Missing physicals/Dental Exams

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Specializes in Emergency Medicine, Women's Health,School Nursing.

So this is year 2 in my CSN position. Now that I finally have some what of an idea of what I am doing (ha) I am trying to get all the required Physical and Dental exams in order (the nurse before me left this place a mess with no order what so ever.) What do you all do about the kids who never turn one in. I started sending home monthly reminders that proof of these exams are required and have attached consent forms for parents to complete if they choose to have the school physician or dentist do the mandated exam. Most have turned the required forms in but I am still missing quite a few despite the monthly reminders-its still too many for me to physically call each one individually. When I talked to my mentor who is the HS nurse she said they give the kids detention when they do not turn in the required forms but I do not think that is fair for elementary school kids, its not their fault.

Recommendations? Advice?

Thanks in advance

Specializes in school nursing, ortho, trauma.

Since they are state mandated exams, i would send out one more letter with a deadline date - if the exams are not received by XX day then students will not be permitted to attend school until these mandates are met. Of course, make sure your admin will back you on this prior to sending something like this out. If they won't then your letter has no teeth. Does your admin know that this issue exists?

Specializes in Emergency Medicine, Women's Health,School Nursing.

Yes they are are aware and were kind of waiting for my suggestion as to what to do...this is my principal and vice principals first year in their position, they're pretty good about going along with my suggestions. Fortunately I have a great team. I was going to suggest this (similar to our vaccine requirements) but was not sure if other schools went this route but these exams are required as the vaccines are so it makes sense to exclude the child from school if its not done.

Specializes in ICU/community health/school nursing.
So this is year 2 in my CSN position. Now that I finally have some what of an idea of what I am doing (ha) I am trying to get all the required Physical and Dental exams in order (the nurse before me left this place a mess with no order what so ever.)

Thanks in advance

YAY!! Every year it gets easier as you find your groove. And I'm sorry the nurse left your clinic in disarray.

What does everyone else in your district do? We don't require physical forms. There's a general health form and if the parent does not complete it then I tell them (at least three times, with one of those attempts being a phone call) that I cannot even give the kid a band aid without that form. That usually spurs them to completing it.

Is this a cover your assets thing? If so, I'd just document that you've made (numerous) attempts and have had no luck. Is it mandatory? Get your admin staff to make a deadline and dismiss the kid from school.

Good luck!

Specializes in Emergency Medicine, Women's Health,School Nursing.
YAY!! Every year it gets easier as you find your groove. And I'm sorry the nurse left your clinic in disarray.

What does everyone else in your district do? We don't require physical forms. There's a general health form and if the parent does not complete it then I tell them (at least three times, with one of those attempts being a phone call) that I cannot even give the kid a band aid without that form. That usually spurs them to completing it.

Is this a cover your assets thing? If so, I'd just document that you've made (numerous) attempts and have had no luck. Is it mandatory? Get your admin staff to make a deadline and dismiss the kid from school.

Good luck!

So the middle school and high school told me they give the kids detention as incentive to get the mandated forms completed. When I brought that up to my admins we all agreed that was probably not suitable for Elementary as they are so young and we did not think it was fair to 'punish' the child. But I agree that I think excluding them would be a good way to get the parents on the ball with this (also because detention would just be an extra hour of free babysitting for the parents at the end of the day.) And yes the state requires that all students in elementary school (K-5 here in my building) have a physical exam and a Dental exam some time between kdg and first grade and then another dental exam in grade 3.

Specializes in Emergency Medicine, Women's Health,School Nursing.

Update: I emailed our state 'school health consultant' who works for the DOP and she basically said no school exclusion is written into the law. How to handle the noncompliant students is strictly up to the school district itself and can be decided upon at a local level. And of course the school does get reimbursed based on the number of completions.

Thanks for any additional input you all have to offer

Specializes in Peds, MS, DIDD, Corrections, HH, LTC, School Nurse.

At the beginning of the year we exclude kids K-12 who do not have all required immunizations, Birth certificate or Visa and physicals. Kids aren't allowed to attend school until all requirements are met. You'd be surprised how fast parents respond when their kids are forced to stay home. HeHe. Food for thought for the beginning of 2018-19 school year. Nip it in the bud the 1st month of school. Transfers are treated the same way.

Specializes in Emergency Medicine, Women's Health,School Nursing.
At the beginning of the year we exclude kids K-12 who do not have all required immunizations, Birth certificate or Visa and physicals. Kids aren't allowed to attend school until all requirements are met. You'd be surprised how fast parents respond when their kids are forced to stay home. HeHe. Food for thought for the beginning of 2018-19 school year. Nip it in the bud the 1st month of school. Transfers are treated the same way.

Yeah I'm hoping to implement something like this when I start kindergarten screenings this year in March-at least I'll be the one enforcing everything and saying THIS IS REQUIRED!!! Last year was my first year and I was on maternity leave during kdg registration week so I couldn't make sure this information was being spelled out for these parents (and 75% of them do need it repeated 5 times for them to get it)

Specializes in Peds, MS, DIDD, Corrections, HH, LTC, School Nurse.
Yeah I'm hoping to implement something like this when I start kindergarten screenings this year in March-at least I'll be the one enforcing everything and saying THIS IS REQUIRED!!! Last year was my first year and I was on maternity leave during kdg registration week so I couldn't make sure this information was being spelled out for these parents (and 75% of them do need it repeated 5 times for them to get it)

I know right! I work for in the central nurses office (12 months instead of 10) and I start sending letters to the parents of those going into 7th grade (Tdap) during the summer and the secretary and I divide up the 7th grade students and make phone calls the last 2 wks of summer before school starts to the parents that haven't turned in proof of Tdap. It never fails that the first day of school parents are saying "i didn't get a letter" or "i didn't talk to anyone". But like I said earlier some how they get on it when the kid is excluded. It shouldn't take so much effort to get parents to do what is required by the state. On that first day and the parents looks like they're in shock that the kid is being exclude I want to say "we've been telling you this was going to happen, what? you thought I was kidding?"

Specializes in Med-surg, school nursing..

The only thing we (in our district) can exclude for is immunizations. Parents know this so they don't really care if they turn the paper work in. Frustrating.

Specializes in School nurse.

Immunizations and entrance into school physicals are state mandated. No one local is allowed in school if these are missing. The only exception is international or out of state students who have 30 days from enrolling (I get a provisional from the health dept). At the end of the allotted time the health department mandates exclusion. If a student is playing an intramural sport then a current sports physical along with info about concussions etc are also required prior to the first practice. Incomplete or missing forms equal no play, no exceptions. Yep, I'm the meanie.

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