Frequent Flyers

Specialties School

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Just started my first year school nursing and I have been trying to manage my frequent flyers who took advantage of the nice school nurse last year.  Any tips for the FFs that seem to be overly dramatic and relentless until they are sent home?

Specializes in school nurse.
1 hour ago, BrisketRN said:

This is awesome.  Our cleaners are more focused on spraying down surfaces & my corners have become very dusty. You're getting me thinking...

Go for it!

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Specializes in Cardiology, School Nursing, General.

I remember when I had my FF. I wasn't playing around with them, I would ask them why. They would sometimes tell me something was going on at home or in the class, so I would send them to the Dean of Students to handle that and I would call parents to let them be aware of the student's visits. 

By the time I was there in my last year, I cut down my Original number of having 65 students visit me every day my first year to only 10 a day my last year. 

You can do it OP and don't be afraid to asks questions here, if I didn't do it here, I would've not survived my last job! Good luck!

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Specializes in retired LTC.

Amethya - welcome back!

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Specializes in School Nursing.
On 10/22/2020 at 3:00 PM, Lbarba84 said:

Any tips for the FFs that seem to be overly dramatic and relentless until they are sent home?

If there is nothing wrong with them back to class and let the teacher deal with their behavior. 

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Specializes in school nurse, hospice, OB.

I let the kids come in initially until I get to know them, then if they are coming in frequently I first want to ask the "why".  I have lots of kids who are frequently in my office, but most of the time there is a reason why- often not physical in nature.  If I am truly here to serve the kids and their needs, I want to figure out why that child is seeking so much attention.  Is it possible they just want out of class?  Yep.  But is it because they are doing poorly, can't pay attention, are behind in their work, have a learning need that has not been addressed?  I find that kids that are healthy physically and emotionally, and their needs are met, they are not the kids that come into my office.  

My thought is, who cares if the stomach ache is caused by a virus or by anxiety?  If it is a need, then it's a need.  If I can meet that need then the visits stop or slow down.  What if the kid just needs support or a hug? (yes, I know we are limited right now) 

If the pat on the back, the hug, the peppermint, the not needed ice pack, the temperature check, etc.  provides the child with a feeling of being taken seriously and supported, then I have done my job.  They are only kids.  How much responsibility is an 8 year old supposed to have?  Adults complain of aches and pains all of the time.  

I fear that school nurses feel the need to not be the nice nurse because they are taken advantage of, or the kids use the visits inappropriately.  I disagree.  I will be the nice nurse, but I will also tell the kids who need to go back to class to do so.  My job is to see each child and use my best judgment to figure out if there is a deeper need first.  I couldn't care less if the student comes in for a daily dose of kindness, as long as it is not taking away from time in class or interfering with school.  I do work to find a balance.  But more times than not, that kid who kept coming in had a deeper need, often a crappy life outside of school.  I can be that person who loves them unconditionally.  And once in awhile, we can ignore an issue with a child who has cried wolf so many times that their real symptoms are not taken seriously.  Just my opinion. 

 

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27 minutes ago, nurse elaine said:

I let the kids come in initially until I get to know them, then if they are coming in frequently I first want to ask the "why".  I have lots of kids who are frequently in my office, but most of the time there is a reason why- often not physical in nature.  If I am truly here to serve the kids and their needs, I want to figure out why that child is seeking so much attention.  Is it possible they just want out of class?  Yep.  But is it because they are doing poorly, can't pay attention, are behind in their work, have a learning need that has not been addressed?  I find that kids that are healthy physically and emotionally, and their needs are met, they are not the kids that come into my office.  

My thought is, who cares if the stomach ache is caused by a virus or by anxiety?  If it is a need, then it's a need.  If I can meet that need then the visits stop or slow down.  What if the kid just needs support or a hug? (yes, I know we are limited right now) 

If the pat on the back, the hug, the peppermint, the not needed ice pack, the temperature check, etc.  provides the child with a feeling of being taken seriously and supported, then I have done my job.  They are only kids.  How much responsibility is an 8 year old supposed to have?  Adults complain of aches and pains all of the time.  

I fear that school nurses feel the need to not be the nice nurse because they are taken advantage of, or the kids use the visits inappropriately.  I disagree.  I will be the nice nurse, but I will also tell the kids who need to go back to class to do so.  My job is to see each child and use my best judgment to figure out if there is a deeper need first.  I couldn't care less if the student comes in for a daily dose of kindness, as long as it is not taking away from time in class or interfering with school.  I do work to find a balance.  But more times than not, that kid who kept coming in had a deeper need, often a crappy life outside of school.  I can be that person who loves them unconditionally.  And once in awhile, we can ignore an issue with a child who has cried wolf so many times that their real symptoms are not taken seriously.  Just my opinion. 

 

Totally agree--it's that fine line between addressing an issue and enabling them to miss out on class time.  I find myself teetering on that at times.  This is why it's so important that every school has a nurse and a social worker/guidance counselor.  Kids need the holistic care, and they need someone watching out for them.  Class sizes play into this too.  When a teacher has 30+ kids, the one who is having issues at home might be overlooked because the teacher is just trying to stay afloat.  But kids really do need us.  I watched the Mister Rogers documentary a few years back, and when they showed clips of him talking about addressing the emotional needs of children and how important it is for adults to consider kids' emotions and my world was totally rocked.  The way I treat these little ones might stick with them forever, and if we aren't totally bogged down by having too heavy of a load we might be able to be their safe space.  We might be able to be the one who helps them to cope with the aches and pains they'll experience throughout life.  We might be the one who realizes they need resources for a deeper issue.

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Specializes in school nurse, hospice, OB.

Yes!  Totally agree.  I know that little kids are excellent actors, I know they do try to take advantage of situations to get out of class, homework, etc. but the memories I have of teachers and school is remembering feeling loved and accepted, right now the whole year has rocked everyone's world.  A lot of kids are anxious and don't talk about it, but it comes out in other ways.  

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Specializes in Peds.
On 10/29/2020 at 10:12 AM, nursetlm said:

Guidelines for Nurse’s Office2016.docx

I don't have any specific advice- but this form helps me quite a bit at the beginning of the year.  

I love this document and will certainly "borrow it" to tweak for my office.  I do have to say that I am extremely jealous that you get a lunch break.  If I get to eat my lunch, it is as I am monitoring a student in my office.  Good for you!  Thank you for sharing this document.  So well worded.  I am going to share it with my fellow county nurses. 

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Specializes in School Nurse.

I also tell the story of the boy who cried wolf.  "You want me to believe you every time you come in"

 

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Specializes in school nurse, hospice, OB.

yes, good one for sure!

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On 3/9/2021 at 2:49 PM, BrisketRN said:

Totally agree--it's that fine line between addressing an issue and enabling them to miss out on class time. 

We want the health office to be comforting but not comfortable (as in, a place to relax from math class).

 

I switched schools in the middle of a school year a few years ago and the previous nurse was obviously a lot more casual than I was. I had (junior high) kids coming going "I've got a headache" and proceeding to the nearest chair and pulling out their phone without another word. It took me about a month to get the number of unscheduled visits a day from 80+ to ~40. 

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Specializes in School Nursing.
On 3/23/2021 at 11:16 AM, kidzcare said:

We want the health office to be comforting but not comfortable (as in, a place to relax from math class).

 

I switched schools in the middle of a school year a few years ago and the previous nurse was obviously a lot more casual than I was. I had (junior high) kids coming going "I've got a headache" and proceeding to the nearest chair and pulling out their phone without another word. It took me about a month to get the number of unscheduled visits a day from 80+ to ~40. 

Wow. If you have a headache, the last thing you should be doing is reading your phone. Did you institute a 'no phones in the clinic' policy?

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