Judgement being questioned

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Hi all, this is my first year working in the schools. Much like everyone else, I've been seeing a lot of students sent to my office by teachers for stomach ache/headache etc who I often end up sending back to class (no fever, no vomiting after monitoring in my office- usually a rest here with water and they feel better). Today my principal (also new this year to the school) came to me and said that one of the teachers wants to discuss with the school's leadership team how students are sent back to class from the nurse's office. This same teacher came into the main office a few weeks ago and informed the secretaries that all of the students being sent to the nurse's office should be sent home from school (this was in the middle of a huge increase in flu-like symptoms, and I had already been sending kids home way more than normal). I explained to the principal after hearing about the teacher's comments that I have to go through a process - assessing the student, communicating with the parent if need be, etc and that I can't just send every student home. She is supportive so far, and hasn't ever questioned my judgement.

My feeling is that I'm going to hear from this meeting that I'm not sending students home often enough. I try to communicate with the teachers about why I'm sending students back to class, and have tried implementing a "nurse's office pass" that teachers can use to send a student to my office, and I use these to write a quick note back to the teacher. Many teachers still don't use these when sending students though, so I'm not as in practice writing notes as I'd like to be. If it seems like unusual symptoms or I've seen the student twice, I'll definitely call the teacher/write a note. I've gotten emails this year from teachers questioning how I was dealing with kids who have lice with comments like "we've never seen this before" (really, she's never seen kids with lice in school?). We also implemented new rules to deal with food coming into the schools for birthdays mainly (to address food allergies and all of the cupcakes/treats trotted down the halls), and teachers have been pretty vocal about not liking this either.
I'm concerned that the teachers have decided not to trust my judgement, and I'm worried that this will lead to more problems. Has anyone dealt with this in the past? It could be just the combination of a new front office team and longtime teachers with the school who aren't willing to accept that change in staff (or any change). My overall feeling after hearing from the principal today is that the negativity at this school is wearing on me, and if I can't win their trust this might not be the right job for me.
Specializes in ICU/community health/school nursing.
18 minutes ago, Flare said:

Teachers can be such germophobes. Uh... you work with tiny snot factories (and some not so tiny). Yes, you may get sick. Take some echinacea, wash your hands and keep swimming. Go use your prep to drink some herbal tea and think about how the school nurse doesn't get her "contracted" preps. ?

I really wanted to like this but the new system says I've liked things so flagrantly today that I cannot like any more!

1 Votes
Specializes in school nursing, ortho, trauma.
8 minutes ago, ruby_jane said:

I really wanted to like this but the new system says I've liked things so flagrantly today that I cannot like any more!

you're a serial "liker"! Outstanding!! It just goes on to prove the point of how dang supportive we are of one another! Joe V will need to make some accommodations us! No eating our young at this nurse's station

4 Votes
51 minutes ago, Flare said:

Teachers can be such germophobes. Uh... you work with tiny snot factories (and some not so tiny). Yes, you may get sick. Take some echinacea, wash your hands and keep swimming. Go use your prep to drink some herbal tea and think about how the school nurse doesn't get her "contracted" preps. ?

Our teachers are stocked with Clorox wipes. I'll let them know a student is going home and suggest a wipe down of their desk and door handles. Teacher will say "oh the cleaners will do that tonight." Then 72 hours later the teacher is getting their temp checked in my office and loudly wondering how they got sick especially since I never get sick. GEE! I WONDER!

Must be my school-nurse-germ-fighting super powers.

4 Votes

You can remind them that part of the school nurses job isn't to send kids home, it's to keep them in school if they are well enough to learn.

8 Votes
Specializes in IMC, school nursing.

You could always say the teacher isn't failing/ passing enough students. This is exactly the same thing she is doing to you. Our school sent students home a lot before I came on, now it is rare to need to send a student home. My role here is to keep everyone safe and to keep their donkeys in classes.

4 Votes

Yep you are not alone. I have been with this school district for 3 school years and I felt the same way. Hold your ground and trust me things will get better soon. And it's so good to have Administration on your side. You are the nurse on duty and I'm sure you have been doing your job well. Just explain to the teachers why you didn't send student home and keep it moving. Hold on just a little while longer.??

1 Votes
Specializes in kids.
17 hours ago, Flare said:

you're a serial "liker"! Outstanding!! It just goes on to prove the point of how dang supportive we are of one another! Joe V will need to make some accommodations us! No eating our young at this nurse's station

Better a serial liker than a serial licker...

4 Votes
19 hours ago, LikeTheDeadSea said:

I think this is similar to many of our first-year experiences in a school setting. I've talked with other new nurses that it's almost like your building is trying to test how far they can push you. If they can take advantage and get a student causing disruptions out for a day, some people will use whatever they can to make it happen.

Hold your ground - sounds like your administration is on board with you.

This.

Stand your ground. Set your boundaries. Of course, if they have concerns about a student you sent back, then yeah hear them out. However, YOU are the MEDICAL PROFESSIONAL. You know how to assess, and if you don't see a reason to send a child home, then explain it to them.

This is my second year in school nursing and it has been much better than my first.

Also know your policies because saying "per policy...." always helps in many situations.

3 Votes
Specializes in ICU/community health/school nursing.
19 hours ago, MrNurse(x2) said:

You could always say the teacher isn't failing/ passing enough students. This is exactly the same thing she is doing to you. Our school sent students home a lot before I came on, now it is rare to need to send a student home. My role here is to keep everyone safe and to keep their donkeys in classes.

This is funny, but right on. Teachers don't completely understand us and we don't understand them. But I do not question how a teacher teaches, at least not out loud. Maybe to y'all. Maybe in my head. Hope you now have enough ammo, OP, to feel good about the meeting.

1 Votes

I think this is all good! I was pulled into the meeting mid-day and after this teacher and principal had been talking already, so I'm not sure what was said before I walked in. The only thing they asked me for was a consolidated guidelines list regarding self-care and when to see the nurse/call the nurse. Which is fine (this was something I had sent out already of course, but it gives me an excuse to make time to update it). And I'll start enforcing the nurse pass! The point I tried to make is that it helps me if I know what the teacher is seeing, and I don't get that without the nurse pass (unless the teacher walks them down, which is pretty rare). And the pass is something I can use as a follow-up tool. We will see how this plays out. Thanks for the votes of confidence!

2 Votes
Specializes in Pediatrics Retired.

Welcome Gertie!! Only here can you get "in the trenches" and sincere advise from those who've been there and done that. The only thing I can add to such excellent input is that I can't add anything!!

2 Votes
Specializes in Cardiology, School Nursing, General.

I understand your struggles. First, I would see what your principal has to say. If anything is not fixed, then I would try your head nurse, they have bigger say so than us sometimes.

I went through the same things too my first year and a lot of "Well the last MA did it like this." and it was frustrating. Finally during my second year, I got more of a "I don't care and I'll do what I want because I'm the medical aide here now and she's gone." I was given more freedom and my opinions mattered more. It's my 3rd year now and it's gotten better. My rules have been implemented since the beginning of the year, thanks to the new AP helping me. I am the medical authority here and I don't let anyone forget that. And I successfully erased everyone's memories of the last Medical aides. NO one remembers them and it's like I been here forever.

I wish you luck and remember things get better!

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