pineappleupsidedowncake

I typically don't mind "difficult" parents. Most of the time I can sympathize because I understand anger mostly comes from parental concern. But flat out - rudeness - (screaming, cursing, etc.) is what I HATE about this job. Why do some people think that they can treat us the way they do? Very recently, an incident occurred in a class and a student ended up falling and bumping her head on a chair. Another classmate pulled out the chair as she was going to sit down. She was asymptomatic and I called her mother to update her and notify her from a medical standpoint. Well, mom was more concerned with the fact that another student pulled out the chair. Of course I understand this! I told mom that I was unsure if it was intentional or an accident, the student herself told me she "didn't know," and that her teacher would be the one to handle any behavioral issues. Well, I guess I came off as too friendly or nonchalant... mom yells "why are you laughing?! you're the f****** nurse?!" I'm kind of shocked at this point. I definitely was not laughing. I am aware that I have a sunny disposition, and since the little girl was still standing right next to me, my tone could have certainly come across as lighthearted. And initially I felt awful, apologized for the misunderstanding and assured mom that I did take this situation seriously. The women did not accept my apology and proceeded to curse and scream at me for several minutes, threatened a lawsuit ?, and demanded that she speak with the principal to report me. I said that of course I could transfer her to the principal... I just happy to get her off the phone so I could go cry in the bathroom ? What the heck???? Maybe next time I should have the teacher contact a parent first when an incident like this happens. I'm sure I'm not the only one who has this stuff happen to them. But man o man does this make me want to leave school nursing.... okay venting over!

I'm sorry if someone already posted about this! I haven't seen a post dedicated to covid-19 policies for the new school year. Has anyone's policy changed from last year? Or is it generally the same? Despite asking multiple times, my school (a private school) has still not provided me with a written covid policy. The school admins suggested that I follow the CDC guidelines, which is: For students with chronic conditions, a positive screening should represent a change from their typical health status. Temperatureexternal icon of 100.4 degrees Fahrenheit or higher Sore throat Cough (for students with chronic cough due to allergies or asthma, a change in their cough from baseline) Difficulty breathing (for students with asthma, a change from their baseline breathing) Diarrhea or vomiting New onset of severe headache, especially with a fever Obviously, this leaves out a few symptoms that -could- be covid (headache by itself, runny nose). Now I have teachers refusing to accept students for a minor headache, as it "can be a symptom of covid..." It is just a mess. I'm dealing with way more kids as usual, no written policy, and I can't please anyone. I hope things change for the better soon, as I'm not sure how much longer I can deal with this before I burn out completely. Thanks ❤️

Me too! A lot of just sneezing/runny noses are coming back positive. But I have also been seeing a lot more fevers than last year as well.

Hello! I’m a relatively new nurse (going on year 3). Currently I work in a school setting, and before that I was on a med-surge/ortho unit. I really like working in a school (especially during covid!), but I don’t feel like there is much room for growth. I’ve been thinking about going back into the hospital setting after this 2021-2022 school year, however I had a pretty bad experience working inpatient. I’ve thought about the ER (I really enjoyed my ER clinical), but I’m not sure if my personality is necessarily fitting for it. I’m laid-back and on the quiet side, and sometimes I struggle with assertiveness, confidence in my clinical judgment, and I can be pretty sensitive. A (non-nursing) friend told me she didn’t think I would be able to survive in the ER. since she’s not in the medical field, I didn’t really take that personally, but maybe there is some truth to it? Is there a type of personality best for emergency nursing? Are there some personality types that don’t do as well?

Regarding a student fainting (lasting less than a minute, with no other symptoms) would you always call 911? I had this situation last year and I called EMS - although she ended up not going to the hospital. However, I read somewhere (I don’t remember where, some first aid manual) that it was not necessary to call EMS in cases like this. That just makes me very uncomfortable, especially with the little kids (I am pk3-8th grade). I’m probably over analyzing! This will be my second year in the school setting, and I’m still very anxious to go back. I didn’t do any nursing this Summer, and I’m assuming that is playing some part in the anxiety ? thanks!

This happened to me today ? It was a faculty member experiencing nausea/vomiting. They asked me to take their BP, which was high (PMH of HTN). It wasn’t high enough to be considered a “hypertensive crisis” but my mind automatically went to cardiac. So they didn’t want me to call EMS, and of course we can’t force an adult to go to the ER... but I’m more so upset with myself because I feel like I’m almost too calm in these situations. Maybe I should have been a little more insistent that they call their doctor or go to urgent care??? If it truly was a medical crisis that needed immediate intervention, that person may have needed a little bit more of a stern push to go checked out. maybe I’m over reacting. It certainly didn’t help that all the other teachers were freaking out ?

I ended up leaving my first nursing job early and breaking my contract. Why? I was sick of being constantly understaffed and felt very unsupported by management. I also simply realized that I hated adult med-surge. I was also very anxious. I'm not trying to whine about it - at the end of the day it just wasn't a good match for me. And I am very grateful for the valuable experiences that job gave me. Thankfully, I didn't have to pay because my new job was not at a competing hospital. I'm curious as to what your contract said exactly, if you would be willing to share... While I do agree with everyone that you should read and understand a contract before signing it, sometimes life happens. Sometimes you need to prioritize health and happiness over "sticking it out." That is your prerogative. If you can stick it out, good for you - but I don't think anyone should feel guilty for leaving a nursing job (especially one that makes you feel unsafe). I actually know many people who left their positions before the contract was up, one for (mental) health and a few for relocations. However, I'm pretty sure none of them had to pay. I'm not sure if you tried fighting it yet, but it might be worth giving it a shot... I'm sorry that is has been a bad experience for you. Nursing is a very hard job, especially as a new grad during a pandemic. I do believe the problem is systemic. Hospitals should treat their employees better and listen to their complaints if they want them to stay. One last thing - I understand that new grads cost money. But, at least in my case, I wasn't given the orientation and training I was promised. I won't get in to details... but I cannot fathom how it could have possibly have cost them that much. Good luck!

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.

I don't send home every headache. Our current policy is that a new onset severe headache must go home, especially with a fever (this is based on the CDC recommendations). Sometimes it is hard for me to distinguish a severe headache when in comes to the little kids though. I usually do my typical headache assessment (onset, characteristic of pain, any recent head injuries, did you eat breakfast/drink any water today, etc). I usually let them lay down for a little bit, and if they don't feel better after that I'll call home and recommend that they are picked up. But as long as it is a mild headache unaccompanied by other symptoms they are not required to go home at our school. I usually find that some water and a few minutes of rest is all it takes, at least the majority of the time.

I'm trying to hang in there and stay for at least another school year. This was my first year as a school nurse, and a crazy one at that d/t covid. Still, even the worst days in the school setting were FAR better than a normal day at the hospital. Hopefully things start to cool down a bit soon!

This is very helpful, thank you! I'm not sure why I have never heard of that rule of thumb, but it makes sense.

I had a parent try to have me administer prednisolone to her child. The prescription was once a day for 5 days and the reason was for an asthma exacerbation. However, for several reasons, we decided that she should administer this medication at home. I'm still new to school nursing and so I have never considered what sorts of medications should be "off-limits." Would you ever administer a new medication such as prednisolone at school? And what are some other medications which you would not administer?

No cough, but mom did say she gave him robitussin yesterday... so that is definitely possible!

I have an elementary age student with history of asthma complaining of "throat" pain (he points to the center of his neck) when he breathes in. I gave him his albuterol, vital signs look good, lungs sound good, and there are no other symptoms. He states his throat still hurts. Mom was notified but didn't think he needed to go home. I have never had an asthmatic with only that symptom. He doesn't appear to be in any sort of respiratory distress... but should I have been more insistent in sending him home? Neck pain always frightens me, but it doesn't seem urgent, just the fact he is an asthmatic. I also asked him if he thinks he needs to go to the hospital in my attempt to gauge the true severity of the situation and he said no. This is still my first year school nursing, so I just want to be extra careful with everything.

Thanks for all the responses! I really have tried to be super cautious, and the only students I have sent back to class have been those with one symptom who stated they felt completely better after a few minutes. But now I’m thinking I should just send them home right away... I KNOW I need to develop thicker skin to deal with all the unhappy parents haha. I think I also need to remind parents again of the clear covid policies in place so they aren’t surprised when I call home. It has been a crazy first few months of school nursing, many ups and downs, but I am definitely learning a lot quickly!

Part of the trouble is that I work at a small private school, and the policy has been evolving constantly since August. But fundamentally it is similar to yours. For any of these symptoms (fever, sore throat, cough, difficulty breathing, diarrhea or vomiting, abdominal pain, new onset of severe headache) the student has to go home. Any student sent home must stay home until symptom free for 42 hours without fever reducing medicine (do the families follow this policy? that is a completely different rant). I guess my question is, when are we supposed to use our nursing judgment? I was told I could use my nursing judgement... But I don't pretend to know the first thing about covid, so I don't want to be to lax either. If the student comes in with a stomach ache routinely because they don't eat breakfast and then the stomach ache is resolved after eating some crackers - that would be an example. I only have one teacher who gives me a problem when I send kids back in cases like this (this teacher also sends me more kids every day then every other teacher combined). I'm planning on meeting again with my principal tomorrow to discuss our policy. Did I mention this is my first year as a school nurse? So much different then working in the hospital, ha

That's a good idea!

Woah, that's pretty cool.

I know this has been discussed many times before... but the "every kid with any symptoms needs to go home" thing has been really bugging me. Am I a bad nurse? At my school, the policy for sending sick kids home has always been what the CDC has recommended: "The presence of any of the symptoms below generally suggests a student has an infectious illness and should not attend school, regardless of whether the illness is COVID-19. For students with chronic conditions, a positive screening should represent a change from their typical health status. Temperature of 100.4 degrees Fahrenheit or higher, Sore throat, Cough (for students with chronic cough due to allergies or asthma, a change in their cough from baseline), Difficulty breathing (for students with asthma, a change from their baseline breathing), Diarrhea or vomiting, New onset of severe headache, especially with a fever" I absolutely think this is fair. I must admit that I have been allowing my frequent flyers who come in complaining of a "sore throat" to lay down for a few minutes and/or gurgle some salt water. If they magically feel all better after that and are no longer complaining of a sore throat (and after a focused assessment as well), I see absolutely no need to send them home. Same goes for belly aches or mild headaches. I can't imagine calling home and saying "hello, so-and-so had a sore throat for a few minutes and is now feeling all better, so can you come and pick him up?" If they still feel bad after an assessment and interventions (ex: using the restroom for a bellyache), I will absolutely send them right home. I have one teacher in particular who will ALWAYS send the student back - with their backpacks on no less. So, I just do as she wishes... Maybe I'm a pushover or maybe she is right and I should be way more cautious. In her defense, she is probably just as frustrated. It is just extremely exasperating being the middleman between teachers who want their students to go home for every single thing and parents who only want me to call if their kid has a fever. My job feels futile if every kid is going to go home anyways. I would love to hear your school's protocol - does every single symptom have to go home, no matter how minor? Do you try some interventions first or put the kid into isolation right away?

I was wondering if anyone has any nursing "hacks" to deal with things like eczema, bug bites, etc. I think its ridiculous that I am not allowed to have petroleum jelly or lotion in the clinic (not even with a verbal consent, it needs a WRITTEN PRESCRIPTION filled out by a physician). Is anyone else's school like this? One of my students came in with some mild eczema today. She no longer uses any medication for it, just basic lotion at home. The best I could do was a cool compress to at least relieve the itchiness. When I did camp nursing we were not allowed to even give out prune juice for constipation. I had to get very creative. I have done toothpaste and baking soda for bug bites... because for some reason I can give that but not aloevera??? I think it is silly but, oh well. I would love to hear some of your magical tips and tricks. Also, just throwing it out there, I am so thankful for this website. As a new school nurse, this has been so extremely useful.

Let me first preface this by saying I am new to school nursing, let alone new to pediatric nursing. I had this happen way too many times this year, with a few of the same asthmatic kids. They come from PE having an asthma attack and no albuterol available at school. I always call the parents right away and put the pulse ox on. I do my assessment, have the kid try to calm down and take deep and slow breaths. It has never been "severe enough" to warrant EMS. In 100% of the cases, the student will approve naturally or they have their medication (illegally) in their backpack. In the case they do have their inhaler but no physician note, I just have them use it... I couldn't imagine doing otherwise. But it still makes me feel uncomfortable giving meds with no orders! I have followed up with the parents quite a few times about having the doc sign the necessary forms so that they can have their meds at school. Usually the parent will say that the doctor does not have any open appointments or they have an appointment scheduled for this weekend.... but then it ends up "getting cancelled." I am not trying to judge or assume but I am not naïve either. What else can I do? And should I be calling 911 if they don't have their medication?? Of course I would call 911 if there was no improvement or the kid appeared to be getting worse, but that is never the case. I also feel like every time a parent comes to pick up their kid and they have already almost completely improved, it just makes the situation worse... Anyways, what would you do? Am I getting too stressed over this? Is this a common situation?

I worked at Baptist Medical Center in Jacksonville... maybe the lowest paying hospital in Jacksonville but I do think it is a bit easier to get a job there compared to hospitals like Mayo Clinic. I didn't love it, but I wasn't in the ER. The Beaches campus is supposed to be a great place to work, and it is right on the beach so that is a plus! I do hear pretty good things from nurses who work at Mayo Clinic and the pay is pretty good.

This may not be exactly the advice you are looking for, but I did a Summer of camp nursing right after graduating nursing school. Of course, this all depends on covid and the area you live in. It was a medical camp, so I did gain some experience AND it was a lot of fun. I felt like this helped when I started looking for pediatric jobs. I do work in a school setting though and camp nursing was essentially the same thing!

I work at a small (~384 students) Catholic school in Florida (in a pretty urban area). Our students can be back on campus FT or online learning, but more and more students come back every day. We have only had 2 covid cases (one student and one teacher) which did cause some panic among the staff. I think my school is doing the best they can, some improvements could be made though. I mostly feel bad for the teachers who have to prepare lessons plans for both their in person and online students... I know some of them are burning out. It is just an impossible situation, isn't it?

update: They started treating him for seizures. He started Keppra and has an EEG and MRI coming up. No episodes since he started he medication, and hopefully no more to come! Thanks for all the advice and confirmation, its so hard not to doubt yourself... especially when you are the only one with medical experience around!