First week as elementary school nurse

[peaceful2100, BSN, RN]

Last week was my first week as an elementary school nurse. I have done high school before.

I have a couple questions.

1)Do you call parents over every single Recess injury sent in your office? Obviously, Recess time is a very busy part of the day. Obviously I know big stuff like anything involving the head, and possible concerns with fractures/sprains is a call home but, what about the rest?

I feel like I am walking on egg shells and don't want to overly call.

2) If the kids at your school wear uniform and they are out of compliance is that your issue to deal with?

Fridays is dress down day if the kid pays $1.

10 minutes into the start of the school day I had 6 kids (3 from the same class at the same time) in my office because they was not in uniform and they did not have a $1.

I already had a couple kids with legit medical issues in my office at that time.

The nurse closet barely has clothes for kids who have accidents on themselves during the school day which I know that is definitely my issue.

[NurseBeans, BSN, RN, EMT-B]

1. No, only for visible scratch/cut/bruise to face or neck, or if I feel like the student needs medical care beyond me (concussion eval, fracture obviously, etc) OR if I know that parent is a needy Nellie who wants a phone call for every little paper cut

2. Not a chance. These kids will never learn responsibility if they have the nurse covering for their poor choices/poor planning. I used to lend sneakers to the girls for PE when they wore boots or sandals to school and I finally cut it off because I realized I was only enabling them. Also, you are not the clothing department at Sears, you are the nurse and you have serious business to conduct

[OldDude]

I see you're settling in well

[moreoreo]

I have been at my elementary school for a couple months. I was told prior to starting that my school is especially over-cautious and that I "would hear about it" if I did not call parents even for the small things. So anything on a child that is different from when they arrived (even some papercuts), I do call. Even if they fell and their hands are red but not bleeding, I call. Some parents, I can tell kind of roll their eyes at my phone calls (especially those who have clumsy children who come for a bump or fall every week) but most are very appreciative.

I have preschoolers and I do call on nearly every visit for them even if I think they are totally fine, because they are so little and also they cannot be relied upon to tell mom or dad about not feeling well/falling/etc. today.

One thing I do not call about is losing teeth, unless the tooth is literally lost or came out early due to injury. I think that is an expected event and not one they need the nurse to explain! I usually do not call about nosebleeds either unless they are frequent or heavy or more than one in a day. Some may disagree but when I was little we took care of those in the classroom, so unless a child has a related condition I don't feel it warrants a call home.

I will mention, that an aide brought a student in early one morning last week because "her shoes are too big and she forgot her backpack," in the middle of handful of other children who fell outside at morning recess. I took care of it, but does it make sense to the parent when I tell them I am the nurse but that's why I'm calling them? Because it doesn't make sense to me.

[RatherBHiking, BSN, RN]

If I had to call for every injury I'd never be off the phone. I did make up a form letter with blanks that basically says " The injury did not appear serious at this time but if any pain, bruising, or swelling are bad enough to interfere with daily activities please follow up with your dr and feel free to call with any questions." It saves more time than calling. If it's something more severe like a questionable head injury or sprain I call. I have a couple parents I know to call if their child graces my presence.

The clothes I don't understand what they're wanting you to do. Give them a dollar or make them change into a uniform? That should be administration. If what they're wearing is fine if they'd brought a dollar then why is it your job to enforce the rule? If that's a huge issue with kids then the special dress for a dollar deal needs to be stopped since it's not working. It's not like hat day where you can just make them remove the hat for not bringing in a dollar!

I also had a gym teacher who would send me kids that forgot their gym shoes. I said nope, they'll never learn to wear them if they aren't made to suffer consequences. Make them sit out a few times and they'll learn.

[Amethya]

1) I have to yes, because I need to document and I don't want to be called later or the next day with mama bear yelling at me for not telling her child got hurt.

2) Sometimes, if I can't help them, I tell them to call their parents to bring them clothes or they have to go to the Admin and ask for a pass for the day. If I do not have a size for them, that's what I do. But if they keep sending you these kids, make sure to ask if that's your responsibility, because you have a limit of clothes and you need it for children who have accidents.

[MrNurse(x2), ADN]

My administration wants every visit followed up with a call or email. I see 10-15 students per day with an average of 4 minutes, so it isn't asking much. It also has an added bonus that they are able to see who my FF are.

[scuba nurse, BSN, MSN, RN]

I call for anything that is major, like a bruise or cut they didn't come to school with, or something obvious. I do not call for random "invisible" things that I give badaids or ice packs for.

As for the uniform....HELL NO, that is NOT YOUR JOB! The nurse doesn't dictate what people wear, the policy is to be enforced by the principal or whoever, but not you. Maybe the previous nurse took this responsibility on, but being new, I would tell the principal upfront that it is not your job.

[janetpa]

I agree with the above posts---I do not monitor uniform compliance however I do have a very limited supply of sweatpants/sweatshirts (from the unclaimed lost and found) in case of an accident. I always call if I think there will be a bruise. Either I or the teacher will call the parents of Kindergartners for just about everything till they ask us not too but that is because of their age. I also call if I want to alert the parents of the possibility of an injury being worse than what it appears. I always call for head injuries--we are very conservative regarding concussions. Our school is smaller so I don't send a note home.