New school nurse - making changes for next semester

Nurse ABC · Dec 10, 2013

"Do you often do things just because you know the kids will feel like you care when you do them?"

All the time!! There's nothing wrong with that. A lot of kids just need to feel heard or that someone cares enough to listen. A lot of students don't get that at home. A lot of kids don't realize that within the first 30 sec we can tell if they really need something or not. We are assessing the color of their skin, their demeanor, seeing if they are guarding an area, how active and talkative they are, etc but if we just look and say you're fine and dismiss them then they feel like we didn't care. We don't want kids to feel that way. So yes, I go through the whole taking a temp, feeling a belly, looking at throats, etc when I know I don't need to just so they will think I really checked them out. Sometimes, I do find something I didn't expect to see-totally unrelated to why they were in there that does need care so it never hurts.

I do understand about the kids wanting ice for every little thing or bandaids. Luckily those items do not come out of my pocket so it's a quick easy fix that I use to make the kid happy. I don't give out bandaids if I can't see a scratch however. I do give out ice because even if something isn't swollen it can numb the area that's in pain which helps. I've even given ice for headaches-it gets the kids through the day sometimes! If it's a "this happened last week story" then assess the area-if you don't see anything tell the student if they are still having problems they are going to need to follow-up with the dr and you'll be happy to write a note to mom if they wish but since you don't see swelling the ice isn't going to help. If it's a yesterday or day before then ice may be the cure-all.

Even the teachers know some of this is just placebo effect but it keeps the kids from bugging them all day. Some teachers are tough and will say quit whining but a lot don't. This is awful to say but if you inconvenience the teachers enough they won't send as many kids-they will only send the ones they really think need help as compared to ones for every little thing. Make up a pass they must fill out with the student's name, time, reason for visit, etc (good for safety reasons anyway-making sure you know who the student is and going where they should, etc) or make them call you on the phone before sending a student down telling you who it is and why they want to send them. Either one makes them stop what they are doing to really think if it's worth it. Also, put bandaids in their mailboxes so they can be in charge of passing those out for little things and I bet when they take the time to look at a scratch if they don't see something they'll tell them to go sit down.

You have to walk a fine line so you don't get accussed of not wanting to do your job. We all know exactly what you're talking about and your reasons are legitimate but it's very easy to be taken the wrong way from teachers and you don't want that. Good luck!

Flare, ASN, BSN · Dec 11, 2013

i've gone back and forth over the years. In my heart, i like baggies and real ice. it works better and it's more sanitary but in practice when you see the kids wanting to ice the pain that was moments ago a 10/10 on the pain scale for 15 d**m seconds then skipping away totally fine the waste of supplies gets totally annoying. So because I have little kids that are apt to do that and would be apt to play with baggies of real ice, i stick with reusable packs that I take a sani cloth to - and those packs don't leave my office or i never see them again. But if i were working with older students (middle school and above i'd expect this from) I feel I can trust to take a baggie of ice cubes back to class and toss into the trash once done with it. It gets them back to class quicker and i expect them at their age to have the maturity not to play with it. In my last school I had a great portable ice maker and just made ice when needed and filled up the baggies.

As far as bandaids go - if i can't see it, i'm definitely not dressing it. The phrase "I think you'll be okay" seems to carry a lot of weight out of my mouth with some kids. The one that gets me is the kids that insist on having their temp taken constantly. I will feel them and tell them they feel cool but they often times don't believe me until they see the almighty number. I've even gotten to the point that i can pretty much guess within .2+ or - most times

JenTheSchoolRN, BSN, RN · Dec 17, 2013

But if i were working with older students (middle school and above i'd expect this from) I feel I can trust to take a baggie of ice cubes back to class and toss into the trash once done with it. It gets them back to class quicker and i expect them at their age to have the maturity not to play with it. In my last school I had a great portable ice maker and just made ice when needed and filled up the baggies.

I wish I had an icemaker! I have a tiny fridge/freezer in my office and work with middle school and high school; no space or budget for an ice maker (though I have been looking). I've been trying to come up with cold effective ice packs since the beginning of the school year. Currently, I have reusable packs and stress the need to return 'em - probably have a 75% return rate. I also tried wetting sponges and placing them in baggies and freezing, but found that actually worked better for heat packs, actually (not the freezing part, of course).

Ice can be a peace maker and it also shows you are listening to something a child - even if it is very only a couple of minutes - thinks is painful. It helps forge a relationship sometimes so that the time I see that kid, I might be able to say "I know it hurts, but let's try sitting a minute without an ice pack this time and see" and a couple of minutes later, kid is fine and out the door.

As for bandaids, I put a very basic first aid in every classroom at the beginning of the year, restock in a few times throughout the year. Because of it, I actually rarely see students needing a bandaid because of a simple scratch.