All Content by raebabelvn
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When to administer Epi-Pen?
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
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Any tips for constant coughing?
I have small hard candies I give out as "cough drops". They seem to help some!
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Thermometers
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.
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Faking sick
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.
- Guilt About A Med Error
- Natural "Medicine"?
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School Nurses, When To Call Parents!
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.
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New Nurse
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.
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Do You Work at Your Kid's 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!
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LPN restrictions in school setting
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.
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Help Type 1 diabetic and lunch
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.
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Health aid or assistant school nurse?
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.
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Epi pens and stomach pain
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.
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Attendance?!?!?
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.
- Tired of being "the bad guy"...
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LPN in Distress
I often feel like that too. I work as an on-site nurse for an elementary school, and I gotta say, I love it. Moon is right. It's just you. Observation and assessment skills are huge! Plus, you have the chance to be exposed to emergency management -- epipen, 911, giving report to EMS -- and some interesting first aid situations. I've done a lot of splinting broken bones, sent kids to the ER for anaphylaxis or deep wounds, post-op care (minimal, but it's happened), medication administration and more. While part of me thinks going back for my RN is a good idea, the majority of me believes I'm perfect where I am as an LVN. You just need to find your niche.
- COVID-19: Calculating Quarantines/Isolations
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Will you take the Pfizer Covid Vaccine?
I'm an LVN working in a Ca school. Best we've heard, is that we may get lumped into the PHD staff tier, but nothing concrete. One of the district RN's is advocating for us. I wish we definitively knew!
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MED ERROR went to corporate
Oh my... I agree with the quoted post 100%. You gave a narcotic early at the very least -- I'm still confused if it was even ordered. If you gave a narc that was dc'ED?! HOLY COW! As the licensed professional in this situation, it's absolutely your job and your responsibility to make sure all the meds are correct. You failed with the med rights. It's super disappointing to see the lack of humility and responsibility being taken here. If I was your supervisor, you wouldn't have been suspended, but fired. As well as reported to the board.
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Other certifications, licenses?
I'm currently in school to be a Health Educator. I can get a CHES certification (Community Health Education Specialist).
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Anyone Just Interested in Being an LPN, and not an RN
I love being a LVN. I used to want to get my RN, but I honestly love what I do. I am going for a degree in Community Health Education. I work in a school and believe that'll be very beneficial for everyone. As a school nurse, I get to do a lot. Wouldn't change my job for anything.
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Should, I giveup?
My second term of nursing school was a NIGHTMARE. It almost made me quit. My clinical instructor treated me like I was an idiot who knew nothing, tried to fail me, and so much more. By the time the next term rolled around, I realized the instructors from last term were just awful, and I really wasn't stupid and I knew things. I was one of the highest performers for the rest of the program. Your answers and statements were absolutely ok. Nursing school is about learning and expanding the way we think. I don't think you're stupid at all. I think its awful that you've been treated this way. Keep going and persevering. You're going to be an awesome nurse!
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School Nurse or Health Aide
I'm a LVN and my technical job title is "Health Clerk ll", but I'm often called the nurse or site nurse. I'll tell parents that I'm the "nurse on site" daily, vs the District RN who covers multiple schools and is present 1-2x a week. The job description for Health Clerk ll is geared towards LVN/RN, but I just hate being called a clerk. Rubs me the wrong way.
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What's the biggest challenge being a school nurse?
I'm also an LVN that works in our health office. The District RNs seem to be stressed all the time, dealing with health plans and other administrative things. I have thought about going back for my RN, but I honestly like where I am now. I am getting my bachelors, but not in nursing.
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What happens in the nurse's office stays in the nurse's office
This is exactly what i say