Excessive visits

KKEGS, MSN, RN · Mar 29, 2017

What is the 60 visit kid coming for?!? Is this elementary or secondary school?

momto5RN · Mar 29, 2017

Yes, elementary. 4th grader. He does have asthma and some visits were definitely needed. The rest are stomach aches, sore throats, congestion, etc. Driving me nuts. I have spoken to mom who is a nurse practitioner last year about overuse of the inhaler. That has pretty much stopped this year. I don't keep him for long unless he is having asthma issues . I think I may need to speak with mom again.

Nurse_JackieVA, BSN, RN · Mar 29, 2017

I have a few that have been here +20 closer to 30 times already.

I'm at the point where I just have them call their parents (if they're old enough) then I talk afterwards if they want to speak to me - they usually don't.

I had one 1st grader come to me 7 times in one day - various complaints (stuffy nose, hit finger on desk, paper cut, etc...) I went to the teacher and asked what was going on - she didn't want to deny him going to the nurse, okay fine but 7 times in one day! He's on my automatic call list.

I have several littles that will become incontinent when they don't want to be in class and one that likes to vomit so he can go home.

Brother and sister in competition to see who can see me the most in one year. Bonus points for phone calls home. Mom actually told me about this competition.

I have several kids on different plans to try to decrease the amount of visits to me. I have spoken with the Principal, Teachers, and Parents. I try to get everyone onboard. These kids are here to learn, not sit in my office doing nothing/playing.

Trust me my office is not fun, I hide the books and anything they can play with because I don't want my office to be a hang out spot or somewhere to play. If you're sick, you're sick - no playing. Peeing on yourself on purpose is not okay and I will not reward you by giving you fun things to do in here while we wait for Mom to bring clothes - some parents just won't bring extra clothing, grrr.

I had one kid ask me why I didn't have a TV because my office was so boring, lol.

MrNurse(x2), ADN · Mar 30, 2017

Brother and sister in competition to see who can see me the most in one year. Bonus points for phone calls home. Mom actually told me about this competition.

Oh, if this were my boys, the winner would wish they had lost!

cooties_are_real · Mar 30, 2017

I had one student that was in my office a total of 223 times in 2 years. We did it all. Called GM (who didn't know what to do and was taking her to the dr. all the time), teachers call me before they sent her, got principals involved, and she even wore out the counselors. Finally got her on a 1/2 day type plan that stopped some of it. This year her visits are way way down, partly due to her seeing an "adult" dr and new plan of care, however the biggest thing is she has a boyfriend she can only see at school.

JenTheSchoolRN, BSN, RN · Mar 30, 2017

I have students in the 30-80 visit range. And one student who last year saw me 117 times. And bragged about it. We tried some things, but to be honest, teachers were not consistent with it. And that was hard.

I had another student about 3 years ago with similar excessive visits, so we tried something different. This student got a one-time use daily nurse's pass. This student could use whenever they wanted during the day (except during tests/important class assignments) and it was a 5 minute visit. Once it was done, no more visits. So yes, the student saw me nearly every day, but this was an improvement over 3-4 times a day. And the next year, visits dropped to 2-3 times a week, and even lower this year. Progress!

NurseBeans, BSN, RN, EMT-B · Mar 30, 2017

I had another student about 3 years ago with similar excessive visits, so we tried something different. This student got a one-time use daily nurse's pass. This student could use whenever they wanted during the day (except during tests/important class assignments) and it was a 5 minute visit. Once it was done, no more visits.

I have a couple of 4th grade boys who have a teacher-initiated once-per-week pass. They use it, that's it. Barring an emergency, of course. That way there's no argument in the classroom when they ask to come see me, and they use it wisely. It really helped. I don't see them even weekly anymore.

WineRN · Mar 30, 2017

I have a couple of 4th grade boys who have a teacher-initiated once-per-week pass. They use it, that's it. Barring an emergency, of course. That way there's no argument in the classroom when they ask to come see me, and they use it wisely. It really helped. I don't see them even weekly anymore.

I really like this idea! I think I will try it in the fall with my returning frequents :)

Embralpn · Mar 31, 2017

This is my biggest problem. I started 2 weeks into school and got two days of orientation from the nurse who worked the first 2 weeks. I struggled with the sheer volume in the beginning - I'm better about getting them out of my office but can not figure out how to stop them from coming. I've got kids with 78 visits this year . I swear these kids talk and they know if they say they hit their head I'm gonna keep them for at least 15 min for 2 Neuro checks - even if I think they are lying because what if they aren't? Mine are 7-8 graders, I know every teacher can't know this kid has already been to the nurse twice today but still - if you send him every single day for a stomach ache? I'm on spring break, so I'm not as fitted up about it as i usually am, lol