Sudsy 2,484 Views
Joined: Sep 8, '11;
Posts: 74 (19% Liked)
; Likes: 18
I am just glad you care enough to help. My dad became terminal when I was about 2nd grade and died the summer before I entered 7th grade. Through all that time the school(s) couldn't have cared less.
They also sell those little inky roller thingies that blot out info. I use them for when I throw out my own med bottles at home.
I'm not a camp nurse but I run into a similar problem in the hospital with pt.'s meds that are sent from pharmacy in a ziplock w/ a label affixed that contains the pt. 's info. The labels are almost always impossible to peel off. Here's some thoughts:
A.) Is there a locked box for depositing papers w/ sensitive info.? In the main office perhaps? You could put all the wrappers in there.
B.) Do you have access to a shredder? You could run them through a shredder. If you taped them to a piece of paper it would make them easier/quicker to shred.
B.) Easiest way: black out the information w/ a black Sharpie as long as you can get it dark enough to obscure the information. Make sure it can't be smudged off. You can then throw in the regular trash.
Top 10 things you should know: signs of an allergic/anaphylactic reaction and how to use an epi pen, vomiting doesn't count unless witnessed by an adult, band aids and ice packs heal most things, never ace wrap anything, If they need an ace, they need an x-ray, any head injury needs a parent call, fractures are not always obvious..if pain or swelling, suggest an x-ray, keep Clorox wipes on hand at all times and wipe down everything the students touch if they are sick, always use universal precautions...MRSA is rampant in schools, unless students have a severe illness, 20 minutes of rest and back to class is a good rule of thumb, Make friends with other nurses in your district, they will be a lifesaver while you are learning the ropes, oh one more, this site is great Good luck you will love it
i've gone back and forth over the years. In my heart, i like baggies and real ice. it works better and it's more sanitary but in practice when you see the kids wanting to ice the pain that was moments ago a 10/10 on the pain scale for 15 d**m seconds then skipping away totally fine the waste of supplies gets totally annoying. So because I have little kids that are apt to do that and would be apt to play with baggies of real ice, i stick with reusable packs that I take a sani cloth to - and those packs don't leave my office or i never see them again. But if i were working with older students (middle school and above i'd expect this from) I feel I can trust to take a baggie of ice cubes back to class and toss into the trash once done with it. It gets them back to class quicker and i expect them at their age to have the maturity not to play with it. In my last school I had a great portable ice maker and just made ice when needed and filled up the baggies.
As far as bandaids go - if i can't see it, i'm definitely not dressing it. The phrase "I think you'll be okay" seems to carry a lot of weight out of my mouth with some kids. The one that gets me is the kids that insist on having their temp taken constantly. I will feel them and tell them they feel cool but they often times don't believe me until they see the almighty number. I've even gotten to the point that i can pretty much guess within .2+ or - most times
"Do you often do things just because you know the kids will feel like you care when you do them?"
All the time!! There's nothing wrong with that. A lot of kids just need to feel heard or that someone cares enough to listen. A lot of students don't get that at home. A lot of kids don't realize that within the first 30 sec we can tell if they really need something or not. We are assessing the color of their skin, their demeanor, seeing if they are guarding an area, how active and talkative they are, etc but if we just look and say you're fine and dismiss them then they feel like we didn't care. We don't want kids to feel that way. So yes, I go through the whole taking a temp, feeling a belly, looking at throats, etc when I know I don't need to just so they will think I really checked them out. Sometimes, I do find something I didn't expect to see-totally unrelated to why they were in there that does need care so it never hurts.
I do understand about the kids wanting ice for every little thing or bandaids. Luckily those items do not come out of my pocket so it's a quick easy fix that I use to make the kid happy. I don't give out bandaids if I can't see a scratch however. I do give out ice because even if something isn't swollen it can numb the area that's in pain which helps. I've even given ice for headaches-it gets the kids through the day sometimes! If it's a "this happened last week story" then assess the area-if you don't see anything tell the student if they are still having problems they are going to need to follow-up with the dr and you'll be happy to write a note to mom if they wish but since you don't see swelling the ice isn't going to help. If it's a yesterday or day before then ice may be the cure-all.
Even the teachers know some of this is just placebo effect but it keeps the kids from bugging them all day. Some teachers are tough and will say quit whining but a lot don't. This is awful to say but if you inconvenience the teachers enough they won't send as many kids-they will only send the ones they really think need help as compared to ones for every little thing. Make up a pass they must fill out with the student's name, time, reason for visit, etc (good for safety reasons anyway-making sure you know who the student is and going where they should, etc) or make them call you on the phone before sending a student down telling you who it is and why they want to send them. Either one makes them stop what they are doing to really think if it's worth it. Also, put bandaids in their mailboxes so they can be in charge of passing those out for little things and I bet when they take the time to look at a scratch if they don't see something they'll tell them to go sit down.
You have to walk a fine line so you don't get accussed of not wanting to do your job. We all know exactly what you're talking about and your reasons are legitimate but it's very easy to be taken the wrong way from teachers and you don't want that. Good luck!
I'm still surprised you are permitted to work in such a role as a new grad paramedic. In my state paramedics are only permitted to administer medications & ALS treatments under direction/protocol of an emergency department physician.
Do you have a physician signed asthma action plan for this child ? Blow by is quite often used in pediatrics. If the child started with neb treatments at a young age this may be all they know. Granted an MDI with spacer & mask is more efficient medication delivery system. (Children's Hospital of Philadelphia even uses MDI's with spacer & mask in the NICU)
Wait, you just added more to the story. Why on earth would you think creating a care plan on patient 1 was more important than getting report on patient 2? You are just as much responsible for patient 2 as you are patient 1! Also, please tell me you did assess each patient ASAP during your shift. I once assessed a patient at 7:15 and realized she was going into shock and not arousable. You better believe I peek on ALL of my patients before or during report and assess them very quickly thereafter. I hope I am misreading your post... You should know this by the time you graduate.
What bothered me is that I felt I did not have an advocate throughout the entire situation. My school's leadership was only concerned with the image of the school and not what my side of the story was. I am out nearly $3k in tuition for the semester and my graduation date is pushed back by 2 more months. If that is indeed a HIPAA violation, my school did not properly educate it's students that it indeed was as my entire class was absolutely stunned by this and were so worried they asked my teacher in class "what exactly are we allowed and not allowed to do" during lecture. Mind you these are senior nursing students still confused on what we can and can't do. I asked the nurse beforehand hand if it was fine if he looked at the patients ventilator in which she gave permission. Next thing you know I am being kicked out of class for "unsafe reckless behavior and HIPAA violation."
Actually our school doesn't go beforehand, or the night before to research or patients. We show up the morning of and start gathering information. Had I gone the night before to research meds, I would of been well prepared on what medications were given. My nurse was the one hanging the medication and I asked her what one of the meds were as she was hanging it. As I mentioned before we immediately entered the patients room after report to start hanging meds, so there was not enough time for myself to prepare. My school told me that is not an excuse and that I should of told her that I need to sit here and research meds first before shadowing her. I just wanted to get up and get going, I am there for 12 hours so I have plenty of time to research meds. With the insulin, I pulled out 30 iu's and the nurse noticed immediately that it was too much directly at the med station. It never even came close to the patients room where I do another check. Regardless I admitted to the mistake and have learned from it and will move on. My main problem was with the HIPAA violation, because I felt so caught off-guard by this. My fellow students and I have been doing similar scenarios all throughout our clinical experiences and my entire class didn't know that this was a HIPAA violation, so wouldn't it be the schools responsibility to relay this information to us instead of making me the whipping boy for it? I asked the nurses permission before myself and the other student entered the room if it would be okay for him to see a patient on a ventilator, in which she obliged. What bugs me is that during the entire day, the nurse or her supervision never once talked to me about my behavior or told me I was being unsafe. My nurse continued to let me do patient care all day and literally to the last minute of my day there.
students have 504's written for specific testing times. Ihave diabetics test before a test, then again at the next break in the test, (1-2 hrs), if there is an emergency, the book gets closed and does not get opened again.
Been in school nursing for 20 years...there is no High Stakes testing that cannot be postponed due to an emergency.
This child's toilet training is part of his education in life skills, and not a health issue per se. His toileting needs should be addressed by the educational staff. You may be included in his overall IEP planning and implementation. That would certainly be ideal. But writing a health plan for toilet training independent of his overall educational plan would probably be a waste of time.
Unless his lack of training can be attributed to a physical problem (gi abnormalities, medication side effects, etc.), then it represents an educational need, not a health need. No disrespect intended, but educational needs are best addressed by the educational staff, who spend time with the child, know his schedule, habits, cues, etc. Bringing this child to the nurse's office for toileting would also be an unnecessary disruption of his routine, which is not tolerated well by students with ASD.
Your role is to teach proper handwashing, infection control, safety and risk management (2 adults present to prevent accusations of inappropriate contact), as well as help the staff to identify and prepare a private area for toileting/diaper changing of this and other special needs students.
Enjoy your year!
I get this a lot too. I usually just look at them and very excitedly exclaim " Hooray. You have a loose tooth, how wonderful. Just keep wiggling it and it will come out when it's ready" and then send them back to class. Usually me being happy about it for them relieves their fears.
Does your school do the Youth Risk Behavior Survey? if so there should be some GREAT data there about what is happening in your district.
It addresses: drugs, alcohol, driving, mental health (suicide atttempts).....if not there is information on the CDC re the national trends.
Alos texting, sexting, socail media, the list goes on and on....good luck!
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