Does your policy have "teeth"

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Specializes in School Nursing.

The age old question for my SN Peeps......So we strongly recommend that if a student has Vomited, had Fever or Diarrhea, they should stay home and be free (from either malady) for 24 hours.

Now the problem is: This is only as STRONG SUGGESTION. We do not have a written policy for this.

Most parents will adhere to this. Some do not.

The problem is when the parents send them back to school the next day and the teacher becomes irate with me because they are here.

I tell the teacher that if the parent sent them, then there is nothing we can do. Of course if they get sick again and are not acting normal...then of course I will call the parent.

I get dirty looks from teachers about this, but what in the world can I do ? I have asked that we get something written in stone about this SUGGESTION, but the powers that be are not wanting to do this.

How is this situation handled in your school system. Any suggestions will be greatly appreciated.

Oh, and have a great weekend to all of my School Nurse's !!

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Specializes in Home Health,Dialysis, MDS, School Nurse.

My school has very few actual policies relating to medical. I think the only ones are that we need parent sig and dr. order for medication and one on communicable diseases. I asked about writing some policies and was told they would rather have me put them as "procedures" and then these would go into the handbook. So not law, so to speak, but strong suggestions. So to answer your question, No they don't have "teeth", and I'm not sure having them in the handbook will do any good either.

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Specializes in school nurse.

If kids just show up post (fill in the blank) in spite of policy, no we don't send them home. On a slightly different but related note, I strongly disagree with being pigeon-holed re: the vomiting and going home practice. A lot of vomiting is mechanical in nature (esp with the little ones) or psychosocial (I had a kid who could vomit on demand when he didn't want to go to class). I prefer having some judgement/wiggle room. Also I ascribe to the "if a grown-up didn't see it, it didn't happen" philosophy of vomit reporting.

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If kids just show up post (fill in the blank) in spite of policy, no we don't send them home. On a slightly different but related note, I strongly disagree with being pigeon-holed re: the vomiting and going home practice. A lot of vomiting is mechanical in nature (esp with the little ones) or psychosocial (I had a kid who could vomit on demand when he didn't want to go to class). I prefer having some judgement/wiggle room. Also I ascribe to the "if a grown-up didn't see it, it didn't happen" philosophy of vomit reporting.

There are always exceptions. ie: The student who had lunch and then sprinted in PE 5 minutes later who vomits gets to sit in my office for a while and hydrate. Our handbook also notes that vomiting must be witnessed and that everything is left to nurse discretion.

Our policy does state that students MUST stay home. But some parents send them anyway and I cannot police this 100% of the time.

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Specializes in school nursing, ortho, trauma.

i am not a huge fan of the 24 hr rule myself. More so because the teachers are incapable of seeing any gray zone whatsoever with it. They will march a student into my office that just barfed up their nachos after trying their best on the "spinny toy" (i hate the spinny toy) and will argue with me that the student needs to go home. Uh, no... if i had a pack of rampant 4th graders sit YOU in the spinny toy and spin you with a belly full of school grade nachos from taco Tuesday, i'll bet you'd create a masterpiece on the playground that Jackson Pollock himself would have been proud of.

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Specializes in Home Health,Dialysis, MDS, School Nurse.

This is what I am proposing goes in the handbook this year: (there is nothing currently)

  1. Vomiting: Students who vomit in school (witnessed) will be excluded and parents/guardians notified. There may be exceptions if it can be determined that vomiting was caused by factors such as nervousness, excessive crying/anger, phlegm in throat, ect. Children who vomit at home should not come to school until free from symptoms for 12 hours.

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I'm not a fan of the 24 hour rules unless it is viral, meaning the child is sick, and not puking after track, football, or the dreaded shuttle run.

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I do not like the 24 hour rule for a single instance of vomiting, honestly, I may not even send a kid home for a single episode. I agree that if there is a clear non-contagious cause, no reason to miss school. However, if your kiddo has been reflexively vomiting, dry heaving, chills, and otherwise "looks sick", for the love of Pete, keep them home for 24 hours!

Oh and if an adult did not see it, it didn't happen. Also "I threw up in my mouth a little bit" does not count for anything!

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Also "I threw up in my mouth a little bit" does not count for anything!

I tell the kids that real vomiting will be forceful enough that it cannot be contained in the mouth

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Just had a kid come in from throwing up in the cafeteria because a kid did something gross with his food and it made her sick and she threw up.

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I tell the kids that real vomiting will be forceful enough that it cannot be contained in the mouth

Truth.

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I tell the kids that real vomiting will be forceful enough that it cannot be contained in the mouth

Ooh, I like this! Gotta remember for next time!

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