I also think you should just finish out the school year. Legally you may only need to give 2 weeks but with only 3 weeks left, I think they would be very unhappy with you leaving them without coverage the last week. That gives them the summer to hire a nurse for the next school year. Good luck!
I deal with this alot, not necessarily in special ed students, but with my younger grades. Plus, once the teacher starts the "Aww, you don't seem to feel good" doting, the kids really don't have a reason to "improve". Lots of teacher attention and the chance to go home. I stand firm on my 'send home' guidelines at the risk of upsetting the teacher.
Thank you! I agree that I don't want to do away with OTC meds altogether, just hoping to find some middle ground. If a child has regular migraines or has an ear infection and needs pain control a couple of days, I would like to have specific instructions with a time frame and permission from the parent. Currently, our parents sign a blanket auth to give all sorts of OTC meds, but only at the beginning of the year, good for the entire school year. That basically means I can give their child tylenol, etc even if they come 3x a week all year. Just trying to make it not so convenient for my frequent flyers to get out of class. I'm hoping to limit maybe how often I can give OTCs without an order from an MD, maybe? Just looking for ideas from others that I can maybe implement.
And yes, I have been here 7 years and it has bothered me more and more each year. Not sure why today I decided I needed to be concerned about liability. Maybe I'm just ready for summer break
I know that here in Texas, public schools do not give OTC meds without MD auth, parent permission, etc. Below is a post I put on RNsights so I apologize for those who see it twice. I stepped into a private school nursing job several years ago and the parent annual OTC authorization was already in place. Looking to change it and needing ideas for backing up my decision in terms of liability for the school and my license, etc from private or public school nurses. Thoughts? Here is my original post:
"My private school has annually gotten a blanket permission signed by parents to authorize certain OTC meds as needed throughout the school year. Although it is nice to give a child who truly has a headache a dose of tylenol, I constantly feel as if I'm giving meds to kids who really don't need it. I am looking to make changes next school year and not keep a stock of the OTC meds for just anyone's use. Unfortuantely, our school parents see things such as this as a "perk" of private school and there will be a lot of resistance to making the change. I am in Texas and the state guidelines strongly discourage giving OTC meds unless they are brought in by the parent and is for a designated time frame. How does your private school handle this?"
I have also called parents to let them know their child is suddenly using their inhaler daily. Lots of times, the parents don't know because the child is never "needing" the inhaler at home/ on weekends. I express concerns about overmedicating if the child truly doesn't need to use an inhaler daily, esp if they do not appear in any distress and have great sats. I have so many kids with MD orders for prn inhaler use at recess/PE, it sometimes feels like a free for all around recess time in my clinic.
Pretty much the same thing here, plus requesting homework assignments for absent kids. I've never been to a school where this is a practice. But here, when parents call in the absence, they can request the days work be sent to the office. I email those requests to the teachers. Seems odd if I child is sick enough to stay home that they shouldn't be up late doing homework
When the outdoor allergens are bad, teachers wanted to let kids who had to stay indoors at recess stay in the clinic instead. Put a stop to that one quickly!
Maybe I am under reacting but my thought is you can't force them to take her in. Although vision is important, it is not life threatening. I agree if it is affecting her academically, then maybe the parent will be more likely to take action. Otherwise, document that you recommended a rescreen and the parent's response re: the MD recommendation. Good luck!
I think you did the right thing! I also would never deny care to something emergent but you don't want people to just assume you are there anytime something is going on on your campus. I like the "no ice after school". I learned early on that the earlier I get to school the earlier they start coming in. Same with after hours. I'm amazed at how many kids come to my door once school is out. My kids also go here so I am often hanging out waiting for practices, etc to end so I can go home.
My school actually looked at having an hourly nurse after hours just because we have so many extra curricular activities and sports. They decided it wasn't in the budget....no surprise!
I think it is a bad idea, but it's an ongoing battle here. Kids can definately be allergic to guinea pigs, hamsters, rabbits, etc. One teacher here actually had ferrets as class pets! The entire hallway stunk by the end of the year. Administration finally made her take them home.
I only send home for a fever. I may let a parent know if the throat just looks terrible (spots, patches, etc) but leave it up to them in regards to a pick-up. I will mention though, that we have had a run of kids with strep without fever, so fever may no longer be the tell-tale sign
I also think you should just finish out the school year. Legally you may only need to give 2 weeks but with only 3 weeks left, I think they would be very unhappy with you leaving them without coverage the last week. That gives them the summer to hire a nurse for the next school year. Good luck!
I'm suddenly feeling very lucky! !8 days for me. We start mid August
I deal with this alot, not necessarily in special ed students, but with my younger grades. Plus, once the teacher starts the "Aww, you don't seem to feel good" doting, the kids really don't have a reason to "improve". Lots of teacher attention and the chance to go home. I stand firm on my 'send home' guidelines at the risk of upsetting the teacher.
This is helpful and I am excited to start working on guidelines. Thanks!
Thank you! I agree that I don't want to do away with OTC meds altogether, just hoping to find some middle ground. If a child has regular migraines or has an ear infection and needs pain control a couple of days, I would like to have specific instructions with a time frame and permission from the parent. Currently, our parents sign a blanket auth to give all sorts of OTC meds, but only at the beginning of the year, good for the entire school year. That basically means I can give their child tylenol, etc even if they come 3x a week all year. Just trying to make it not so convenient for my frequent flyers to get out of class. I'm hoping to limit maybe how often I can give OTCs without an order from an MD, maybe? Just looking for ideas from others that I can maybe implement.
And yes, I have been here 7 years and it has bothered me more and more each year. Not sure why today I decided I needed to be concerned about liability. Maybe I'm just ready for summer break
I know that here in Texas, public schools do not give OTC meds without MD auth, parent permission, etc. Below is a post I put on RNsights so I apologize for those who see it twice. I stepped into a private school nursing job several years ago and the parent annual OTC authorization was already in place. Looking to change it and needing ideas for backing up my decision in terms of liability for the school and my license, etc from private or public school nurses. Thoughts? Here is my original post:
"My private school has annually gotten a blanket permission signed by parents to authorize certain OTC meds as needed throughout the school year. Although it is nice to give a child who truly has a headache a dose of tylenol, I constantly feel as if I'm giving meds to kids who really don't need it. I am looking to make changes next school year and not keep a stock of the OTC meds for just anyone's use. Unfortuantely, our school parents see things such as this as a "perk" of private school and there will be a lot of resistance to making the change. I am in Texas and the state guidelines strongly discourage giving OTC meds unless they are brought in by the parent and is for a designated time frame. How does your private school handle this?"
I have also called parents to let them know their child is suddenly using their inhaler daily. Lots of times, the parents don't know because the child is never "needing" the inhaler at home/ on weekends. I express concerns about overmedicating if the child truly doesn't need to use an inhaler daily, esp if they do not appear in any distress and have great sats. I have so many kids with MD orders for prn inhaler use at recess/PE, it sometimes feels like a free for all around recess time in my clinic.
Don't make them too comfortable! They will never leave
Pretty much the same thing here, plus requesting homework assignments for absent kids. I've never been to a school where this is a practice. But here, when parents call in the absence, they can request the days work be sent to the office. I email those requests to the teachers. Seems odd if I child is sick enough to stay home that they shouldn't be up late doing homework
When the outdoor allergens are bad, teachers wanted to let kids who had to stay indoors at recess stay in the clinic instead. Put a stop to that one quickly!
Is it summer yet?????
Maybe I am under reacting but my thought is you can't force them to take her in. Although vision is important, it is not life threatening. I agree if it is affecting her academically, then maybe the parent will be more likely to take action. Otherwise, document that you recommended a rescreen and the parent's response re: the MD recommendation. Good luck!
I think you did the right thing! I also would never deny care to something emergent but you don't want people to just assume you are there anytime something is going on on your campus. I like the "no ice after school". I learned early on that the earlier I get to school the earlier they start coming in. Same with after hours. I'm amazed at how many kids come to my door once school is out. My kids also go here so I am often hanging out waiting for practices, etc to end so I can go home.
My school actually looked at having an hourly nurse after hours just because we have so many extra curricular activities and sports. They decided it wasn't in the budget....no surprise!
I think it is a bad idea, but it's an ongoing battle here. Kids can definately be allergic to guinea pigs, hamsters, rabbits, etc. One teacher here actually had ferrets as class pets! The entire hallway stunk by the end of the year. Administration finally made her take them home.
I only send home for a fever. I may let a parent know if the throat just looks terrible (spots, patches, etc) but leave it up to them in regards to a pick-up. I will mention though, that we have had a run of kids with strep without fever, so fever may no longer be the tell-tale sign
Just yesterday a little boy came in "hyperventilating" because the boy next to him kept farting and the stink made him hypervetilate
mc3, If you send me your email address, I will send you a copy. We get them printed as a duplicate ay office max. I'm kfergerson@saintgeorgeschool.org