raebabelvn

All great information provided! So for severe allergies... I follow the general plan laid out by FARE. I have attached it as well. This is generally for food allergies, BUT I follow the guidelines for insect bites/stings as well. One or more severe symptoms, or two or more mild symptoms involving two systems. We have stock epi here, and I've used it a lot. Do not be afraid to epi, its so much better to be safe than sorry. I've called parents before of students who were having a reaction and they've said the same (don't call 911, benadryl first, wait for me, etc). Just remember, you are the licensed health care professional, you are seeing what's happening first hand, if you think you need to epi, then do not hesitate. And document, document, document. FARE_FAAECP-2023-for download_fillable.pdf

I have small hard candies I give out as "cough drops". They seem to help some!

I have IR and oral. For orals... tell the kid to open their mouth as big as they can - do not say anything about their tongue. Once their mouths are open, it retracts the tongue a bit and you can place it in that back pocket. Do not let them close before you place it where it needs to be. Then tell them to close their mouth like they're drinking out of a straw. Works about 95% of the time. I have trouble with some of my developmentally delayed or medically fragile kids. IR is my first go to. If I suspect the temp is off, I'll take an oral temp.

I work with K-5, so its a little different here. I will often ask them what this throw up looks like, and they give me all kinds of weird descriptions. There are some students that never complain, and I know its legit... but any vomit that is not witnessed or seen by an adult "doesn't count". 90% of the time, kids with the bigfoot vomit (I've started using this term!) keep water and crackers down and head back to class. My FAVORITE thing to ask my students is "What does that mean to you?". I use this for just about everything - being dizzy, light headed, diarrhea, etc. The majority of the time, the student has no idea what it actually means and gives me another definition. For example, I'll ask the student what dizzy means to them, and they'll respond with "my eyes are tired". As for diarrhea, I'll ask what that term means, sometimes I get the correct response. If I do get the correct response, and it's a frequent flyer, I'll tell them to come use my bathroom the next time they need to so I can see what their poop looks like. I have yet to have a student do this.

The day my grandfather passed was one of his best days. He was happy, minimal complaints, minimal pain... it was amazing. But, he laid down to take a nap and had a heart attack in his sleep. Sometimes having a good day prior to death seems to be a thing.

Hmm.... sounds like MLM but OK. Who do you sell for? Young Living or Doterra?

Lets see... I only call home if necessary. Obviously for the actually ill kids, and major injuries. For other stuff... I call home for facial/head injuries, multiple "illness" visits, anything I think is concerning, etc. If I called home every time a student came to visit, I'd be on the phone all day.

What are the responsibilities and roles for each position? I'm a site nurse at the elementary school, so I manage day to day things - injuries, illness, field trips, COVID, etc. Our district RN is mainly administrative - IEP's, vision/hearing screenings, back up for site nurses/health aides, etc. While the district RN is hands on with kids, it's not nearly as much as the site nurses or health aides. For me, I need strong assessment skills, critical thinking, as well as have knowledge about allergic reactions, minor/major first aid, common illnesses. I love my job, and I'm finishing up year 5 of being a site nurse for an elementary school.

Yup. It's so convenient! Even if my 2nd grader pitched a fit, I'd tell him to get over it. It's happening LOL!

I think it would all depend on your scope of practice as well as your schools policy and procedures guidelines. I'm in Ca, and here as long as it's an order from the doctor, I would be able to give it. The district RN's would probably review IM injections with me and I'd be good to go.

My T1D is a 1st grader. I'm in constant communication with the family. He brings a lunch and the carb count is usually done. However, I'll know ahead of time if he's grabbing something from the hot lunch line so I can calculate carbs ahead of time. He comes to me and I do a finger stick, and then dose him. He has an aide with him to make sure he eats everything. A few years back I had a 5th grader T1D. It was about the same process... parents did carb count for me, and I did it if she got hot lunch. I checked her BG and dosed appropriately. She was good about finishing her food.

Our district has two credentialed RN's, and a health clerk/LVN/RN on site for each school. I'm the LVN on site at one school. I think it works out well.

One of my allergy kids presents first with a stomach ache. One presents first with a red, itchy eye. Most others have itching, rash, drop in o2 sats... If a known allergy kid comes in with a stomach ache, I observe them. Obviously if it progresses, its an epi and 911. But most kids I've epi'ED have 2+ symptom involvement, with one being respiratory.

Highly involved with attendance here too. The secretaries and I work together. Basically, I look at our attendance list that the teachers/office inputs. If there is an unverified absence, I add them to my list. Between the main secretary and I, we call or email the families letting them know they need to clear the absence. We get a lot of vague messages (my child is out because they don't feel well, or my kid has a cold), we try and get ahold of the family to find out what symptoms are present and then go from there. We just started accepting remote learning as being in class, but only if the student is on a covid related isolation/quarantine. The district office gave us a special code. If a teacher doesn't offer zoom links to class (only a couple do, kids are here 5 days a week, half days), and a student is out due to covid stuff, then we put together an independent contract for them. Once they turn in the work, they get credit for being here the days they were out.

I'm dealing with the exact same things here at my school. I feel ya!