Elementary nurses - teacher referral?

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Specializes in ICU/community health/school nursing.

This week I'm getting a lot of students referred by teacher for vague symptoms ("feels hot," "looks sick," "brother was sick," "coughing," etc.)

If the student is afebrile and not acutely ill I'm sending that student back with a note saying that the teacher's welcome to call/email the parent but I can't send the student home if s/he doesn't meet dismissal guidelines.

So far that hasn't curbed anyone sending me a vaguely ill, mostly well body. I don't want to be in the habit of calling a parent just because the teacher asks, or because "he's had his head down all day and he's not working." (That one got a disco nap in the clinic and it was apparently curative).

Thoughts?

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Specializes in School Nurse, past Med Surge.
"he's had his head down all day and he's not working."

Thoughts?

This is a classroom management problem, not a nurse problem. I have similar issues with one teacher & I finally said something to the principal. I'm sorry you've got a doozie of a class this year, but if they're not sick they should be in class. I'm not about to call a parent to leave work & miss pay because their kid is tired & slacking.

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I shoot an email over to parents "Hi, so-and-so was in the nurse's office today because his teacher said he was coughing excessively. He doesn't have a fever, and his lungs are clear. So-and-so is fine to stay at school. He's back in class now. Please contact me if you have any questions." I usually get "Ok thanks," completely ignored, or a phone call back.

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Specializes in ICU/community health/school nursing.
I shoot an email over to parents "Hi, so-and-so was in the nurse's office today because his teacher said he was coughing excessively. He doesn't have a fever, and his lungs are clear. So-and-so is fine to stay at school. He's back in class now. Please contact me if you have any questions." I usually get "Ok thanks," completely ignored, or a phone call back.

I've had 15 visitors. I would have emailed 9 times today if I did that - but since we're testing I might have time for it today. Other days...I'd be sending that email out at the end of the day because between lunch recess and recess recess I am hit with an average of 5-10 of them.

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Specializes in Pediatrics Retired.

It's not OK for teachers to communicate with parents about health related issues just like it's not OK for you to communicate with parents about academic issues. Twice yearly I send out a campus wide email about staff liabilities associated with communicating with parents regarding health related issues, asking parents to come pick them up, and often times violating FERPA laws. Staff concerns about health related issues must be communicated to parents through the health office.

If your assessment doesn't indicate a sign of illness or need for intervention send them back to class with a simple note..."OK to RTC" or something like that.

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I have been having similar things. I don't mind seeing any kid but most of them go back to class. I don't get much push back. I think it's just the time of the year they're all worried they will get sick!

I wish I had an email the parents option! For me it's phone calls or notes home and i try to only do it when it needs to be addressed with parents. Every bump, scrape and sore throat does not get a call.

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Specializes in ICU/community health/school nursing.
It's not OK for teachers to communicate with parents about health related issues just like it's not OK for you to communicate with parents about academic issues. Twice yearly I send out a campus wide email about staff liabilities associated with communicating with parents regarding health related issues, asking parents to come pick them up, and often times violating FERPA laws. Staff concerns about health related issues must be communicated to parents through the health office..

AAAHHH. Well. That makes sense! I will actually have to research this because on our campus the teachers and (some) parents are in constant contact regarding the sniffles, sneezes, and coughs. I have never had a parent show up to take a kid home because of a teacher, though.

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I've had 15 visitors. I would have emailed 9 times today if I did that - but since we're testing I might have time for it today. Other days...I'd be sending that email out at the end of the day because between lunch recess and recess recess I am hit with an average of 5-10 of them.
I don't email every parent of every child who comes into my office, just if there's something to keep an eye on or if the teacher is persistent or if they're what we call "an informed parent" (up our butts about knowing about every small boo boo their precious baby has). Then I can say "mom and dad are aware."
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Specializes in school nurse.
It's not OK for teachers to communicate with parents about health related issues just like it's not OK for you to communicate with parents about academic issues. Twice yearly I send out a campus wide email about staff liabilities associated with communicating with parents regarding health related issues, asking parents to come pick them up, and often times violating FERPA laws. Staff concerns about health related issues must be communicated to parents through the health office.

If your assessment doesn't indicate a sign of illness or need for intervention send them back to class with a simple note..."OK to RTC" or something like that.

I don't like teachers assuming nursing duties more than any other school nurse, but I believe you've overstated the reach of FERPA. If a teacher sees one of their students in class with the sniffles, head down, and feels warm to (their) touch, they are certainly legally able to communicate this to the parents. (Not saying they should, but some do.) Their classroom, non-clinical observations are not PHI.

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Specializes in Pediatrics Retired.
I don't like teachers assuming nursing duties more than any other school nurse, but I believe you've overstated the reach of FERPA. If a teacher sees one of their students in class with the sniffles, head down, and feels warm to (their) touch, they are certainly legally able to communicate this to the parents. (Not saying they should, but some do.) Their classroom, non-clinical observations are not PHI.

I agree...but teachers can't help from embellishing their story with things like, "they're dropping like flies in my classroom," or "I have 4 kids out with strep," or "the kid that sits across from him was out yesterday for vomiting," - that kind of stuff.

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In the districts that I have worked for, only select people can exclude students form school. Admin, counselors, nurse AND there should always be sound reasoning and complete documentation to back those decisions up.

My current district is really picky on attendance. My principal was angry at the AT at the beginning of the year for not notifying the attendance clerk when sending injured/ill kids home. He also felt she was sending home too quickly (I threw up in the bathroom, etc) and she is a medical professional. He would go bonkers if he knew teachers were pushing kids to go home.

He likes me a lot because he agrees with my philosophy of keeping their hineys in class.

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Specializes in school nurse.
I agree...but teachers can't help from embellishing their story with things like, "they're dropping like flies in my classroom," or "I have 4 kids out with strep," or "the kid that sits across from him was out yesterday for vomiting," - that kind of stuff.

Ah, gotcha.

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