Would you have called?

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Third grader has c/o earache which started less than 1 hour previously, afebrile, no crying or apparent distress and bilateral tympanic membranes are pearly gray. Tympanic membrane on side that is painful might have slight amount of fluid. Student states she takes allergy medicine but did not take it that day.

Would you have called home?

Specializes in School Nursing, Hospice,Med-Surg.

I agree that parents need to be informed..to a point. Our previous school nurse didn't document AT ALL and didn't communicate with parents AT ALL. My daughter told me if she went to the nurse and told me if she took medication (we fill out clinic cards granting permission for specific OTC the nurse may/may not give to our child following assessment).

When I became the school nurse 3 years ago I began a strict policy of emailing parents a copy of my assessment and documentation for every visit that required medication. I do not contact parents for minor visits like scrapes and boo-boos. I call for anything major that I would want to be called about as a parent-injuries, fractures, concussions, illnesses, etc and things that are just crazy or difficult to explain thoroughly in documentation.

My parents have become accustomed to my communication method and often thank me for how I go about contacting them when their kids come to see me.

With that said, I definitely have housewives, accountants, engineers and other general laypersons who feel very comfortable calling or stopping by to tell me how to do my job. If I medicate their child, they're mad. If I don't, they're mad. If I underdose, I didn't give the child enough to treat their pain. If I appropriately dose, I should probably have underdosed first. One of my worst parents, though, is a nurse. She is busy, I get it. But she sneaks her kids in after they've been vomiting at home all morning. She argues with me when I call her to pick them up when they're sick and burning up with fever. Her argument is typically, "I don't send my kids to school sick!! I'm a NURSE!" Another mom will say, "I can't come pick up my sick daughter, I'm busy. I'm a cardiology nurse practitioner!" They are both wiser and above me in status, apparently as are all the laypeople who tell me how to do my job despite my 19 years of experience.

Guys, we are preaching to the choir. I've spent years convincing my kid that she doesn't need a pill for every feeling her body experiences..discomfort isn't pain. My reward is 300+ more kids who completely disagree with me.

Specializes in Med-surg, school nursing..

I've proudly never done a drug, except for hydrocodone for the occasional (3) c-section. I've also only drank during wine tasting in France (my grandmother then proceeded to call me a drunk!!) Having family who is addicted has made an impact on my life for the better. I didn't have a choice but to be around it when I was younger, but I now have the choice to not ever let my kids go through the hurt of seeing that.

First visit with pain that started less than hour ago and ears appear WNL - Most likely I would not have called (really depends on the student). I would have told student give it another hour or so, if still hurts return and I will contact parent.

Specializes in NCSN.

I call for all ear aches just because I have a few who go from Cheery and fine to full on tears and fever in less than a half hour.

But I agree with what most of the others have posted about. My teachers complain that "kids now a days are weak/snowflakes/whinny/etc" but they are the ones who send me the kid with the rosy cheeks.

My principal has given me the go ahead to talk to the teachers during the start of the year orientation about who should be sent to the nurse. I plan on providing the number of visits, and other facts to help push home that not EVERYONE needs to be sent here.

I have low expectations on if this will work, but it's nice to have support from administration.

This couldn't be anymore true, magic icepacks and magic water does wonders.

And parents tired of phone calls... or complete opposite LMAO

No. Elementary schoolers don't tolerate pain. You'd see some sign of discomfort. The exception would be if this kid is a Platinum Level Frequent Flier and has graduated to the "call every time they come in club."
Specializes in NICU, Telephone Triage.

Our protocol is to have the parent treat the ear pain with Tylenol or Advil for 48 hrs. If they still have pain at that point, we make an appointment to see the Dr. Studies have shown 75% of ear infections go away on their own without antibiotics anyway. I am not a school nurse, so I am not sure what your protocol is. Did she have allergy medicine with her? Maybe the parent could have brought her the allergy med? I totally agree these days parents are so paranoid. I work telephone triage. I get parents calling me when they are rushing to go get their child from school because (OMG!) they just vomited ONCE. Should they come to the Dr?? It ranges from that to "my son cut himself when he fell. no, I'm not with him yet, no I don't know if it needs stitches. The school just called me. What do I do??" I usually have to tell them to call back once their with the child to see if they need stitches or not. Parents are more and more helpless. I get to the point where I want to ask them "were you ever sick as a child?"

I really don't understand all the anxiety, unless it really is something potentially serious like a head injury. These kids with anxious parents will grow up to be worried about every tiny little scratch on their body. They will also think they're dying if they're vomiting. And they want a pill to fix everything, especially Zofran to stop the vomiting. Ok, then the kid will most likely get diarrhea and the med may not even work. ugh.

Makes me laugh - my mom used to tell me I wasn't a caring enough parent because when my son fell and skinned his knee (or whatever) I would tell him "It's a long way from your heart" and send him back out to play. Funny - he's now a fully-functioning adult that has been to ER once in his life (he was in a car wreck and the paramedics took him.)

I would not have called. She didn't come back after you advised her to if the pain continued, and her initial exam did not show anything out of the ordinary. Let dad whine a little, but you didn't do anything wrong, and you are the nurse and the one with the education!

Omg. Yes. This is my greatest source of worry/annoyance/surprise as a new school nurse. When I was a child, I didn't even know that there WAS a school nurse. If I bumped my arm or knee or even skinned it I knew it would feel better with time. Meanwhile paper cuts, nosebleeds, minor "twisted ankle" injuries or "bumped my elbow on the wall but it feels fine" or "hit my finger in my desk" are all sent here like they need to be evaluated and treated immediately. Headaches and stomachaches that started "right now" as well. I want to teach all of them that minor discomforts are part of life and that they are strong resilient young people but I feel like their teachers also feel that each complaint is a genuine concern--which is great that they are so caring, but where will the children learn to tough through it? By the time they get to me their complaint is legitimized and it's hard to reverse the sense that they needed the visit!

I don't have an otoscope, and although I work in elementary, I do not see many earaches. Depending on the student (is it a student I have never seen before that "never complains"?) I might give the parent a call as a head's up. Any time a child states "I didn't take my medicine" I usually give a courtesy call. But on a busy day if I did not get to make that call before the end of the day I would have felt comfortable backing up my non-call, especially because such an articulate child is capable of letting her parents know.

(I work at a school where I was told to call even for little scrapes so I do make probably 30 calls a day... :down:)

Certainly when I was at school, and I think even now, in England we don't HAVE school nurses. Period. If you get sick, suck it up. The only time your parents got called was if you were seriously, and obviously, unwell...broken bones, projectile puking, coma, death.....that type of thing. If you got a cut or bruise, you were lucky to even get a sympathetic nod, never mind a Band-Aid and an ice-pack.

The only time I saw a nurse in school was for the annual shots/immunizations and the visits from "Nitty Nora the Biddy Explorer", AKA the nurse who checked for head lice every 6 months.

Specializes in School Nurse.
"Nitty Nora the Biddy Explorer", AKA the nurse who checked for head lice every 6 months.

:roflmao::roflmao::roflmao:

I usually call on earaches just as a heads up (but not for headaches or stomachaches). Often, my parents will come on up and get them. But, my clinic is small and I have more time to call on things like this than someone who is seeing 60 kids a day...

Nope. If the student would have returned to the clinic again that afternoon I probably would have called but otherwise no.

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