[Praiser]

Just pondering this and want your feedback please.
If a student comes to you with an old cut that is covered with a bandaid, or an arm wrapped in an ace bandage, and these injuries all occured while at home, and the teacher or parent wants you to unwrap and evaluate. Do you do it ? Or do you just leave it and chalk it up to home injuries. I mean, we are not MD's and cannot diagnose. What would you do ?


Thanks to all for your feedback.

__________
Praiser

[luvschoolnursing]

I'll unwrap ACE bandages or take off dressings if the student hasn't been seem by a MD and the parent put it on. That way I can evaluate for s/s infection or (to the best of my ability) determine if an area probably needs an x-ray due to possible broken bone. I follow up with a call to the parents to let them know if I see anything that warrants a trip to the doctor. Especially in my area, where community acquired MRSA is such a big thing right now, I refer any wound with pirulent drainage for a culture whereas before I just might put some neosporin on it and let it go. Why are the teachers asking you to look under bandages?

[michigooseBSN]

I, especially, am happy to rewrap aces if asked (and if not applied by a doctor) because so often they are applied improperly at home. I've seen circulation almost compromised by tight aces.

[glolilly]

I will unwrap and evauate the cut if the doctor didn't place it there. But I will not keep evaluating it if they haven't been to the doctor and are using me in place of one. I tell the students that I am not their home supplier of bandaids. And with parents so uptight about the staph and mrsa, I place the burden on them to seek help immediately if there are s/s of infection. They should not be allowed back to school unless seen by a physician. I tell them 2 things: 1. keep hands washed and 2. keep your wounds covered. But I can not evaluate 900 students old wounds on a regular basis, impossible. Parents should take responsibility and I inforce the ones I know about. It's impossible as I told one parent to have knowledge of every student at school that has a sore or cut. They won't all come and tell you this.

[mamunsey]

I will remove old band aids and bandages if placed by a parent or the student, evaluate and recommend. I also tell students that if they need more than one band iad during the day, that they need to bring them from home. I have a 1 a day limit on bandaids unless they come off during gym, etc. or are re-injured. And in my area schools, we are not allowed to apply Neopsprin, it contains a medication, and the only way we can apply it is to have a non prescription medication form filled out by the parent and on file for the current year.

[missfixit]

After contacting the parent, I will remove bandages with permission and if it seems necessary. I only remove bandaids if they are soiled or the student complains.

[firefightingRN]

I will also redress most home injuries. My pet peeves about home are improper dressings - such as a child who came into me and could barely walk because Mom treated a blister on studen't foot by wrapping it loosely with an ace wrap (a filthy ace wrap), and also filthy old bandaids that you know have been on for days. I am sure like the rest of you, I won't needlessly disturb a "professionally" dressed wound.

[TXNurseBSN]

I agree with the above posters - do not disturb something that was placed by a physician. I will look, redress, etc. if it was did at home. However, I will only do this once. The staff / parents at my school think I should follow every kid with every booboo everyday. With 1100 students, this is just not possible. The staff feel they need to tell me about every illness or injury a kid ever had.

It gets to be too much when you are treating everything!! I get kids sent to my clinic for things in which they are already under the care of a physician for, parents know about, they are already on meds for, etc. What else do the staff think we can do at that point??

[okschoolnurse]

Honestly, it totally depends on what time of the month it is, what kind of mood I am in, what the circumstances are and who the child is!!!!!
Some days I am very loving compassionate and take time to fix hair and paint fingernails. Other days I bark loudly and chase them back to class.