Inappropriate to ask teachers to stop sending kids after a certain time?

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School gets out at 330. Yesterday I had 24 kids sent to my office after 3. We have to document quite a bit about every student that comes in. Every single one was headache/stomachache. Today...19 after 3. Ok if someone has some bleeding mess, loses consciousness, is a diabetic, walks home and seems legitimately ill then fine...but I'm thisclose to sending a mass email saying look if a kiddo says oh my head hurts or my tummy hurts and there's 30 minutes left of the day let's use common sense and say ok lay your head on your desk for a few minutes and tell your parents when you get home. Especially when I've already sent them back twice that day. Or am I being nit picky? So I end up staying hours over to actually do documentation and paperwork. They always send them with their backpacks too basically getting them out of their hair for the day. so I waste snacks and drinks trying to placate tired, hungry, grumpy kids...and have to do vitals and document the time, their complaint, my assessment, my interventions, and their response. Then if I have a kid until dismissal I have to treat it like a send home and do extra documentation. Really teachers?!?

Specializes in School Nursing.

Ah, yes, for chest pain (which I don't get often), I would do full vitals, no matter what. I used to do the same for dizziness (when I was wee newbie), but I see that complaint so often I try water/snack/rest first (if students seems well otherwise), and it often resolves (or I notice the student is quite talkative, and I say, "Oh, you must be feeling better?". ;)

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Specializes in school nursing, ortho, trauma.

sometimes too i gently mention to the kids "i know your (fill in complaint) , but do you think you can tough it out until dismissal. That's only XX minutes away." Majority of the time, the kids have no idea that we're leaving in 5 minutes and their symptoms disappear right before my eyes. Miracles happen in my office ALL. THE. TIME.

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Specializes in Psych, Peds, Education, Infection Control.
sometimes too i gently mention to the kids "i know your (fill in complaint) , but do you think you can tough it out until dismissal. That's only XX minutes away." Majority of the time, the kids have no idea that we're leaving in 5 minutes and their symptoms disappear right before my eyes. Miracles happen in my office ALL. THE. TIME.

Time heals everything...

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I agree with WineRN, check them and send them back, "ok to make it til dismissal".

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Specializes in School Nursing.

I would gently bring it up to the teacher and DEFINITELY send any kid without a fever (or other EMERGENCY) directly back to class. I have very little patience for kids being sent to me in the last 30-60 minutes of class. Most of the teachers at my school know not to send kiddos first thing because attendance incentives.

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Kids can pretty much come and most times if you are on the clock. Just try to get control over why they are coming.

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Nurse to Nurse, what the hell are those teachers thinking? For Christ's sakes have some professional courtesy! Taking a step back I'm sure it's more complicated, you've got latchkey kids and kids headed to after school programs and day cares where there is no nurse, so they may have actually put in some brain cells.

From the licencing liability level, for the love of God don't put anything in writing! Teachers are not triage, they may have enough experience to know most of the time when a student is faking or attention seeking, but they aren't licensed to make that call, you are. You could casually bring up around the water cooler how all the kids seem to get sick at the same inconvenient time so if they could catch it earlier it would be helpful.... they might get the hint.

You don't need me to remind you about the wrath of parents. When I was in Jr. High, I had In School Suspension and started feeling terrible, I sat in the nurse's office for an hour and she didn't look at me. When I heard her tell a friend on the phone she only had one kid in the office right now "trying to get out of suspension" I got up and walked out. I called my mom from a pay phone and she came to get me... I had a 104 temperature and turned out to have Mono!

My mom was an RN, she reported the school nurse to the BON for failing to assess her patient, falsifying documentation, and I'm sure anything else she could think of. They didn't even wait till school was out to fire her. I felt like such a *****, I never meant for that to happen. I just felt like ****, wanted to go home, and wanted my mommy. But I tell this story a lot as a pediatric nurse. CYA has a whole different meaning when your dealing with people's kids.

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Specializes in School nursing.
Nurse to Nurse, what the hell are those teachers thinking? For Christ's sakes have some professional courtesy! Taking a step back I'm sure it's more complicated, you've got latchkey kids and kids headed to after school programs and day cares where there is no nurse, so they may have actually put in some brain cells.

From the licencing liability level, for the love of God don't put anything in writing! Teachers are not triage, they may have enough experience to know most of the time when a student is faking or attention seeking, but they aren't licensed to make that call, you are. You could casually bring up around the water cooler how all the kids seem to get sick at the same inconvenient time so if they could catch it earlier it would be helpful.... they might get the hint.

You don't need me to remind you about the wrath of parents. When I was in Jr. High, I had In School Suspension and started feeling terrible, I sat in the nurse's office for an hour and she didn't look at me. When I heard her tell a friend on the phone she only had one kid in the office right now "trying to get out of suspension" I got up and walked out. I called my mom from a pay phone and she came to get me... I had a 104 temperature and turned out to have Mono!

My mom was an RN, she reported the school nurse to the BON for failing to assess her patient, falsifying documentation, and I'm sure anything else she could think of. They didn't even wait till school was out to fire her. I felt like such a *****, I never meant for that to happen. I just felt like ****, wanted to go home, and wanted my mommy. But I tell this story a lot as a pediatric nurse. CYA has a whole different meaning when your dealing with people's kids.

In this circumstance, you should not feel badly about it! Yes, we're human and can miss things like a minor fracture here and there, but a kid with a 104 temp usually presents with a ton of physical red flags. A basic temp check is one of my go-to tools, regardless. I have a temporal thermometer sitting next to me on my desk that gets a workout every day, even for the students I see 30 minutes or less prior to dismissal.

Now, as for the OP - I had a problem with tons of not necessary visits near dismissal. I mentioned it casually to my boss who helped me brainstorm ways to handle it (we both knew approaching with teachers directly wasn't always the best idea to do in writing). Not a ton worked, unfortunately and we do have a lengthy afterschool program for our MS kids that has a lot of them staying at school until 5 PM. But a kid never stays with me to be dismissed by me unless they truly need to be. Otherwise, I assess and back to class they go.

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Specializes in school nursing, ortho, trauma.

indeed! i may inwardly (and sometimes outwardly!) roll my eyes but if a kid says they feel sick, hot, chills i check their temp. I get enough calls from parents from kids I never even saw that day. Why make it harder on myself? Same goes with icepacks. They don't leave my office, so the kids don't get a trophy to show the rest of ther class. if the terrible injury from "bumping their arm in the desk" (the horrors! someone queue up Lifestar) is bothering them enough for ice, them put it on there. I have to chart the visit anyway. Ice is already clicked off in the template. Usually they are done with the ice before I'm done with the chart. It beats getting the irate parent calling and tearing me up for not giving them some ice for their traumatic boo boo.

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Specializes in kids.

You cannot win by asking them not to come that late. Asses them and send'em back!

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agree. i am careful about telling teachers not to send kids since that headache may be a raging fever - i check. if it's nothing quick drink and on your way - or better yet, "hit up the fountain for a nice long drink on your way back and tell someone when you get home if it's still bothering you." I get enough calls from irate parents that get their kids coming home with fevers that I haven't seen at all that day, why give them ammunition by putting a limit? I do think it's odd when a teacher sends a child a 5 minutes to dismissal on a friday for a temp check, especially when the kid looks at me perplexed and says they feel fine. But this is why they pay me the big bucks :roflmao:

I ABSOLUTELY LOVE THIS POST. I see your posts all over the school nursing forums and your posts are always so helpful, thank you!

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Our middle school did send and email and told the teachers at the beginning of the year during a staff meeting that the Health Room hours were from 9:00-3:00 (school was open from 8:45-3:25). We explained that the times before/after those were for kids with medications, our diabetics students, and emergencies only. Emails were sent throughout the year to gently remind teachers. If a kid showed up outside those times, we would ask them why they were there and decide whether or not they would stay. We did turn kids away- headache, vague stomach ache, random pain with no swelling or sign of injury- and remind them that they were about to go home and that there was nothing we could do for them. The early birds were told they could call home if they felt that badly, or to go to class and if they needed to come back during open hours, please do. Most didn't come back.

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