Cutting down on visits

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Today starts the last 5 weeks of school and by now I know which students come in for minor and unnecessary issues. I send back a FF that did not have fever with stomachache-he thinks it was his breakfast- he wanted to lay down, but assured him he could go back to class- he's tried the whole "but my stomach keeps hurting and my mom told me to have you call". I've already spoken to the mom after he was picked up for sever pain and went home but wanted to play video games, so she doesn't want him missing class. Today a kid asked me if he could draw until he felt better -he came in for nausea- i allowed him to sit up and instructed him that laying down will not help if he is nauseated- i observed him for 10 minutes and send him back to class , if he actually has vomiting episode he'll come back.

I love my job and I like caring for those kids that have chronic issues, so i don't want to get burned out with visits that require non-nursing attention and can be handled in the classroom or are non-existing stomachaches just to get out of math class. I'm sending emails to teachers and letting them now which students are coming in frequently and how many times ,they are minor issues. So far it's been working.

Visits have gone down from 30-35 to 20-23 per day as of last week.

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Specializes in school nursing, ortho, trauma.

so you're getting there then! It will take a little time for your freq flyers to realize that you aren't going to fall for their BS any longer. If i have a student that insists that I call their parent to pick them up, occasionally i will indulge them, though the look of disappointment on their face then i throw them under the bus ("Jimmy is fine - no temp, no vomitting/ diarrhea... but insisted that you wanted to be called if he came in, as he assured me you'd want to pick him up") because the are usually just trying to play games. More often than not the parent will tell me to send Jimmy back to class and they can't leave work (again). I like to use those opportunities to let the parents really know what is going on: Jimmy has 29 visits logged for the year, just as an FYI... and most of them seem to be during Science class.

That changes behaviors very quickly.

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In my case, the teachers know which kids are FF's. They just send them to me because they can't taking the whining anymore!

:nurse:mc3

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Oh, and if I have another kid come up and say "Mom told me me to come to the nurse and you'd call her to pick me up" again, I may just vomit :barf01: My response is I'm sure she meant to call IF you're sick and need to go home....unless they have a note from home from Mom directly, if they're not sick they go right back.

FYI for the Moms that do tell their kids to go to the nurse? Why even bother to send them if you're telling them to call and you'll pick them up if they're fine???? I understand it's a way to get them off your back and into school, but it's just wasting my time! :madface:

Thanks - I feel better now..

mc3:nurse:

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Specializes in Acute Care, CM, School Nursing.
...Jimmy has 29 visits logged for the year, just as an FYI... and most of them seem to be during Science class...

Do you have some sort of program or something to keep an ongoing tally of how many times a student has been to the Health Office?? Other than my handwritten daily logs, I don't. I was thinking of maybe doing a spreadsheet or something. I have tons of frequent fliers, and wish there was a way for me to keep an ongoing count of visits. I think the teachers and parents would be shocked to actually see those numbers!!

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Specializes in school nursing, ortho, trauma.

my healthmaster software does that for me!

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Do you have some sort of program or something to keep an ongoing tally of how many times a student has been to the Health Office?? Other than my handwritten daily logs, I don't. I was thinking of maybe doing a spreadsheet or something. I have tons of frequent fliers, and wish there was a way for me to keep an ongoing count of visits. I think the teachers and parents would be shocked to actually see those numbers!!

I used an excel spreadsheet one time to keep track. It eventually got too wieldy to easily use. I need to use something, too!

mc3:nurse:

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Grrrrr. Big pet peeve of mine. Monday mornings are the worst! Before I can even unlock my cabinets, I have a line of students telling me they're sick and mom said to call her. Then, mom who just dropped this child off 10 minutes ago, has apparently disappeared off the face of the planet and cannot be found. The teacher doesn't want the child in the class because they've vomited 5 times at home, and I can't reach the parent and have to babysit for hours. :madface:

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What words do you use to tell a student, your thoughts: I know you are not sick (we never really know and this scares me), you have got to stop coming here for minor things.

What words do you use to tell teachers to stop sending the kids who are frequent fliers? I don't want to get in trouble or put the teacher in jeapardy for not reporting an illness.

I have the parent communication down: report the number of visits and ask if they can think of any other reason the child may need me or desire to be out of the classroom.

I would love to have a process where frequent fliers get a mtg with the counselor. I'm new, not ready to suggest this yet.

I'm finding my self stuck with sharing my thoughts in these frequent flyer circumstances. And I have an avg of 50 visitors per day in a school with 700. Its an elementary.

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Specializes in Acute Care, CM, School Nursing.

Jennyflo, I feel your pain...

My elementary school only has about 360 students. I usually average about 40-50 visits (or more!) per day! I'm told that this is a lot for such a small school, and I believe it. Unfortunately, I am used as a babysitter a lot, IMO. When all else fails, and nobody wants to deal with the child, send them to the Health Office. Last June, I had students sent to my office because they were "too hot". Meanwhile, it was 95 degrees outside, and I am sitting in my office, sweating as well! I do have a rickety old air conditioner in my office, but it's on its last legs. When I try to speak with the teachers I am told, "If the child says they are sick, we have to send them to you." There is not much support from the higher-ups, either. It is extremely frustrating...

I am about to begin my second year next week. As I get more comfortable, I'm hoping that I'll be able to speak up more.

Hang in there!

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Specializes in school nursing, ortho, trauma.

Sometimes it's like playing a game of tennis. The teacher will send the student, you'll see that it's an unnecessary visit and send the student back. Before you know it, that student is decorating your office again. I find that sending a note back with the student saying "student is ok for class" that most teachers get the message

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Specializes in school nursing; pediatrics.

Just started in a small school with infants through preK. Amazing how quickly even these little ones learn to fake it! They swarm all over me like bees when they see me. "Nurse, my head hurts, my tummy hurts..."

I agree that sometimes the teachers just send them to me because they cannot deal with their crying or whining. I do spend a lot of time just comforting (which is ok by me because I adore this age group and some of these little kiddos are on campus from 7 am to 6 pm). Sometimes just a sip of water does the trick.

One of my 4 yr old FFs is quite creative. Was in his classroom the other day and with an absolutely pitiful face got "Nurse, my leg is broken. I hit it really hard on my bed this morning. The bone is broken..."

Kids, gotta love 'em!

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