New school nurse here - previously worked in public health and a hospital ED.
I like the job, I like ruling my own roost, I like the kids (high school), the pay is OK and the hours are amazing...one thing I can't figure out is my coworkers, the teachers and aides.
Our district has a clear policy that work-related injuries are to be called to the occ health triage nurse, and then if needed the employee reports to the designated urgent care or ER. I was very firm about setting those limits from the beginning - nope, I'm not looking at your injury - and that part is now going OK.
Apart from that though, the teachers and aides are in here constantly....they want ibuprofen, they want me to look at a bug bite, they want an ace wrap, they have a cough and want to know if they should go home. For OTC meds I generally have an overabundance (we can only order large bottles; our school is small and meds generally expire before I can use them up), so I will say, "I don't give medical advice or recommend medications to coworkers per district policy, but if there's something in this cabinet that would be useful to you, you may take it."
I'm a pretty direct person. Asked to look at someone's stitches, I said, "You should call your surgeon if you have a concern; I don't want to give you bad information" Asked if I think a teacher should go home sick when she had a cough, I said, "That's up to you - you should do what you think is best. I'm not your boss and you don't need an excuse from me. I hope you feel better."
And yet....this continues. It just seems really weird to me. These folks have good insurance and it's hard to imagine how to express myself more clearly. Does this happen to you? What do you say??
Yesterday I had a staff member show me their swollen ankle and said "if I've done this before and the doctor just told me to ice it and take ibuprofen then I really don't NEED to go to the doctor this time right? I don't want to spend money to hear the same thing again." So I said "you're an adult so you can make that decision, but if you were a student I'd call your parents and recommend they have a doctor check it out." Then he stares at me and says "so I can just not go to the doctor?" You do you booboo.
Myself, I usually invest in some "grown-up" otc supplies, and allow staff to "borrow" if they want. I don't make recommendations about what they choose to take however.
Specializes in Cardiology, School Nursing, General.
I always get the adults asking me if they should go home or not and what I think of things. I keep telling them I'm not a nurse, but I would suggest to go see their PCP if they feel that's something wrong.
If they ask me if they should go home, I tell them they can make the decisions from that since they are adults.
Thank you for posting this! I am not a school nurse but I work in a large office building and am the only nurse in my department. I get asked to look at people's scabs that aren't healing, teach them about their meds, etc. I hear them sometimes giving each other BAD medical advice (these are office workers, I.T. professionals, etc.) and I try to bite my tongue and not get involved if it's nothing serious. One coworker wanted to adjust his own BP meds and asked my advice. Um...NO!
It's been that way as long as I can remember and isn't likely to change. It's a balancing act. You need to remember most of these people have never lived life outside the walls of some kind of educational institution. I'll leave that at that.
I offer nursing assessments on a regular basis to staff (however frustrating it is) but I don't step over the line to endanger my nursing license. Pick your battles. There is one of you and a bunch of them. They would not be asking you if they didn't look upon you as a medical authority. So, keep everything in perspective and try to move forward for the collective good...know what I mean?
Yesterday I had a staff member show me their swollen ankle and said "if I've done this before and the doctor just told me to ice it and take ibuprofen then I really don't NEED to go to the doctor this time right? I don't want to spend money to hear the same thing again." So I said "you're an adult so you can make that decision, but if you were a student I'd call your parents and recommend they have a doctor check it out." Then he stares at me and says "so I can just not go to the doctor?" You do you booboo.
Do you think part of this might be attributed to lousy insurance and the staff hoping you'll tell them it's ok to not see a doctor to save them the expense?
Well then folks, at least it's not just me! I just wanted to make sure.
The funny thing is, they're hanging on my every word about self-care for a URI. Yet, the one time this school year that there was potentially a real emergency (female teacher who never comes in with anxiety-type questions for me, mid-50's, every risk factor for cardiovascular disease, hasn't seen a PCP in years, c/o chest pain and nausea, diaphoretic, had that bad color, feeling of dread)...not so much. Teacher absolutely refused 911 call, saying she was going to refuse to let them do an EKG and would refuse transport no matter what. Impervious to my long explanation that simple EKG, xray and labs would go a long way toward ruling out big problems and "You're right it could be nothing, you're right that you'll be stuck there for several hours. But it would be much better to go home tonight with a GERD diagnosis than die at home this afternoon. I know it's not what you want to hear, but literally any nurse or doctor would send you to a hospital right now."
Eventually she decided to have the principal drive her to the hospital - believe me, I also let them know why that was a bad idea, and documented my recommendations. They ended up keeping her overnight and doing a stress echo the next morning, so they must've seen something a little funky...who knows, she was annoyed at me for being the bad guy, and didn't discuss the outcome in detail. But at least I didn't have to bust out the AED in my first month on the job, ha.
These teachers are the same ones that send kids to the clinic in droves!!!
OK, your user name is the best. Because that's my other question - WHAT IS WITH THE ICE? Why does everyone (students and staff) want ice packs all the time? Also, why the fascination with Ace wraps? I have never seen so many people who want to compress and ice their healthy body parts!! :)
It's been that way as long as I can remember and isn't likely to change. It's a balancing act. You need to remember most of these people have never lived life outside the walls of some kind of educational institution. I'll leave that at that.
Oh my goodness- that is the single most insightful thing I have ever read about teachers! (I have a LOT of teacher friends) Seriously wow!
I find it frustrating when the same teacher keeps coming back to complain about their illness or ask over and over again what they "should do", after I have already told them what I think. I just had this happen last week. A very young (both in age and maturity level) teacher's aide who is 21, already has a 2 year-old came to ask me about her pain, bloating and cramping. Long story short, I told her that she needed to call her OBGYN and get checked ASAP, based on her HPI. She came back the next two days in a row with the same issues and continued to ask more questions. I again said you need to go be seen NOW. She finally went and got seen and totally has a pelvic infection from her IUD I mean seriously, if you are going to ask me my advice, for the love of God, listen to it! When she told me what they found I said "I am so glad you finally listened to me and got checked". She laughed like it was NBD. I think she really doesn't get the seriousness of it and how badly it could have ended.
I mean seriously, if you are going to ask me my advice, for the love of God, listen to it! When she told me what they found I said "I am so glad you finally listened to me and got checked". She laughed like it was NBD. I think she really doesn't get the seriousness of it and how badly it could have ended.
BrisketRN, BSN, RN
916 Posts
Yesterday I had a staff member show me their swollen ankle and said "if I've done this before and the doctor just told me to ice it and take ibuprofen then I really don't NEED to go to the doctor this time right? I don't want to spend money to hear the same thing again." So I said "you're an adult so you can make that decision, but if you were a student I'd call your parents and recommend they have a doctor check it out." Then he stares at me and says "so I can just not go to the doctor?" You do you booboo.