New to school nursing...Please help with a few questions!

BeckyESRN · Mar 10, 2017

1.) I chart electronically with SNAP, i jot visits down on paper when it's crazy in here.

2.) I have around 400 kiddos and see anywhere from 15-70 a day. Mondays are always the worst, especially after a break or long weekend. This Monday(we were off last friday) I saw 58 kids and maybe 10 of them were legit reasons to visit the nurse. You're new, the kids want to check you out and see what you'll do with them, so once you lose that shiny new school nurse smell, they should slow down.

3.) I have nothing to with attendance, thankfully!

4.) 100.4 or over goes home with a note stating they cannot come back to school until fever free without medication for 24 hours unless otherwise they present a note from the doctor stating that they are cleared for return.

Congrats on the new job! It's usually a great gig once you settle in. Keep the questions coming- this is the greatest nurses I've ever been a part of!

RNLisaC · Mar 10, 2017

Thank you Becky, for your quick response! I really love the kids and am so happy I found this forum. Today is a snow day so I'm viewing everything possible and looking things up! I have been sending kids home with a fever over 100 but the note is a great idea! Since there is nothing in place, I think that it is something that I can make a policy on (they expect me to write policies too). Thanks again.

KKEGS, MSN, RN · Mar 10, 2017

Welcome!

1. I chart with Skyward. I cover 2 schools. My middle school health aide writes them down on a paper log and then puts them in the computer when she has a few spare minutes throughout the day and finishes them at the end of the day when it has quieted down. My elementary school health aide puts them directly into the computer and we only use a paper chart when there is a substitute.

2. At my middle school we see around 30 to 40 a day and that includes the 23 daily meds we give. At my elementary school we see 55 to 60 a day with only 13 daily meds.

3. The middle school has it's own, full time attendance person and the elementary school health aide does attendance and Child Study (Special Education paperwork and scheduling).

4. Fevers of 100 degrees or higher go home

RNLisaC · Mar 10, 2017

Thanks Kschenz! They are open to suggestions so I ag ask about someone else handling the attendance piece. The filing is so backed up. They also expect me to find RN coverage for field trips and then communicate whether the field trip can happen based on my getting coverage. I may bring that up as something that can be turfed. Reading responses so far has me convinced visits should definitely be documented in the system. They actually have not counted meds visits which I thought to be odd. I have been doing that. I've had second thoughts about staying but maybe I can make a positive change. Thanks!

KKEGS, MSN, RN · Mar 10, 2017

Without proper documentation they have NO IDEA how busy a school health office is. We document every single person that crosses our doorway because it's what they base our staffing on. According to suggested staffing from NASN my large district should have 13 full time RNs. We have 7 but are hiring another one for next year! Woot!

moreoreo · Mar 10, 2017

1. I keep a daily visit log with in and out times and whether they returned to class or went home. Additionally we have large index cards on which we record details about each visit--complaint, assessment, intervention, and disposition. I am to chart every single visit, even just for chapped lips.

2. We have 800+ students, PK through 5th grade, and I see 30-50 most days, plus 9 daily medications and one student who I work with twice a day. Some teachers send children back down (and I in fact tell some students to come back if still not feeling well, or feeling worse).

3. I do not do anything with attendance, thankfully! Attendance makes note of the doctor's excuse and then gives me a copy for the health file.

4. Yes, we send any child with fever 100 or higher home. I do round up on the 99s especially if symptomatic.

Best of luck to you! If you are like me, you will gain a lot of knowledge and reassurance here!!

SaltineQueen · Mar 11, 2017

1. We use CareDox, a web based charting system. (It's free. You should have your admins & legal look into it) If you use paper logs, you need a separate sheet for each student.

2. It varies, but usually 12-20 per day. I have about 300 in K-3.

3. No

4. Yes

welcome to the trenches!

SaltineQueen · Mar 11, 2017

Thanks Kschenz! They are open to suggestions so I ag ask about someone else handling the attendance piece. The filing is so backed up. They also expect me to find RN coverage for field trips and then communicate whether the field trip can happen based on my getting coverage. I may bring that up as something that can be turfed. Reading responses so far has me convinced visits should definitely be documented in the system. They actually have not counted meds visits which I thought to be odd. I have been doing that. I've had second thoughts about staying but maybe I can make a positive change. Thanks!

What state are you in & what are you medical kiddos' issues? Do you need RNs for a field trip or can you delegate tasks to teachers or paras? In indiana, we can delegate quite a bit to UAPs. I don't have any complex medical kiddo's, so I don't send RNs on field trips.

RNLisaC · Mar 11, 2017

Thanks!! I'm taking notes. So this computer systems also tracks vaccines and physicals too?

SaltineQueen · Mar 12, 2017

Thanks!! I'm taking notes. So this computer systems also tracks vaccines and physicals too?

Vaccines, yes. Physicals...I'm not sure, but probably. You can scan & upload any document you want. We don't require them any longer, but most get them for K.

RNLisaC · Mar 12, 2017

Hi Beth,

Did you decide and come up with a policy that the physicals are no longer needed? Thanks. :)