School nurse...and more!
The job of a school nurse is rarely just sitting around and passing bandaids and ice packs. From first aid to orthodontic assessment to counseling and that's usually just the students! - Just a snippet of my day earlier this week!
The bell rings at 7:15 sharp every morning. Mondays are probably the busiest. Soon there is a line of half a dozen middle school aged children, all clutching papers, sporting hospital bracelets and comparing the injuries they got over the weekend. Then someone hobbles in on crutches they don't know how to use. Suddenly their injuries are not a cool, and they quietly take their PE excusals and leave. Meanwhile, I begin a session of impromptu crutch training with the student that had just moments earlier been deemed "lucky" by their jealous peers. I was on crutches once too - I thought of myself as anything but lucky. It takes full adjustments to get the crutches fit to my student's height. Don't they do this in the ER? I silently wonder as I remind he student for the fourth time not to rest on their armpits.
8:00 begins the parade of students with dizziness or stomach ache. Odds are that 90% of them will admit to not having breakfast (and I don't necessarily believe the other 10%). This parade will continue until lunches begin at 10:05.
The lunch periods bring a free "flex" period where the students are encouraged to read or get extra academic help. It is also the period where students come to ice week - old injuries or try to lie down because they didn't get enough sleep. I have very little tolerance for these reasons for visiting the health office. These students are usually quickly turned away.
My own lunch takes about 20 minutes. I have trained the students by this time in the year not to come to the office at that time unless it's a matter of life or limb. Lo and behold, that lesson didn't take nearly as long as I thought it would.
The rest of my day is a mixed bag. Broken braces make me feel like an amateur orthodontist. Then I switch rapidly to becoming Pearle Vision for a pair of glasses that should have been replaced eons ago. I manage to get them back together with a toothpick, a drop or super glue and a wing and a prayer. A sobbing student makes me secretly wonder if I should have become a guidance counselor, as I give a quick pep talk. Another student comes in shortly afterward with a "migraine" but as soon as she begins laughing and joking with another student in queue they both get sent back to class.
The nice weather is here - so that means students violating the dress code with ill-fitting and too-skimpy clothing. They somehow expect that I can get their clothing to somehow pass the dress code with a handful of safety pins. I'm good, but not that good. Their old flip-flops from last summer also start making a comeback. This is fine and apparently doesn't violate any dress code in the administrators' eyes. Buy before the day is out I'll be asked to fix at least one strap blow out. The students will whine when I Coban the flip-flop to their foot, but can't argue with me when they see that my way is at least going to keep the shoe on their foot.
A fight breaks out and one of the scuffled students will be walked down by the admins. I'll assess, treat as necessary (usually pride trumps any need for treatment, especially in the winner of said kerfuffle).
My day is winding down. My diabetic drags herself into my office, unescorted. Blood sugar of 52. Super! A little juice will bring her right out of this and the day has slowed to a point where I can give her my full attention, right? Wrong!
"Nurse Flare?" A voice crackles over the oft forgotten walkie-talkie on my filing cabinet. I answer it, knowing full well what is coming next. "Mr. Bonn would like you to come to his classroom. He has a sick student." I assure them that I cannot leave at the moment, that I am attending to another student and that the student will have to wait or be brought to my office. They relay my message. 3 Minutes later a frantic Mr. Bonn brings the mortified student into my office, sits her on my cot and plunks an oversized garbage can in front of her. I ask what happened. "Shelly almost threw up in the trash." I ask the student if she actually threw up. She says no. That she was coughing and simply gagged once. Mr. Bonn paints a different picture, though I am pretty sure Mr. Bonn would wear a full hazmat suit to work if he could, classic germaphobe (and an earth science teacher to boot!).
My diabetic student has improved. I dismiss her back to class and enjoy the momentary quiet to catch up on some charting. My phone rings: "Is this the nurse?" A shrill voice rings into my ear. "My daughter just called me from the bathroom in tears telling me you sent her back to class without even checking her temperature. I can't believe you run an office like that!" I am not going to get a word in edgewise. Finally the angry voice on the phone takes a breath before preparing to ream me out some more.
"What is your daughter's name?" I calmly asked.
"Alison Atterson." The voice spits out. "I am going to tell the principal about this!" She threatens.
I pull up my records. "Ma'am, I haven't seen your daughter in this office in 2 months. I assure you if she came in with a complaint, she would get assessed, as would any other student."
"Also Ma'am, students are not permitted to use their cell phones during school hours. I will be reporting to the principal the unauthorized use of the cell phone in school." I would have probably let that one slide if she hadn't been so toxic with me on the phone.
Dismissal begins. By this time in the day, students should be worried about going home, but not always. My door opens one more time. A seventh grader flops down onto my cot. "I have a stomach ache." He whines.
"You do realize it's time to go home, right?" I ask him.
"Yes, but I don't feel well. "
"Too sick to get on the bus?"
"No, but I want you to check my temperature." So this is where I begin my mental pros and cons list. It would literally take me 3 seconds to check his temp. No temp and he gets sent on his way. Fever and I have to call a parent for a pick up. I decide to chance it. I take a quick temp. 99.2. I assure him he will survive the bus ride home and tell him to keep an eye on his temp.
I get ready to pack up my things- I am about ready this day to end. The last bus pulls out and I begin my walk down the hall. I get almost to the door when someone calls my name. "I read in Prevention that I can take Tibetan Yak Jelly to relieve my constipation! What do you know about that?" Yak Jelly? Constipation? Yuck! I know I don't want to have this conversation!! I smile and tell them I'll have to look into that.
I finally make it into my car. As I get halfway home I remember that tomorrow the PE teachers are having playoffs for the "Drag tag" teams in class. I make a mental note to make some extra ice as soon as I get in. Tomorrow will bring more adventures for me and my middle school students - and I'm looking forward to them all!Last edit by Joe V on May 2, '12
Full-time School nurse, part time wise cracker! Each day is only as good as you make it!
From 'Eastern Sea Board'; Joined Jul '05; Posts: 2,754; Likes: 6,415.2May 2, '12 by NutmeggeRN, BSN, RNOMG, my stomach hurts and I may need Depends!!!!!!!!!!!! Tru dat!
That is awesome and true stuff. Happens all day, everyday. I like the flip flop fix, need to file that away.
Always enjoy Flare's posts!1May 2, '12 by OnlybyHisgraceRNI've had many, many days like this. You described what us school nurses do perfectly.0May 2, '12 by CrissiQBrings back a ton of memories and made me smile at the same time. Thank you so much!0May 2, '12 by merleeWhat happened to all the meds, especially the neb treatments? Otherwise, it was right on!6May 2, '12 by Wave Watcher, BSN, RNI love school nursing!! My kiddos crack me up and love seeing them everyday!!
Today was pretty good. I'm straight forward with the kids and have a dry sense of humor...some get it and some don't.
Kid: "My eye itches."
Me: "Let me look." (no redness, drainage, swellling, etc.)
Me: "What do you do when it itches?"
Kid: "I scratch it."
Me: "Does it help?"
Me: "Good. Go back to class."1May 2, '12 by flyingchangeI always wondered if school nurses end up caring for the staff as much as they care for the students!0May 3, '12 by 100kids, BSN, RNlove love love this Flare! You were cracking me up and at the same time I'm thinking "Yup. That happens all the time".3May 3, '12 by SchoolNurseTXstyleGotta love the teachers tht call you to their room for "emergency vomiting."1Jul 2, '12 by Liddle NoodnikWow very well written, I can't quite catch my breath after all that! whew!0Aug 15, '12 by LogCabinMomI am going for a 2nd interview for a school nurse job on Monday - I've wanted to be a school nurse since first starting school - I love the independence of the nursing office - what is the one thing I can say to really impress these people?
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