cjl_RN

??‍♀️ I do. This is my 4th child nursing and pumping. What I recommend to put on the sign is “nurse is not available please return at 3:00” or whatever. A lot of kids don’t understand the concept of 20 mins plus they don’t know when you put it up etc. I made a sign with the time blank. Laminated it and used a dry eraser marker to fill in the time since the times often changed. I also included on the sign “please do not wait, see the office staff if it’s an emergency or go back to class and come back at a later time.” You could also send your staff an email when you go. Let them know there will be a sign on the door. That way everyone can see and hopefully avoid sending kids other than emergencies. Not sure how close your office is to the front office. It’s good to find a support person too. I had the counselor watch the clinic if I couldn’t get away, but now I switched buildings and have the office staff keep aneye instead of shutting it down. (They prefer to leave it open) but like you a lot of times I often have a clinic full a kids waiting. I think this is a reason why supply is down bc I’m stress pumping. Ppl don’t realize you have to be stimulated that it’s not always instant. And it’s hard to get stimulated when you know what your coming back too. a billion kids. I feel so rushed. I usually pump for 15 mins. Twice/shift which isn’t really enough, but I don’t know when else to take it. Our school lunches last half the day cause our cafe is so small and I am so busy. My New counselor pumps and she does 3x. Not my support person. But If you can do it do it by all means. We should get to pump 3x. It’s very difficult pumping while being a school nurse. I bought a willow pump, but haven’t used only a handful a time bc it often hurts.

What are some gentle words you use when talking to parents... like hit=bump, smashed=caught, stab=poke ....others? talking to parent tips... anything you can give me! Just eel like I’m not efficient in this yet, never been much of a talker or good with my words. My usual is “Johnny not feeling well to his stomach was going to see if someone could pick him up from school?” I feel like I’m a nice blunt lol Also do you offer suggestions to parents on what to do for Illness and injuries or wait until they ask? Just worry about liability. I don’t feel most stuff we see needs seen by a doctor, but I don’t want to be accountability if I don’t tell them too.. especially injuries.

I have two separate teaching projects due for my school internship to graduate and get my school license. I have to do a teaching lesson to staff and a separate teaching lesson to students (middle school aged 7th & 8th grade). I have no idea where to start. I was wondering if you all could please give me some ideas and maybe if you had to do it what you guys did. side note: I am very overwhelmed in my life right now. 4 kids- 3 of them is 3 and under 1 is a newborn. Plus we’re trying to put our house on the market and buy a new house. Oh and I work full time and my husband works basically two full time jobs and coaches. Sport schedule for son is heavy. Help is limited. Not trying to throw a pitty party, ahh just ranting. So I’m still not sure how I am going to pull it off. I am not a good talker and choke when I have to get in front of ppl also. Yay me.

Skill wise you will be fine. But def look into type 1 diabetic care totally different than type 2. Get familiar with asthma and inhalers equipment etc, epi pens, diastat, and nasal versed emergency meds. Action plans. Your school guidelines when to send a child home. Make sure you have an exclusion chart handy. Know your forms like med dispense. Know the requirements for vision and hearing screening. You will also need to know your states immunization Requirement and your schools exclusion date. And resources to give Family For a child to get vaccines who don’t have a doctor or health insurance. Make a thorough sub folder the sub will appreciate that and may even enjoy and be comfortable subbing at your building. Also learn what part you play in 504 and Ieps. Medicaid billing. ETR forms. Biggest thing is learning how to communicate with parents and even staff. Don’t be afraid to stand your ground. Staff and parents will question your assessment. A lot of time staff and parents think all we do is see sick kids with stomach aches and headaches that are trying to skip class. They do not realize how much more we do and that is only a small percentage of our daily job. It will get aggravating hearing that but just try to ignore it. Don’t be like me when I was a sub and send everyone home who said they vomited in the bathroom or classroom. Call the teacher to see if they vomited in the classroom. Most of the time they didn’t. Also if a student is sick it’s unlikely they made it to the bathroom to get sick. If it’s a student I see often I’ll send them back to class if it is a a student I’ve never seen I call home because it’s certainly possible. Diarrhea is also a tough call call home if your unsure and the student isn’t a frequent flyer. Rashes I hate!!! You will learn to hate lice and it’s lower on your priority list but first on teachers and admins! But anyways You may sometimes feel alone, but you are not you got us and hopefully other nurses in your district or nearby who know what you are going through ? I love this group! Don’t be a stranger!

A lot of nurses are saying to get CPS involved. CPS will do nothing for bed bug infestation. Considered basically a nuisance. They are not known to carry diseases so they don’t pose a health threat. I hate the fact we are involved with bed bugs there is nothing we can medically about them. I feel this should be more of an admistarion issue. Lice is different there is a medication treatment. Only way I could see if it was neglect if the student was covered with infected bite marks and parents were refusing to get proper medical treatment. Like someone said above bed bugs are NOT easy to get rid of. They have a tough shell, if small and clear be difficult to see, and the cost to get rid of them is high and they may not be the issue of the bed bug reason why it occurs. I feel you on this issue and hate this for the student. I found close to 20 in a students notebook one time. But our policy is put the belongings they don’t need and double bag them put them in the locker, the classroom in which they were found is sprayed, and phone call to parent to let them know what was found and what steps to be taken but they are never excluded from school.

Also I can give you some advice a lot of the nurses are saying check your orders and I am sure you did that. But reality is a lot of times the physician does not put in wether to give or hold, but they put the NPO after midnight order in which technically includes meds, but they are usually worried about the food for aspiration purposes. Meds are usually out of the belly within 30 mins- hour. You likely will always give the blood thinners especially plavix and aspirin. Plavix has to be held for a few days before it would even be beneficial to hold. Angiograms usually always give plavix its more of a risk if you hold it. It can clog a stent or cause clots by holding it and angiogram we want to keep the vessels open. Lasix a lot of doctors I’ve worked with want it held if you have a morning dose and morning procedure becus then the patient will have to keep urinating in the table. You ultimately want to do whats safest for the patient. Although those nurses experienced they can be wrong and saying nurse Kathy said it was okay wouldn’t hold up in court. But asking the doctor and then documenting a quick note what the doctor said will! The doctor would rather you reach him for a question than to make an error even if he does act like a dick he will hopefully learn to appreciate and respect you for that.

If you ever question an order until the point where you ask multiple nurses get in contact with the physician performing the procedure or even the cath lab nurses. I worked on a cardiac floor and anytime I had an angiogram the only med I would hold is lasix. There are many reasons why a patient would have gone to the ICU after an angiogram a big reason is they left the sheath in. Only icu can have a patient with a sheath left in or another reason they went to icu is medication. The blockages maybe severe and they need closer monitoring. You can always ask your charge nurse why (they usually know) or the cath lab that not violation of hipaa. Don’t suffer yourself next time ask if you have questions. But trust me if it was becaUse of any medication you gave you would have already heard it from someone. Don’t worry about this. I remember being a new nurse and was always in a panic try to relax, especially on this situation. You’ll get plenty more worries throughout the years!

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?

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!

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

Old Dude- If Diastat is smooth muscle relaxer to stop convulsions why would it need to be given for a student who has a seizure that is not convulsing? But a head drop, or starring. I thought the reason it was given is to relax the body to stop the convulsions so adequate oxygen blood flow etc gets to the brain and body. I feel like if I am giving it for a student starring or atonic seizure I would be almost worsening the condition. Your right the order is generic for “seizure” none of my state the specific seizure type.

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.

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!

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!