Any school nurses doing things differently?

Nurses COVID

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Is there anyone who is doing things differently due to the swine flu outbreak/hysteria? (IMO it is equal parts of both!)

I of course send kids with flu-like symptoms home, but I do not usually require a doctor's note for them to return, as long as they are fever-free. I am considering asking for a doctor's note on any kid I send home with flu-like illness, although I would pretty much have to allow them back without it if they are symptom free. My thought on it is that it might help in identifying the spread quicker if it does turn out to be swine flu.

Has anyone ever required a student to wear a face mask while waiting to be picked up? I have not, and I have a feeling that the parents would be offended if I did. Just curious if anyone else has done this.

Any extra education efforts going on? I sent out a lengthy email to teachers/staff and have made the offer to come and talk to the classes about hand hygiene and flu prevention. We'll see if anyone takes me up on it. I might ask admin for a mandatory class if enough teachers don't take the offer!

Stay well, everyone!

Specializes in School, Camp, Hospice, Critical Care.

Luckily, in my state most public schools are on spring break this week, so the situation has time to play out and we can develop a plan of how to deal with it.

Our School Health Department has daily advisories. We always exclude any kid with fever for 24hrs after resolution--though parents don't really comply with it (I get kids in all the time with "I had a fever this morning and mom gave me Tylenol . . ."). I do want to send out a stern email before we go back stating this must be enforced.

Health Department has recommended daily temp checks of any children who have been in areas where there are confirmed cases over break--again, we'll be dependent on self identification. They have already prepared a letter for parents about swine flu--two dense pages long, and I worry most of our parents will barely read it and assume "OMG, it's in the schools!"

I have a couple of real PIA teachers who always think half their kids have scabies, or lice, or whatever, and can be, shall we say, very persistent in repeatedly sending the same kids for eval, telling me I don't know what I'm talking about, the kid "obviously" has the disease du jour, etc. Before we head back, I want to clarify all exclusion criteria with my principal, so I can just send the PIA teachers straight to him, if (really, when--cause I KNOW it will happen) they challenge my evals.

So, I'm prepping myself that going back will be miserable, hopefully I'm wrong. I anticipate that a few individuals --parents as well as teachers-- will make the first week back entertaining.

Good luck to all!

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Specializes in School Nurse, Maternal Newborn.
Just had a teacher come in and tell me to watch out for the student that just came from a cruise from down south. I was like... ??? okay ?

Might that student been on a cruise in the Gulf that may have had stops in Mexico?

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Specializes in LTC.
Might that student been on a cruise in the Gulf that may have had stops in Mexico?

Nope I asked ! I have to admit, that I'm a little nervous about going on my honey moon in Aug. We are going to couzmel, mexico for a little while and then the Cayman islands. I'll continue to do my research, but I'm sure I'll be fine ! :heartbeat

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I sent out letters to the staff and teachers with the info from the CDC website. I typed up a cover letter emphasizing "Our best defense against this strain of flu is being proactive and fighting fears with knowledge". In other words, wash your hands and quit freaking out!! :)

Our asst super was insisting an employee with a sore throat at the DO go home. I joked with my colleague that we should all get N95 respirators and paint pink snouts on them. I know, I know, I'm horrible but its been a long day and that just really made me oink...I mean giggle.

All kidding aside, I am just trying my darndest to educate as much as I can. I have been making rounds and just briefly talking with everyone. You know that the teacher that sends a kid just for farting is going to have her whole class up in our offices while all of this is going on. (Deep, cleansing breaths.) This too shall pass.

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Specializes in school nursing.
I sent out letters to the staff and teachers with the info from the CDC website. I typed up a cover letter emphasizing "Our best defense against this strain of flu is being proactive and fighting fears with knowledge". In other words, wash your hands and quit freaking out!! :)

Our asst super was insisting an employee with a sore throat at the DO go home. I joked with my colleague that we should all get N95 respirators and paint pink snouts on them. I know, I know, I'm horrible but its been a long day and that just really made me oink...I mean giggle.

All kidding aside, I am just trying my darndest to educate as much as I can. I have been making rounds and just briefly talking with everyone. You know that the teacher that sends a kid just for farting is going to have her whole class up in our offices while all of this is going on. (Deep, cleansing breaths.) This too shall pass.

I stole your line about knowledge! I hope you don't mind - I thought it was so good! I know this swine flu is serious. However, the media just sensationalizes things to death. I have spent all morning explaining my actions to staff and trying to calm them down. I am seeing kids with no fever, no body aches, just mild sore throats with normal tonsils, and minor stuffy noses. They are being sent down in the middle of state testing on top of it. I am not sending them home until they are done testing if they have no flu-like symptoms. One cough does not swine flu make!

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Specializes in LTC.

So a student comes in with cough, sore throat, SA, congestion, no fever, chills, or the other sx.

What gets me is that these symptoms are so vague. The teacher asked me if he had swine flu and I told her that the physician is the one to diagnosed.

I did urge mom to get him a doc appt. and to keep him home until he feels better.

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Specializes in School Nursing.

If there is no fever, flu of any sort is not even on my radar. I always considered fever the hallmark of the flu, at least as far as differentiating it from the common cold. No fever, mild symptoms, they are staying at school!

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i'm not worried. i sent out an email with the link to the cdc's website called "swine flu and you". it's a great q&a section. i reminded them it is treated with medicine that is readily available and that the prevention of spread is as simple as with influenza- good hand hygiene.

i wonder if it's been around much longer and it's been mistaken as influenza?

first, a school a few miles away (chicago) has been closed because of a highly suspected case of h1n1.

second, for the purposes of assessing a student at school, flu-like symptoms are flu-like symptoms. that child needs to be sent home, period. we'd likely not be able to discern the difference in a few minutes at school unless a child was presenting with really severe symptoms. and still, the symptoms are basically the same.

the school staff is tasked with following up on students who were sent home or who are not in school - to find out why they're out, if they've gone to the doctor and the diagnosis. this information is then to be forwarded to the main offices of cps and cdph.

this school is 99.9% hispanic with a large portion of mexicans so as far as i'm concerned, all bets are off. you just have to do what you feel is appropriate. opinions, please.

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There is a lot of talk going around our school and I've had a lot more students sent to me to check fevers but no one is making a big deal out of it yet.... I've thought about sending out a memo about handwashing and such but TV has made such a big deal over it I feel like I'd just be saying what's already been said.

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Specializes in Cath Lab, OR, CPHN/SN, ER.
first, a school a few miles away (chicago) has been closed because of a highly suspected case of h1n1.

second, for the purposes of assessing a student at school, flu-like symptoms are flu-like symptoms. that child needs to be sent home, period. we'd likely not be able to discern the difference in a few minutes at school unless a child was presenting with really severe symptoms. and still, the symptoms are basically the same.

the school staff is tasked with following up on students who were sent home or who are not in school - to find out why they're out, if they've gone to the doctor and the diagnosis. this information is then to be forwarded to the main offices of cps and cdph.

this school is 99.9% hispanic with a large portion of mexicans so as far as i'm concerned, all bets are off. you just have to do what you feel is appropriate. opinions, please.

i'm not sure what i'd do. i'm in a state that hasn't had any confirmed cases, so our case criteria is different. if they've got one symptom and have traveled to a state with confirmed cases or out of country, they get tested and 7 day quarantine (or until their test is negative). all cases go through public health for approval to send the test to the state lab (before this the state lab got swamped). if they've got all the symptoms but haven't had travel or close contact with someone who has met travel criteria, they get treated as a normal flu case. of course, this could all change later if we get a confirmed case in our state.

as a school nurse, i've made it clear to the school staff that i want to see *every* student who is going home sick. doesn't mean i'll do a full assessment on them, but at least want to ask some questions and then an assessment if there is suspicion.

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