Bed bugs

[schoolnursejennie]

so today a teacher came in with a bed bug wrapped in a paper towel and i positively identified it as a bed bug. it was then brought to one of the science teachers who agreed it was a bed bug. the student changed his clothes and put the old ones in a plastic bag. the teacher then told me that i had to call every student's parent in her classroom to let them know what happened as well as send a letter home detailing the events. the head of the school was called and she generated a letter to each student's parent. i told her that i didn't think a phone call was necessary but she told me that some of the parents would be upset with just a letter so i proceeded to call each student's parent. the parent of the student with the actual bed bug on him was unavailable. most of the parents were very receptive but one parent told me she didn't want to speak to me and would only speak to her son's speech therapist (still don't know why but she was transferred to her) and another parent wanted her son removed from the classroom and was transferred to the head of the school. my question is, have any of you ever dealt with bed bugs in school and, if so, how did you handle it?

also, what do i do when the administration in my school wants to handle every out of the ordinary event as an emergency and dumps it on me as the nurse? i felt like telling them and the teachers that i am a nurse, not an exterminator and please send the students back to class. (this was after they had me assess every student for bites)

[schoolnursejennie]

oh i also had to call every student's parent that was on the school bus with the student. this is if i had nothing better to do. i have a bunch of students with prn medication orders with no medication in school. these people think i sit around all day doing nothing. i feel highly disrespected and devalued. do they think every "non academic" occurrence is the nurse's responsibility?

[schooldistrictnurse]

I feel like some more investigation might be in order before the notification. Did the student present with bites? Is the home known to be infested? Was he even staying at home?

Does the parent have plans to fumigate if the infestation is verified? I would have hesitated to call the parents b/c the first thing they will ask is"what are you doing about it?". and I don't think at this early date you can respond. I would confer with my local Health Dept for guidance also. Can the student legally be excluded from school? What about his clothes and/or backpack? Lots to consider over one bug.

[safarirn]

Don't know which state you live in, but here is some helpful information...

http://www.michigan.gov/documents/emergingdiseases/Bed_bugs_schools_293498_7.pdf

[Purple_Scrubs, BSN, RN]

Does your district have written policies to guide you on things like this?

[schoolnursejennie]

no written policies. the student had no bites. the student said that his home is infested. the head of school wanted me to call parents to let them know their child had no bites. when they asked "what is the school doing about it?" i referred them to the head of school.

[Purple_Scrubs, BSN, RN]

The only thing I can think of since there are already no written policies would be to draft some, based on recommendations from organizations like the NASN, AAP or AMA. Surely with the recent headlines about bedbugs they have recommendations on this. Maybe with some evidence based information concerning this you could mitigate the panic a bit...but if the fear is anything like how it is with lice perhaps not. At least you would be armed with information. Tough situation.

[DennRN]

Hi Jennie,

I agree with you, you are not the Emergency Broadcast System.

This is however a community health issue that you are uniquely qualified to handle when compared to your non-health related collegues. I understand your frustration and your need to vent, and it is obvious that your time is precious.

From a parents/PR perspective it makes a lot of sense to have the nurse call, the school is clearly trying to perform damage control.

I'm not a school nurse so please forgive me if this won't work, but I thought I'd spitball ideas.

Nothing can be done about it now, but you can still be proactive in seeing what resources you can bring to bear on the particular students behalf to minimize impact/spread of this problem. I agree with the above post you might also want to bring this issue up again but I would broaden its scope and devise a actionable plan should any future community health issue emerge.

Devising a protocol that frees up your time to implement the necessary adjustments to ensure health on an individual and aggregate level, while still getting out the information in a timely manner just makes sense. I would push for a policy that includes support staff to notify parents. One potential issue with this might be privacy/confidentiallity. I would include that you will be responsible for notifying parents of those students that are symptomatic of the illness/condition as it arises, and will field calls from parents who request to speak to you. This would allow you to best serve the students daily needs as well as emergent issues.

I hope some of this is useful to you.

-Dennis

[schoolnursejennie]

thanks for your input guys and your advice. i really appreciate it, i am just so grumpy! i know that it was my responsibility to alert the parents that this was happening in school but i just feel like the teachers and administration is dumping on me because they feel like anything non academic is automatically my responsibility. i just started at this school about 2 weeks ago. apparently there was a similar situation last year and the last nurse who was there for 4 years did nothing but send one letter home to the student that had the bed bug on her. so, i'm thinking devising a protocol that the school can follow in the future is not a bad idea. again thank you so much for your advice!!!

[Sudsy]

Would your school do emails rather than calls? I do emails for this sort of thing and it is SUCH a timesaver. I work in a private school, though, and we don't have anywhere near the number of rules to follow that you do.....(btw, I know the few parents who don't use/check their email and those few I do call).

Hang in there, Jennie!

[schoolnursejennie]

i work in a private school as well. the problem is that the students come from NYC and many are poor and may not have internet access at home. emails would be a lot more efficient though. thanks!!