Head Lice!

SnowyJ, RN · Nov 14, 2014

Thanks for the great resources!

The AAP does not endorse exclusion from school for head lice. We are lucky to have our school physician write our own policy.

I also have a "don't ask/don't tell" policy, or else half my day would be head checks.

As a courtesy, I will check a class if they have lice. Like someone else said, I rarely find others in the class with it.

I have had 8 children so far this year. (That I know of.) Not a huge deal considering the size of our population.

OldDude · Nov 14, 2014

I do want to throw this out while we're on the subject....be careful about doing classroom head checks. You may have to defend that action some day and there really isn't a legitimate defense. Since lice don't carry diseases and are not a health hazard what could your defense be? How about ticks? They can carry disease but if a student comes to you with a tick attached to their scalp, do you go check all the students in that's child's class? Transmission mechanism is the same as lice. Or if a child visits your clinic with a flea on them? Do you go do a classroom head check? How about an ant, suspicion of scabies, bedbugs???? Yes, back in the day when we did classroom head checks our district was threatened with legal action for just this reason. So, be careful, this subject is hysteria driven, just sayin.

JenTheSchoolRN, BSN, RN · Nov 14, 2014

I do want to throw this out while we're on the subject....be careful about doing classroom head checks. You may have to defend that action some day and there really isn't a legitimate defense. Since lice don't carry diseases and are not a health hazard what could your defense be? How about ticks? They can carry disease but if a student comes to you with a tick attached to their scalp, do you go check all the students in that's child's class? Transmission mechanism is the same as lice. Or if a child visits your clinic with a flea on them? Do you go do a classroom head check? How about an ant, suspicion of scabies, bedbugs???? Yes, back in the day when we did classroom head checks our district was threatened with legal action for just this reason. So, be careful, this subject is hysteria driven, just sayin.

I wish I could persuade my school to avoid classroom checks, but I have gotten them to limit it "class only." Our young students tend to travel with the same group of kids all day and I only check them with a *confirmed* case - I have yet to see any spread student-to-student. I am hopeful I can do away with that later this school year given that data... I have been able to do away with classroom head checks with a confirmed case in the high school grades.

I will always check siblings of a student with a confirmed case of head lice, however.

allnurses Guide · Nov 15, 2014

OldDude . . .fortunately I was given that same advice when I first started as a school nurse. I do not do classroom checks.

Good post!

SnowyJ, RN · Nov 16, 2014

If I stopped checking classes, the teachers would be very upset. My worry is that it gives a false sense of security..I could easy miss something when I am checking 26 children.

I personally feel that checking students should be a parent responsibility, not mine. But this practice of checking whole classes for lice has been in place for over 20 years and heaven forbid I change it now.

Though I have certainly considered it. WAY too time consuming. I have a very busy office.

SassyTachyRN · Nov 17, 2014

We don't do classroom checks. Period! I simply tell the teachers that our policy is that we only do checks on kids with itchy scalps as part of our nursing assessment or those whose parents call and ask me to check their child. I don't investigate into the "my child was at a slumber party and so and so has lice." I also ask teachers if they want to deal with the angry parents who call wanting to know why their child's head was dug through at school, they usually say uhhhh... No.

SnowyJ, RN · Nov 17, 2014

For me, this precedent was set a long time ago. (Checking classes.) The teachers are used to it, and expect it.

I am still thinking of doing away with it. We have no formal "policy" on checking classes. Not sure why they even started doing it at all WAY back when. Come to think of it, I remember my class lining up for lice checks when I was in elementary school and that was a looooong time ago. I guess old habits are hard to break.

Flare, ASN, BSN · Nov 17, 2014

i don't terribly mind checking the little little ones - the pre k's and kindergarteners as those kids still have nap time and no sense of boundaries. The older kids - especially the ones that are not housed with the same cohorts all day are too difficult to do mass screenings on. I've told parents before there's no special training needed to look through hair to find things that shouldn't be there. Check regular, treat thoroughly if there's a problem.

cynmrn · Nov 19, 2014

I'm seriously already over head lice. We had a small change in policy that allows kiddos who come up with live head lice to stay until the end of the day rather than being kept in the office all day if a parent doesn't want to/can't pick up. We still call parents and a lot of them will come pick them up, and we encourage this...YET. Teachers are FREAKING OUT, first of all, thinking that we are just

"allowing" lice to roam free and second of all, thinking that this has caused a big outbreak of lice. No one believes that lice don't fly/jump, no one believes anything that I attempt to tell them about how lice is spread. Today, I had a parent call me freaking out because her kid has had her head checked EVERY DAY for the last couple weeks and was excluded from an activity at school today because the teacher was afraid she would spread head lice (she was found to have live lice today; no other days). I can't even....Mom is on full war path mode...

SnugglePuggle, MSN, RN · Nov 19, 2014

I had a parent come to me and request that I do a classroom check because her daughter had Lice and "she had to catch it here at school." I explained to her that we do not do classroom checks anymore and she wigged out! She actually asked me if she had cause for a lawsuit against the parents of the "suspect" classmate. LOL

Flare, ASN, BSN · Nov 19, 2014

oh, i had a parent who accused me of lying last week when i sent his child home with lice when he asked if lice was going around and i told him that i had know of no other active cases. it's not like i can give him a list of names. He emailed another staff member and told her to forward the email to one of the administrators because i was lying and he knew for sure that there were other cases of lice in the school. Good to know he's out there personally checking heads. :sarcastic:

abbibarnes · Nov 19, 2014

We do classroom head checks here only if there is a confirmed case in that certain classroom. I had a class at the beginning of the school year that was a class of 15 that had 8 of them with lice!! I then went from those 8 to their siblings, and some had them and some didn't!! I then had some of the older siblings of the group of 8 that were in basketball, so I then went and checked the entire basketball team!! Whew!! What a day that was!! 2 from the basketball team in addition to the siblings that were on the basketball team had it. The 2 that had it were close acquaintances with the siblings that were on the basketball team. So I do firmly believe that in this case particularly that lice does spread quickly. I also in a sense don't believe that we need to go looking for the problem either.