Immunization compliance and exclusion

[Mavnurse17, BSN, RN]

Hi all, and welcome back to a new school year!

This is my second year as a high school nurse. I started midway through last school year and I had no idea what I was doing, so I kind of just went with the flow and only enforced policies that were glaring, like med policies, etc. I didn't pay much attention to Texas' state law that states students need to be UTD on vaccinations or they are to be excluded from school (there are some provisional stipulations, but none of my kiddos fit them). Apparently, the school nurse before me didn't enforce it either.

This year, I am doing my best to enforce this law, since so many of the kids at my school are delinquent and have been since before the summer. Not only is this unsafe for my school, but it reflects poorly to my nursing supervisor since we're required to have a 99% compliance rate.

Long story short, I notified admin of this policy/law and gave exclusion dates to all the students that are delinquent (being extremely generous with the date...some nurses in my district only give parents one business day to get everything sorted!!). They seem to be on board since I pointed out that it's not just me being ugly, it's a literal law, but they initially reacted as if I was out of my mind. I have been diligently sending letters home, making referrals to immunization clinics, phoning parents, etc....all with no response and no updated records. How else am I supposed to enforce this if I don't exclude the kids who are continuously delinquent?

End of day today is the exclusion date for a number of kids that have been delinquent since before the summer. They are not to show up to school on Monday if I don't get a record. I'm nervous that Monday will come and parents/administration will see this as "how can you keep a poor child out of school when they're just trying to learn?"

How do you guys handle immunization delinquencies and exclusions?

[AdobeRN]

I am in Texas - it takes a team to enforce. You may need to get your principal/admin involved. In the past our principals were not to happy enforcing the exclusion - the message had to come from their boss/superintendent of the district before the principals started to back us nurses up and enforce the exclusion policy.

I know our middle & high school enforce the policy by withholding student schedules at the beginning of the year - students do not get their schedule until all paperwork, including UTD shot records are turned in.

At elementary - myself, data clerk, front office and teachers work together. I give plenty of notice to these parents. Teachers are notified on Meet the Teacher night to send parents to me to discuss and given a notice to hand to parent. First day of school if kid shows up in classroom teacher is to direct student and parent right to my office before unpacking. This year was the first year I had involved the teachers and it really helped - I had a couple kids excluded and sent home right away with parents - all kids came back a few hours later with UTD shot records.

[ruby_jane, BSN, RN]

Exactly how you did it. I do feel sorry for the kid but it's not like the parent did not KNOW about this.

It's amazing how fast we get UTD records when the parent has to come pick the student up. It's sad that the parents do it. But I cannot care more than the parent does...

[theksmom, ADN, BSN]

I am also a Texas school nurse and this is the start of my 4th school year. You are doing exactly what you are supposed to do. I hate to say that I've grown numb to the parents getting angry, but I really have; especially those who have had all summer and multiple notifications. Short of physically driving them to the clinic to get it done, there is nothing else you can do. Our exclusions start with meet the teacher. No shots, no teacher! I float to different schools and sometimes you have admin backing you and sometimes you don't. As long as you're following the law, your back is covered. Hang in there!