Tired of kids coming to the nurse...

sharpeimom · Nov 26, 2012

One of our neighbors' sons teaches 4th grade. He stopped the stampede of unnecessary useless trips the nurse

very cleverly, I thought. Most of the needless trips were for papercuts or headaches.

For headaches, before going to the nurse, the teacher would open a window and have the kid breathe deeply.

The windows all had bars on them so falling or jumping out wasn't possible.

For the dreaded papercut, he bought bandaids he discovered in his college alum magazine that also advertised bookstore "stuff." Those decorated bandaids from Mr.___, beat the heck out of the nurse's plain ones!

Anything questionable and you saw the nurse.

mandm97, RN · Nov 26, 2012

Like all School Nurses we face this issue everyday! I tend to be a "tough love" school nurse. My main goal is to keep students in school as much as possible! I do enjoy working with the Middle School age much better then the younger set. After almost 13 years as a school nurse, I still get upset at times when I hear ..."that nurse is mean", "she doesn't let anybody go home". I will call parents of my FFC's (Frequent Flyer Club) and most of them tend to appreciate the heads up. It is helpful when you have the support of the staff and adminstration. All my staff have a supply of bandaids and gloves and that does tend to help with some of the "little isssues". I'm hoping by dispensing some "tough love", I'm contributing to the students overall health. :sarcastic:

Flare, ASN, BSN · Nov 26, 2012

i am just appreciating this thread today - noting how busy i am today vs how i saw practically nobody on Weds before the holiday...

niferbu · Feb 26

I am 16 years in and feel like I have pled and bargained and wished away any chance of help curtailing the frequent flyers! This year they went from asking to see the nurse multiple times per week, to asking to see the nurse multiple times per day (up to 7!) -- btw, these are High School students! I have one student that has been to my office over 400 times already this school year!

Anyway, I finally decided that it was going to be better to ask for forgiveness than for permission and I sent out a staff wide email with the "rules" for seeing the nurse. I have my door open for 30 minutes in the morning for scheduled visits and then open again from 11:30 -1:00 for all scheduled meds, diabetic cares, enteral feedings. Otherwise, my door is shut & locked! If a student is "needing" the nurse, they must have asked their teacher, then the teacher must call my office and confirm if I am avalable/when I will be available to see this student. If I have seen and treated this student already, I have the option of declining request.

I started this process at the beginning of February and went from averaging 100 visits a day to averaging 55 visits per day! It allows me to actually do all the other duties that our jobs require without having to be here until 5pm every day!

The "fight" I am fighting at the moment - and I will send out another email to all staff today - is that the students come down to my office with a handwritten pass because "when their teacher called, I did not answer"! I thought it would stand to reason that, if I don't answer, I am not available/in my office and to try again later, if needed. If it is an emergency, contact the main office and they will make contact.

It is a forever battle, but I will not give in and eventually (I hope) this will be the "norm." Good luck fellow school nurses!

k1p1ssk, BSN, RN · Feb 26

niferbu said:

I am 16 years in and feel like I have pled and bargained and wished away any chance of help curtailing the frequent flyers! This year they went from asking to see the nurse multiple times per week, to asking to see the nurse multiple times per day (up to 7!) -- btw, these are High School students! I have one student that has been to my office over 400 times already this school year!

It seems like we're jointly feeling this recently! I am likely in a MUCH smaller school, but I just ran a mid-year report and found who my most frequent flyer was - he had more than twice the visits of the next most-frequent visitors. I let his teacher know how many visits he had and she was shocked. She asked when his last 5 visits were and of course 3 of them were from this week, but he had not asked permission to come any one of those times... he's now on a nurse-pass system.

I get that sometimes kids just need a break and they make up stuff to get it - but some definitely abuse that. 400 visits from 1 student is insane, and only halfway through the year?! That kid needs a plan.....

nurse__ab19 · Feb 26

niferbu said:

This year they went from asking to see the nurse multiple times per week, to asking to see the nurse multiple times per day (up to 7!) -- btw, these are High School students!

I'm in a high school as well and I unfortunately have one of these; MINIMUM 3 times EVERY DAY!! Brought it to the attention of the teacher and he doesn't care, administration aware, have had 2 meetings with the parents about this among many other issues. It's gotten to the point I know the sound of them walking to my office from down the hall and mentally prepare myself for what today's magical, moments from death, undiscovered by science illness is.

niferbu · Feb 26

k1p1ssk said:

It seems like we're jointly feeling this recently! I am likely in a MUCH smaller school, but I just ran a mid-year report and found who my most frequent flyer was - he had more than twice the visits of the next most-frequent visitors. I let his teacher know how many visits he had and she was shocked. She asked when his last 5 visits were and of course 3 of them were from this week, but he had not asked permission to come any one of those times... he's now on a nurse-pass system.

Quote

I get that sometimes kids just need a break and they make up stuff to get it - but some definitely abuse that. 400 visits from 1 student is insane, and only halfway through the year?! That kid needs a plan.....

We have had countless meetings with student, student's family, family and admin, family and all current teachers... Plans are made for when student may see the nurse, but come the next day, she is (was) back 5 times! Since starting this new "rule" I have only seen her twice and for a total of less than 5 minutes! It is almost like she didn't NEED to see the nurse all those other times! LOL

niferbu · Feb 26

Flare said:

I am just appreciating this thread today - noting how busy I am today vs how I saw practically nobody on Weds before the holiday...

And don't you just love how no one is sick on days with "fun" activities like pep rallys or guest speakers?

I did have an issue early on of having my office swarming with students on Fridays (can't wait to kick off the weekend, I guess)... I started calling the parents and beginning the conversation with, "Johnny is sick and needs to be picked up, but I think if he stays home and in bed all weekend, he should be good to go by Monday." Once I ruined enough weekends, that problem stopped!

niferbu · Feb 26

nurse__ab19 said:

I'm in a high school as well and I unfortunately have one of these; MINIMUM 3 times EVERY DAY!! Brought it to the attention of the teacher and he doesn't care, administration aware, have had 2 meetings with the parents about this among many other issues. It's gotten to the point I know the sound of them walking to my office from down the hall and mentally prepare myself for what today's magical, moments from death, undiscovered by science illness is.

I did have a student once that I created a plan for that allowed the student to see me one time per day for 5 minutes. He had to be very wise in chosing the moment because once it was gone, it was gone! I knew that he didn't have anyone "on his side" at home, so I was happy to greet him and let him know that we were so happy that he was in school, and then send him on his way! It worked really well for him because I KNEW that there were no medical issues, but a little encouragement each day from the nurse, seemed to go a long way!

He graduated in 2013 and still pops in to see me when he visits over the holidays!

niferbu · Feb 26

caregiver1977 said:

I am not a nurse, but a teacher assistant. Our school nurse got burned out about the second week of school with this crap. I wonder if some of these parents realize how much time their child is spending out of class in the office to see the nurse (the parents that would actually care)? If some of these teachers had more of a backbone, this problem wouldn't be happening as much. What gets me is that the students at my school with chronic conditions usually complain the LEAST!

Maybe it would help if each teacher had a small first aid kit in their room to take care of bandaids and things like that (for those of you who are not "soap and water" only). Some teachers at my school bought their own supplies. Last year the PTA/PTO provided it.

It has gotten to the point that I am trying to help the school nurse with the more minor issues ( I have her blessing with some things). Sometimes I feel more like a medical assistant than a teacher assistant.

I supply every classroom with a PPE bag (gloves, disposible clothes) and then a goody bag of bandaids, cough drops, and foil packets of lip balm and will still get multiple students walking in asking for these things daily!

I call parents to let them know if their kiddo is coming to the nurse more frequently than needed - I.e. asking for medication for headaches multiple times each week, daily requests for cough drops, etc. and am almost always met with astonishment because "(s)he never complained of this at home." I will get a reprieve for a week or two and then it starts up again! I have to shift a lot of the blame over to the teachers after this happens and info of parent response is shared! I don't know why the word "no" is so difficult?!

Cattz, ADN · Feb 26

nurse__ab19 said:

I'm in a high school as well and I unfortunately have one of these; MINIMUM 3 times EVERY DAY!! Brought it to the attention of the teacher and he doesn't care, administration aware, have had 2 meetings with the parents about this among many other issues. It's gotten to the point I know the sound of them walking to my office from down the hall and mentally prepare myself for what today's magical, moments from death, undiscovered by science illness is.

When I have this happen- Of course, I contact the parent and let them know- question if there may be a medical problem. If the visits from a specific student don't slow down- I fill out an "Illness/Injury Referral" - I summarize the student's frequent complaints, and make sure I put in it how the student's class time is so frequently interrupted. I tell the parent they need to make and appointment and take my referral note to the Dr- have it completed and bring back to school. The bottom of the note asks for the assessment/findings, pertinent information for the school, if the student requires frequent absences from the classroom. if the student has any activity restrictions, if a follow up appointment is needed, etc.

niferbu · Feb 26

Cattz said:

When I have this happen- Of course, I contact the parent and let them know- question if there may be a medical problem. If the visits from a specific student don't slow down- I fill out an "Illness/Injury Referral" - I summarize the student's frequent complaints, and make sure I put in it how the student's class time is so frequently interrupted. I tell the parent they need to make and appointment and take my referral note to the Dr- have it completed and bring back to school. The bottom of the note asks for the assessment/findings, pertinent information for the school, if the student requires frequent absences from the classroom. if the student has any activity restrictions, if a follow up appointment is needed, etc.

This is brilliant! I might have to steal this idea!!