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  • Sep 27

    OP, have you considered maybe building a "check-in" only plan with his Mom? I have some kids that I work with that can get physically sick when they get anxious. In addition to checking in with counselor, I had one student that could not focus unless she talked with her mom (and she was much older than 5). She would get physically sick and make herself miserable. At first I was resistant and realized that wasn't the way to go at all. So I talked with Mom and the counselor. We set up a "5 minute check-in" pass with Mom each day. No more than 5 minutes, could only happen during lunch or a study hall, and if Mom was unavailable, she could leave a message, but had to return to class. She was not allowed to ask Mom to pick her up.

    She used it regularly for a couple of weeks, but then it tapered off. She found her grove in the school year and lost the need to have that check-in.

    Now, I know negotiating with a 5 year old is very different, but maybe setting some kind of limit with him would help.

  • Sep 27

    After I listen to them drone on, I always like to start out my response with, "Well, you realize you are closer to death right now than you were when you woke up this morning."

  • Sep 27

    My favorite line that I use "I can see what is happening on the outside, I cannot see what is happening on the inside." With my population of affluent helicopter parents, I tend to over refer for musculoskeletal injuries just to cover myself.

    This morning, I was walking a possible wrist fracture down the hall. One of his teachers saw him in the triangular bandage/ sling and yelled "OH MY GOD, is he going to be ok??Poor baby, Poor baby." I ignored her. C'mon now - what am I going to say to that? "No, he is going to die!" Just made the poor kid more anxious than he already was.

  • Sep 27

    So, by chance if you come across a live one put it in a zip lock on your bulletin board and see how long it will live "outside" of a host; I mean for scientific research.

  • Sep 23

    Quote from kidzcare
    I send those notes out passively. As in, I do not sign my name on them and keep them very generic. It has the students name and the immunizations that are missing but it's on a template and signed "School Health Services" Then when the parents call, upset about the letter, I say something like "Oh, yeah. I heard those letters went out. It is our policy, blah, blah" Usually if it appears that I am just the messenger then they are much nicer to me.
    I had my principal sign them. Our state school nurse association recommends them coming from principals since kids can be excluded and that's not actually the nurse's recommendation in this case. I'm happy to follow that recommendation!

  • Sep 23

    Quote from BeckyESRN
    This reminded me; I saw this at football practice this summer and thought it was brilliant(this pic is from pintrest, but you get the idea)

    Back on topic:My c'mon now ocurred about 1 minute after students started arriving
    5th grade girl "I woke up at 6am and went to the bathroom"
    me: okay? was something wrong? diarrhea? pain when you pee'd?
    5th grader: "Eww, no. I just don't think it's normal to wake up just because you have to pee"
    me: That's perfectly normal, promise!
    5th grader: "Well, I think it's weird and I wanted to tell you about it"
    me: Okay, you've told me, now go to class
    I'm still confused about that entire exchange...
    My first conscious thought, every day of my life has been "I need to pee". My son can get up, eat breakfast, watch Mike & Mike for an hour- THEN pee. How is that?

  • Sep 23

    Creepy crawly. Very pretty girl with about 12 that I saw. And nits. An infestation.

    Teachers are panicking in the streets.

    This is the body of the letter I just sent:


    "Please be advised that lice cannot be spread from person to person unless their hair comes in CLOSE contact and the louse crawls from one head to another via the hair shaft.
    Lice do not fly.
    Lice to not hop.
    Lice do not wait on desks or chairs to attack the next unsuspecting victim.

    That being said, if you see students hanging all over each other, their hair (or anything else) in close contact, please break it up.

    If you suspect a child has lice, please send them to me immediately!

    Any questions please do not hesitate to call me.
    (I know your head is itching now…)

    Thanks,
    Far"

  • Sep 22

    It would be helpful if we knew the age of the student. You also need to know the answers to these questions: What is the severity of his hemophilia? Does he have inhibitors? Is he on prophylaxis? Does he self-infuse (many learn around age 7)? Does he have a port?

    In general, you do not need to stock any special supplies in classrooms. However, you should have a dose of clotting factor on hand and infusion supplies at your office (preferably refrigerated). Presumably, the mother is adept at mixing the factor and accessing his veins or the port.

    Most bleeds are into the joints: you are unlikely to see external bleeding. Teachers should send student to your office if he complains of joint pain or other problems (joint pain is typically treated with a dose of factor). The only true emergency you may encounter on campus might occur if the student sustains a hard blow to the head, which may cause intracranial bleeding and requires immediate infusion of factor. National Hemophilia Foundation has educational materials for teachers and nurses and your local Hemophilia Treatment Center may also provide training for you or the staff (as might the parent).

  • Sep 22

    Quote from kidzcare


    What did you say??

    I told the family member that that was NOT a solution! I also let the family member know that (from what the office staff said) the student had a very rough year after her head was shaved last year.

    The family member was blaming the student for not washing her hair, blah, blah, blah.

    YOU are the parent. YOU are responsible. I'm all for teaching our kids responsibility. But they cannot treat themselves for lice.

    COME THE HECK ON!

  • Sep 22

    Quote from BeckyESRN
    5th grader: "Eww, no. I just don't think it's normal to wake up just because you have to pee"
    me: That's perfectly normal, promise!
    5th grader: "Well, I think it's weird and I wanted to tell you about it
    After 3 kids in 2 pregnancies, this is my most reliable alarm clock.

  • Sep 21

    Quote from Amethya
    ...it really made me feel like a failure. A lot of the kids who came in here really like me, so when this happened, i feel like I really messed up.

    Have you ever had parents complain about you or anything in this aspect?
    Honestly… I get it. I would be upset by that form of communication, too. She was condescending to you and rude, but you have to LET IT ROLL OFF YOUR SHOULDERS. Don't take it personally. When I briefly worked in Paediatrics I was mentored by a very wise, older nurse who advised me to always remember the following (with all patient interactions, but especially with parents of young/special-needs patients):

    Think of these parents of patients as being armed with a “backback” full of worries, and often they’ll unload the contents of their “backpack” onto you. But it’s not you, they’re projecting all the crap they’re carrying in that “backpack”. It’s part and parcel to working with these little ones. Politely excuse yourself, go to the break-room, take a deep breath and re-visit the situation… Always bring attention to the fact... if they use inappropriate or violent language towards you. If the situation escalates or they try to (physically) attack you, you’ve can always immediately refuse care, call security or a Code White . Try to be helpful as best you can, but don't be anyone's punching bag (literally or figuratively).

    Hopefully you'll never experience an escalation, but you gotta just let those rude comments roll off your shoulders.

  • Sep 20

    This has happened to me occasionally. Teacher shows up a few minutes before the charter buses are ready to leave for their field trip, and wants the meds and first aid pack.......NOW !!

    Hey, did you ever give me notice ? No. Sorry...but you'll have to wait for a little while when I have the time to get it all prepared.

    Totally Pizzes them off !!

  • Sep 20

    I have some naked walls in my clinic that I need to fill up! I'd like to see some of your favorite School Clinic décor - Educational, Inspirational, Motivational !

  • Sep 20

    Quote from MrNurseXY
    I agree that an ounce (or few cc's) of prevention is worth a pound of cure, but Benadryl may work and the child doesn't go to the ED, if you give epi, it's an ED visit. Not to mention they feel awful.
    Supernrse01 But it's not always the first line of defense. I have several students that, according to their Emergency plan, are to get Benadryl first. Obviously, that stands to go by the wayside, based on the symptoms and what the student is telling me. What seems crazy to me is the fact that this particular student's Emergency plan specifically (according to the article) states that she needs the EPI first and the nurse still chose to call mom to confirm, before allowing administration.
    That is very dangerous.


    http://www.stlallergy.com/pdfs/Child..._Allergies.pdf

    ...There are several KEY POINTS that need to be fully understood and have changed the way experts now approach food allergy patients since new Food Allergy Guidelines were published in the fall of 2010. Not all Emergency physicians or ambulance EMTs, doctors or nurses are yet aware of these changes in the updated Guidelines.

    1. If there has been a suspected INGESTION of a food to which your child is allergic and any body-wide (systemic) symptoms occur, Epi Pen or Epi Pen Jr should be given immediately without hesitation and then you should call 9-1-1!
    2. Benadryl is no longer recommended for allergic reactions due to food allergy INGESTIONS as it does NOT stop anaphylaxis (a potentially life threatening and rapidly progressive body-wide reaction).
    3. Benadryl may help a rash from a skin contact to a food allergen, but it takes 30 to 60minutes to begin working. Always wash off any area on the skin where a food allergen has contacted.
    4. There is NO HARM in giving an Epi Pen or Epi Pen Jr for a suspected food allergy reaction. Fast heart beat and shakiness are major side effects for about 15 to 20minutes, but failure to administer epinephrine injections or a delay has resulted in fatalities. .....



  • Sep 20

    The majority of mine say Benadryl first as well, then I have to hound the parents to send it.

    Someone from the school should have definitely went with her. But as I think back to the two times I was transferred via EMS to the hospital, no one rode with me.

    I am confused on why the school is paying her medical bills? Had the nurse given the epi-pen just a bit sooner the outcome would have been the same, no? Either way 911 would've been called and she would've ended up in the ER.

    Using peanuts as a substitution?!?! The cafeteria should be in more trouble than the nurse in my opinion.


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