pink eye season!

[pineappleupsidedowncake, BSN, RN]

Does anyone have a specific pink eye policy they would be willing to share? 

This has become the bane of my existence. As the pollen increases, the number of students coming to me with "pink eye" has sky rocketed. The teachers always think that they are contagious, and of course, for good reason. I always send the kid home if drainage/crustiness or other symptoms are present. However, the majority of these kids have no other symptoms other than pinkness and a history of seasonal allergies. I'm not trying to diagnose, but why should these kids always need to be excluded from school if it is a recurrent event? The next day these children come back to school with completely cleared eyes and in two days it happens again... I tried to check my school's policy, but unfortunately, we don't have anything written. My principal wants me to send home everyone with pink eye until cleared by a doctor, which I have been doing, it just seems unnecessary sometimes. But then again, I don't want to miss a pink eye epidemic. What does everyone else do? And should a student be required to have a physician note for allergic conjunctivitis? 

By the way, I'm not allowed to give any eyedrops (including saline) without a medical order. So I usually do a warm compress as an intervention. 

[BrisketRN, BSN, RN]

I'm in Illinois and follow the IDPH Communicable Diseases in Schools chart.  Exclusion criteria for conjunctivitis states: "Exclude if conjunctivitis is accompanied by symptoms of systemic illness or if the child is unable to keep hands away from eye."

If a student has conjunctivitis-like symptoms I notify parents by phone.  If the student is able to keep from rubbing/touching eyes then they can stay in school.  If the student continues to rub/touch eyes they can go home.  I usually only recommend a visit to the doctor/optometrist if there is discharge, itchiness, and/or widespread pink or red around the whites of the eyes.

[NurseInTheHall, ADN, RN]

Our current school policy is that the student may return 24 hours after 1st treatment or when released to return to school by a medical professional.

I'm sorry to hear that your principal is crossing into your lane. The decision to send home for evaluation of conjunctivitis is (should be) at the nurse's discretion. Sometimes the teachers don't like it but we are the trained medical professionals in the building so the nurse provides education to the teachers as needed and we make the best decisions we can with the information available. For colored discharge they go home - the rest is subjective based on the severity of symptoms. If we sent every kid who had itchy watery eyes home, we would have more kids at home than in school. Maybe I'm just lucky, but I have never seen a pink eye epidemic - I don't think I've ever even seen an in-school transmission of pink eye.

Have you checked your state or county health department for their requirements/recommendations? Ours says "Conjunctivitis without fever and without behavioral change generally does not require exclusion from group settings (e.g., child care, school, etc.) unless it prevents the child from participating in normal activities or requires care that is greater than staff can provide." You might also try using the CDC as a reference to standards of practice to make your case for autonomy in the decision.  https://www.CDC.gov/conjunctivitis/index.html 

Good luck!