I know there are dozens of threads regarding this itchy, annoying, emotional topic but I am interested in an up-to-date response regarding how you check for lice themselves.
The reason I am asking is because I have a parent who kept her child home from school today. The student was treated on 10/16 and began coming to me for daily checks (for 2 weeks, as per our policy) on 10/17. I haven't seen ANYTHING since then. She has insanely thick hair so I really take a few minutes and look through her head. A few nits were found the first day but mom combed her out and since then she has been good. Yesterday afternoon mom messaged me saying "Little Susie has nits, I am taking her to a lice clinic tomorrow." This afternoon she sent me a photo of a cup full of what I am assuming are dead lice saying "This came off of Susie's head."
I don't get it! Am I missing something? She really had NOTHING that I could see yesterday morning. I parted her hair in several spots, used a light, used a little stick to separate the hair, checked at the nape of the neck and behind the ears. I truly didn't see anything and now I feel dopey. I'm sure mom thinks I'm a total flake (especially since she and her family worshiped the previous nurse) for not seeing this but I like to give myself enough credit to think that I would have seen all of those lice yesterday AM.
How do you guys usually check for lice? Do you do follow up checks after an infestation? I'm just looking for some insight as to how I could improve my practice.
Specializes in School Nurse. Having conversations with littles..
Well here's the thing. It's not YOUR responsibility to make sure her kid stays/is lice free. She could've picked up something after you checked her or maybe one or two nits hatched and began the whole process over or they finally got big enough to see well. Either way, I always tell the parents I only have time for a quick screening but YOU need to be thorough. YOU need to check your child daily, weekly, etc. I don't know why that's your policy. That's taking responsibility away from the parent.
And yes, I have missed lice before even after checking thoroughly. Sometimes they're just too tiny, match the hair color too much, or maybe the hair is just so thick. Those little suckers move fast and avoid the cold air as I part hair. Plus I just don't take a long time to check. I just don't have time for that.
Don't feel stupid. It happens and why didn't the parent catch it before that point? Probably because they expect you to. They aren't yours to raise. Even if that's your policy, change it around to making the parents responsible and you as just a back up in case THEY missed something!
Specializes in School Nurse. Having conversations with littles..
Our policy for lice is: If lice are found by me, the child's parents are notified by the end of the day-the child is not excluded. If found at home-well, most parents won't tell me anyway. The child may return to school after being treated. They should bring in the box top from the treatment and be checked for effectiveness by me. If the child is not crawling with live lice, they come back to school and I do not recheck until 10-14 days later. All cases of lice found by me get a letter home that explains that PARENTS must be diligent in checking for re-infestation and treatment effectiveness. This is NOT a school issue, it is a home issue and I'm so glad that our policy supports that!
I do quick screenings for lice. Part the hair, use a light, I usually ask where they have been itchy the most and start there.
Becky- Would you be willing to copy and paste or attach your parent letter? It sounds like it has some really good wording that maybe we could incorporate in our letters.
Specializes in School Nurse. Having conversations with littles..
I ask where its itchy, and I part and really get in there. I use a lighted magnifier to really make those bugs BIG! Then I wash my hands really well. If I see nits or live lice, home goes a packet on mythbusters, how to clean hair, how to handle environment, a letter to sign and return and usually a follow up phone call. I always let the parent know I'm willing to help in any way I am able.
Oh-
Its a big problem here, and one that continues to spread due to complacency at home, unfortunately. Most parents that I am able to follow up with "I don't clean house" or "got tired of combing" or "they wouldn't sit still" or "I didn't feel like it" or "I combed until 2 am!" some other nonsensical reply when the student is obviously totally crawling and its not a fresh new hatching.
Oh tamarae- I like the idea of a letter home that the parents sign and send back. Mind attaching it or copy and pasting?
Then I wash my hands really well. If I see nits or live lice, home goes a packet on mythbusters, how to clean hair, how to handle environment, a letter to sign and return and usually a follow up phone call. I always let the parent know I'm willing to help in any way I am able.
grammy1
420 Posts
What is it that your policy says? How long to you have to check them on a daily basis?