Alternative to call/pass system


Hi all!

I'm looking for solutions on how to create a calmer, less distracted clinic for my middle school of 500 students.  My clinic volume has tripled and I have several procedures that take me out of the clinic roughly 10-20 mins of most hours of the school day.

Our current system is for teachers to call before sending students.  But the constant ringing of the phone & missed calls are stressing me out & making it difficult to focus on the student/s currently in my clinic.  I'm also trying to manage multiple calls & emails about the dozens of covid cases & contact tracing we have in between students & procedures.  I also have to do actual covid testing when needed & requested (which is often).

I spoke with my principal about using a pass system and having students wait on the bench by the clinic.  But that system isn't ideal for many reasons & I can see it leading to abuse of passes & discipline problems, in addition to an increase in missed instruction time.

We quickly brainstormed & are considering an email system. (Teacher emails me that LD needs to br seen for xyz & I call them to send student down when I'm ready). Thoughts?  Downfalls?

I also know I need to implement some paper disposition form for students.  I used to walk students out to parent, but this year that has been impossible.  Our interpreter ends up fetching them more often than not.  

The volume is very challenging, but possibly manageable (most days --- if I work a bit of OT to chart & finish pressing covid stuff).  My last 30ish minutes of shift are typically student-free.  However, that's also generally my first chance to pee/eat/drink so I'm not using that time very productively by that point.

I also want to note that many of these kids are actually sick, so other than a couple of known ff's & drama queens, the clinic isn't being abused.  My APs & school admin have been great about handling/intercepting/stopping visits for non-medical stuff (clothes for dress code violations,  care closet items, maxi-pads, requests for water, etc).


Has 20 years experience.

The e-mail system might sound nice, but will you really have time to check your e-mails frequently? 

Also, I would be very sure I feel confident in knowing that the Teachers would know to call OR send students that truly couldn’t wait. 


52 Posts

Good things to consider!  Thanks.  I *think* checking email might be quicker than taking calls.  But realize that the reality could be different.  It would also be a new system, so there'd probably still be calls mixed in with emails for awhile, so that could complicate things.

I've returned to my clinic several times to students puking in the trash can or bloody noses so they definitely will send them for that.  But even with call system I've occasionally had some significant sob students & potential allergic reactions waiting in classrooms while I tended to other students with minor things.

We are also down quite a bit of staff due to delta, so it seems that this may just be the new normal for the time being. I've forced myself to slow down from the pace I was going a couple weeks ago, as it wasn't safe.   

Maybe just turn down phone volume so it's at least quieter,  push off all charting & covid stuff until after hours & turn my overhead lights off & take 10ish mins mid-day to eat a sandwich & go to the bathroom.  


Specializes in pediatrics, school nursing. Has 12 years experience.

This sounds super stressful. I'm assuming based on your text that you are in an area with high covid transmission and maybe not so great vaccination rates/no mask mandate (thus more sick kids)? Does your school use the Google suite of apps for email, calendar, etc? I have had teachers send me a chat ( rather than an email. It makes a noise, and if they are at their computer, its quicker than email. You can also set your availability, so if you need to step away, the chat feature can indicate that you are not taking visits... It might split the difference a bit? 



52 Posts

Thanks!  We do have Google, but I'm not familiar with the chat feature.  I'll look into it.  

I am in a district with a high transmission/low vaccination rate.  We do have a district mask mandate - but there's an opt-out option.  My school has very, very low opt-outs though so we're faring a lot better than those with high opt-outs. I feel for those nurses.  20-40 hrs of OT/week is pretty standard now for them right now.  I'm grateful I'm only averaging 10ish hrs/week.

Specializes in School Nursing, Pediatrics. Has 33 years experience.

In my school, k-6, I have teachers text me before they send someone down. I text them when I am ready for them. unless an emergency of course. It works out well and it weeds out the FF or complainers that just want to get out of class. 

Specializes in School Nursing, Ambulatory Care, etc.. Has 13 years experience.

We use a Google Form e-pass.  The teacher fills it out, there are check boxes for why they are being sent and one "free space" to write in some details, and then the nurse gets an email notification.  The nurse calls into the classroom when it's clear to send the kid.  If it is an emergency - asthma, bee sting, etc. - the teacher can call for the nurse to come to the classroom or to send the kid to the clinic.