclude students from school - starting this school year. This paragraph is printed in our student/parent handbook -

Head Lice

As reported in the September 2002 American Academy of Pediatrics, Clinical Report:“Head lice are the cause of much embarrassment and misunderstanding, many unnecessarydays lost from school and work, and millions of dollars spent on remedies. It is probablyimpossible to totally prevent head lice infestations.Head lice are not a health hazard or asign of uncleanliness and are not responsible for the spread of any disease.” There is nostatute in Texas that addresses excluding children with head lice from school. Lice are nota public health threat. They do not carry disease. Therefore, the Department of State

Health Services does not monitor or track cases of head lice.

In my district the role of the school nurse regarding head lice is for identification and education; there's nothing to "enforce." The hysteria runs in cycles; sometimes surrepticiously perpetuated by staff who fan the flames instead of reasonably educating the parents about treatment and prevention strategies. I try to remind staff that head lice were here before they came to work here and head lice will be here after they move on. I began school nursing during the classroom head check era. Head lice are are no more prevalent now, when we don't do classroom head checks anymore, than they were back then. Some parents are interested in the subject - some are not. You can tell em their kid has head lice and tell em how to treat and tell em how to prevent infestation but you can't go to their house and do it for em. Just sayin.....

As my school nurse mentor told me at the beginning of the year: no one ever died from lice!

Speak with your pre-K teachers about not sharing pillows or blankets in naptime, not sharing hats, keeping everyone's jackets separate, no playing hair dresser in the classroom, etc. Let them know the new policy, that you can't send kids home for lice anymore.

I'd be glad to have my district adopt such a policy. We're still on "no nits," despite all the recommendations against it!

I think you may be misunderstanding the policy. The student does not go home until the end of the day, but they still need to be treated to return to school and you can check them when they come back. Most of the time it's not difficult to tell whether or not they have had the shampoo and nits combed. My District has allowed me to purchase no-name Nit shampoo and the metal combs for parents who cannot afford it. Also, Medi-care/Cal covers head lice shampoo. But they need to still make an appointment to get the prescription.

Policies that keep students out of the classroom for lice and nits are only for the psychological comfort of the adults and not for the benefit of the child.

Wow, and this entire year all of the nurses were following the policy that if a student is indentified with live lice they need to go home asap and cannot return until the hair is treated. Turns out tx state health depart changed that before this year even started. I'm going to bring that to the attention of our nurse manager.

If your district has a stricter policy than the state, it can override in most cases. So while your state may have changed that last year, your district may have elected to keep a stricter lice policy for now.

^What fetch said above. For me, being in charter school that is its own "district," we look at state policies, but can be stricter in some places. For lice, I send home active cases with instructions they cannot return until after treatment. But the exclusion is mainly to get parents to treat because if I wasn't that extreme, some parents would never actually treat their child, believe it or not!

I do a head check when they return. Nits do not equal exclusion and that freaks some teachers out, but I'm trying to make head-way with teaching about commons lice myths. I also work in a lower income area and luckily have a budget that allows me to provide combs and shampoo to families that can't afford it.

This is my school policy, Clayton County schools of Georgia:

Pediculosis (Head lice) - student should be excluded from school until after treatment. In order for the student to return to

school, written documentation of treatment is necessary. The parent must present a medicated shampoo/lotion box top or empty

bottle with receipt for verification of treatment. chronic cases may be referred to dFacs as appropriate. When a case of head lice

is identified, head lice checks on students in the same classroom will be conducted as deemed appropriate by school health

personnel.

This is my school policy, Clayton County schools of Georgia:

Pediculosis (Head lice) - student should be excluded from school until after treatment. In order for the student to return to

school, written documentation of treatment is necessary. The parent must present a medicated shampoo/lotion box top or empty

bottle with receipt for verification of treatment. chronic cases may be referred to dFacs as appropriate. When a case of head lice

is identified, head lice checks on students in the same classroom will be conducted as deemed appropriate by school health

personnel.

That's pretty funny...what do they require if something of concern occurs, like flu or chicken pox?

I have a couple of tidbits. The first especially for those dealing with teachers and staff hysteria- It has taken awhile, but the teachers/staff all know that the status (or not) of lice on a student, is NOT "need to know" information. I don't tell them the results of if I have to check a student's head.

#2- I have attached a form that I made up to track head lice...One is for an individual student, another is for tracking students in the same family. I have shared it before, but since it has been awhile. I want to share it again for our new co-workers, in case it may be helpful.

I agree with OD- I have seen no increase in the amount of lice. I will say, I kind of held my breath the first few years. I understood the science behind the policy change, but this is such a overly-sensitive topic, I wanted to see it work. AND. IT. HAS. NEVER. LET. ME. DOWN.

Lice_tracking_sheet_family_unit.pdf

LicetrackingsheetSingle Child.pdf

That's pretty funny...what do they require if something of concern occurs, like flu or chicken pox?

Health and Safety Emergency/Illness

To provide a healthy and safe environment for students, parents/guardians are asked to follow the guidelines below:

1 Students should not be sent to school with a fever of 100.4 degrees Fahrenheit or greater. The student should be fever free for

24 hours without the aid of fever-reducing medication before returning to school.

2Parents should respond to an emergency notification in a timely manner. otherwise, the school will contact the appropriate

authority, which may include eMS, DFAcS, the police, etc.

3 School officials, such as the teacher, Healthcare Technician, Supervising Healthcare Professional or counselor, should be notified if a student has a chronic medical condition or disability that may require special care or emergency treatment.

4 Parents/guardian will be required to provide additional documentation (individualized Health Plan) from a medical doctor to verify the chronic medical condition and to provide special care instructions.

Health and Safety Emergency/Illness

To provide a healthy and safe environment for students, parents/guardians are asked to follow the guidelines below:

1 Students should not be sent to school with a fever of 100.4 degrees Fahrenheit or greater. The student should be fever free for

24 hours without the aid of fever-reducing medication before returning to school.

2Parents should respond to an emergency notification in a timely manner. otherwise, the school will contact the appropriate

authority, which may include eMS, DFAcS, the police, etc.

3 School officials, such as the teacher, Healthcare Technician, Supervising Healthcare Professional or counselor, should be notified if a student has a chronic medical condition or disability that may require special care or emergency treatment.

4 Parents/guardian will be required to provide additional documentation (individualized Health Plan) from a medical doctor to verify the chronic medical condition and to provide special care instructions.

So it's easier to return to school after having been sent home with a contagious illness than it is to return to school after having been sent home for head lice...that makes sense.

Wow, and this entire year all of the nurses were following the policy that if a student is indentified with live lice they need to go home asap and cannot return until the hair is treated. Turns out tx state health depart changed that before this year even started. I'm going to bring that to the attention of our nurse manager.

I am thinking state health depart statements and recommendations are one thing but your particular school district may need to adopt or adapt a current policy to change how you treat. I am still part of a no nit no lice policy, one nit and they are bounced out, cannot return until the health office gives an okay. However I am part of an area that is upper middle class and parent would revolt if this policy was to change. I keep hoping but not yet. I do class and bus checks on each reported case.