Handwashing at School

ruby_jane, BSN, RN · Dec 11, 2018

Sigh. Well...you have two doctor's notes. Is this accompanied by a dose of a steroid or non-steroid cream and liberal application of lotion? The kid has to actually wash his/her hands a couple times a day, right???

As a side note, in second grade RJ Junior had a massive eczema flare of hands related to the soap and (sand)paper towels. Alcohol hand sanitizer (used in the time of the Swine Flu Plague) was also bad. We ended up with a non-alcohol sanitizer and put different soap in the class sink for everyone to use, and brought Bounty paper towels (for everyone to use).

Guests · Dec 11, 2018

I would think baby wipes would be more irritating to eczema than plain water. More likely to remove germs with vigorous back and forth under running water than a few wipes with a baby wipe anyway. Oh well. I agree I would be ticked off as well with that other teacher.

UrbanHealthRN, BSN, RN · Dec 11, 2018

Sigh. Well...you have two doctor's notes. Is this accompanied by a dose of a steroid or non-steroid cream and liberal application of lotion? The kid has to actually wash his/her hands a couple times a day, right???

I've brought up the idea of keeping lotion in the classroom, but because these kids are 4, they'd have to use the lotion under staff supervision, and I think staff see it as too much of a hassle to be repeating the special soap/lotion routine multiple times a day. I've also wondered if we could designate certain situations for handwashing, like before meals and after the bathroom, but the doctor notes literally say to use only wipes.

I would think baby wipes would be more irritating to eczema than plain water. More likely to remove germs with vigorous back and forth under running water than a few wipes with a baby wipe anyway. Oh well. I agree I would be ticked off as well with that other teacher.

For the first kid, wipes were a source of irritation, until mom found the right brand. I'm thinking it's going to be the same with the second kid- trial and error, not an overnight fix.

Side note to Ruby- Bounty brand? Kudos to you! I'd be in your classroom whenever I needed to wash my hands just for that name-brand softness.

MrNurse(x2), ADN · Dec 11, 2018

Feel free to use my anecdotal for handwashing... my MIL had obtained C-Diff after her stint in a rehab facility after hip surgery and I had to get her and 3 boys under six to the urologist at 8AM. She had completed her vanc treatment and was having solid stool, so I wiped her down with a baby wipe and got a new one for my hands. Thankfully I had an awesome doc who called in my vanc order. Her C-diff lasted 6 months and needed transplant to abate. Sometimes soap and water are the only thing that protects you.

nursekoll, BSN, RN · Dec 11, 2018

I have a couple kids in elementary that are sensitive to the school's soap. They bring their own soap to use at school, provided by the parents. No Dr. order, just moms requesting this. I'm fine with it, as long as they are washing with some type of soap! I would be curious to see if the baby-wipe kids are sick/absent more than others. It doesn't seem to me that baby wipes would be very effective in removing germs.

UrbanHealthRN, BSN, RN · Dec 11, 2018

Feel free to use my anecdotal for handwashing... my MIL had obtained C-Diff after her stint in a rehab facility after hip surgery and I had to get her and 3 boys under six to the urologist at 8AM. She had completed her vanc treatment and was having solid stool, so I wiped her down with a baby wipe and got a new one for my hands. Thankfully I had an awesome doc who called in my vanc order. Her C-diff lasted 6 months and needed transplant to abate. Sometimes soap and water are the only thing that protects you.

Wow! I'm assuming by transplant you mean fecal? Or something else? Either way, I will definitely add this to my ever-growing collection of "real tales of nursing".

UrbanHealthRN, BSN, RN · Dec 11, 2018

I have a couple kids in elementary that are sensitive to the school's soap. They bring their own soap to use at school, provided by the parents. No Dr. order, just moms requesting this. I'm fine with it, as long as they are washing with some type of soap! I would be curious to see if the baby-wipe kids are sick/absent more than others. It doesn't seem to me that baby wipes would be very effective in removing germs.

I have no problem either with families supplying brands of soap that they prefer their child use. I don't ask for a doctor's note, either, because most of the time the doctor hasn't discussed it with the family, and I'm not sure they'd have any way of officially endorsing every single brand of soap out there. If a soap is medicated or prescription or whatever, then of course I'll get a doctor's note for that. Otherwise, we keep the special soaps labeled with the child's name and stored away from the other kids.

I'm curious, too, about what the sickness rates will be in these two kiddos. The first kid's mom is super on top of his health, and considering his multiple health issues, I think he has some of the best attendance around. For the second kid, I'm not so sure. I know finances are very tight in the family, and so money drives a lot of their health decisions. For example, before switching to baby wipes, the family was supplying a dollar store head-to-toe wash that they thought was helpful for her eczema.

NutmeggeRN, BSN · Dec 12, 2018

I started this year with one student who has a doctor's note to use baby wipes in place of handwashing due to severe eczema. Not gonna lie, I was a little skeptical to allow this, but after talking with mom, we decided that this really is the best plan at this time.
Now there's another kid one classroom over whose eczema is flaring up, and apparently the teaching staff took it on themselves to request an MD note for the same thing- baby wipes, no soap and water. And the doctor wrote a note!
I'm kind of ticked that nobody checked in with me before pursuing this plan. I really don't want folks thinking it's ok to just use baby wipes in place of soap and water. On the other hand, as a lifelong eczema sufferer, I completely understand a family wanting to get relief for their child's eczema.
Anyone else have kids with alternative skin care/ hygiene plans at school?

They have no business contacting the MD... yeesh!

MrNurse(x2), ADN · Dec 12, 2018

Wow! I'm assuming by transplant you mean fecal? Or something else? Either way, I will definitely add this to my ever-growing collection of "real tales of nursing".

Fecal, my wife pushed the gastroenterologist for it, before it was commonplace.

ruby_jane, BSN, RN · Dec 12, 2018

Side note to Ruby- Bounty brand? Kudos to you! I'd be in your classroom whenever I needed to wash my hands just for that name-brand softness.

It was just the one year...when the school changed brands of toweling and the towels were LITERALLY sandpaper. And did not absorb a darn thing. But Bounty made me the teacher's favorite.