How many kids do you see in a day?

WineRN · Mar 29, 2017

I'm in a k-5 around 400+, Most days around i see around 50.

BUT I have been taking measures to cut it down. My first 2 weeks I saw between 60-70 kids each day.

The previous nurse would keep EVERYONE a minimum of 30 minutes. All bumps, bruises, tummy aches, head aches, and chronic pretenditis students got to sit or lay down in the office. So the frequent flier flock was bigger than I think most are. Once they figured out that I wouldn't be keeping them in my office, and if they stayed it would be pretty darn boring, most of them gave up.

I also have talked personally to teachers if they are sending me the same child with the same symptoms all day. I try to do this either during my lunch, after school or first thing the next day. So far all of the teachers I've spoken too (with two exceptions) have responded well and send far less.

And as others have mentioned, parents are the best at getting their little ones to stop. If its bad I call, explain that their child is fine medically but keeps returning and *avoding* class and that I need them to talk to their child to help convince them to return to class. This method usually induces tears and sometimes anger on the child's part, BUT they never come back after that.

I'm slowly getting down to more 40 and i had a 30 student day recently that was extra awesome. I'm thinking of sending out a letter similar to what was posted on here for the fall.

Nurse_JackieVA, BSN, RN · Mar 29, 2017

I'm in an elementary school with 560 students. Today was a slow day (2 grades out on fieldtrips and 1 grade testing) - only 34 kids but usually to 40-50 depending on what day it is.

Amethya · Mar 29, 2017

580 students, K- 8th grade. Typical day around from 20-30 students, give or take some FF and medications.

RNLisaC · Mar 29, 2017

Don't you include your med visits? You document those as well, right Schoolnurse73?

RNLisaC · Mar 29, 2017

What grades are you managing? It is okay in your meeting to give some general guidelines for the most common complaints. For stomach aches, teachers should ask how long they have not felt well and if less than 30 minutes, then send students to the bathroom, hydrate and rest at the desk and if after 30 minutes still not well then send. Headaches, same ask how long, hydrate and wait 30 minutes prior to sending. It truly still amazes me how many times the answer to that question is discomfort for less than 5minutes. Make up bandaids bags for each class and tell the teachers replacement bandaids or injuries that are simple can be washed in the bathroom and give student a bandaid. You want the active bleeders or playground abrasions, but not the picked cuticles, etc. Sore throats; as long as they do not have a fever, I usually give them a good salt gargle and they never come back, but I ask the teachers to have them drink some cold water before sending. Allergy season is coming so I like to remind the teachers that sneezing, nasal congestion, watery eyes, dry throats are normal and encourage water be allowed desk side to push fluids. likewise bug bites are coming and the little angels can use one of your bandaids you gave them and during recess or snack time they can come down for some anti itch lotion, but that is not a reason leave a math lesson. The bangs and ice seekers 80% of the time they don't need ice and are trying to make the classmate that accidentally hurt them feel bad or are attention seeking. I usually ask the student to demonstrate on my arm how hard they were banged and after they demonstrate a light tap, I reassure them they are not bruised, swollen or bleeding and send them back. If they really wind up I pull my arm away before I need ice...but that is rare. What paperwork are you bringing home? It is a process to find your own way, patience. It's really a great job and out of the mouth of babes will have you smiling more than anything else...for example. Kindergartener comes in for I forgot reason but had untied shoes so I ask him to lift his foot on my open draw because "I am an old lady" to which he responds you don't look too old, you don't even have a beard yet! I laughed so hard my gum flew across the room.

Thanks! These are great tips! I did write up some guidelines based on what I have seen, this forum (thank you!!) and something else I found online that I will present tomorrow. Of course I have to run it by admin.

The grades are K-7 but we are getting 90 new students next fall because they are adding an 8th grade! I feel as though things need to get in some type of order before this happens.

I'm grateful for all the responses. I ran numbers by the director today and she was shocked but glad that I was able to find something to give as examples.

RNLisaC · Mar 29, 2017

I have 650-ish in my school. I see about 30 per day, plus daily meds. I have never taken work home at night or over the weekend. It definitely sounds like a talk with the teachers is in order. Good luck!

Thanks for the luck! I take home a copy of the daily log and the laptop so that I can do my notes. I can get through some of them throughout the day but between all the visits, calls to guardians and other things that come up, I just don't have time.

I also have a school nurse manual I got online for the State as well as the statutes, etc. so that I can start to read it over and come up with policies/protocols. Today I fell behind again because the nurse no showed for the field trip and I had to go on it. I LOVE the kids. It is just so much at once and with nothing in place, I have no choice but to take work home. But this is keeping me up at night :-(

RNLisaC · Mar 29, 2017

I have around 800 - usually see 45-55 a day.

I cannot wait to present these numbers. Only 300 students and Monday I saw 48.

RNLisaC · Mar 29, 2017

560 in my biggest school and when I'm here a full day I see about 30-40. I have 225 in my small school and I'm there a half day a few times a week and I see around 10 on average (some days just a handful, the max is 18 this year). I don't take work home. Definitely keep educating the staff and kids, eventually they will catch on. My kids knew after my first year that I won't give an ice pack for an "invisible" injury. They quit asking.

Thank you!! I plan on the education. I love the "invisible injury." I cannot believe the obsession over ice packs for everything and cough drops!

RNLisaC · Mar 29, 2017

I am really lucky b/c this year my school is K and 1st, a total of 240 kids. Last year was just K. I see maybe 10 kids/day. My worst day so far this year was a day I saw 20 kids in the first hour I was here, all with high fever, sore throats, etc. I have zero kids on daily meds right now which I know is a major blessing. Part of that is because they are so young. I am sure next year when I have K-2 there will be some. I also made big tupperwares for the teachers at the beginning of the year with lots of ice packs and lots of bandaids. This significantly reduces my visits. I have a few frequent flyers that I am managing with the teachers and parents. My school has a LOT of kids with stressful social/home issues so some of my visits are more social/emotional than anything else and I try to remember that when I get frustrated with the same kid coming in to see mt three times. Yesterday I had a little girl who has had some major behavior issues in the classroom, also has really awful eczema and complains of stomach aches a lot. Some hygiene issues as well. Found out yesterday she is now homeless and staying in an emergency shelter So while I might not see a lot of kids on a daily basis, when I do, I am often doing more than "nursing" stuff, which most of us do as school nurses. I think the important thing is for you to make sure your job is respected, as well as your time. If the same kid is coming 4 times a day all for stupid stuff, time to call home and speak with the teacher. You need to be able to see kids and get everything done and no way should you be taking work home with you.

That is so sad!! There are a lot of sad cases here too and some strange things that I learned. Lots of IEPs and 504's. It's a charter school. I have tried speaking to a couple of teachers but it hasn't helped, that is the reason for the meeting tomorrow. And I am only an agency nurse!! They want me to stay on and I have not said anything yet. I hate to desert them because of the number of nurses they have had. Thanks for all your input!

RNLisaC · Mar 30, 2017

Small Catholic school. 200 students, Pre-k to 8th grade. Average visits 15-22 per day. I occasionally get a day where I hardly see anyone but those are outliers. When I first started last year I would treat everybody, even those invisible boo-boos. I was always nervous to get a phone call from an angry parent saying how I didn't do anything for their baby.
But this year, I'm a little more practical and I am tired of being behind on everything. No bleeding, no visible scratch, back to class you go no matter how much they says it hurts. Stomach ache with no fever, giggling and talking my ear off...water and rest for 10 minutes and out the door. If I'm not too busy of course, I will place a band aid on a non-existent injury.
It can be tough though because teachers send for everything!! But what really gets to me is the important stuff they won't send in. Like yesterday for example. About 3:00, student comes in saying my teacher thought I didn't look good all day. School gets out at 3:30. Sure enough, 102.7 fever. But she will send a student because of a tiny microscopic paper cut. Or another one that drives me nuts is when a teacher sends someone where they do need immediate attention and then they send another student in from their class asking what is taking so long!
As I'm typing this, the infamous third grade teacher (most of the frequent flyers are from her class and the class is big!) sent a student in because another kid accidentally hit his eye. Really?? There was nothing going on!! Ice pack number one sent out for today. It better come back to me and not end up on the floor!

This is still less than what I see percentage wise. I love that I have these numbers. I am just using the number of students and how many visits, not mentioning anything else. I'm so glad I have this!!!

I'm learning about the stomach aches and headaches that come and are all up in my business, smiling and talking my ear off LOL. I am not going to start with the invisible boo boos (so cute though).

I can't believe what the teachers send! And you're right, what about the important stuff? I laughed so hard about the microscopic paper cut! A healing bruise the size of a pea, yet a kid stabbed herself with a pencil in the face and they don't send. ANNNNNND they want me to do the training so I will delegate. I'm going to feel comfortable delegating to those who are nervous about a one inch scratch? I think my favorite is a pass from the student to tell me there is a pencil in the urinal. That took the place of the teacher that asked me if the students could do his work in the office because he was coughing.

I limit the ice packs because the teachers love them as much as the students. I have so much to learn and I have to say, I'm learning a lot from here!!

RNLisaC · Mar 30, 2017

I don't have daily meds as well. I do have three students every Tuesday use their inhalers before gym. And throughout the year, I'm usually giving out PRN neb treatments, benadryl, pain relievers, etc. All of which have doctor's orders of course.

That sounds decent. Stupid question but do you lock up all of your medications including the inhalers? I have been given some backlash because I am told that the statue states that the inhalers don't have to be locked up. I don't understand this because it's a medication. I am researching further.

RNLisaC · Mar 30, 2017

My campus is Pre-K thru 2nd grade. We have 840 students total. I see 90-100 students a day!! (This does include 16 daily meds) I really wish I knew how to decrease this number because at least half of these are nonsense visits! I have tried talking to the teachers but it did not help.

And you are by yourself???? I'm taking the advice of others here and am going to try to get through to the teachers. They also suggested that I go around to every class and tell the students when to see the nurse. I don't want to do this. I would rather do this in the office. I really feel for you!! How do you put in all the vaccines, do screenings, input immunizations, etc.? Do you take work home?