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!

[scuba nurse, BSN, MSN, RN]

If nits are found, they stay, if live lice, then they go home, and that is mainly because of the principal and teachers who freak out over lice.

They need to be rechecked the next day upon return to school. We do not send any notes home to classmates. And I usually have to check the entire grade of the student who has the lice, this is not policy from nursing side, but from my principal. I don't agree, it is usually the same child each time, but I just do it to basically keep the peace, it is not worth my fighting over.

[JerseyTomatoMDCrab, BSN]

We have a no live lice policy. Nits are okay. If lice are found in school, they are sent home to be treated. They can return the next day and I do daily checks in the morning for 1-2 weeks. I also hound the parents about how I just do a screening and it is THEIR job to really check and comb out the nits to prevent a reinfestation. We do not require proof of treatment to return to school, it's usually very apparent who was treated and who was not.

Much to the dismay of the teachers and principal, I do not do classroom checks nor do I send a letter home when lice has been found. This causes undue panic, unnecessary treatment (which contributes to lice resistance to OTC products) and a WHOLE lot of work for me. It's not our policy to do these things and my supervisor is very supportive of us on this front.

A kindergarten teacher has asked me twice if I can check a child, not because he was itching or she saw something in his hair, but because he "looks dirty." -__-

[MHDNURSE]

New policies do not recommend sending home for lice. I call and inform the parent and g through how to treat, combing daily, etc. I tell the parents that they do NOT have to pick up. About 50% of the time, a parent comes to pick up because they want to treat and comb right away.

That's really it. Since I can't send a kid home for having lice, there isn't much more for me to do.

[ruby_jane, BSN, RN]

This past year and a half my daughter has gotten this "super lice" 5 times. 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" It's been exhausting.

You have been through the lice mill, and you're doing the best you can with what you have. Two observations from summer camp nursing and from this year:

First, some of the pediatricians are prescribing oral Ivermectin (don't know dosing and this is not a recommendation to treat or a diagnosis - just info sharing). One dose now, one in 7-10 days. Oral Ivermectin is not completely benign but if the bugs are resistant to permethrin, then this may be something to look into. If the lice are resistant to Ivermectin surface treatment, then probably this isn't the answer.

Second (and this came from this year): There are newer alcohol-based Rx treatments now which may help. The one kid (in five years here) I found with live lice was prescribed Ulesfia (benzyl alcohol). One dose and the live bugs were gone, and the nits were husks. Kid had a second dose in 10 days and no further nits. Again, this is for informational purposes. I have no idea what it cost but it seemed almost magical....

Hang in there!

[Amethya]

We have a no nits or lice policy. Basically I get a report on a student, I send a letter home first to that class telling parents I will be doing a lice check and they can do that too at home to make sure their kid is clean. The next day I do the check, I take them out one by one and do it in the hallway. If they just have dandruff and no nits, or if it's the infected child and their mom did the treatments and cleaning, then back to class. Sometimes I get one or two of them who do have it, I call their parents to come pick them up. And that's it. I tell the parent until that child is completely clean, meaning that it's okay there's some nits, but if they are dry and dead and you cleaned them good, they can come back. I then give them the 10 day rule and to use conditioner to clean out the nits and that's that.

[hppygr8ful, ASN, RN, EMT-I]

Not sure why people get so worked up about head lice. Not a school Nurse but I do work in acute psych and we see a fair amount of head lice. I get the "Bugs in my hair Ick factor" but the CDC stops just short of calling head lice normal skin flora. They do not recommend treatment nor exclusion from other patients. Nor do they state that head lice create any public health concerns. I have been arguing this for years with our admin - Our current policy is to treat and isolate patient in an isolation room for 48 hours. This causes and issue for my patients who need to walk about to relieve some of their symptoms.

Also what you end up with is a student or patient who now feels singled out or embarrassed.

Hppy

[abc123RN]

Not sure why people get so worked up about head lice. Not a school Nurse but I do work in acute psych and we see a fair amount of head lice. I get the "Bugs in my hair Ick factor" but the CDC stops just short of calling head lice normal skin flora. They do not recommend treatment nor exclusion from other patients. Nor do they state that head lice create any public health concerns. I have been arguing this for

Also what you end up with is a student or patient who now feels singled out or embarrassed.

Hppy

And that travels with a kid all the way to graduation. This is why I usually send the kid on back to class if I find anything, don't tell the teacher anything and call parents. If the parents pick kid up no one except me knows for sure why.

[JustbeRN]

we are still no nits/lice policy and have to go home..

Its a tough one. I check, call parent, encourage pick up. ( If not braid hair and they stay in school until dismissal)

I recheck in the morning upon returning to school. If it looks like it was treated and nothing is live and few dead nits- I let the principal know and its his call to make. we do sent a general lice letter out the class affected..

I do not make classroom calls just because.. If I do get send one because at teacher says to check them- I will and call the parent to let them know.. Let me tell you nothing like a upset parent stating you are picking on their child.

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

You have been through the lice mill, and you're doing the best you can with what you have. Two observations from summer camp nursing and from this year:

First, some of the pediatricians are prescribing oral Ivermectin (don't know dosing and this is not a recommendation to treat or a diagnosis - just info sharing). One dose now, one in 7-10 days. Oral Ivermectin is not completely benign but if the bugs are resistant to permethrin, then this may be something to look into. If the lice are resistant to Ivermectin surface treatment, then probably this isn't the answer.

Second (and this came from this year): There are newer alcohol-based Rx treatments now which may help. The one kid (in five years here) I found with live lice was prescribed Ulesfia (benzyl alcohol). One dose and the live bugs were gone, and the nits were husks. Kid had a second dose in 10 days and no further nits. Again, this is for informational purposes. I have no idea what it cost but it seemed almost magical....

Hang in there!

I will keep that in mind. So far we are having luck with that newest rid I got that was made for the super lice. It was like a mineral oil. No smell at all which was nice. But I am hoping she hangs in there for 2 more weeks until summer and then we can at least get a break. lol I know it's been a huge epidemic in North Carolina anyway and in San Diego

[emilly.lynn]

Well, I don't have kids my have a little niece, whom I take care for school related stuff. So I keep checking her head because her school also have "No Nit" policy, even few months before her school management send her back because she was itching from that time. I went through her hair with fine tooth comb and didn't find anything, but still, I guess school should be a bit flexible in this policy. Even if they find something in child's head, then they should warn us first rather then sent a straight kid to the home.

[Nurse in MT]

Super lice. I know they are in the area because I dealt with them at my previous place of employment outside of a traditional school system.

Last Thursday when we treated & combed two siblings with amazing thick hair (Yes. I'm envious.) we saw that the lice were resistant to the first treatment of Nix that we used. When combing we found live lice on both heads. Gross. So we treated with Rid shampoo next and combed, combed, combed, and combed some more. All lice and nits were removed that we could find.

In subsequent head checks both kiddos have been clear.

I think it really boils down to extremely fastidious combing with good combs. Good combs make all the difference.

I am considering a nit-picking business on the side. Primarily because I need a reason to scratch my scalp related to psychsomatic itchies over the summer too.

[ArryOtter]

Our school has a strict No Nits policy. They're to be picked up ASAP if possible, to return they must either have a Doctor's note clearing them or I re-examine in the clinic to clear them. I think it's silly, but even though we're a charter we follow our local district's policies.