How do you manage your clinic?

Flare, ASN, BSN · Apr 27, 2012

If I am handling an emergency and another student comes to me with something minor, I simply tell them to leave their name on one of the stickies on my desk and that I will call them back when i am able to. It another emergency crops up, i can handle more than one - but i certainly am not going to see a student for a sore throat they've had for 3 days when i have a diabetic tanking on me. Sometimes I'll just tell then to return in 20 minutes. It's amazing how often the urgent need for the nurse fades because the period has changed and the students are in a class they enjoy.

Purple_Scrubs, BSN, RN · Apr 27, 2012

That's a good idea to have them leave their name and to call them when you are ready. I give them a note to return in 30 min (or whatever time frame I think is reasonable), but I like that much better. I do get a quick temp on them before sending them along, but if they pass a quick visual inspection, are afebrile and are well enough to chat, they are well enough to wait in class until things settle down.

rdsxfnrn · Apr 27, 2012

Silence is golden! Seriously, I do let them chat but if they are well enuf to chat and fool around then they dont need me, do they?Back to class they go! Get rid of the books, you are making it too enjoyable for them. :)

mc3, ASN, RN · Apr 28, 2012

Books are gone! :) That was a good suggestion. I'm afraid if I start a clipboard, I'll never get back to them because of the flow of kids not letting up. Seriously. I figured it out last week. I see 1 kid every 6-7 minutes. Non-stop. Between trying to assess and treat, and calling home (often 4-5 calls to finally get someone, or I have to wait until the translator gets to my office). I consider myself very organized, but this has been a tough year. We've had the most kids ever, and I was used to having someone help me when it got busy, but that's not happening. If it continues, I'll have to talk with the AP. I just don't want to sound like I can't deal with it.....

mc3 :nurse:

OnlybyHisgraceRN, ASN, RN · Apr 28, 2012

I subbed at a school with 420 kids and will get 40-60 visits a day. I have several diabetics and when they were sick many students had to wait.

If I assessed them and they are fine, they are going back to class.

If I can't assess them right away, I tell them to have a seat and I will be with them in a minute.

I love school nursing but couldn't see myself being in the health room full time. It really gets annoying seeing the same students with minor issues.

SchoolNurseHolistic · Sep 13, 2012

It sounds like your school ABSOLUTELY needs a 2nd nurse. That is actually quite dangerous to be responsible for that many students/faculty. I would really strongly encourage you to advocate for yourself, and always use the word "safety." Many parents and schools want to know the kids are safe. If you state "It is unsafe," you may be heard.

I am strict about the nurse's office as far as behavior, buddies tagging along, etc. I hate to be so no-nonsense, but otherwise the kids think it is too fun to come...then I'm stuck documenting fake sore throats.

If I have even 2 kids (treating one, one is waiting) and a third comes, I ask if it is an emergency and if it's not then I say come back in 20 minutes.

NutmeggeRN, BSN · Sep 13, 2012

Our school has about 1000 kids and 60 staff. I see about 50-60 kids/day. It's just me in the clinic. The old receptionist was wonderful in helping me out, and further back up was a call away, but now it's changed. The new one is nice but not helpful. She was medication trained but has yet to step into the clinic to look around, never mind do anything. She's too busy redecorating the office (seriously) and yes I know I'm being mean but it's the truth! And yes, I've asked her many times.. I'm hesitant to say anything because the principal hand-picked her and loves her. I'm looking for a better way (if there is one...) to take control of the clinic when I've got all chairs full and others waiting in the outside chairs. Obviously, I triage them, but I'm wondering....the ones that are chatting and seem fine don't really need to be there, but I have to take the time to check them before they go back. The diabetic kids and the obviously sick kids naturally get first priority, but the others end up waiting around because of it (and having a grand time chatting, goofing around, etc). It's starting to really annoy me... Is there another way I can manage this? Do you let the kids talk while they're waiting, or do you make them be quiet? I put away the coloring books and crayons (I keep them in my desk) because I swear the younger ones just came up to color. ( I have a basket of books they can look at while they wait.) Or is this just a typical clinic and I just need a vacation???
Thanks for your thoughts,
mc3:paw:

You are certainly over the 750:1 Ratio recommended by the NASN :dead:

I would ask the prinicpal how she would expect you to best utilize the help you have. That you value her and want to make sure that everyone is seen...blah blah....maybe it will get her thinking...or maybe not.

Good Luck!