Telemedicine

Specialties School

Published

Hello,

I am new here and a new school nurse. I am an LVN and I am supervised by the DIstrict RN, PHN (she has been a school nurse at different grade levels for most of her career and at this district the past 7 years).we have a small district five k-6 schools and a preschool. The district nurse was on her own until my position was created this past summer and filled (by me) at the end of September. We are paving new paths since we are both new to this situation.

Later this week we will begin using a telemedicine service at 2 of our sites to be expanded to all sites over the next month. I am both excited and nervous about this. Have any of you ever worked with telemedicine. If so do you have any thoughts or advice?

Thanks

Specializes in Psychiatry, Community, Nurse Manager, hospice.

We have telepsych in my hospital. It's useful for commitments but not much else. My 2 cents: I think a school nurse should be able to call for orders rather than having to call a teledoc. An RN in-person assessment should trump a doc's tele assessment.

Specializes in Pediatric Critical Care.

I have no experience from the school nurse side, but the Children's hospital that I worked at piloted telemedicine in some local school districts (chosen based on what zip codes had the most non-emergent ED visits to our hospital system). From what they told us, it went great and they are rapidly expanding the program. The way it works is that they let parents sign a blanket consent to telemedicine visits at the beginning of the school year, and then the school nurse can just use at their discretion. Then again, the first year it was free to parents as a pilot program, and now visits are $35 or so....so time will tell if parents still agree to it.

The hospital PR people told a story of one kid that was really helped by the program. School-age boy, had a bump on the back of his head. Came to school nurse who said to do ice and come back if it doesn't get better. Came back the next day, was unchanged, so they did a telemedicine visit where the doc said....ice and come back if it isn't better. Helpful, right? Well the kid came back the next week and it wasn't better, and in fact was bigger and the hair had fallen out. Did another telemedicine visit and the doc sent him straight to the hospital to be worked up for oncology. Who knows how long it would have gone on before mom took him to see a doctor about a random bump on his head?

Specializes in pediatrics, School LVN.

To all of you following this, we launched telemedicine at 2 sites today, but since non of the kids with a consent came in it was business as usual. I'm sure as consents continue to trickle in we'll get a chance to try it out for real. Thanks to all for your support. As soon as something to report happens I'll let you know.

Specializes in pediatrics, School LVN.

So for those following. I did my first telemedicine visit. It went well. The student came in with stomach ache. The exam was interesting to watch. The provider had the student palpating his own abdomen and the student (5th grade boy) was cooperative. The provider ordered Pepto which I gave. I printed out and gave the student his visit summary and sent him on his way. The provider contacted the parent, so that was nice too. I did have several other kids come by during the visit for bandaids and whatnot, so that is a challenge because of privacy issues I can't have the other students in the health office during a telemedicine visit, so I was in and out of the health office treating booboos at the secretaries desk. It's a work in progress, as we get more consents, I expect it will get more challenging, but with a slow start we have time to iron out the wrinkles.

Specializes in school nursing, ortho, trauma.

interesting. continue updates please :)

Specializes in ICU/community health/school nursing.
The provider ordered Pepto.

Hmm. Iiiinteresting. Our summer camp protocol (written by a teledoc) says not to give Pepto to kids under 18 (Pepto has aspirin and therefore is contraindicated r/t Reye's Syndrome in kids under 18). Maybe it's just contraindicated in febrile kiddos. Not second guessing you, more second guessing the doc, I think.

Hmm. Iiiinteresting. Our summer camp protocol (written by a teledoc) says not to give Pepto to kids under 18 (Pepto has aspirin and therefore is contraindicated r/t Reye's Syndrome in kids under 18). Maybe it's just contraindicated in febrile kiddos. Not second guessing you, more second guessing the doc, I think.

We have the same protocol. We stopped having Pepto available about 3 years ago.

Specializes in kids.
Hmm. Iiiinteresting. Our summer camp protocol (written by a teledoc) says not to give Pepto to kids under 18 (Pepto has aspirin and therefore is contraindicated r/t Reye's Syndrome in kids under 18). Maybe it's just contraindicated in febrile kiddos. Not second guessing you, more second guessing the doc, I think.

I thought the same thing and was going to post but dang,the kids keep interupting me!

Specializes in NCSN.
It's a work in progress, as we get more consents, I expect it will get more challenging, but with a slow start we have time to iron out the wrinkles.

Keep on updating us! I really think this is amazing!

Specializes in pediatrics, School LVN.
Hmm. Iiiinteresting. Our summer camp protocol (written by a teledoc) says not to give Pepto to kids under 18 (Pepto has aspirin and therefore is contraindicated r/t Reye's Syndrome in kids under 18). Maybe it's just contraindicated in febrile kiddos. Not second guessing you, more second guessing the doc, I think.

I didn't know pepto had asprin in it. Children's chewable pepto was the what the provider ordered and what I gave, I'll have to check the ingredients. Thanks for the info.

Specializes in pediatrics, School LVN.
I thought the same thing and was going to post but dang,the kids keep interupting me!

It's children's chewable pepto, which I did check and there is no aspirin in it. I should have been more specific.

Specializes in pediatrics, School LVN.
We have the same protocol. We stopped having Pepto available about 3 years ago.

I definitely need to be more specific. I was not aware that pepto had aspirin in it. Children's chewable pepto is what I gave. we were supplied with only children's specific OTC medications.

+ Add a Comment