Lice dilemma

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Specializes in School health, pediatrics.

Okay, let me start by stating that I am opposed to lice exclusions from school. I understand the many problems with such policies and have stated them many times.

Our district has a no live lice policy. Students found to have lice are to be sent home immediately and may return when they are free from live lice. They are to be checked upon return and then 1 - 2 weeks later.

There is a family here that has 2 students in my school, 1 in the behavior intervention school, and one at the high school. The youngest was found to have lice end of November. Mom is not reachable during school. There are no emergency contacts. Technically the student is supposed to stay in the office all day in this situation, but we made an exception due to an attendance issue/to not punish making it to school on time. I left a detailed message and I sent home fliers with info about lice, a form so that I could treat the lice at school if mom was unable, details about home cleaning as well as checking the whole family. The vice principal even purchased and sent home lice treatment.

This student was out for five days after this. On recheck he had one louse, which I removed.

Since then I have had two staff report to me that the brother has lice. Apparently a student that sit behind him is telling staff that she sees bugs in his hair.

Ya'll I don't know what to do. I have a fundamental problem with excluding for lice, and I don't think that I can continue to use HIPAA as an avoidance mechanism.

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Specializes in School Nurse, past Med Surge.

Is your issue whether or not to check?

Has the teacher seen any live lice? I'd maybe not jump at the gun to check a kiddo based on what another kiddo says (because maybe they're just being mean) but if the teacher has seen it I'd call them down and check.

Is this a chronic issue or first time for them?

How long do you have until break?

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Specializes in School Nursing, Ambulatory Care, etc..

How do we know to check a kid for lice in the first place? Either the kid tells the teacher their head itches, the teacher witness the kid scratching excessively, or somebody reports they have seen/suspect a kid has lice. In this case, somebody has reported it. Check the kid - if all he has is a louse or two, pick them out, go through his head with the nit comb, send him back to class, and contact the parent by whatever means you can; if he is not treatable at school, follow the policy.

Also, and probably way more important than the kids having lice, get administration involved regarding the lack of contact information for the parent. If, the Lord forbid, one of these kids would need to go out by ambulance someday, how/when would the parent be notified??

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Specializes in Pediatrics Retired.

You know, and I know, and every experienced school nurse knows this "dilemma" is due to lack of parent intervention; regardless of what excuses you've been fed. CPS usually won't intervene for lice issues but they will intervene for attendance issues. Go that route. If your admin is on board, the student can still be counted "absent" even though they are "dumped" off at school and the parent can't be found during the school day. So, making exceptions for the kid to be at school when they have lice and not supposed to be at school is enabling and perpetuating the problem.

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Specializes in School health, pediatrics.
BunnyBunnyBSNRN said:

Also, and probably way more important than the kids having lice, get administration involved regarding the lack of contact information for the parent. If, the Lord forbid, one of these kids would need to go out by ambulance someday, how/when would the parent be notified??

Administration is aware. We would leave her messages.

We start break with a half day on Thursday.

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Specializes in School health, pediatrics.
OldDude said:
If your admin is on board, the student can still be counted "absent" even though they are "dumped" off at school and the parent can't be found during the school day. So, making exceptions for the kid to be at school when they have lice and not supposed to be at school is enabling and perpetuating the problem.

I am sure they would be on board, but honestly it seems like class discrimination. This is one of the poorest families in the district, the kids are more or less raising themselves, and they are already on the truancy list because they are responsible for getting themselves to school.

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OhioBPH said:
Administration is aware. We would leave her messages.

We start break with a half day on Thursday.

Maybe stall on the check until Thursday? That way, you've done your due diligence and you don't have to exclude. Personally, I would not check a student because a teacher said another student saw bugs in a classmate's hair, but I do check siblings when I find head lice.

I wish people were half as concerned about the flu as they are about head lice.

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Specializes in School Nursing, Ambulatory Care, etc..
OhioBPH said:
I am sure they would be on board, but honestly it seems like class discrimination. This is one of the poorest families in the district, the kids are more or less raising themselves, and they are already on the truancy list because they are responsible for getting themselves to school.

this is heart breaking. There are some kids I want to grab by the shoulders and say, "Suck it up, Snowflake" and others - like these kids - I want to hug and say, "Life isn't supposed to be this hard for you right now. I'm sorry it is."

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Specializes in Pediatrics Retired.
OhioBPH said:
I am sure they would be on board, but honestly it seems like class discrimination. This is one of the poorest families in the district, the kids are more or less raising themselves, and they are already on the truancy list because they are responsible for getting themselves to school.

Even more of a reason for CPS to be involved. Calling CPS sometimes isn't a bad thing for the family.

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Specializes in Peds, MS, DIDD, Corrections, HH, LTC, School Nurse.

Just did a head check to clear a student to return to school. I made a comment on how soft her hair was and that it smelled like apples. The dad said "yeah I went by Tractor Supply and picked up lice medication for livestock... worked like a charm" I question why he thought to go to a farm supply store to buy lice treatment meant for livestock to use on his child. His reply "It's a hellofa lot cheaper than the stuff in the pharmacy". SMH, just when you think you've heard it all! ?

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Specializes in school nursing, ortho, trauma.

watch for re-infestation in that one! Headlice are exclusive to humans so it wouldn't surprise me if the treatment was ineffective in getting everything. On the other end of the spectrum -because it's for livestock, is it going to make her feel sick in 2 days when it's fully into her bloodstream because it's so strong with pesticide?? I'm staying tuned to this one

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Specializes in Peds, MS, DIDD, Corrections, HH, LTC, School Nurse.
1 hour ago, Flare said:

watch for re-infestation in that one! Headlice are exclusive to humans so it wouldn't surprise me if the treatment was ineffective in getting everything. On the other end of the spectrum -because it's for livestock, is it going to make her feel sick in 2 days when it's fully into her bloodstream because it's so strong with pesticide?? I'm staying tuned to this one

I will try to keep you updated, I'm subbing today, but I will try to follow up with the nurse when she returns to this clinic. I'm interested to see what happens as well.

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