Telemedicine

  1. 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
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  2. Visit Glitternurse profile page

    About Glitternurse, LVN

    Joined: Feb '18; Posts: 51; Likes: 129

    27 Comments

  3. by   Flare
    no, but if telemedicine means i can work from home, then sign me up! Seriously! Keep us posted as to how it works!!
  4. by   Farawyn
    Quote from Glitternurse
    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
    Welcome.
  5. by   ruby_jane
    I've only had personal experience with a teledoc, not work experience.

    From the doc's end... I am sure you'll have a lot of protocols. Do you guys get cool toys with cameras on them?

    This fascinates me and worries me. I often think "I wish I had a doc here" because I know kids are going home and the parent is not taking them to the doctor. Or to rule out or rule in things like conjunctivitis. My fear is that the teledoc will be used in place of the school nurse.

    Let us know how this goes! Good luck and welcome.
  6. by   AdobeRN
    The local Children's hospital in our area is starting to do this with some of the lower income schools. I have mixed feelings about it - as a working parent I think it is a great idea - my kid has a sore throat and to have the school nurse have the tools with a doctor/NP on call to run a rapid strep, flu etc test then have the RX called into a pharmacy and all I need to do is worry about picking my kid up and getting them home would be awesome.

    As the school nurse with this in the office - I am not sure about it....it would be alot of "extra" stuff that I would need to do and frankly there are days when I can hardly keep up with routine meds with all the kids coming/going - also what would the compensation for me be to do all of the extra stuff? Hopefully the nurses who have this in their office are compensated in some way for it.
  7. by   Glitternurse
    Quote from AdobeRN
    The local Children's hospital in our area is starting to do this with some of the lower income schools. I have mixed feelings about it - as a working parent I think it is a great idea - my kid has a sore throat and to have the school nurse have the tools with a doctor/NP on call to run a rapid strep, flu etc test then have the RX called into a pharmacy and all I need to do is worry about picking my kid up and getting them home would be awesome.

    As the school nurse with this in the office - I am not sure about it....it would be alot of "extra" stuff that I would need to do and frankly there are days when I can hardly keep up with routine meds with all the kids coming/going - also what would the compensation for me be to do all of the extra stuff? Hopefully the nurses who have this in their office are compensated in some way for it.
    Thanks Adobe,
    There is quite a bit of extra stuff. Plus the whole privacy/confidentiality thing is going to be tough since the students who need band aids and ice packs can't just come in to get them, they will have to wait until the consult is done. It will be great to get orders and dispense OTC meds and topicals so kids can go back to class and don't need to be picked up. My biggest worry is definitely work flow, especially when we are doing screenings and we aren't in the office. I will keep you all posted.
  8. by   MrsMRN
    this is fascinating to me! I understand it would be more work, but think of the amount of help we could provide to so many kiddos who may otherwise not have access to good healthcare! Wow. I will be following this
  9. by   OldDude
    Quote from Flare
    no, but if telemedicine means i can work from home, then sign me up! Seriously! Keep us posted as to how it works!!
    I'm in!!
  10. by   Glitternurse
    Quote from ruby_jane
    I've only had personal experience with a teledoc, not work experience.

    From the doc's end... I am sure you'll have a lot of protocols. Do you guys get cool toys with cameras on them?

    This fascinates me and worries me. I often think "I wish I had a doc here" because I know kids are going home and the parent is not taking them to the doctor. Or to rule out or rule in things like conjunctivitis. My fear is that the teledoc will be used in place of the school nurse.

    Let us know how this goes! Good luck and welcome.
    Thanks ruby_jane,
    I think my job is safe for now. The secretaries are our health aids and they do not want to add all that extra stuff to their workload, I'm sure the union would step in. We do not get the cool toys only an iPad and a printer. We can not dispense a cough drop without parent permission and a doctor's order so it will be nice to get orders and dispense OTC meds and topical so kids can go back to class instead of going home or laying on my cot. It'll be nice to have someone look at that weird rash that I can't identify. They will be able to send out scripts to the prefered pharmacy, they will keep in touch with the primary doc and can help families find primary doctors so it will be a great benefit to some of our families that need assistance. Tomorrow we launching at 2 of our sites. I will keep you posted
  11. by   Glitternurse
    Quote from MrsMRN
    this is fascinating to me! I understand it would be more work, but think of the amount of help we could provide to so many kiddos who may otherwise not have access to good healthcare! Wow. I will be following this
    MrsMRN,
    I completely agree it will be great and help immensely. I think the pros outweigh the cons for sure. I know that at least once a day i say "I wish I could give tylenol, or benadryl". I'm not so much worried about the extra work, but how we are going to be able to get it all done.
  12. by   pedi_nurse
    Our local children's hospital has implemented telemedicine in 4 of our district schools, including mine. Honestly, I don't use it much because I can hardly get anyone to sign up for it (that's another story though, and not for a lack of support on the hospital side of things). Honestly, it's awesome and pretty easy to utilize once you have kids enrolled. I was not a fan of the idea at first being that it was being placed in my school my very first year as a school nurse. However, now I find myself wishing I could use it more often than I do. It's awesome that it can be used for the things my kids should be seen for (earaches, chronic eczema, asthma follow ups, etc), but whose parents won't or can't take them to the doctor for. Just today, I found out that it can be used for assessing students for possible mild concussions! All that being said, you still send kids home if they have fevers, etc... you don't keep them waiting around for a telemedicine appointment, just if the parent will be an hour or so before they can get their kid. You also don't HAVE to utilize it. If I'm crazy busy, I just don't offer it as an option.
  13. by   Glitternurse
    Quote from pedi_nurse
    Our local children's hospital has implemented telemedicine in 4 of our district schools, including mine. Honestly, I don't use it much because I can hardly get anyone to sign up for it (that's another story though, and not for a lack of support on the hospital side of things). Honestly, it's awesome and pretty easy to utilize once you have kids enrolled. I was not a fan of the idea at first being that it was being placed in my school my very first year as a school nurse. However, now I find myself wishing I could use it more often than I do. It's awesome that it can be used for the things my kids should be seen for (earaches, chronic eczema, asthma follow ups, etc), but whose parents won't or can't take them to the doctor for. Just today, I found out that it can be used for assessing students for possible mild concussions! All that being said, you still send kids home if they have fevers, etc... you don't keep them waiting around for a telemedicine appointment, just if the parent will be an hour or so before they can get their kid. You also don't HAVE to utilize it. If I'm crazy busy, I just don't offer it as an option.
    Thanks Pedi-Nurse,
    Yes getting consents back is always the issue. The consent form has a place to decline service, so our schools are having a contest to see which class can get the most consents turned in (yes or no doesn't matter) and that class will have a pizza party. We are also having a parent information nights at each school site, so hopefully we'll pull in more consents from that. We definitely intend to evaluate the student first, if it's obvious they need to go home then we'll do what we always do. I see a lot pros with it and I'm very nervous about the workflow. I'll keep everyone posted. Tomorrow should be ab interesting day.
  14. by   FolksBtrippin
    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.

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