Too Sick To Stay Policy?

  1. Do you all have a policy where the nurse can decide a student is too sick to stay at school? Even if there is no GI upset or fever? With a Dr's note? Can I see some examples? I'm trying to come up with some verbiage to add to our policy.

    We had a parent bring a child (staff-child at that) come in saying the child had croup, but the doctor's note said they were OK to return as long as they were free of fever for 24 hours. She didn't have a fever and according to mom hadn't had one at all. So per the note, she was OK to return even though I thought she needed some more time at home (she still acted/looked/seemed sick). Principal ok'd it. Yada yada. Come to find out, mom wasn't exactly truthful about the fever and now we have more cases of croup with one in the ER for it. Just trying to see what we can change to hopefully prevent this in the future. We're a small charter and currently, our policy is to just follow our local district's guidelines (which their stance is it's OK to return with Dr note) and follow state statutes.

    Thanks for your guidance! I just want to make sure we're doing everything we should be.
    •  
  2. 18 Comments

  3. by   ruby_jane
    Oy.

    If the MD note indicates the student can come back if fever-free, it seems like you have to let them (and their dose of Tylenol) in. However, if the student is unable to remain in the learning environment, I am not sure what good it's doing for him/her to be back at school. Whatever the policy is - it should allow for a certain amount of nursing judgment.

    And CROUP. The coughing. The non-stop explosive coughing... I can't see teachers being excited about that in class. Not that it should matter, but again, it goes back to whether Sweet Baby can learn in class.

    Perhaps your administration will learn from this episode?
  4. by   OhioBPH
    Some info from our attendance policy as it relates to your croupy kid

    a. Symptoms preventing participation in school activities and requires a need for care that is greater thanclinic staff can provide without compromising health and safety of others. Examples include:
    iii. Continuous coughing.
  5. by   avery_shark
    Our policy states continuous coughing that prevents sleep or even a productive cough is reason for child to stay at home. We also have listed nasal discharge that is not clear and rashes with blisters or discharge. Still, there will always be the parents that SWEAR they were fine at home.
  6. by   OldDude
    As long as there is subjective information in the deciding equation you're never going to prevent it.
  7. by   Jedrnurse
    As obvious as it might seem, there should be a place for common sense and judgement to come into play. Maybe a part of the policy can state if physical symptoms interfere significantly with learning the child should go home? Oh, and the MD can write whatever they want; they don't make school policy. (I've seen some overreaching MD notes that are like a blank check for certain manipulative types of students- and parents.)
  8. by   ArryOtter
    Quote from ruby_jane
    And CROUP. The coughing. The non-stop explosive coughing... I can't see teachers being excited about that in class. Not that it should matter, but again, it goes back to whether Sweet Baby can learn in class.
    That's another thing, she didn't have a crazy incessant cough either which kind of supported the dr's note for return. Mild cough, she was a little more tired than normal but nothing crazy. She's in our PreK room and she laid around a bit more than usual.
  9. by   kidzcare
    I believe our handbook states we can send home based on professional judgement. Not all illnesses come with a fever.
  10. by   JenTheSchoolRN
    Quote from kidzcare
    I believe our handbook states we can send home based on professional judgement. Not all illnesses come with a fever.
    This. I use it all the time. I've had kids look miserable in my office, head down, pale. They are not productive in class at all. And no official fever.

    And I've sent them home.
  11. by   MHDNURSE
    Quote from girlcalledryan
    Some info from our attendance policy as it relates to your croupy kid

    a. Symptoms preventing participation in school activities and requires a need for care that is greater thanclinic staff can provide without compromising health and safety of others. Examples include:
    iii. Continuous coughing.
    I just sent a K student home about 45 minutes ago for exactly this. He has no fever, but is pale, watery eyes and has not stopped coughing since he arrived. Lungs are clear and is not in distress but is coughing so hard that he is gagging and it is extremely disruptive to the other students as well. He mentioned he was "awake during the night" coughing so the poor kid is also probably exhausted. Mom was annoyed when I told her to come get him if his lungs are clear and he has no fever. I explained that it was unfair for him to cough all day long and difficult for the other students to learn.
  12. by   Kooky Korky
    Do you guys ever have parents who are happy to pick up their sick kids?
    When I was young, my Mom was so sweet about keeping us home or picking us up if we got sick at school.
    I have never seen any post on here about parents who are glad to get their kids from school or keep them home to start with when sick.
  13. by   Farawyn
    Quote from Kooky Korky
    Do you guys ever have parents who are happy to pick up their sick kids?
    When I was young, my Mom was so sweet about keeping us home or picking us up if we got sick at school.
    I have never seen any post on here about parents who are glad to get their kids from school or keep them home to start with when sick.
    That's because we don't need to vent about that.
  14. by   ohiobobcat
    Quote from Kooky Korky
    Do you guys ever have parents who are happy to pick up their sick kids?
    When I was young, my Mom was so sweet about keeping us home or picking us up if we got sick at school.
    I have never seen any post on here about parents who are glad to get their kids from school or keep them home to start with when sick.
    Sure we do! We just don't really talk about that here because, speaking for myself at least , I don't need advice, guidance or support from my "coworkers" (this is our virtual nurse's station) regarding parents who are happy/able to pick up sick students.

close