Kids staying home

AdobeRN · May 18, 2021

I don't - I feel we need to let parents parent - they know their kids best. Now if kids are out 2-3 days I will call them to find out details and push for a doctor's visit - although we don't require a Covid test we do require a doctor's note with some kind of diagnosis or a statement from the physician saying "not Covid related" if those parents are twitchy about personal info being shared.

k1p1ssk, BSN, RN · May 18, 2021

I have a list of "major" vs. "Minor" symptoms. If they have even just one major symptom, or 2 minor ones, I have them get tested. It has been extremely effective. We have not had any sick kids actually test positive, however, every kid I've had in quarantine due to being a close contact who subsequently tested positive, HAS ended up with symptoms. They have all been mild, and usually only have lasted a day or two. One kid only had a sore throat for 2 days, another had some nasal congestion and a cough, one was just unusually fatigued, despite sleeping well... So, with that anectdotal evidence, I feel comfortable being insistent on the students getting tested, even with mild or a single symptom.

I have found families have been more willing to get tested if you provide easy access to testing. Do you have any sites that will schedule a test online without a doctors order? We have one place that is located within 15 minutes of our schools and when I speak with the parent, I offer to sign the kiddo up to get tested there, while they are on the phone with me, or to email them the website. It has been extremely effective.

Avill, BSN, RN · May 18, 2021

I am a firm believer that we are in our positions because we can use our nursing judgement.

So for example, if I have a kid that is nauseated and I know that there is a bug going around, I am not going to make them present me a negative COVID test. I do tell them to keep them home until a 100% better though, mostly because they can log into their classes on zoom.

If they have several COVID symptoms then I ask to keep them home for 10 days, or present a negative COVID test to come back before then.

Also, if that is their baseline (for example they always have allergies) then I allow them to come back

nursey_717, BSN, RN · May 18, 2021

1 hour ago, k1p1ssk said:

I have a list of "major" vs. "Minor" symptoms. If they have even just one major symptom, or 2 minor ones, I have them get tested. It has been extremely effective. We have not had any sick kids actually test positive, however, every kid I've had in quarantine due to being a close contact who subsequently tested positive, HAS ended up with symptoms. They have all been mild, and usually only have lasted a day or two. One kid only had a sore throat for 2 days, another had some nasal congestion and a cough, one was just unusually fatigued, despite sleeping well... So, with that anectdotal evidence, I feel comfortable being insistent on the students getting tested, even with mild or a single symptom.

I have found families have been more willing to get tested if you provide easy access to testing. Do you have any sites that will schedule a test online without a doctors order? We have one place that is located within 15 minutes of our schools and when I speak with the parent, I offer to sign the kiddo up to get tested there, while they are on the phone with me, or to email them the website. It has been extremely effective.

That's a really good idea to help the parents schedule a test. I will definitely try this out ?

nursey_717, BSN, RN · May 18, 2021

26 minutes ago, Avill said:

I am a firm believer that we are in our positions because we can use our nursing judgement.

So for example, if I have a kid that is nauseated and I know that there is a bug going around, I am not going to make them present me a negative COVID test. I do tell them to keep them home until a 100% better though, mostly because they can log into their classes on zoom.

If they have several COVID symptoms then I ask to keep them home for 10 days, or present a negative COVID test to come back before then.

Also, if that is their baseline (for example they always have allergies) then I allow them to come back

I am also a firm believer in using our own nursing judgement. I just mean for when the parents keep them home and we aren't able to assess them ourselves. That's the part that gets tricky in my opinion.

WineRN · May 18, 2021

I do similar to the above where we share the list of high and low risk symptoms and request testing for any high risk and more than 1 low risk. I've had a handful of positive, ALL started with low risk symptoms

JenTheSchoolRN, BSN, RN · May 19, 2021

I have a health screener that goes out every morning (via text and email) and when a student fails, I get to see their symptom list. The screener lists everything - which can both be UGH and very useful for assessment.

Allergy season is here and fierce by me. This can be SO HARD to nuance, but nursing judgement - I'm not having every kid with nasal congestion and headache, for example, get immediately tested IF the test they did in my weekly onsite testing was negative and they have no known exposure (We do testing for ALL staff and students every Monday).

Now, strep like present sore throat? Yep. That one I refer out for both strep AND COVID testing. And COVID is actually winning there diagnosis wise over strep. Extreme fatigue and change of taste/smell (not always loss of) is what I have also seen lately.

But as I said, I do weekly onsite testing here and we have several free state run testing sites that don't need a doctor's office I can send a family to for symptomatic students.

I do have a rapid test I can do onsite if the student presents with several COVID-like symptoms during the school day. (Don't use this really, though, screening tool works super well at helping/assessing sick students BEFORE they get to school).

guest464345 · May 19, 2021

I require them to get tested or study online x 10 days if they report any of the symptoms on our list, major or minor. Doesn't matter if they insist it's food poisoning, or (not previously documented) allergies, or change of weather, or whatever.

And you know, it's been a total roll of the dice. The last kid I sent out to be tested had a stomach ache and a tiny bit of nausea for only a couple hours, really looked fine - I was very tempted to skip the whole protocol - positive for COVID. I was surprised by one flu case too; only one I saw this year.

We don't test at school but fortunately there is a place down the street doing antigen testing with federal funds for high-risk zip codes (they don't even ask for insurance info), and they always have same-day appointments.

I want kids back in person as quickly as possible when they feel better, but I'm sticking to my guns about testing because so far my clinical eyeball is just not reliable with COVID.

guest464345 · May 19, 2021

On 5/18/2021 at 7:22 AM, k1p1ssk said:

I have found families have been more willing to get tested if you provide easy access to testing. Do you have any sites that will schedule a test online without a doctors order? We have one place that is located within 15 minutes of our schools and when I speak with the parent, I offer to sign the kiddo up to get tested there, while they are on the phone with me, or to email them the website. It has been extremely effective.

100% agree! I wish we had testing right here on site (though I know from @JenTheSchoolRN's posts how much work that is). If parents agree, I also make the appointment for them - at this point I'm very efficient in finding open spots.

I always emphasize how much we want the kids here in person (we do!), just that we have to protect everyone's safety. Every 5 minutes to make an appointment probably saves me 15 minutes with frustrated, argumentative parents.