Teacher assessments

[KeeperOfTheIceRN]

I know many of you don't document teacher assessments and I don't either, but I just want to "confirm" my nursing judgment, if you will, about a teacher I spoke with today.

***ADMINS, NO FACEBOOK PLEASE***

My admin assistant calls me to tell me about teacher asking to go home because they don't feel well, complained about their blood pressure. We have no subs available right now d/t testing, so teach has to stay for now. Admin assistant asks if I would go check the teacher out to make sure they aren't going to pass out or anything (this teacher can be a bit dramatic sometimes)...

Get to the classroom and pull the teacher out and we chit chat about whats going on. Take their BP, systolic is good, diastolic slightly elevated, nothing alarming though. HR and RR WNL. Teach is complaining of a headache. Denies feeling lightheaded, dizzy, or seeing stars, no palpitations, does not feel clammy. Just generally unwell and that its mostly located in their upper body/chest plus the headache. They've already called their doc, no appointments available today. Teacher is still adamant that they feel crummy because of their "elevated BP" and that they have a family history of normal cardiac functions. Teacher requests I listen to their heart to "make sure I don't hear anything". Lungs clear to auscultation, heart sounds normal. Then the teacher goes on to say they're really stressed and tired and that they did not sleep well last night and forgot to put their CPAP mask on (its at this point I do not see the situation as "emergent" but rather, they're just tired and stressed). Instructed teacher to drink some more water and try to tough it out until a sub is available and that I feel they're ok and probably just need some really good rest and to decompress but to call me if new symptoms start (i.e.: racing HR, dizziness, lightheadedness etc. etc.). Teacher smiles, shakes their head, and thanks me as the return to class.

For the most part, I feel confident that they are just beyond tired and have a lot going on. But there's still a little twinge of "what if I missed...." I've made it 2.5 years (knock on wood!!) without a major health emergency on any of my campuses and I don't want today to be "THE day" because I didn't see an inkling of a cardiac event brewing...

[ruby_jane, BSN, RN]

Maybe the staff tab is an add-on. On our version it's at the top on the main screen between "families" and "office." I enter staff visits in the "Office visits" tab, "entry by date" and there's a button for staff.

This kind of situation drives me bonkers. It's not my job to be the employee attendance police, and I dislike when administration puts me in the position of "telling" a teacher s/he can't go home because s/he isn't "sick enough" or there are no subs. They're grownups. Most times teachers teach when they are sick, instead of leaving when they're healthy...

[tining, BSN, RN]

In SNAP you can add staff.

In between where you put the last name and search tab is a "new student" tab. Hit that and your on your way.

For teacher, grade & classification there should be a staff choice - just scroll.

I put teachers in all bold to distinguish them from students.

[MrNurse(x2), ADN]

First things first, a gross assessment without diagnostic tools as EKG, is just that, gross. Cardiac events are sudden in nature, you don't see "warning signs" per se. Yes, you MAY have flu like symptoms pre MI, but they may be the flu. Given your limitations in your setting, you did fine. I have coded numerous people in my career that I would have never said I had a "feeling" about. You did fine with the info you had.

[LikeTheDeadSea, MSN, RN]

In SNAP you can add staff.

In between where you put the last name and search tab is a "new student" tab. Hit that and your on your way.

For teacher, grade & classification there should be a staff choice - just scroll.

I put teachers in all bold to distinguish them from students.

Some nursing staff got a little change/addition-happy, so only the designated "SNAP gurus" of our district have editing capabilities. My buttons are all inactive.

[cjl_RN, BSN]

As still also a cardiac nurse Not wearing your CPAP machine will cause low oxygen levels in the blood and high CO2 levels which in turn causes restlessness which is probably Contributed to why he feels bad. I think you done the right assessment and made the right decision. He is an adult and makes the final decision on if he feels he can stay at school or go home and see a doctor.

[KeeperOfTheIceRN, ADN]

As still also a cardiac nurse Not wearing your CPAP machine will cause low oxygen levels in the blood and high CO2 levels which in turn causes restlessness which is probably Contributed to why he feels bad. I think you done the right assessment and made the right decision. He is an adult and makes the final decision on if he feels he can stay at school or go home and see a doctor.

This was my exact thought process too!

[WineRN]

I think you did perfect. As everyone else said, the teacher is an adult and can make her own choices on what is best for her. I've told teachers they were 100% fine to stay and watched them walk out "sick" after lunch. Then there those where I am almost begging them to call their doctor as professionally as I can.

[ohiobobcat]

In SNAP you can add staff.

In between where you put the last name and search tab is a "new student" tab. Hit that and your on your way.

For teacher, grade & classification there should be a staff choice - just scroll.

I put teachers in all bold to distinguish them from students.

I did not know this!!! I don't add students very often, so I never realized there was a drop down menu there that has a STAFF option. I will be sure to document here for staff interactions from now on. I don't tend to see a lot of staff, but I have called 911 for MI symptoms twice, and stroke-like symptoms another time in staff members. It's good to know there is a secure place to document those incidents.

ETA my reply to the original post: If I assess an adult, I can recommend what they should do, but ultimately it is their decision. I had a staff member sprain her ankle at home. She came in and asked for ice, which I happily gave her. Then she came back a couple hours later and asked me if she should go home. I told her she was an adult, and didn't need me to assist her in making that decision. What would she have done if she worked somewhere where she didn't have a nurse to access? That's kind of how I think of it when it comes to staff members. That being said, I do appreciate when staff keeps me informed of health issues they are dealing with, though.

[scuba nurse, BSN, MSN, RN]

In SNAP you can add staff.

In between where you put the last name and search tab is a "new student" tab. Hit that and your on your way.

For teacher, grade & classification there should be a staff choice - just scroll.

I put teachers in all bold to distinguish them from students.

ONLY in some SNAP systems they allow that, ours does not allow us to add 'new' people. We have STAFF,STAFF that we document staff under.

[Kellsters516]

We use skyward too. The problem we have encountered with entering staff visits in the "entry by date" section, is that there's not a way to go back and view what we documented on the staff visit. It shows we saw them but no way to see the note. If it's a visit where the staff member is referred to hospital/ER we fill out an accident/incident report. That's the best we can do for now.

[ruby_jane, BSN, RN]

We use skyward too. The problem we have encountered with entering staff visits in the "entry by date" section, is that there's not a way to go back and view what we documented on the staff visit. It shows we saw them but no way to see the note. If it's a visit where the staff member is referred to hospital/ER we fill out an accident/incident report. That's the best we can do for now.

Yup. You have to keep the visit open or make a new visit.