Help me understand school nursing or lack there of. (I'm a LTC nurse)
It is a small Catholic grade school. We have a school nurse from the local school district. She is only there once a month and it isn't to see children but just complete paperwork? I think she goes to all the local Catholic schools in the district.
So, what happens when the children get sick? What should happen?
Right now, only inhalers and epi pens are permitted and in the absence of a RN or LPN, the child is only permitted to administer the medication. It doesn't say anything about insulins (we haven't had diabetic children than needed insulin....we did have a child with a pump a few years back)
So...no more cough drops at all. A letter came home stating that parent can send in 2-3 cough drops that the home room teacher will keep for the child. The child must take them on their own. This will be fazed out because cough drops are used as "crutches". I get the fact that cough drops, even Ludens non menthol, are considered meds...in LTC we need an order for them too.
I guess I have an issue that we really don't have a school nurse. We had a child that had a seizure once. I think they were told "we can't handle him" I'm assuming this is where the parents would need to get a nurse to go to school with the child?
Do you have the secretary call the parents to come in to give cough drops? Tylenol? Tums?
What suggestions do you have for kids with a cough? Sip on water? Cough med at home before school (not really effective)? Keep the kids home for the week or so until the cough subsides?
Petition the school to become the school nurse in exchange for free tuition? :) ....if only this was an option! I have my BSN but no school nurse cert!
I live in Canada. Our public schools (in my region, anyway) never have school nurses. It's just not a thing that's done. We have public health nurses that cover about a dozen schools each and, I'm pretty sure, deal mostly with immunizations and care planning for super medically complex kids.
When I was in high school not that long ago I had tons of meds with me all the time. Advil, Tylenol, cough drops (god forbid). I had friends who carried their own prescription meds - inhalers, whatever else. All school staff were trained how to use epi-pens and so were all the kids, actually. I remember learning how to use an epi-pen in the second grade because I grew up with a kid with anaphylactic allergy to peanuts. It is crazy to me that teeangers can't be trusted to carry their own cough drops?
No. They do sneak it, and they can be trusted with cough drops.
The problem is, if you need a cough drop in the hospital, it would have to be ordered. Remember tessalon perles? Any kind of lozenge? It was always a PRN order. So, because of that, it's considered a med, an therefore, they cannot carry.
The only things the kids can self carry are inhalers and Epi.
I agree with most of our protocols, but self carrying cough drops at the HS level seems a bit overkill to me.
Anyway, like I've said, I'm not ransacking backpacks for cough drops.
I don't carry cough drops. They're considered a med and I don't have parental permission or a standing order for them. While they are legitimate, really, most students aren't using them appropriately and it takes learning time away to have them come and get one anyway. I carry tums, advil, and tylenol in terms of OTC meds because that's what I have permission to give. But, and I think this is the important part. Those are not emergency meds. If they weren't available, some students may be more uncomfortable briefly but the vast majority would be able to function just fine overall.
But, I think as others have pointed out, that the bigger issue is the lack of a nurse in general and the need for administration to see that concern and fix it.
It's my understanding that Private schools are kinda like private nightclubs. If you agree to their rules and can afford the membership you can come in. They are answerable only to state and federal statutes. It's a bitter sweet deal. Private schools have their advantages but not having a school nurse "ain't" one of them. So, unless and until, it becomes a priority for the administration of the school it's not gonna happen. I don't think it's a budgetary issue. Good luck and keep hammering at em,
Exactly! I am a private school nurse. We didn't have one for ten years. This school had volunteer office staff that would give out afternoon meds (when they remembered, very infrequently) and gave no prn's. Had a few "more than minor" traumas that rocked them, thankfully to staff kids, so the need wasn't as evident. We are now in the process of expanding and most of the parents coming through are stoked that there is a nurse and many have chosen here based on that fact. It was a budgetary issue here, but they feel that the liability was just too great. I discourage cough drops, instead, I push fluids as that makes for a better outcome all around. I live in an area where which private high school you attend is more important than the university you went to and companies look more at that than anything, so school nurses are pretty common in private schools around here. Until someone steps up at the school and volunteers or makes arrangements, it won't be a priority.
I'm certain there are all kinds of meds floating around the halls of jr high and high schools. Way easier for a kid with a cold to have his/her parents tuck some Sudafed in a back pack and say "take this at noon" than to go to the hassle of calling the dr for a signature, bringing it in to the nurse's office, and then picking up any remaining. I confiscate what I see, but I don't search back packs.
In my area, you don't have to have your school nurse cert. to be a nurse at a school. You can be an assistant nurse or just use the title RN-avoiding the whole "school nurse" title because that implies certified. Our private schools operate much the same way. The HS and MS nurses in our district cover all of the private schools, but only for screenings, immunizations, and other required stuffs. They do not see students for illness/injury visits. All meds are given by parents or, in the case of Epi-pens/inhalers, self carried and administered by the student. The office staff handles illness and injury, which basically consists of calling home for everything (or nothing, depending on which school!) 2 of the private schools have done exactly what you suggested, they have an RN mom there in exchange for tuition.
As for cough drops, I need an order to administer. But lots of places use a consent slip for parents to sign at the start of the year. I don't like my elementary kids carrying cough drops. Last year a kid choked on a cough drop that was given to him by a friend, year before that a girl broke out in a crazy rash after having one with red 40(known allergy). So, yeah, they can't be trusted. I send them with 1 extra, if I think they really need it. I've had to call parents to say "enough with the cough drops already! Your kids is missing sooo much class time and is NOT coughing" For coughing/sore throat I use ice chips, water, maybe a mint, salt water gargle.
Private schools do not have to accept everyone, so they can pick and choose if they want the responsibility of diabetic or known seizure student. It is disheartening knowing that there is no one with any in-depth knowledge of disease process, medications, emergency care watching over the student body.
The coach at my school found a bunch of cough drop wrappers during a 1st grade class, second period. When asked the student admitted to having his pockets full of cough drops when he came to school. Without supervision the student probably had 10 cough drops by 9am. Cough drops are probably as effective as a peppermint - same amount of sugar too. If someone does bring them, I wait every 2 hours before giving the second. I prefer h2o at their desk &/or salt water gargles (SWG). I assume private school office staff would not do the SWG. In an unsupervised circumstance I agree with admin - no cough drops at private elementary school.
Specializes in School Nurse. Having conversations with littles..
I don't go to night clubs either, LOL. I'd love to try school nursing but getting the certification isn't in my budget now
Michelle- Come to Missouri. No certification required, and we have an amazing State School Nurse Consultant. I am the School Nurse that I am because of her. True Story.
I don't go to night clubs either, LOL. I'd love to try school nursing but getting the certification isn't in my budget now 
Farawyn
12,646 Posts
No. They do sneak it, and they can be trusted with cough drops.
The problem is, if you need a cough drop in the hospital, it would have to be ordered. Remember tessalon perles? Any kind of lozenge? It was always a PRN order. So, because of that, it's considered a med, an therefore, they cannot carry.
The only things the kids can self carry are inhalers and Epi.
I agree with most of our protocols, but self carrying cough drops at the HS level seems a bit overkill to me.
Anyway, like I've said, I'm not ransacking backpacks for cough drops.