ConnecticutMassRN

This is a great question and I'm personally glad you asked it. There isn't an easy answer, unfortunately. First, I would consider your DNS and Administrator's characters. Have you been privy to similar conversations? Do you know how they react to concerns raised over staffing, acuity of patients, admissions, etc? In my experience, I have had to advocate for my patients and staff for these same reasons/scenarios. Depending on the Administrator and/or DNS, your concerns may fall on deaf ears; they may only have the $$ on their minds, which will always conquer. You may be lucky enough to work for an administration who values quality healthcare. In that case, use your voice. Be professional, calm and give straight facts. You will never regret advocating for delivering the best, quality care.

I believe you do have to call it a DTI because you are unable to assess the damage to the underlying skin.

What?!?!?!?! I just want to know what in the name of God happened that made some super intelligent administrators decide this is a good idea??

I have had to become very selective with who I lend clothes out to. My supply dwindled down to almost nothing and I can’t believe the stuff the teachers and kids will come to me looking for a change of clothes for .... a tiny water spill on your legs? Deal. You blatantly played in water or mud and you’re not 2? Deal. I give cloths and ask them to clean up in the bathroom. Or I wave a blow drier around their water spills - if I have time and there is not a waiting room full of students.

I have 688 students (pre-K - 6) and we average 60 visits a day (this includes daily meds. I have no diabetics). 5,059 visits this year to date. This is an improvement from 60-80 visits a day when I first started in 2017.

That's hilarious! I think it will give a few lol's ?

LTC has a large psych component but without the specialized training, resources and most importantly, staffing. I've done both and found LTC to be 10x more stressful.

Feeling grateful that I've never encountered a hot glue gun injury ?

I don't understand how this is a nurse dismissal? If the student has opted to call their parents, rather than present to the health office for an assessment, this is not a nurse dismissal (in my school)... this would make me crazy!

You've got this! 40 more days. I love the advice of the poster above - write it all down while it's fresh. Then, once it's dumped out on paper, breathe deep and let it go for today. We've all been there.

I thought I'd just recap some of my favorite visits from today: * Had a 4th grader come in 3 times with mild redness (more like, light pink) bilateral sclera. No swelling, no tears. C/o itching. Asks to do a tap water rinse and hold an ice pack for 5+ minutes each time. I called mom and asked that she start Claritan/Zyrtec and perhaps some Zaditor eye drops, or we're in for a long month of May. Mom was sweet and said she would start this regime tonight - and asked if she should come pick the LD up early * 2nd grader visits with a light pink rash, not raised, on her left lower arm. She had just come from outside, sitting in the grass, during a science class. I asked her to use and soap and water to wash the area and told her there is a lot of pollen, dust, etc in the air and on the ground right now and she might be having a reaction. Her response, "Yeah, no, I don't have ANY allergies" * 3rd grader visits with moderately red bilateral sclera. Excessive tearing. C/o itchiness. States she was outside at a reward extra recess. I gave her an eye rinse, cold/moist compress for 5+ minutes. Upon leaving, ask her to let her parents know that she seems to be having a reaction to some seasonal allergens to which she responded, "I DO NOT HAVE ALLERGIES!" I don't understand it. It's late April in New England. The trees are budding and have a light green, almost fluffy appearance. It was 72 degrees yesterday...I'm no physician, but it does appear that we have some seasonal allergy sufferers here

I wonder this also.

Fantastic idea! Thank you!

Spring allergies are not even in full effect in my part of the Northeast yet we are starting to see the kids (some come in right off the bus in the morning) with allergy symptoms. Mostly itchy, red eyes. Last May, I saw an average of 45 visits a day (many of the same kids/several times) with allergy symptoms. Almost all of them argued with me, "I don't have allergies" Ok, so what do you attribute your red, itchy eyes, clear runny nose and absence of fever to? How do you treat? I allow the kids to rinse their eyes, hold an ice pack for 2-4 minutes and return to class. I encourage them to tell their parents to utilize OTC allergy relief. In many cases, I contact parents and have the same conversation. When I see the same students multiple times a day, I do tend to get frustrated. I ask, "did your parents get the OTC allergy meds we talked about?" No... I reach out to the parent again. I'm not sure what else is expected in terms of treatment. I encourage the students to get back to class and manage through the day with their mild allergy symptoms. Last year, I had some refuse to leave my office until I cured them.

I'm in elementary school, so I rarely have girls who request them for cramps. But, I do find they come in handy for some ailments (ear pain, neck pain). They are not allowed to leave my office with them (I have both electric and instant).