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Discussion

a mix of rants and question

I went to charter school k -8 thru agency and I asked admin staff if they have the same policy and procedures as a public school and they said yes, I think so. Well, when I look at past nursing logs I see many nurses were giving cepacol for c/o sore throat and were even giving tylenol with parents permission for something like menstrual cramps.(they actually documented that on the log!) Anyway when i a student came to me with a pass from a student saying give 2 cough drops, I was thinking why did teacher put that, let me assess them first. I did not give any student cough drops and cepacol and instead told them to gargle with warm h20. No saline was available. Also I did give a student tylenol with parents permission verbally over the phone and i did not document it. There were 40 students that came for halls and cepacol and each was told to gargle after seeing no irritation and sent to class. Also there was one kid who had a small nosebleed due to being hit by by a ball, assessed, first aid given, and sent back to class, this happened at 320 and kid was going home at 345 so I just gave anote to observe him. Mom calls office and screams about why I didn't call her,I told her he was fine,he was not c/o pain. Anyone see anything wrong I did in above situations? How do u think I did with no orientation and first school day?

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I'm not surprised you didn't get an orientation. Each school is different in what htey allow the nurse to do. In my school, we have the school physician write "standing orders" for things like hydrocortisone cream, TUMS, visene, etc. Those things we can give. I actually won't even use visene, I got an order for artificial tears for my office.

Anyway, I my school, to give Tylenol or such, the parent must have a physicians order as well as a parent form filed out. In the last school I worked, a parent note was sufficient for any OTC product. I didn't like giving OTC without a physician's order, because if we were in a hospital, we would not give it. We can't prescribe, not even Tylenol, as I have explained to parents more times than I can count. They don't understand that we are not just the child's parent or babysitter, we are licsened professionals and must follow the standards of our licesne.

If you are going to be placed in this school a lot, you need to ask to see a copy of their policies and standing orders. You have to protect yourself-the school won't.

As far as the kid with the nosebleed, I think if you sent a note home, you did fine. If you work in a school very much, you will be yelled at by parents for not calling home and you will be yelled at by parents for calling them and disturbing them at work for something "unimportant" Fortunately, more parents appreciate me than yell at me.

I've been yelled at for not calling for a stubbed toe, a scratch that I put a band-aid on etc. I got used to it. As for a nosebleed, I probably would have done the same thing. As far as meds, in my district in Texas...parents could send Tylenol but it had to be age appropriate. I worked with 10 and 11 year olds so they had to have Children's Tylenol. If the bottle said Under age 12 consult physician, we had to have it signed my a MD. Like you, I got no orientation and had to read through the policies myself with the help of some of the other school nurses. Good luck!

Always err on the side of caution. Do not do anything else until you know your policies and procedure and above ALL else your State Nurse Practice Act. Good luck!

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