Is this normal or okay??

Specialties School

Published

  • Specializes in Home Health, Mental/Behavioral Health.

It's come to my attention that my kids' school nurse has had to leave early on several occasions, that I personally know of. I'm sure there's been more cases that I'm not aware of though. In her absence, the school secretary has been providing "boo boo" care to the kiddos.

The other day my little girl was apparently running at super speed during recess, tripped and took a nasty spill. The secretary took care of her and sent her back to class. No biggie IMO. She didn't need much, just a quick "rinse and patch" ...

But what if it was something more serious, requiring a trained eye to identify needs beyond just a quick clean and cover technique? The incident report says it was at 1:55 pm. School ends at 3:30pm. Large gap to not have a nurse, I think anyway.

What if it was my son, who needed his PRN inhaler? Is the secretary allowed to do that?? I don't know :confused:

I'm not sure why their having problems getting a sub for this nurse, or what she's going through. I hate to sound over reactive. But I would feel much more comfortable knowing there were a trained nurse staffed during the entire day, especially at an elementary school.

Should I bring this up to the principal? I don't know... it's just unsettling to me.

MrNurse(x2), ADN

2,558 Posts

Specializes in IMC, school nursing.

Depends on your state law. Is every school required to have a nurse, as many districts have a shared nurse, leaving office staff to fill in (could that be why she is "unavailable"). I rarely have times when my sub (my wife) can't fill in because of obvious reasons, but I work at a private school. There was no nurse here 19 months ago, they had 2 major incidents, both to staff kids, but they realized they dodged a huge cannon blast without a trained staff here.

BeckyESRN

1,263 Posts

Lots of schools operate without a school nurse on a daily basis. Some districts employe one nurse for several school, others use a part time nurse who may be there a few hours a day 3 or so days a week. Even in my district, where we have a full time nurse in every building, there are days that a few nurses may "come in late" or 'have to leave early' in order to cover the private schools in the area(by law, the school district has to cover the private school screenings and immunization compliance). A lot of schools train staff to administer medications. If a serious injury occurs, staffs calls the parent and/or 911.

kidzcare

3,393 Posts

What if it was my son, who needed his PRN inhaler? Is the secretary allowed to do that?? I don't know :confused:

I'm not sure why their having problems getting a sub for this nurse, or what she's going through.

Should I bring this up to the principal? I don't know... it's just unsettling to me.

As others have said, it's very possible that the nurse covers many buildings.

On the medication sheet you turned in with your son's inhaler, it is probably indicated that by signing the form you agree that another staff member can administer the inhaler if the nurse is not available.

If I had to speculate, I would guess that the reason they have a hard time finding a sub is because they pay subs garbage. My current district has internal subs but in my last district it was finally raised to 17/hour after being $88/day for the longest time. For an 8 hour day that works out to $11/hour.

If you feel so strongly about it, you could always take it to the principal or the district. If enough people complain, maybe they will find room in the budget for a FT nurse in every school

BabyFood26

203 Posts

Specializes in Home Health, Mental/Behavioral Health.

Wow... shows how clueless I was! Thanks guys for getting back to me. To be honest, I just feel a lot better now knowing that this is more common/normal then I originally thought.

I haven't noticed any problems with the way this operates for my kids' school so far. So I'll just take a chill pill for now lol

Thanks all

Windchaser22

408 Posts

Specializes in School nurse.
Wow... shows how clueless I was! Thanks guys for getting back to me. To be honest, I just feel a lot better now knowing that this is more common/normal then I originally thought.

I haven't noticed any problems with the way this operates for my kids' school so far. So I'll just take a chill pill for now lol

Thanks all

but after finding out your state law and how your district policy is implemented, perhaps this is a time to make a positive change. Less than half of public schools in the US employ a school nurse. Rolling the dice, to me, just so the district can save a couple of bucks, is not a best practice. We need more parents to speak up since few listen to us.

BabyFood26

203 Posts

Specializes in Home Health, Mental/Behavioral Health.
but after finding out your state law and how your district policy is implemented, perhaps this is a time to make a positive change. Less than half of public schools in the US employ a school nurse. Rolling the dice, to me, just so the district can save a couple of bucks, is not a best practice. We need more parents to speak up since few listen to us.

Good point, I'll definitely keep a sharp eye. My state of residence is Ohio, and to be totally honest I am having a hard time sifting through the laws and regulations. I'm on a mission though. Believe me, I will get clarification soon! I'll probably have to talk to the school. All this small print is giving me a headache!:facepalm:

Specializes in CVICU, SchoolRN, MICU, PCU/IMU, ED.

I was just recently hired at an elementary school that didn't have a full time nurse. They had a part time nurse three days a week then the medical designees were able to pass meds and do other parts of my job on the other days. Basically if anything happened they just called the parents and let them decide what they wanted to do.

You could bring your concerns up to the principal but there could be many reasons why there isn't a full time nurse at the school. In my district alone there are still two empty elementary schools and we have no subs.

caliotter3

38,333 Posts

At the school where I attended with my patient, the school nurse divided her time between several schools in the district. She spent X number of hours at this campus on Y day of the week. I don't really remember what provisions the staff made for those times when she was not physically present. I think they consulted her by phone, called 911 if necessary, or called the parents to come pick up the student. If this concerns you, I wouldn't hesitate to bring it up to the principal.

Flare, ASN, BSN

4,431 Posts

Specializes in school nursing, ortho, trauma.

The law states in my state that there must be a certified nurse for each campus but doesn't really go on to define what the legal definition of a campus is. My last district was multiple schools and we were traded around like baseball cards in case of absence or unfilled field trip with the closest nurse the the next school having to cover two. I worked in a school adjoining two so i often had to cover a high school and a middle school.

When I got this job I asked about things like leaving for lunch (since i live literally 3 minutes from here) They didn't say no - but they didn't really give me an enthusiastic thumbs up either. On occasion I leave to get a sandwich from a nearby deli. But i always have my phone on me.

My other question was what if i get sick part way through the day? Honestly in god knows how many years on this job now I don't think I have ever left early because i was sick. I have teachers come in to me all the time to get my "blessing" (read: justification) to go home. The office switches out a few classes, shuffles a bit of staff and viola that class is covered. But with our line of work, it's not that simple. There have been times that i've been there sick and knowing it and staring at the clock - but thinking that i have 4 diabetics that still need tending to or that there is a two pm med that needs to be given and just sucking it up. But we all probably do that.

CoffeeRTC, BSN, RN

3,734 Posts

Our school has a nurse in the building once a month. This is common for all the Catholic schools in our area.

For my district, I'm the only nurse for the 3 campuses that are included in the district. And I'm only part time. I work 6.5 hrs a day, 3 days a week and I have to schedule visits to all of my campuses (which are in 3 different cities) within the 3 days I work. When I'm not on the campuses, our administrative assistants are who the kids go to when they come up. All three of ours are great, but they're also not a trained medical professional. I don't know if maybe that's the case with your school nurse, but I agree with the other posts, its taking a big gamble not having a full time nurse on every campus. Many admins don't see the benefit of a full time nurse until after a major incident occurs and they realize they aren't prepared for it. Hopefully by contacting your principal and drawing attention to it, you'll be able to change that for your school! Good luck!

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