Minor Questions

[moreoreo]

If there is already something like this, please let me know, but I thought there could be a thread for minor questions that we would feel silly to start an entire topic for. I know there are a lot of newbie school nurses who cling to this forum so I thought it might be a nice spot for our side concerns.

An example: do you have your students clean their inhalers after each use? In the hospital, not a single one of my patients EVER did this. None of the students seem especially inclined to do it except for one who does it every time with a tissue.

[OyWithThePoodles, RN]

I call for every head bump, regardless of how minor it seems. But I make sure to let them know if there is no mark at the time.

[ArryOtter]

Our policy is to call for every head injury, no matter how minor and send home an Injury to the Head Report.

[kidzcare]

I call for pretty much every head bump and ask the kid to check in with me in an hour (and I be sure to document that I told the student to check back in with me)/

My spiel goes something like "Hi Mr/Mrs X. This is nurse T from abc school. I wanted to touch base with you to let you know that Johnny had a bump on the head in PE. There is no bump or bruise and he is feeling fine right now. He's holding some ice on it. I wanted to let you know in case he was in pain later on or other symptoms developed. I asked him to come back and let me get another look at it in an hour and I will update you if there are any changes."

[JenTheSchoolRN, BSN, RN]

I don't. But you would be surprised how many visits I get for "I bumped my head on the door" and "I bumped my head on the desk." All said with a smiling child asking for ice and no signs of injury with exam, so it really can depend. I also don't work with the younger kids, though. Actual bumps during PE, I typically call.

Flip side with the older ones, I feel like I get a lot more actual legit head injuries as well, often from after school sports that I pick up with presenting symptoms 1 or 2 days later. Parents are typically like "really? he/she was fine yesterday" when I call and tell them to pick up their child to be evaluated. But, not to toot my own horn, I've never had one in a circumstance like that come back without at least a minor concussion diagnosis :).

[moreoreo]

Does anyone know about how much it cost to implement their computer charting system? Our "system" involves index cards and Excel spreadsheets up the wazoo. Binders and folders galore. It's not something that I could decide to implement but I am just curious. When an inhaler is brought in or I have to note a new health concern I have to edit several different documents and print out new copies. It almost keeps me up at night to worry if I made sure I edited everything, even though I consider myself an organized person.

[MrNurse(x2), ADN]

We are leasing SNAP, $300/ annually. I approached our administration with the legal aspects of paper charting. It protects them AND you.

[WineRN]

We are leasing SNAP, $300/ annually. I approached our administration with the legal aspects of paper charting. It protects them AND you.

We also use SNAP for the same amount as above.

Prior to that they used a program called "health office" which was described as "nice but buggy" to me

[MrNurse(x2), ADN]

I appreciate SNAP because it is pretty intuitive and I had to self teach and then teach my wife (I can't call her my sub, that just has double connotations). I am sure there are parts I am not utilizing, but it works for what I need.

[moreoreo]

I approached our administration with the legal aspects of paper charting. It protects them AND you.

Do you mind elaborating a little? I know SNAPs website states that paper visitor logs are illegal. My district nurse is older and i don't know that she will love my asking about electronic charting but I do feel it is safer and I think that cost would be within our budget. (Id rather spring for SNAP than buy more cases of ice packs!!!) I just would like to ask with as much ammo as possible.

Thank you both for your info!

[MrNurse(x2), ADN]

Paper charting does not time stamp documentation. This is a gold standard from a litigation standpoint. Paper documentation can always be questioned in terms of accuracy and documenting after the fact. It really is a bad system.

[JenTheSchoolRN, BSN, RN]

I used to use SNAP. Oh, how I loved it. Now I use something called Schoolbrains, specific to my state. It intergrates very well with the rest of our systems (attendance, grading, SPED, etc) but as an EMR, it sucks big time. I'm on year two of using it and still trying to get to work better for me. But it does document visits well with a time stamp. Ugh, I could not imagine logging all my visits on paper...

[Kittery]

Why did teachers sign up to work in a building full of children if they're so afraid of germs and getting sick?

(Sorry, I know this should probably go in a different thread ...)