attendance a nurses job?

bergren · Feb 8, 2003

Attendance is a tough nut. On the one hand, it is great to know who is out of the building and why. On the other hand, it is a time consuming clerical duty that someone else could do and give YOU the report. I am familiar with school nurses receiving calls from parents or even taking the messages off of the attendance phone line regarding illnesses. In the schools I am most recently familiar with, parents must leave a message on the phone line if a child is not going to be attending school. A clerk or a school nurse, depending on the district, then records the information. It is then a clerk's responsibility to reconcile the calls with who is actually there. Part of the reason for this process is to be alert for possible abductions - has anyone who was expected at school not shown up? It is imperative that this be completed and followed up on early in the day. It does not help to have the attendance class completed by 12:30 pm and realize a child did not show up. This is usually why a school nurse cannot do it. I am personally not familiar with nurses getting a report from the teachers of who is present and who is not. Is it relayed to you via Phone? What do you have to do with it before sending it to the clerk? This does not seem to come under the school nurse's health role. Did you question this after you were hired? Does your immediate supervisor know you are doing this? What then does the clerk do? Why are so many people involved in this process? Why not streamline it and send the reports (written) to the clerk and then she can copy you for an FYI? Has anyone looked at the process regarding what makes sense, or is this how it has "always been done"? What year did this process start? I suggest asking your immediate supervisor to meet with your in your office regarding this issue DURING the time the absentee information comes in. It would seem that this is a process that is setting you up for medication errors.

See article below:

New study shows medication errors high among school nurses. A study commissioned by the Midwest Nursing Research Center shows that half of all school nurses reported errors in administering medications, primarily drugs to treat Attention Deficit Hyperactivity Disorder (ADHD). The error most often cited was missed doses, but others included dispensing the incorrect medication and administering medication without proper authorization. The errors occurred despite the fact that more than 98 percent of school nurses had access to medication guidelines. About 3 percent to 5 percent of children, mostly boys, are diagnosed with ADHD or related disorders. The survey also revealed that 75 percent of respondents delegated the administration of prescription drugs to people with little or no medical training. Secretaries were the most common delegates, followed by principals (62.2 percent), health aides (42.2 percent) and teachers (18.1 percent). Medication errors were more than three times more likely to occur when unlicensed personnel did the dispensing, the study found.

(2/16/01) http://www.aft.org/healthcare/schoolnurses/news.html

MomNRN, BSN, RN · Feb 8, 2003

I do the attendance list and phone calls. All teachers complete the little slip and then it gets routed to me. I don't know why the nurse gets to make the phone calls. I guess it is one of those things that has been done that way forever.

We only have 139 students and about 10-15 absent daily. This is a special needs school and 99.5% of our students arrive by bus. These buses pick up students at their front door, so abduction isn't a direct threat! Our bus drivers are fabulous and usually know more facts about the kids and their families than we do!

I try to contact all homes of absent students. Many do not have phones, have phones that are temporarily disconnected, or do not have answering machines. I do not go through their emergency contact listing if they do not have a phone.

I may have to resort to that soon though. We had one student whose mother left him home alone to catch the bus. He left before the bus got there. Teacher reported him absent. I contacted the home - no answer. Since this student is absent at least once per week and his parents do not call him in, I did not panic. In the future, I will contact his mother at work.

Is this my job as the nurse? Not sure, especially since I don't always have time to do the calling. If more instances like the one described above occur, I will be passing this job on to the secretaries!

Mrs. · Feb 8, 2003

Thank you all for replying. This can be such a lonely job. There is no one close by to commiserate with. Here's the story. I work in an elementary school with about 425 kids (K-5). At this point the teachers mark a class list daily showing who is out and send me the list and cards for those students. I collect all these and create a list which I update throughout the day as kids sign in or out then send it to the attendance officer in the high school. I am required to make calls regarding absence and to notify the principal of kids with excessive absenteeism. I definately do not have time to call on every child but I have a list of twenty or so kids whose parents signed a form letter requesting notification for all absence. I call for children who are out for three days. As it is, I am not able to make these calls until at least 9:30 because it takes that long just to go through the lists and see who is out. There are days that it is quite late because so many kids come to me for medical care that I can't even begin looking at the lists until quite late. The principal is aware of the situation, but the district is just not one which coughs up money for help without a lot of prying. This area resists new business in an attempt to maintain its rural air so the tax base is small. I get the assistance of a paraprofessional from 10:30 to 11:45 ( too late to leave the attendance for her to do) but that is just for now as her schedule is free at that time for this year. I usually end up putting her on office watch so that I can touch base with teachers to clarify discrepancies in the attendance- a daily problem. Some days I just want to throw up my hands because I can't keep up with it all and they seem to always want more. I just love those days when I am bombarded with sick kids, meds to pass, excuses to collect and organize and some teacher comes in saying they just had a meeting about so and so and they decided the nurse should call the mother to discuss things. I look at them and think about how I work twice the hours I once did and make half the pay. I think about how they discuss a child in depth in their interdepartmental meetings and have all the information on the situation and then ask me to take care of these calls blindly. Then I think of my daughter and how I missed her when I worked at the hospital and I plug on.

MomNRN, BSN, RN · Feb 10, 2003

How rough for you! Don't you sometimes wonder how the attendance job falls into nursing services? I do agree with you regarding busy days and not enough time to do attendance.

The only benefit for me doing attendance is that I know who will not be there to take their meds. Our offices distributes 75-80 regular daily meds. When I know who is absent, I don't have to track kids down!

Recently my daughters' school asked for parent volunteers. They help anywhere needed - playground, lunchroom, library, or office. Maybe you could get a parent or two to help.

The best advantage of school nursing - time with my kids!

dherb · Feb 10, 2003

My office does the attendance through the computer using the"Mac School" program. My secretary does the actual computing. It is usually is fast and efficient unless the network is down. We also take homework requests for a student absent for two or more days. It is hectic now during flu season!

Mrs.B · Feb 11, 2003

I wish I had seen this posting sooner!!!!

I work at a secondary/high school with just under 1,000 students in a relatively poor area.

Things are pretty complicated at my school regarding attendance too! I have the glorious honor of signing in the tardy kids during homeroom and first period. I am bombarded by a minimum of 60 kids DAILY who all need late passes. After which, a duplicate copy of their late pass needs to be filed. Students with 5 or more unexcused latenesses get lunch detention. BIG DEAL. There are students that are late EVERYDAY and think detention is FUN. Do the teachers take attendance every period? Absolutely not, that's not a teacher's responsiblity (that's a direct quote). Do parents call me when their kids are going to be absent? Maybe about 30% of parents call their kids in. The others? Who knows. The attendance situation at this school is very dangerous. There are probably truants wandering around this town everyday. Believe me, it's not a big town.

As for F/U calls with parents regarding absences...I'm lucky if all of the late passes and absentees get entered into the computer by 11:00!! I absolutely do not have time to hunt down parents.

This is my first year at this school and let me tell you, I'm getting ready to jump out the window with this attendance crap sometimes. The other nurse in my district feels the same way and we plan on forcing the district to change things or hire more nurses.

IT IS NOT A NURSES JOB TO DO ATTENDANCE. I am here to maintain the health and well being of the students and faculty. There is no reason why half of my day needs to be monopolized with busy work. Yes, I'd like to be informed when a student is hospitalized or fighting a serious illness. Do I need to know that Tommy is going to miss 5 days cause the family is going to visit grandma in Florida? NO.

Nurses are given the attendance responsibility b/c we are cheap labor and are less likely to stick up for ourselves (little or no barganing power).

Frankly, thing will probably not change here untill a student is found dead on the side of the road.

I agree with Mrs. I too love the days when I am asked to F/U regarding a situation with a student after not being included in their "crisis intervention." I had a student last month who threatened suicide to the school psycologist. I found out about it, not from a faculty member but from another student!!! Meanwhile, the student who threatened suicide is wheelchair bound and uses my bathroom at least twice a day b/c it's the only one that is w/c accessible. Does he lock the door when he goes in there ALONE? Well of course he does! I couldn't believe that I would be ignored like that. But heaven forbid they need me during my lunch break cause Johnny needs an ice pack or some such nonsense.

Sorry for being so sarcastic and angry but I feel very strongly about all this... :)

Mrs. · Feb 11, 2003

I get very angry too. I couldn't believe it when the teachers balked at having to be responsible for classroom attendance. I thought we were all in this together, silly me. I just ried to keep the sarcasm out of my original post because I didn't really know what the rest of the world does over these issues.

It's insane that they didn't see fit to inform you about a suicide threat. I just don't understand how they can have all these multidisciplinary meetings and leave out the health office!

I had a meeting with the principal today and we discussed how I feel about being assigned to follow up on issues that I was not present to hear about. She took notes and is hopefully going to make sure I am better informed in the future.....we'll see...

Mrs.B · Feb 11, 2003

I sometimes don't think that the teachers understand the situation the nurse is in. I mean, as far as attendance goes, how many students per day could they, the teachers, possibly be asked to be responsible for, 70 or so? In an elementary school that number would be far less without a doubt. The nurse, (notice I used the singular form not the plural b/c it is just little old me in that office!) should be responsible for the attendance of nearly 1,000 students! Teachers KNOW who is supposed to be in their classrooms and when, the nurse may have direct contact with 30 students a day. There are many students in my school that I've never met before and couldn't pick out of a line-up! So why should I, the nurse, isolated in my little office be responsible for determining the whereabouts of all of these students?!

I'm glad that your principal was willing to sit down and listen to your concerns. My principal is very good at listening too. Unfortunately, he is a very busy man and I think that the nurse is very low on his priority list, that is, IF nobody is hurt or sick...

MomNRN, BSN, RN · Feb 12, 2003

Enjoyed reading both of your posts! Mrs B - I can't imagine with a school of your size that they don't have a secretary whose job is purely attendance issues!

Today my jr high daughter was ill and I forgot to call her into until about 10:10 am. I was mortified! Did they even know she was gone? I highly doubt it!

My big adventure for the day - a student whose lunch contained cockroaches as well as lunch! :eek: What is even more gross, but slightly humorous, is her lunch is kept in one of the staff refrigerators. What I asked at the meeting to discuss the issue, was why was her lunch kept in the fridge? Can't her mom put an little ice pack in her lunch like I do?

So anyway, the cockroaches are not only a problem in her lunch, but on her clothing, backpack, etc. We are contacting DCFS on Thursday. I'm sure they will hop right on it!

attendance a nurses job?

Do you keep attendance?