Frustrated to no end.....

[LACA, BSN, LPN, RN]

our county system does not have a "no nit" policy. we do however, have a policy in place that requires that children be sent home if live lice are found....

i have a k girl that i have sent home numerous times over lice. her sister is in one of the upper grades and it's been a constant struggle with her too. the parents just flat out don't care. i've sent home several informative sheets about cleaning the home and things that the children come in contact with and everything i can think of. i even went as far as to get them connected with the health department for further resources because it was becoming such a problem.

i sent the k girl home a couple of weeks ago with lice and sent home the packet containing all the information and a copy of the school board policy. parents send her back the next day with the empty box of lice shampoo and a nasty note telling me that "she must be getting it from school cause they didn't find s***. etc etc."

fast forward to yesterday, the k girl comes in around 1:30, with a note from her teacher. i check her head, and there are live bugs crawling in her hair. i call dad and he is like "okay, okay" and then hangs up on me.

she comes in this morning and immediately is itching. her teacher notices that her hair doesn't look like it has been treated (in the past, when they have actually treated it, it's cleaner and straighter). she sends her to the clinic to be checked. the girl tells me that they didn't do anything to her hair last night, except look at it. i check her head, find a bug. i call mom, she gets huffy and tells me that everyone in the family looked in her hair last night and there was nothing there at all. i tell mom i will re-check and call her back, just to hush her up. i check again, find a different bug and call back. no answer. i leave a message for mom to call me. i've called three more times, they just aren't answering the phone now.

in the mean time, i have spoke to the principal, he says she has to go home if they call back. the county nurse that floats from school to school was on her way to the middle school so i had her stop by here. we found three live lice and caught them with tape. they are now sitting on my desk. there is at least one more in her hair that we couldn't get.

i'm not going to make the kiddo sit in my office all day. i sent her to get lunch and spoke to her teacher (who is wary about the other kids getting it because this little girl loves to hug on everyone and stuff like that) and she is going to eat her lunch in her classroom.

at this point, mom still hasn't called me back. i'm really concerned that her or dad is going to get violent at some point. the principal also has that concern because he asked me to alert the school resource officer (a sherriff's dept employee who works for the school board) to come here just in case they show up fuming. however, the resource officer is off today! of all days!

this little girl has missed several days r/t lice. i've done everything i can think of....

what should my next step be???

[BunnyBunnyBSNRN, ASN, BSN]

Can you send a visiting teacher to the house to alert the parent's the child must be picked up? Can the principle contact transpo and tell them not to pick the child up on Monday? (forcing the parents to bring her to school and show proof of tx) Can you treat her at school?

Ok, with all that being said...at some point, you are going to have to decide that this family is chronic and just educate the children to keep their hair pulled back, not share jackets, brushes, etc, and pray that when they grow up and can take care of themselves, they will. I have a couple in my school that are chronic licers and I've gotten to the point that I just don't send them home. I send home a letter and an info sheet, but other than that, I would rather these kiddos stay in school and (hopefully) get an education so when they grow up, they can decide not to live this way. We get out of school at three, so I save my head checks for 2:00p when I can. That way, I can call the parent and send a letter home - I'll even put them on the bus "since school's almost out and you'll treat her at home tonight".

Good luck!

[LACA, BSN, LPN, RN]

The parents showed up out of the blue about an hour ago to pick her up. I wasn't here, I was at the high school doing drug testing.

I can't treat her at school due to liability issues.

I've even gotten to where I wait until the end of the day to check most of the time. But when she's digging at her head and complaining that it itches, I can't NOT check her. I can't leave her at school when she has live bugs because at her age, they love to "love" on each other and stuff and it would be impossible to keep her from all the other kids, unfair even. I guess I will have to wait and see what they say on Monday, if they bring her back.

[Flare, ASN, BSN]

We abandoned our no nit policy a few years ago. However, if a student is sent home because of lice, they may not return to school unless rechecked by the school nurse with a parent present. If lice are found they must take and treat he child immediately. Can't even check in to class. Because of the ongoing nature of this, you may want to consider getting a doctor involved as well. If you are worried for your safety, definitely ensure that principal and/or the school resource officer is present for all encounters with these parents.

[LACA, BSN, LPN, RN]

I'm definitely worried about my own personal safety at this point. Both of the parents have shown some anger towards me, and I don't want it to escalate. I don't think it would do any good to even attempt to get a doctor involved, they aren't going to care. The principal and the resource officer are both backing me and they are aware of the situation.

[Flare, ASN, BSN]

Well, i know it's not what you want to hear, but if they continue to ignore the lice situation, it warrants a call to child protective services. I know it would throw a cup of gas on the fire so tread lightly.

[rdsxfnrn]

i agree with previous poster. the child is not being provided with a safe clean enviorment. you are mandated to report it. you can get in alot of trouble for NOT reporting.

[Purple_Scrubs, BSN, RN]

Someone told me recently that lice alone is not a reason for CPS to investigate a family (or reason alone for someone to report). Anyone else heard this?

[luvschoolnursing, LPN]

As far as I know, CPS will not investigate this. Our county health dept. considers it a nuisance, not a health concern. We have had parents call the health department to report us (the school nurses) because we would not release the names of who had lice. Lice seems to cause more panic than HIV, TB, H1N1 and MRSA combined!

[rdsxfnrn]

in CT, where I am, you must report ..... not for the nits, but for child neglect..... "......being denied proper care and attention..." straight off the back of the DCF paperwork...... btw, the thought of that makes my skin crawl. poor kids.... there is no liability to mandated reporters if they make the report "in good faith"

[jagalu100305]

i have called CPS before re a student with CHRONIC head lice and also missed a week of school because mom didn't feel like treating it and they told me it was a truency issue and wouldn't do anything

[Flare, ASN, BSN]

i understand that lice is considered a nuisance, but this probably merits a home visit to see if the living conditions are santary. Also - the untreated lice *could* cause an infection if lesions on the scalp are not properly treated.