Help - GI bug

[GatezRN]

Hi All!

First year as a school nurse. Officially "christened" into the job yesterday by a Kindergarten student with a belly ache. For over a week now, so many kids with GI illness. I sent 12 kids home today which is huge for my little school of 140 (PreK and K). I'm definitely monitoring handwashing, sending the sick ones home, and have spoken to the custodians about bleaching all surfaces. All nap time blankets are being sent home today to be washed. What else can/ should I do? I'm thinking if the situation doesn't turn around by next week having the drinking fountains shut down and requesting all kids bring a water bottle from home.

[schooldistrictnurse]

Maybe a letter home to say "we are seeing a lot of diarrhea/vomiting/whatever

"illness at school xyz. Please keep your child home if they are showing the following symptoms: xyz. Children should be fever-free for 24 hours before returning to school. Children should be free of vomiting and /or diarrhea episodes for 24 hours before returning to school. Remember to have an emergency contact available to pick up your child if they become ill at school. Help us keep all our students healthy.

[kidzcare]

I sent home a letter about a GI bug once and it did not go well... the next day almost 200 of 950 students absent, calls from parents about how we must not be cleaning the school, kids piling up in my office. At my school, the primary symptom was stomach ache- which any kid can say they have, so it was an insanely awful day. Best of luck!

[Farawyn]

Stomach bug here, and with the teachers, too!

[Massmagic]

Yas, the letter home to parents never works well for me. It is like mass hysteria when a letter goes home. Plus, the kids think they are sick or going to get sick because they are hearing about it.

Just recently our Tech teacher was out sick and when she came back to school she told all her class how sick she was and her symptoms…..well, I had so many kids come in thinking they had what the Tech teacher had because she was in their classroom the day before she became ill. Or they told me My tech teacher said she was dizzy and I am dizzy, I think I am getting what she had.”

The GI bug goes around all the time. I do not get upset as there is nothing that can be done. I never get upset or react as the kids pick up on it. It is very hard to stop that virus in a school setting or any setting for that matter. I just keep telling the kids to wash their hands. People over react and I am not downplaying the illness as it is not pleasant as we all know, but the kids pick up on the fear and anxiety of it all.” There is really nothing you can do….encourage good hand washing…that bug goes around all the time. Don't sweat it…it too shall pass.

[RatherBHiking, BSN, RN]

Our kids don't go home just for stomachache. No fever, no vomiting, no diarrhea then no going home. Now if they are super young, looking green, or i just have a gut feeling then I will send them but that doesn't happen very often. If they can eat breakfast and lunch and play at recess then they can stay as well. I had a few today saying they didn't feel well and we're putting on a good show, coming back a second time, etc but I saw them in the hallway later and they were as happy as a clam so be careful you don't have a lot of fakers. I think kids need to learn it's ok to stay in school even if you don't feel wonderful. Also, once one kid sees another going home with the only symptom of a stomachache then all of a sudden they all have one.

However, it is that time of year where you will have lots of fevers and vomiting. We instituted a county wide handwashing program several years ago so all classrooms have either soap or hand sanitizer in their rooms and we do a handwashing program on every grade every year if teacher willing. Kids required to wash after bathroom breaks, before eating, after recess, etc. It's cut down illnesses a lot. Also, we push no returning to school until no symptoms for 24 hrs which helps. Other than that we don't make a big deal out of it-it is what it is.

[mariebailey, MSN, RN]

You likely have a free resource at your disposal that can do some of your work. That's your local health dept., and they should be notified in what appears to be an outbreak. You goal is to contain the outbreak, which can be accomplished through appropriate environmental disinfection and parent guidance on when to keep their kid home from school. I strongly suggest letting public health help you. Hope those kiddos get well soon!

[blue bag nurse]

I just feel like stuff has to work it's way through. You are doing the right things, and I agree with the others about not sending a letter. Puke happens. Stay healthy!

[mariebailey, MSN, RN]

I just feel like stuff has to work it's way through. You are doing the right things, and I agree with the others about not sending a letter. Puke happens. Stay healthy!

Nope. A letter is prudent and appropriate. A letter demonstrates action. A letter could prevent other students from getting sick by telling parents to keep their sick kids home.

[fetch, BSN, RN]

Nope. A letter is prudent and appropriate. A letter demonstrates action. A letter could prevent other students from getting sick by telling parents to keep their sick kids home.

Spoken like someone who is not a school nurse . . .

Truly no offense meant, but parental reaction to health letters varies wildly by each school building, depending on the culture of the area and the age of the students. Sending home a letter in a PreK and KG only school could result in mass absenteeism as parents over-react and keep home perfectly healthy kids, which doesn't sound too bad on the surface, better safe than sorry right? But in actuality, if they keep home healthy kids and see that the kids are perfectly fine, in my experience they'll be less likely to react when the kid is actually sick. "Last time you sent my kid home and they played all day long, I'm not coming to pick them up today because they're just faking it!" is a dreadfully common phrase to hear.

On the other hand, it might increase awareness, especially if the letter is carefully worded to say "please keep your child home if they have XYZ, but if they have ABC then they are fine to come to school unless more symptoms develop." It really does depend on the culture of the school, if one parent decides to take to the school Facebook group and blast about something, if the teachers are over-reacting, etc.

If I called the health department for every cold that worked its way through the building, it would literally be a daily thing.

[blue bag nurse]

Ahhh, Fetch, thank you. And you nailed with mentioning the culture of the school. If I sent a letter home, everyone would stay home as a precaution until I deemed it safe to return.

[rollernurse365]

In general, if I see a trend in a particular class or 10% of our total school population is affected, I will send a notice home. It simply says _______ School is seeing an increase in _____. List symptoms. Assure proper cleaning measures are happening at school. Reiterate policy on when children may return to school. That is it. This way, I have performed my professional duty and parents are on the hook to some extent.

I keep a running list for myself on things like flu and strep which helps track total numbers and identifies if a pattern is emerging.

I'm not saying this will fix your issues but it does give you some written verification of communication with parents and staff.