Isolation Room

[schoolnurse1118]

Hi,

What are your thoughts on a covid isolation room? It’s been recommended that we find an available room, with sink and bathroom available and possibly an exit door. Any child expected to have covid will need to wait there until they can be picked up.

My worries are:

—Who is monitoring this room (in full PPE gear) while I’m tending to sick kids in my office? Do I try to get someone else to help with routine visits while I man the isolation room? Budgets are tight

—I feel like a TON of kids will be sent home given the list of covid symptoms. How many kids with cough or nausea or headache do we see that stay in school? Now kids with any of the 10+ symptoms must be sent home? I will need 30 isolation rooms!

It just feels so overwhelming especially since you can also be asymptomatic. Will I spend the majority of my year triaging “Is this possibly covid?” ??‍♀️

Thanks for any advice!

[ruby_jane, BSN, RN]

So....in our district the initial plan is to have the nurse be detailed to the isolation room (in full PPE) IF the kiddo needs that much observation. The clinic assistant gets the rest of the kids. If there's no clinic assistant...the secretary or designee, who are taught to give meds, are the back up.

I don't like it and predict that will change.

We are now having the teachers call when they send in a coughing student (to allow the nurse to properly garb, adding the N95 to whatever s/he is wearing. You are right.

We've prepared the principals that this year their staff is absolutely, positively going to have to keep the non-ill, FF, math-itis, "I have a headache" kids out of the clinic.

Flexibility. That's going to be key.

I am worried about nebulizers and suctioning. We just don't have places to do those in enclosed rooms that may be shut for three hours to let particles settle.

[JenTheSchoolRN, BSN, RN]

On 7/28/2020 at 9:15 AM, ruby_jane said:

So....in our district the initial plan is to have the nurse be detailed to the isolation room (in full PPE) IF the kiddo needs that much observation. The clinic assistant gets the rest of the kids. If there's no clinic assistant...the secretary or designee, who are taught to give meds, are the back up.

I don't like it and predict that will change.

We are now having the teachers call when they send in a coughing student (to allow the nurse to properly garb, adding the N95 to whatever s/he is wearing. You are right.

We've prepared the principals that this year their staff is absolutely, positively going to have to keep the non-ill, FF, math-itis, "I have a headache" kids out of the clinic.

Flexibility. That's going to be key.

I am worried about nebulizers and suctioning. We just don't have places to do those in enclosed rooms that may be shut for three hours to let particles settle.

My state has recommended not using nebs and working with providers on alternatives. But I have found a small use space for neb in absolutely needed.

My school is hiring me an LPN, which thank goodness! That person and I will alternate between the nurse's office and isolation space as needed. I will have to do all the initial COVID assessments, but if I am called elsewhere, my LPN can stay in the isolation room or work with a scheduled medication kid, for example. My state guidance is that teachers have to call the nurse if a kid has any of the symptoms, and the nurse has to go to the classroom (in proper gear), collect the student and bring them for assessment to the isolation space.

I will say this, my guidance is that headache, fatigue, and nasal congestion/runny nose ALONE, are not COVID refer outs. They need to be in conjunction with another symptom and I can use nursing judgement to determine if runny nose may be due to documented seasonal allergies, for example, when nothing else is present.

Now diarrhea, nausea. Those are such frequent complaints that sometimes are related to students with anxiety, especially if they are short lived. So that will be fun...