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!
They only permit epi pens and inhalers? Like if a kid is supposed to take a prescribed medicine daily at noon/lunch, then too bad? That seems wrong.
Because, especially in the upper grades, there are kids who will take something
JUST BECAUSE IT IS THERE
Without any regard for potential interactions or allergies. And there are just as many that will sell their meds at school, given the opportunity. Kids go to pharm parties where all available meds are dumped into a bowl and handfuls are taken, just too see what kind of high they get.
There absolutely need to be limits on what kids can and cannot carry in school. My kids carry diabetic stuff, MDI's, pancreatic enzymes. After that there are in the health office.
Because, especially in the upper grades, there are kids who will take something
JUST BECAUSE IT IS THERE
Without any regard for potential interactions or allergies. And there are just as many that will sell their meds at school, given the opportunity. Kids go to pharm parties where all available meds are dumped into a bowl and handfuls are taken, just too see what kind of high they get.
There absolutely need to be limits on what kids can and cannot carry in school. My kids carry diabetic stuff, MDI's, pancreatic enzymes. After that there are in the health office.
THIS!! This problem could be at any age level. Say there's a student taking PCN for a few days and brings it to school. Drops it on the ground accidentally. In an elementary school, a curious kindergartener might think "Oooo Candy!!!" and take it. Could be allergic, now there is a student having an allergic reaction in a school with no nurse. You ask the mom if he/she is taking a new med to rule out allergy and of course, NO he/she isn't and the kid is still thinking it was candy.
At the high school level, if a student drops their PCN, another student might pop it in their mouth hoping it's something that will get them high.
THIS!! This problem could be at any age level. Say there's a student taking PCN for a few days and brings it to school. Drops it on the ground accidentally. In an elementary school, a curious kindergartener might think "Oooo Candy!!!" and take it. Could be allergic, now there is a student having an allergic reaction in a school with no nurse. You ask the mom if he/she is taking a new med to rule out allergy and of course, NO he/she isn't and the kid is still thinking it was candy.
At the high school level, if a student drops their PCN, another student might pop it in their mouth hoping it's something that will get them high.
Precisely! Kidzcare. The zero tolerance policies were enacted because we have to account for the lowest common IQ. These policies really protect the school more than the children, schools can say they enforce these policies, so when something happens, it is on the student. The majority of us with common sense are the losers because a small minority can't function at that level. It is where our society lives. The hardest part of this for non-school nurses to get is that what we don't know, we don't know. Let's equate this to an inpatient scenario. Let's say a perfectly stable pt. with a history of HTN, nothing else suddenly becomes unresponsive. Respirations 6, pulse 40's, BP 90/30. You go through most of the usual suspects as the pt degrades further until someone suggests Narcan. Now you say to yourself, but I didn't give him anything, and he isn't ordered anything, but why not?, let's try it. He wakes with a start and lo and behold, he was OD'd. You had no idea that those visitors came in and gave him his fix, for that matter, you didn't even know he was a user. Our student populations remain fairly stable and we have enough kids that we don't know complete histories on, throw pharm into it and it can get bad real fast. This is why we go nuts on this stuff. Hope this helps clarify why we feel the way we feel.
I worked as Camp nurse in 3 summer camps Surprise Lake camp,Kinder Ring Camp and "organic" camp Eden Village Camp. I have to say , from my point of view and it is subjective data( I never collected any statistical data) school children in US are "over medicated.I remember we had counselors from Britain and they were surprised too. Too much medication for allergy,depression, anxiety, ADD/ADHD, steroids.
I learned a lot regarding Asthma management there and the treatment for anaphylactic shock was professional. It was the best immidiate care. So there are advantages in immediate care, but also so many disadvantages in preventative care and lack of education for healthy lifestyle, sport ,stress management: children were asking for NSAID and knew the difference between Tylenol and Advil from age 11-13. (other example from the camp :Heel Viburcol Vials - Homeopathy and Holistic Healing.was used by UK counselors and it is OCT "covered by Ministry of Health " in Germany, UK, Israel but forbidden to be used in USA.)
As for overprescribing antibiotics, I realy do not want to go there, but Europien Gidlines are so striked and culture definition reminded to clients every appoitment from 2003.
I hope that the medical system will be changed and preventative care will be managed better in primary care.
I work at a small private school ( pre-K thru 8) one day a week. My responsibilities are keeping vaccine records updated and reported to my state health department, keeping track of pre-school and kindergarten yearly physical exams and dental exams, and health screenings ( hearing, vision and scoliosis. No meds are allowed at school unless it is a inhaler or Epi- Pen that can be self administered. I also am back up for our local public system ( pre-K thru high school) and that includes everything I do at my private school and driving around to the multiple district schools to do a daily med pass. I would love for my private school to have a bigger budget so I could be there more often. Cough drops are prn at public school ( when I'm there for a routine med)and mints or life savers are offered at private school. Sorry so long.
My daughter was in Catholic school up until a couple years ago. There was a nurse from the state that came in to do screenings and paperwork. She was allotted so many hours at the school based on the school's population from the previous year. The rest of the time, they depended on volunteers. I honestly have no idea how they handled meds. I know they had Epipens but I'm not sure about inhalers, etc. I doubt they had diabetics there. The school closed down last year so I'm sure the issue was mostly budget.
Oh, and as far as cough drops go, I get the really gross ones from School Health (honey flavor). No kid is purposely trying to come down for my cough drops!
Oh, and as far as cough drops go, I get the really gross ones from School Health (honey flavor). No kid is purposely trying to come down for my cough drops!
I get the gross ones as well, but it doesn't stop kids. You get 3 cough drops for the day, kids, and you're done. I have an order for them.
I also manage diabetics, but have a couple with pumps that keep on their own and see me only if needed (I carry their back-up kits); it didn't always work that way, but I helped them transition to this as I can't be there when they are in college!
Farawyn
12,646 Posts
He comes to the nurse's offfice and takes it there.