District Policy doesn't back up nurses.

Specialties School

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Hello my school nurse friends,

Just found out and read that our District does not back the nurses up or the medical stand point. I just got through reviewing the district policy and it does not back me up. The only thing in the policy on a medical stand point, is if the parent thinks his/her child has a fever, it is better to keep him/her home. So if a child comes in the clinic with a high fever, I can only suggest that mom or dad take them home. And it's the parents choice whether they want to send them back to school the next day. If a student has a communicable disease, they may be readmitted only by the school office. Why do they need a nurse? I have no say so in anything here at this school. Does any of you guy's district policies back ya'll up as nurses?

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Specializes in Pediatrics Retired.

We have written school district policy guidelines by which to exclude from school; temperature of 100 or more, for example. You might check to see when your district policy was written. If it was long ago or before there was a school nurse, it's likely attention just needs to be brought to the right person and it be re-written. If it was written, or changed, recently, the district is subverting your RN license to let you have all the responsibility for school district health with no authority to implement it. That way they don't have to ever upset a parent; they can just use you as their scapegoat at their convenience. Check it out...let us know.

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We have written school district policy guidelines by which to exclude from school; temperature of 100 or more, for example. You might check to see when your district policy was written. If it was long ago or before there was a school nurse, it's likely attention just needs to be brought to the right person and it be re-written. If it was written, or changed, recently, the district is subverting your RN license to let you have all the responsibility for school district health with no authority to implement it. That way they don't have to ever upset a parent; they can just use you as their scapegoat at their convenience. Check it out...let us know.

Well OldDude you are right about being their scapegoat. The policy was recently updated last month. Wow...I feel as if my hands are tied behind my back. Smh..

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Specializes in Pediatrics Retired.
Well OldDude you are right about being their scapegoat. The policy was recently updated last month. Wow...I feel as if my hands are tied behind my back. Smh..

Ugh. I frequently use the term "industry standard" because it is self explanatory and applies across the board as to what you are referencing. I would suggest your next step is to approach administration and, as a courtesy, inform them their school district policy is not in alignment with the industry standard for the health section and offer to help them rewrite it and bring into a more comparative updated. If they aren't interested, and you like working there, use it against them and scapegoat back their scapegoating. Tell the complaining parent you have no enforcement authority and to speak with the campus principal about their concern. Good Luck. Keep us in the loop.

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Specializes in NCSN.
Well OldDude you are right about being their scapegoat. The policy was recently updated last month. Wow...I feel as if my hands are tied behind my back. Smh..

That is a tough and dangerous situation for you to be in. There may be situations where your nursing judgement HAS to trump what a parent might want (giving epi, calling 911, sending home etc).

If possible I would start to look at a different district.

If not possible, I would gather some resources from NASN and your states nurse practice act and present them to your admin team so they understand that your polices need some updating.

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Specializes in school nursing, ortho, trauma.

There is going to come a time (if there hasn't already) that a parent is going to send their profoundly sick child in and say "I think they're fine." Which will be code for "I couldn't take time from work" or "i didn't want her home with me - i have errands to run". The child will then either have to camp out in your office for the day or will have to try class and potentially infect the rest of the class. If the kid is camped out by you, it's not a perfect solution. It's taking up space and creating a source of germs in your office and is not restful for a child who should be home recovering. I am hoping on that day (if it's already come, don't worry, it will come again) that your admin realizes that you're not a babysitting service for sick children and that THIS is why we have a policy with teeth in it for the nurse.

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There is going to come a time (if there hasn't already) that a parent is going to send their profoundly sick child in and say "I think they're fine." Which will be code for "I couldn't take time from work" or "i didn't want her home with me - i have errands to run". The child will then either have to camp out in your office for the day or will have to try class and potentially infect the rest of the class. If the kid is camped out by you, it's not a perfect solution. It's taking up space and creating a source of germs in your office and is not restful for a child who should be home recovering. I am hoping on that day (if it's already come, don't worry, it will come again) that your admin realizes that you're not a babysitting service for sick children and that THIS is why we have a policy with teeth in it for the nurse.

Before the policy issue came and before I actually read the district policy, I have just been sending the students home. But the secretary brought it to my attention that a parent might use that it's not in the handbook to send a child home for fever. So....I guess it babysitting time! Not gone happen!

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Specializes in school nursing, ortho, trauma.

if no one's brought it up, then keep doing you! i'm on the same page with OD that school policy is one thing, but best practices are another. You would certainly not keep a child in school if they had a fever of 103.7 because the policy said they didn't HAVE to go home. Any principal that feels otherwise needs to really re-evaluate their standards.

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Just wait until you have a lice outbreak and the parents send their kids to school. I bet your school will want the policy changed then! Nothing brings out the crazy like those flying lice. :laugh:

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Just wait until you have a lice outbreak and the parents send their kids to school. I bet your school will want the policy changed then! Nothing brings out the crazy like those flying lice. :laugh:

You got that right! LOL!!!

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Specializes in School nurse.

Do you have a contract with a physician who is the school doctor? In NJ we are required to have one, usually local, and they write orders that include exclusion criteria. Or, you could work with local PH and get them to give you the industry standard, as OD said. Good luck and let us know.

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Specializes in Med-surg, school nursing..

I would speak with admin and let them know that by them not having any policies in place, it is placing the responsibility (blame) on them should something bad happen, like another poster who had a child have a febrile seizure while waiting for parents. Your policy isn't even for the parent to be called, which is stupid.

If you have a nursing supervisor, have them back you, I know they will. Either way, policies need to be written, and you need to be involved. This is a huge liability for the school in my opinion. And as a PP said, if a parent comes in upset that Susie told her there were four sick kids in her class, tell them that you have no policy to send kids home for fever, vomiting, plague, etc.

Do not let it fall back on you should something go wrong, that said, I would put it in an email so you have a paper trail that you asked for the policy to be revised. That way admin can't say "Well, MrsNurse never led us to believe there was anything wrong with our policy, her being the nurse, she should've made us aware."

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