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duckieRN, BSN 904 Views

Joined: Aug 12, '11; Posts: 10 (50% Liked) ; Likes: 9
School Nurse; from US
Specialty: 5 year(s) of experience in Med Surg/Onc and School Nurse

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  • Apr 30 '15

    I sent out these guidelines to my teachers. I have pre-K (3/4 year olds) through grade 3 so you may need to modify things a bit. I also wrote up some information on what I can and cannot do. I don't diagnose disease. I don't assess injuries that happen outside of school. I'm not covered for that and I am not an urgent care clinic or primary care provider. I sent out school exclusion guidelines (vomit, fevers, eyes with pirulent drainage, open sore, etc). Sometimes you really need to be firm and put your foot down on things. Otherwise the teachers default to calling you for everything.

    I try to make sure my role is not de-valued as bandaid brigade. I am there to ensure the safety of our students. I care for diabetics, kids with asthma, seizure disorders, etc. I perform yearly assessments. I update medical records and ensure students have necessary vaccinations, physicals, etc to be in school. I also explain that my practice is guided by a district doctor who oversees the standing orders (which I explain as well).


    1. Vomiting/diarrhea
    2. Significant bleeding
    3. Students with a history of diabetes, asthma or seizures
    4. Fainting/dizziness/change in level of consciousness
    5. Suspected allergic reactions
    6. Urinary or bowel accidents


    1. Get a drink of water (dehydration); Eat a snack if no breakfast
    2. Nurse has a limited supply of snacks available
    3. Put head down for 5-10 minutes
    4. See nurse if headache is bad enough to interfere with classwork or has difficulty moving head/neck


    1. Go to bathroom (bowel movement, gas)
    2. Drink water; eat a snack (if no breakfast)
    3. Wait 15 minutes after using bathroom and drinking water/eating to see if pain eases
    4. See nurse if pain persists


    1. Drink water
    2. Wait 15 minutes to see if pain persists
    3. See nurse if pain is persist or accompanied by fever, chills or difficulty swallowing


    1. Pinch bottom of nose firmly using tissues

    Tilt head forward slightly
    1. Send student to nurse


    1. Student should wash wound with soap and warm water
    2. Apply band-aid from class band-aid supply for light bleeding
    3. Send to nurse with significant bleeding, infected, dirty wounds or puncture wounds


    1. Cool water with cold water or cold wet cloth. Do not apply ice!
    2. Send to nurse


    1. Send to nurse if the sores are open or student is scratching


    1. Send to nurse
    2. Remind student to wash hands after touching face/eyes
    3. Cool compresses/cold packs may provide temporary symptom relief
    4. Students will excluded for purulent or heavy discharge


    1. Send to nurse. Please report any loss of consciousness or vomiting associated with a head injury to the nurse


    1. Students who need chap stick frequently should be encouraged to bring it from home.

    Call the nurse to the scene for:

    1. Seizure activity
    2. Fainting
    3. Suspected fractures
    4. Falls resulting in head or neck injury

  • Apr 29 '15

    Thanks for all of your advice. I think the interview went well, and the principal plans to make a decision soon. It was strange to not have a panel interview; it was just the principal, and he didn't mention doing second interviews. I'll keep everyone posted...

  • Apr 28 '15

    Quote from duckieRN
    I did High School a few years ago and my mother is still a high school Nurse. Best Wishes for your interview!
    I would focus on health prevention. Connecting student's with resources (health wise) to make them more successful for college. Maybe even discuss partenering with the trainer and coaches regarding sports safety. My first year at the campus, I implemented an emergency response team and AED training. Also, talk about your clinic and policies and how to cut back on absenteeism... they like that lol
    Be youself! If its meant to be, it will happen!
    Preventive health is a biggie. I cover a middle school and high school. The first year I was here, I offered to teach a one class course during our college skills class for seniors that I call "College Health 101." I tackle the transition of managing one's health during college vs. high school.

    Is this a 9th grade only campus? You may want to consider questions re: possible student pregnancy (read up on student's rights in your state) and concussions (even if this go to the trainer, you may be managing return to school). If you have taught growth and development, you may want to talk about as that strength could be utilized to further sex education in 9th grade (and beyond!).

  • Apr 28 '15

    I was waiting until closer to the end to announce but this is as good of a time as any--I am retiring at the end of this school year. I have known that the time was coming (I'm 61) and it just feels right. There are a few volunteer-ish things I'd like to do, we plan to travel (already have two trips planned!) and I can be more available for grandmother duties. So I'm comfortable and happy with this decision. I may peek in from time to time, just to see what's happening "on the board". Continued success to you all!

  • Apr 2 '15

    Belly aches, belly aches and more belly aches. :-)

    I sent out a list of common problems and how staff needs to address them before kids come to me. I was getting upwards of 50-60 students a day. After I sent the list out, it dwindled to 20-30 and I am now back to 30-40. I have a little over 500 in my pre-k through 3rd grade school.

    I have found that I have to get firm with some staff members. They send every little bump to my office. The student isn't even crying and they have to come to me for "assessment." You might even see if you can have some time to speak at a staff meeting and go over your policies, procedures and expectations.

    Kids this age don't self administer inhalers typically. One of my colleagues showed me a better system of organizing inhalers into cheap Walmart brand ziplock containers.

    One of the best ways to calm a crying kid is bandaids with Frozen/Princesses/Cars/Planes/Monsters Inc/Minions/etc.

    For field trips, have lots of plastic bags for vomit. Another good tip is having little baggies of tissues and gloves to function as "nosebleed" bags.

  • Mar 31 '15

    I also notify for first bee/wasp stings - they may not react the first time, but the second time is a doosey. This age they are very much concrete thinkers. I try to explain everything I am checking for and why that matters. Stomach ache - did you eat breakfast - no = eat - mom puts gas in her car - what happens when she does not - same for your body - food is the body's gas. I always have a box of crackers for nausea, did not eat, etc. My best trick is folded paper towels, wet and put in the fridge - they get super cold and when a child requests an icepack and you don't see anything it is perfect. You will love elementary.

  • Mar 31 '15

    Be prepared for answering to needy parents - especially those Kinder parents. Some of them want to know EVERY little detail about their kids day - every clinic visit, why the came to see you, what did you do for them etc...sometimes it is exhausting.

  • Mar 31 '15

    I have a pinterest page for school nurse and camp nurse hacks - Tina Hechler - worth a look.

  • Oct 6 '11

    If priming with NS, I don't start timing the transfusion until the blood product has reached the patient.