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cjl_RN

cjl_RN

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  1. cjl_RN

    My very first squad call

    I’ve been reading a lot your guys first squad call... fearing when would mine be... welp that was today! Teacher walkie in a calm voice need the nurse student fell and wheel chair outside. Responded to scene student is lying on the ground and I could see through his denim jeans that his left knee had poppped out and was external rotated. Ask students his pain level and if he’s moved it or has feeling. Student has no feeling in leg. Immediately yelled for our SRO to get a squad here ASAP. Continued to assess gently lift pants up to make sure there was no blood running down the leg. Jeans were pretty tight. Student was pale in color hollered for my emergency bag to take vitals. Soon as I got my bag the engine pulled up and he had moved his leg and popped back into place. however the squad took him still to be evaluated to the closest hospital. Of course parents couldn’t be reached an admin had to ride with the child they finally got ahold of parents at the hospital. I will follow up with the child’s condition tomorrow. The student was outside there was some staff members wanting to move him inside due to cold weather temps, but I had a blankets on the way for him instructed we could not move him, got a pillow to support his head. Some were wanting me to splint it, but I didn’t see benefit of a split the knee cap was completely out of socket rest of the leg was straight, I didn’t feel comfortable moving him. looking back I should have brought my emergency bag with me, (put scissors in my bag) should have cut to jeans to ensure there wasn’t an open fracture. (Squad didnt cut jeans either). Anything else I should have done differently?
  2. cjl_RN

    PARENTS say the darndest things

    I called a parent to notify her her child came down with right ear pain. I got out my otoscope and literally couldn’t see anything. It was loaded with ear wax worst I’ve ever seen! I called to notify mother she said be seen by a doctor for a ear flushing/cleaning so they can properly see/assess and diagnose/treat the ear. her response “ARE YOU TRYING TO BE FUNNY? YOU CALLED ME TO TELL ME MY CHILDs EAR IS DIRTY! GIVE HER A Q TIP! YOU CALLING HERE SAYING I DONT TAKE CARE OF MY KIDS!” By far the weirdest conversation I’ve ever had in my nursing career. FYI Mother is a nursing assistant in nursing school!
  3. cjl_RN

    Diastat for the seizure student

    I am going to try to call and I will update everyone. Seems this is a very gray area.
  4. cjl_RN

    Got offered a school nurse job..over 2 weeks ago

    After I got offered the job they told me exactly when the next board meeting was and the day after they approved it I was called to sign in my contract. If it was a a head district nurse that hired you I would follow up with that nurse. If not follow up with HR again asking them if they know what the hold up is.
  5. cjl_RN

    Diastat for the seizure student

    I questioned myself yesterday. I have been a nurse for 8 years. First year of school nursing. I was called down to md lunchroom to bring this students Diastat. Little history of this student she is nonverbal- autistic, CP. she functions like probably a 1 year old. She has a history of complex partial seizures where she will cross her legs, breathe heavy, and stare off. This is changed since she is now off lamictal and on depakote. Her seizures have change to atonic seizure where all of a sudden she will stiff up and head will drop or Loose balance and fall. Mother doesn’t seem concerned she let the doctor now and he is doing bloodwork on her to check her depakote level. When I was called down to the lunchroom to bring her Diastat they said she had a 2 mins seizure approx of head drop then lethargic. No convulsions. She has an order for Diastat if the “seizure” last longer than 5 minutes. My question- Diastat is a smooth muscle relaxer for more of a severe tonic clonic seizure, correct? It’s used to stop and relax the muscles. Why would I give it to her In the lunchroom for that type of seizure? Educated me more on Diastat and what seizures require it!
  6. cjl_RN

    Frequent Flyers

    Pass system for sure. My staff has been educated by myself and administration that students are not come down during the lunch period unless emergency. Vomiting, bleeding, breathing etc. I have too many diabetics and 30 meds during lunch I don’t have time to be dealing with headaches stomachaches lice earaches old injuries Vaseline etc. there are some teachers that still like to send students down. I also only allow one student down per classroom unless they both get injured. They are not to sneak in between classes. I make them go get a pass. Teachers don’t like it, but they also want to put in the student in missing and then want to write them up bc there is a time issue from how much class they missed they want to try to put it on you and how long they are missing. This is my first year as a school nurse and I didn’t have a pass system in place at first. But now that I do it’s a lot smoother. It took a lot for me to get the courage to do it but I was sick of being overwhelmed like that. I have nurse passes id say half the staff uses them and other staff members use our regular passes. No one is allowed to eat in my clinic the last nurse before me allowed students to eat in there. I don’t. Almost violates Hippa in a way. Run your clinic what works best for you not others. Teachers and administrators will try to influence you don’t let them. We don’t interfere and tell them how to teach or run their class. A lot teachers think because they are “moms” they can help diagnose etc. it’s annoying. But sounds like you need some structure you will be much happier with your job, I promise!
  7. cjl_RN

    Child Abuse

    I want to share with you a scenario I experienced today at the very end of my day. Middle School 1000 students. 3:15- Counselor calls nurse says look into this situation. Student A is on his way down. Student A notified teacher his right arm is hurting and something happened at home. 3:20- examine student notify counselor of findings. Counselor comes in and speaks more in depth with student. Counselor says come to my office and YOU can make the report. Go to her office I said I will share the medical information. I asked where the teacher was who the student initially reported to if they would be apart of the call. She chuckled and said “No why would they come.” I said cause he was the one that suspects abuse. She said he didn’t say he suspected abuse. I said then why did he call you and not me. She said he did try to call you. I said no he didn’t. (Trust me this teacher is not afraid to send students. He will send 3 at a time, even though I’ve instructed teachers one at a time unless they both got injuried) Anyways, she said well I don’t know. She said really you need to do the investigating when a student is sent to you and report it. She said myself or any of the teachers didn’t have to be involved when the last nurse was here. (I have been here this school only-1st year) I wanted to say the last nurse quit after 2 years bc she was taking on so much, but I didn’t ! She told me I need to learn how to ask more questions and what to ask. I said I was always taught whoever the first person the student tells is the person who has to report it. I of course would then examine for injuries and make sure they don’t need further medical care. She told me teachers can’t stop what their doing in class and investigate and make the call. She basically wants me to handle all the abuse. Counseling, medical, and reporting. I do not think that is right! Of course If the child came me first certain, however I’d still get the counselor involved. What are are your guys thoughts? Am I wrong am I right?
  8. cjl_RN

    May the odds be ever in your favor...

    I am pregnant so I am a little emotionally right now. But a student I see twice a day to give medication, assigned her point person, and always make sure she has a green mint after lunch...... she comes to me with gifts for the principals, school psych, and counselor and asks me where they are since none of them are in the office. Guess what I got .. nothing .... no more green mints for her!
  9. cjl_RN

    Assessing the student on drugs

    What does your assessment consist of for students who are believed to be on drugs? (I am a nurse at the middle school level) Adminstration brings them to me to be checked out and make sure their stable. I do a full set of vitals and check their pupils and alertness and orientation. Also pay attention to any odors.
  10. cjl_RN

    Use of nurse's office

    Or she needs to come at a time that works for you.
  11. cjl_RN

    Use of nurse's office

    It probably is the teachers plan time. I am a school nurse and I have to pump in the bathroom. I can't even lock and shut my door without someone knocking or adminstration unlocking my door without notifying me. There is no where else in the building. Why can't she pump during her plan time in her classroom? That's ridiculous. You need to discuss it with your nursing supervisor or your supervisor. The needs of diabetic health needs should come before a teacher pumping (and I'm a pumper)
  12. cjl_RN

    Staff & Parents

    So for my job eval as part of my goals an intervention of my goal I have to send out a parent news letter with healthy tips and ideas. I am in middle school 7&8 grade. Ideas on what should I include? Do you have any examples I could see? Also I have to include healthy tips for staff members for their own health and how to keep students healthy while at school. Any thoughts?
  13. cjl_RN

    Type 1 diabetics, help!

    Correction dose only of insulin. No carb bolus. And yes of course she checks and corrects every three hours if needed.
  14. cjl_RN

    Type 1 diabetics, help!

    Question I have a student that comes in at 10am. She corrects only at this time. Let's say she's 119 correction target is 120. So she doesn't require any correction insulin. She comes in at 12pm before lunch her sugar is now 175. Is it okay to give her a correction dose of insulin now with her carbs? My second question at any type you can give a carb bolus?
  15. cjl_RN

    Let me give you a mint for asthma

    I had this student come down8th grade today and she presented me with a note from her parent that said "giving a mint for asthma is unacceptable." And she is going around showing all her teachers in the building. I asked the student what this meant and she said this is what the last nurse did at blah blah elementary school. I said oh If you ever need your inhaler please let me know. I listened to her clear oxygen 99%. Gave inhaler per her request. About 30 mins later I get a phone call from her mom saying her daughter came to the nurse for asthma and her inhaler and was brushed away given a mint to go back to class. I said she looks somewhat familiar but when you see 100 kids/day you can't be sure. I check my documentation. Nothing on this kiddo. I said well I have no documentation of her coming here, but she was very insisting. So I get off the phone with her and send an email to the teachers. I had a teacher call me and say " it was me that sent her to you last week bc we were talking and she said she had a sore throat. " Teacher said I sent her down bc she said she's had a bad case of strep in the past. (So student wasn't even going to come to me, teacher recommendation?) but now I remember. Someone comes to me for sore throat and it's normal and no fever. You go back to class. I give you water and a mint for comfort. Not once did she say she was short of breath or anything. So I attempted to reach out to mom no answer. Should I let this get me down?
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