Teacher assessments

[KeeperOfTheIceRN, ADN]

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...

I always make my recommendation, but then quickly follow that up with "YOU are the adult and need to make the final decision about what you need to do. Only YOU can decide if you are too sick to stay/or well enough to stay". I had the opposite where I was recommending a teacher be seen in urgent care/ER for chest and arm pain and he was refusing saying he was fine.

[JenTheSchoolRN, BSN, RN]

I always make my recommendation, but then quickly follow that up with "YOU are the adult and need to make the final decision about what you need to do. Only YOU can decide if you are too sick to stay/or well enough to stay". I had the opposite where I was recommending a teacher be seen in urgent care/ER for chest and arm pain and he was refusing saying he was fine.

Same. Though I had to convince a teacher once that was experiencing chest pain to go to the ED. Even spoke to their spouse. Luckily spouse was able to convince and teacher was admitted for 3 days for a "minor cardiac episode" (teacher's words).

But they are adults, so I treat them like adults.

[LikeTheDeadSea, MSN, RN]

I document staff visits. I run a report at the end of the year and discuss with Admin the level of adult-consulting that can vary year to year.

I always say "if you think their is an issue, keep in mind I am a healthcare provider, but not YOUR healthcare provider. I can tell you my opinion, but I don't diagnose and I am limited in my office significantly" and a nice song-and-dance about how adults make adult decisions and I will not talk to HR/office/admin about your issue today to excuse you from work.

Also, when a staff member tells me "so-and-so said they feel x, y and z...maybe you should go see them," I tend to respond with "If so-and-so thought they needed me to check them out, they know where I am and how to contact me. It's nice that you want to help your friend, but I don't want someone to feel uncomfortable if I ask to see them based on someone else's statements. Please go encourage them to reach out to me if they want my assessment or advice."

And your assessment/advice described above sounds solid.

[OldDude]

Everything from fatigue, dizziness, headaches, hangnails, to yeast infections, get blamed on "high blood pressure." Forget about it. If something different pops up you'll do something different; or maybe you could break out your lucky astrology ouija watch and look into her future...the only thing I can think of that you didn't do was offer her a saltine.

[KeeperOfTheIceRN, ADN]

the only thing I can think of that you didn't do was offer her a saltine.

Hahaha, only because it's the middle of May and I'M OUT!!

[KeeperOfTheIceRN, ADN]

I document staff visits. I run a report at the end of the year and discuss with Admin the level of adult-consulting that can vary year to year.

I always say "if you think their is an issue, keep in mind I am a healthcare provider, but not YOUR healthcare provider. I can tell you my opinion, but I don't diagnose and I am limited in my office significantly" and a nice song-and-dance about how adults make adult decisions and I will not talk to HR/office/admin about your issue today to excuse you from work.

Also, when a staff member tells me "so-and-so said they feel x, y and z...maybe you should go see them," I tend to respond with "If so-and-so thought they needed me to check them out, they know where I am and how to contact me. It's nice that you want to help your friend, but I don't want someone to feel uncomfortable if I ask to see them based on someone else's statements. Please go encourage them to reach out to me if they want my assessment or advice."

And your assessment/advice described above sounds solid.

Thanks! What do you use to document? Our school uses Skyward, but I'm pretty positive I don't have access to teacher info. Do you just keep a running "notebook" in word??

[GdBSN, RN]

Thanks! What do you use to document? Our school uses Skyward, but I'm pretty positive I don't have access to teacher info. Do you just keep a running "notebook" in word??

In our Skyward, I have a staff tab that I can document in. I usually only document serious health situations. with this situation, I would document just to CYA.

[LikeTheDeadSea, MSN, RN]

Thanks! What do you use to document? Our school uses Skyward, but I'm pretty positive I don't have access to teacher info. Do you just keep a running "notebook" in word??

We use SNAP. Some teachers are in it, so I can chart under their names. Those that aren't, there is a general "STAFF" account, and I just lead the entry with name/title. This way it's in a secure server that can't be altered, and I can't be accused of altering it like in a word document or handwritten.

[KeeperOfTheIceRN, ADN]

In our Skyward, I have a staff tab that I can document in. I usually only document serious health situations. with this situation, I would document just to CYA.

GAH!! I had no idea that was even an option!!! Thank you!! I'll definitely do this from now on!!!

[KeeperOfTheIceRN, ADN]

We use SNAP. Some teachers are in it, so I can chart under their names. Those that aren't, there is a general "STAFF" account, and I just lead the entry with name/title. This way it's in a secure server that can't be altered, and I can't be accused of altering it like in a word document or handwritten.

That's a valid point!! Thank you!

[OldDude]

In our Skyward, I have a staff tab that I can document in. I usually only document serious health situations. with this situation, I would document just to CYA.

We don't have a staff tab on our Skyward...or I haven't run across it yet. That would be helpful.