Lice policy?

[momto5RN]

So my school hardly has any policies. I pretty much follow what my own children's school does (they go to public schools) and use basic common sense.

Was just curious as to what your school does when lice is going around. Do you send home if just nits are found? How long do you exclude? Do you need proof of a receipt or box of treatment before allowing back to school? Is it necessary to screen an entire grade or just the students who hang out with the affected student?

This is what my children's school does so I applied it to the school I work at:

-Obviously if live lice are found, they go home.

-the student is to report immediately to my office the following day with the parent for a recheck. If nothing is found, they can go back to class.

- I don't require the parents to show proof of treatment but when my children had it, their school did.

Thanks!

[SaltineQueen]

Pretty much the same as what you do, but if parents aren't able to pick up right away, the student may be in class until end of the day with the expectation that parents will treat that evening.

Nits can be here, but I advise combing every other day for a week or two. And I recheck one week after.

[Jedrnurse, BSN, RN]

In our district, we do not exclude for either lice or nits. Practically speaking, if a student is found to have either, a call home is made along with educational materials. I visit the affected classroom(s) and do a refresher of the lice "safety" class that I do in the beginning of the year.

[ruby_jane, BSN, RN]

Our district no longer removes for live lice... best practice from the AAP here: Head Lice | From the American Academy of Pediatrics | Pediatrics (there's a strong ick factor, I get it). To protect yourself in the future you will need a written policy, otherwise every parent will be jumping on and the principal will be tempted to make a decision that isn't best practice.

The expectation is that parent will treat and I will reassess the next morning, and the end of the week, and 10 days later, and then episodically if needed.

Here's what the CDC says about treatment:

CDC - Lice - Head Lice - Resources for Health Professionals

I think Old Dude had a good post on lice a while back - see if you can search that?

Good luck!

[MrNurse(x2), ADN]

My Principals want exclusion (they were teachers, after all), not sure I would go that far, but we are a pretty physical school, younger students sit in older student's laps, lots of literal head to head contact, etc. You may want to see what support your local health department can give. I was allowed to use the protocols for the next county over and had our health department doctor (a parent at our school) sign off. The health department would have done that anyway, as that is one of their responsibilities. This gives you physician's orders to follow and stand behind, a great CYA.

[OldDude]

Our district school nurse role in this subject is to identify, if requested, and educate. We send out notices twice per year in this regard. Head lice is a parent responsibility and absences from school due to head lice are unexcused.

[Nurse in MT]

Stay in school for remainder of the day. Call home and instruct that the child must have an effective treatment/combing. Advise over the phone for basic cleaning & laundering. (Mayonnaise, olive oil, essential oils, etc. don't count and WILL cause me to make you pick your child up from school.)

We do not send out letters to classmates because it causes mass panic. I hate that. I also will not do classroom head-checks. It wastes my time and the teacher's. Also causes panic when kids tell parents.

That being said, both of us in the nursing office did spend a combined 8 hours washing/treating hair and nit-picking two siblings last week. What a mess. We only do that under very rare circumstances.

[EDIT] My head is totally itching now. Thanks.

[peacockblue]

We have a strict no nit policy. The nurses have been providing evidence against this for years, but the school board won't budge. We do not send home letters, yet, but we are asked to every year and argue against it.

[KKEGS, MSN, RN]

We changed our policy a year ago to be in line with what the American Academy of Pediatrics and the National Association of School Nurses recommends. Therefore, we do not exclude for nits. I will always call a parent and inform them of my findings and 9 times out of 10 they choose to come pick up their child and start treatment but it's not required.

If live bugs are found the school nurse and parent come up with a plan together which may or may not include exclusion. It really depends on how many bugs are found. We do not require treatment since lice do not present a public health problem but more of a public nuisance problem. I have had parents who choose not to treat and there is really nothing I can do about it. But saying the school nurse and parent can come up with a plan gives us (the school nurses) some wiggle room, I guess. I work with some school nurses who have bought the treatment kit themselves and treated the child at school because the parents are incapable (for a variety of reasons) to do it themselves.

We also do not do full classroom checks....for the most part. I was asked by our lead nurse to do a full classroom check once this year but really it was just because a student's mother raised a ruckus with the school board. I think she was sincerely hoping I'd find nothing and we could say, "See? Didn't happen at school!" but, unfortunately, I found 5 other students with nits. Oops.

I will check individual students if they, their teacher or their parent asks me to.

As far as notification goes we will send a classroom letter if 3 cases are found in a single classroom within a 2 to 3 week period. If 5% of a grade level is affected within a 2 to 3 week period we will also send a grade level letter.

People are still getting used to the new policy. We've gotten a lot of push back on the policy this year but, for now, we aren't budging. I work in a bit of a hoity toity area where parents will pay HUNDREDS of dollars to have professional nit pickers treat their children. So sometimes what they're really upset about is the fact that they've spent so much money paying other people to deal with the problem. Our lead nurse is thinking about bringing back the notification letter for every case reported because even though it doesn't really do anything the parents at least feel like we're doing something because they just don't understand why we "ignore" the "problem."

Hope that helps!

[~Mi Vida Loca~RN, ASN, RN]

I was actually going to post in here to ask if your schools have been affected by this super lice. I raised 3 boys, and 1 girl without incidence. This past year and a half my daughter has gotten this "super lice" 5 times. It has been the most frustrating thing to deal with. I don't even have an ick factor with it anymore. Thankfully I don't get it, I am guessing because of my processed hair. But I spend so much time and money to get ride of it for her and things will be good for a few weeks and then it's back again. It's running rampant in the schools here and so it's a no win situation because I can't keep her away from it without keeping her out of school. I am so thankfully school is about to be done for that reason. It's to the point now that after showers we just run over with the nit comb on top of regular brushing just in case. I have always done all the home remedies, the essential oils, the expensive drug store products and the expensive preventive shampoos and sprays. 2 weeks ago we just spend another 40 bucks on the newest shampoo that is supposed to be effective against the "Super lice"

But again, if all the other kids still have it then it's only a matter of time before she gets it again. We even cut off 6 inches from her hair to put it just below the shoulders to help. It's been exhausting.

[tch1920, BSN, RN]

Our district no longer removes for live lice... best practice from the AAP here: Head Lice | From the American Academy of Pediatrics | Pediatrics (there's a strong ick factor, I get it). To protect yourself in the future you will need a written policy, otherwise every parent will be jumping on and the principal will be tempted to make a decision that isn't best practice.

The expectation is that parent will treat and I will reassess the next morning, and the end of the week, and 10 days later, and then episodically if needed.

Here's what the CDC says about treatment:

CDC - Lice - Head Lice - Resources for Health Professionals

I think Old Dude had a good post on lice a while back - see if you can search that?

Good luck!

This is also our district policy.

[JenTheSchoolRN, BSN, RN]

I don't exclude for either. And I don't re-check upon re-entry to school.

But head lice is less common at the MS/HS level. If found, I'll call home, let the parent know and give them the option to pick up if only so they can treat. I'll also check siblings heads; we have a lot of siblings here since we are a 5-12 school. And even if I don't check siblings heads, I will recommend at least a single treatment of siblings at home. We used to send home letters after a single case and check an entire classroom of heads. I did away with two 2 years ago after sharing the latest recommendations from AAP. My admin appreciated the resource and supported my recommendations (I know, I'm blessed!).

OldDude does have an excellent post on lice...if only the search function was being less of a butt to me at the moment.