Lice/rant

[Mavnurse17, BSN, RN]

Just need to let off a little steam.

About 2 months ago, a teacher brought one of her students down because she noticed an active lice infestation. The student told me she was already being treated by her parents at home. Great! I'm at a high school, so we're not mandated to send letters home either. I sent the student back on her way. The next day, I get a call from my nursing supervisor saying that the teacher called her directly to complain about my "not doing anything" and "not caring about the situation." I had told the teacher there wasn't much more to do on my end, but alas.

Yesterday, the same student is brought to me still riddled with head lice. Student confirms that she's still being treated at home. I had previously had a phone conversation with the parents, in which I reinforced how to correctly apply the shampoo. I knew this student was still being treated at home and that lice can be hard to get rid of for good. However, to avoid the fiasco from 2 months ago and to "seem like I'm doing something", I re-explained to the (adult) student how to use the shampoo and I sent her home with a few bottles.

This morning, I'm told that the student's parents are offended I sent the shampoo home and they are wanting to have a meeting with our principal and myself.

So now I feel like I'm trapped...cannot seem to win either way.

Damned if you do, damned if you don't. I always reinforce combing b/c that is 99.9% of the battle. You can shampoo all you want but if you aren't combing you are wasting your time. I would make sure families have a good lice comb and are combing DAILY for two weeks. Every reinfestation I have seen is because the parents do not follow through with daily and thorough combing. I get it- it is a royal PITA to comb. My DD got lice in 4th grade and she has long, wavy mermaid hair. That daily combing was horrendous and took tow hours easily. But I was able to get rid of the lice completely and did not even use lice shampoo. Good luck to you- Lice is one of those things that no matter what you do, everyone panics ?

[nursekoll, BSN, RN]

I have found out the hard way that mentioning things like shampooing and combing for head lice might not be specific enough. I now use very specific questions like "What kind/brand of LICE -killing shampoo are you using?" (had one family just use regular hair shampoo) and "What does your NIT COMB look like? Is it plastic or metal, are the comb tines very close together and longer than an inch? How long did it take you to comb through her hair last night?" (had one family just combing daily with a regular hair comb). I have also asked for the empty box of treatment upon return to school so I know they didn't just use mayonaise or olive oil or something like that. Maintain an attitude that you're only trying to be helpful and work together to eliminate the head lice. Good luck with your meeting!

[ruby_jane, BSN, RN]

I feel you. Lice are tetchy.

What is your district policy? Ours is that I have an rx and a small supply of an anti-lice shampoo to give if the situation warrants. You are indeed getting it from both ends. Review the policy so you're armed with a rationale. It's hard to apologize for trying to do the right thing but you may have to...

[dixiegirl30513, LPN]

On 12/11/2019 at 11:27 AM, ruby_jane said:

I feel you. Lice are tetchy.

What is your district policy? Ours is that I have an rx and a small supply of an anti-lice shampoo to give if the situation warrants. You are indeed getting it from both ends. Review the policy so you're armed with a rationale. It's hard to apologize for trying to do the right thing but you may have to...

I came on this website today with this very same question. Help!! Our district has a "no nit policy" which is not really enforceable at this point. We are fighting a losing battle. What does everyone do concerning absences? When do y'all decide to send them home and when is it excused and unexcused? Any help would be greatly appreciated! I am hoping to help with new protocol in the new year. Thank you!

[ruby_jane, BSN, RN]

On 12/17/2019 at 1:18 PM, cburgess30513 said:

I came on this website today with this very same question. Help!! Our district has a "no nit policy" which is not really enforceable at this point. We are fighting a losing battle. What does everyone do concerning absences? When do y'all decide to send them home and when is it excused and unexcused? Any help would be greatly appreciated! I am hoping to help with new protocol in the new year. Thank you!

NASN and AAP frown upon that no nit policy.

I would seek guidance from your health services director, and definitely come up with some EBP protocol (which will probably look like this: Live lice may go home (not must), nits with no lice may go home but may stay, evidence of treatment the next day via nurse looking at the scalp may direct the rest of the care).