Middle School/High School and Supplies

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Hello, I'm currently a first year school nurse. I have been an
RN
for 11 years but this is my first time in a school. I work in a 8th-12th grade school. We get a $500 per year budget for nursing supplies. I'm trying to make that stretch but oooh, dear.

I have some questions:

1) What do you all do as far as Ice Packs? Do you allow the student to get the ice pack and if their issue is not severe send them back to class or do you keep them in your office until they are finished with ice pack? I made a huge mistake of sending them back to class and now I hardly have any left. It is my fault for not keeping better track. Lesson learned. I have been using Ziplock bags and filling with water and freezing but that apparently is a bad idea. What do you all use for ice packs?

2) Elastic/Ace wraps what do you all use for those. They are obviously very expensive and several students want ACE wraps. Do you give one to students who request them or do you try to discourage them from using ACE wraps and only use for students with true extreme need.

I feel like this should be some common sense stuff but apparently it is not. I need to place another order for supplies. Obviously I need to be conservative because of funding but at the same time I need to have enough on stock.

I have almost 500 students in my school.

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Specializes in Pediatrics.

I fill up a cooler with ice at the beginning of each day and then make ice packs with ziploc baggies as needed.

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We have an ice machine. Kids make their own ice packs. I only use the chemical packs for trips.

I have a budget too. I need a new thermometer and a new BP cuff...and yea. That's pretty much my budget right there.

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Ice packs - before I had a fridge in my office I would fill up a little 12 pack cooler with ice from the cafeteria and keep that in my office for the day - I would have ice available if needed. I put a few ice cubes in ziplock snack bags and wrap in papertowel to give to students and send back to class. the only time I have students sit in my office with ice packs is when I have doctors notes or parent notes stating the student needs something iced - or if there is something I can see that is swelling/bruised, bumped heads, etc - I will monitor for a bit and give parent a call.

Ace Wraps - If something requires an ACE wrap a parent is contacted, I do not wrap anything without a doctor's note. Same with students who want to use my crutches or wheelchair - need doctor's notes.

As far as supplies go - might try to reach out to your PTA for items like bandaids, cottonballs, qtips, feminine pads, kleenex etc. I know at the high school level PTA membership/participation is low but it can't hurt to ask. During nurses week I always get asked what I want or need - I gladly hand out a list of basic first aid stuff and I usually get enough stuff to last thru the next year - granted I am at an elementary school which the parents at this age are alittle different.

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Specializes in School nursing.

I am also in a MS/HS with about 500 students. I do have a larger budget, but even a larger budget doesn't go far.

Cheap ice pack: super cheap sponges (you can get 'em at the dollar store), soak in water, put in plastic baggie, freeze. I ask for 'em back, but don't cry if I loose 'em. I do not have an ice maker at my school, but if you do, baggies of ice work as well.

I do have a small supply of reusable ice/heat packs and a drop box for returning them in front of my office. Return rate is about 70% once I added the drop box. I have used a sign out sheet in the past as well, which worked well.

Chemical packs are only for the sports program and field trips.

I have ACE wraps - but they are only for sports program first aid kits and students with a true need (which is rare).

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Specializes in family practice and school nursing.

ice packs.. no ice machine.. so I just freeze water in ziploc bags.I only have a tiny freezer compartment in my frig so I can't make enough cubes to keep up with the need. I do have chemical ones but only use for field trips or sometimes staff... the kids here would try to eat them (special needs school).

Ace wraps are only for serious injuries that occur at school... after parent is notified.. to stabilize injury before doctor's appointment.

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Specializes in School nursing.

As far as supplies go - might try to reach out to your PTA for items like bandaids, cottonballs, qtips, feminine pads, kleenex etc. I know at the high school level PTA membership/participation is low but it can't hurt to ask. During nurses week I always get asked what I want or need - I gladly hand out a list of basic first aid stuff and I usually get enough stuff to last thru the next year - granted I am at an elementary school which the parents at this age are alittle different.

You get acknowledged during nurse's week? I get nada.

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You get acknowledged during nurse's week? I get nada.

Right?!? Same week as teacher appreciation week (at least here, I don't know if it's country wide) and there's a "School Nurse Day" somewhere in there. No one said a word.

But I the PTO provided lunch for the teachers which I felt perfectly justified in eating :)

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Specializes in School Nursing, Public Health Nurse.

I had a bigger budget (kind of). I just brought boxes and boxes of the instant ice and heat packs. I didn't have a fridge in any of my offices (well one was a staff fridge and there was no way I would keep my ice packs or anything medical related in there). Loved them. However they are costly and the smaller, inexpensive ones were not worth the money because they were not cold as long as the bigger ones. Another option is water with rubbing alcohol (I believe it's 2 cups of water for every cup of alcohol) plus blue food coloring in a plastic bag to freeze for a slushie type of ice pack.

ACE wraps: Most SNs here do not wrap, but I did. I always used my nursing judgement and I would check ROM, color, pulse, etc. If I suspected any time of fracture I just ice and immediately send home. Of course there is always the possibility of it being fractured, but I was comfortable with my decision in that. It is your decision whether or not and do not let your Staff pressure you in to wrapping if you are not 100% okay with it. I keep elastic bandages of different sizes for wrapping and also had some self-stick ones which are awesome! And I could always use less and just cut instead of the entire roll.

Also, shop around for prices. School Nurse Supply is the cheapest, but School Health had more options of some items. Moore Medical is another supply place, and check to see if you school can order from Costco, Amazon, Wal-Mart, etc.

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My budget is slightly under $1/student. My policy is generally that if students are hurt badly enough to need an ice pack then they must stay in my office for observation & assessment. That usually helps control some unnecessary traffic. But I do make exceptions on occasion - like if I don't want a kid to miss lunch I will let them take it to the cafeteria & check in with me when they finish eating.

I do not apply a compression/ACE wrap without doctor's orders so I do not stock or provide them in my clinic. But I do take a couple with me when we take our 5th graders to camp just in case I need the support for some reason.

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I have fridge in my office, so i make ice cubes, put it in the ziplock with water then wrap it with a paper towel. If it's a serious case, I keep the student in my room for observation, if not they go back to class with the ice-water bag.

I use Ace wrap if it's really needed. Some student's would ask for it just to "look cool" :) and that will be a NO.

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Specializes in school nursing, ortho, trauma.

for ice packs - the kids are simply not allowed to take them. it's amazing how quickly the ice therapy can work when the kid doesn't feel like staying in the nurse's clinic. In my old school i did have a portable ice machine (wasn't real expensive -i think it cost around 250 when i got it, but i've seen smaller ones at the home depot got around $100) and it was nice! i'd make up some ice packs and send the kids on their merry way with the ziplocks full of ice. when it they were done with it, they could toss it. Plus i found that the science teachers were happy to know i could make ice for their projects too.

As far as ace bandages, i keep a few on hand for the sports teams and for other rare circumstances (my principal sprained his wrist - i wasn't going to tell him no when he asked for one, but did gently suggest that he get it looked at)

As far as stretching your budget - tap into sources that you may not think of. Ask your PTA if they would sponsor a bigger ticket item that will benefit all the students if you wanted to get one item that you think may benefit all students (like an ice maker) or look for grants or community opportunities for funding. Like i mentioned, Home Depot has the portable ice makers, if you have one in your community, perhaps reach out to them to see if they can make the school a good deal on a "scratch and dent model". Or approach your school board with a capital project - they may approve a higher budget for you with the understanding that its a temporary thing to make improvements to your office and to better serve the students.

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