Do you look...

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in ears and throats? I have been told recently that if a child comes to me with a sore throat or earache, I should not take a look. I am to just report it to the parents. What do you do?

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Why not? Who told you that?

I look in throats.

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I look in ears and throats. But I do not do lice checks based on calls from outside sources saying hysterically "You can to check every child's head; I heard there was a lice outbreak!".

I've even had a janitor and a teacher in the last week ask me to look in their ears . . . . I did it. ;)

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Specializes in Community Health/School Nursing.

Before you know it all our assessment and nursing skills will be taken away from us. If we can not use our scope of practice within the school setting then the front office can send home notes and make phone calls. 911 can be used for all other emergencies. No need to have us there. Sad.

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Specializes in ED, School Nurse.

I look. That way I can tell the parent if I call, "Susie's left ear is hurting her and it looks a lot redder than her right. She should go see a medical provider to get that checked out." I love the kids who ask "Can you look in my throat and tell me if I have strep or not?" Ummmm, I can look in your throat, but 1. I cannot medically diagnose ANYTHING because I am a nurse, and 2. I cannot tell by looking if you have strep throat. I should hang a sign in my office that says that, because I repeat that statement at least 25-30 times a year.

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Specializes in school nursing, ortho, trauma.
1. I cannot medically diagnose ANYTHING because I am a nurse, and 2. I cannot tell by looking if you have strep throat. I should hang a sign in my office that says that, because I repeat that statement at least 25-30 times a year.
I probably repeat the phrase 25-30 times a month! lol but then i deal with a needy bunch!
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Specializes in Complex pedi to LTC/SA & now a manager.

One district has parents sign consents at back to school to authorize quick strep swabs. The quick strep are part of the standing protocol signed by the district physician. There was near epidemic of strep one year when parents were giving Tylenol or Motrin & sending the child back to school claiming to have seen the MD but no note since no strep.

The consent includes permission to send the results to the child's physician. Many parents appreciated this as some insurance weren't covering in office testing and requiring only Lab Corp or Quest to do the test. Saved time at the pediatrician as they already had results, could do an exam and Rx an appropriate antibiotic. This required school nurses to visualize the throat to see if the child met the criteria for quick strep.

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I look and then call parents. I have a hard time with looking at throats - unless the throat is flaming red, enlarged tonsils etc - alot of times I just can't tell if there is something going on. Ears - a bit easier since I usually have a "good" ear to compare it too.

I always call parents with complaints of sore throat and ear aches - with sore throats I usually tell them they are complaining of sore throat but I really can't tell if there is anything going on, usually a parents first comment is "do you think it looks like strep?" - with earaches I tell them I'm not a doctor but ear is red, draining, etc and recommend they have a doctor check the kid.

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Wow JustBeachy . . . . .you have a District Physician!? And your district can afford quick strep tests??

That would be so nice.

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Specializes in Complex pedi to LTC/SA & now a manager.
Wow JustBeachy . . . . .you have a District Physician!? And your district can afford quick strep tests??

That would be so nice.

Most districts in my county have a school physician paid a stipend for consults & signing off on nursing standing orders. Usually a $20,000-30,000 annual stipend. Districts with middle & high school grades (several districts are pK-4 or K-6) the school physician performs the annual physicals and sports physicals at no charge to students.

They found the cost of quick strep kits for all 20+ schools in one of the largest districts in my state was much lower than lost class time, spreading of strep & even lost staff time. I think they charge $2/test now but don't charge those who are title 1 or free/reduced lunch students.

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Specializes in School nurse.

Looking is part of the assessment. A nurse in my district found a bead in an ear. Had the parents take him to the doc who didn't see anything. She looked again and saw it. Had the kid go back and finally the doc saw and removed it. We must be able to function within our scope of practice or what's the point?

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Specializes in Peds, Oncology.
Wow JustBeachy . . . . .you have a District Physician!? And your district can afford quick strep tests??

That would be so nice.

We also have a district physician. They write and sign off on our standing orders for our emergency anaphylaxis and respiratory distress protocols (we have stock epi and albuterol with tubing and neb machines that can be given per the standing orders).

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