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SchlNrsKrn has 26 years experience.

SchlNrsKrn's Latest Activity

  1. SchlNrsKrn

    EMR--what do you use?

    Thanks Ohiobobcat! Another question-is it possible to "narrow down" reports for specific things-for example, can you run a report that will show how many 2nd graders who were seen for vomiting?
  2. SchlNrsKrn

    EMR--what do you use?

    Question for SNAP users-looking at this software now. For Immunization entry, do you have to select the immunization from the drop-down menu for each immunization, or does live version have immunizations for your state "preloaded" so that you just enter dates?
  3. SchlNrsKrn

    Hearing & Vision screens PRE-K

    I have been at Pre-K for 20 years. Texas required puretone for hearing screenings, so we have Abmco 650AB. I do conditioned play where they place a block in a box when they hear the tone. I use HTOV for vision, and I usually wait until we come back from Christmas break to mass screen, as there are way fewer "unable to screen" kids the longer in the year you wait.
  4. SchlNrsKrn

    Cervical Spinal Stenosis Help

    Just my two cents.......why is it your responsibility to get an updated restriction/release from restriction letter? The parent is the one who brought you the initial restriction letter and are dealing directly with these doctors in their offices face to face, they should be the ones bringing you an updated letter. Telling the parents how upset she is every day now that she doesn't get to play with her friends should light a fire under them to get things done.
  5. SchlNrsKrn

    Measles!! No MMR #2 advice

    3 options (I'm in Texas too): Get titers drawn: if good, this would take care of it forever Medical exemption: letter from MD stating medical reason student can't have immunization, must get new letter every year unless letter states "lifelong exemption" Conscientious Exemption: request form from DSHS. Redo every 2 years
  6. SchlNrsKrn

    Judgement being questioned

    You can remind them that part of the school nurses job isn't to send kids home, it's to keep them in school if they are well enough to learn.
  7. SchlNrsKrn

    Vision and Hearing

    Nope. No reason to do now if you are going to be doing again in first few weeks of school-and especially if doing in spring won't count towards their required K screening-double work for little benefit. Adding-I'm at a 500+ student Pre-K. Screenings are supposed to be done first semester. In 20 years here, I have never done during first semester. In an "at-risk" school, the kids just don't know how to follow directions yet. Even 2nd semester there are still a TON of kids that I rescreen because they just didn't "get it" the first time. The older the kid, the more accurate the results and the fewer kids you will send that have a false-fail result.
  8. SchlNrsKrn

    Hearing Test Help

    UrbanHealthRN- Been doing Pre-k for 20 years now-screening 500+ 4 year olds each year-good times! I've had great success with conditioned play audiometry-I have a box of plain wood 1" blocks (cause I've learned they need to be the same, lest you run into the kid who wants to pick just the blue ones, or the ones with the letter A) and I'll instruct the kids on the three tones they will hear (and will play them in the air at max decibels the audiometer can reach and demonstrate that when they hear the sound they need to put a block in the box. I can get the vast majority done that way. When I first started, I had them raise hands-and that was pretty much a disaster, as they would generally not put their hands back down again. Our OAE was purchased by our Deaf Ed department-and as such, they really don't want us using it for general screening.
  9. SchlNrsKrn

    Hearing Test Help

    You may want to check your states guidelines for hearing screening. The Ero-Scan DPOAE is an otoacoustic emissions screener, and is generally not the first line device for general hearing screenings. In Texas, the only accepted method is pure tone screening with an audiometer. Otoacoustic emissions screeners do not measure hearing sensitivity, it is just a measure of the outer hair cell function in the cochlea. Otoacoustic emissions screeners and tympanometry can be used in conjunction with pure tone screening in some states, but is generally reserved for the very young (under 3) or those that are unable to screen with pure tone audiometry. My district has the same Ero-scan, but we only use it on students who we suspect may be truly hearing impaired (ie-who failed pure tone and have no visible ear issues that failure can be attributed to-no wax, fluid, infection, etc). And for me too, it is very difficult to get a seal good enough to get a reading-especially on the younger kids.
  10. SchlNrsKrn

    SPOT Screener

    Old Dude-I've got 550 4 year olds to screen.....Photoscreeners are mixed bag....We got the PlusOptix a few years ago and have been trying to figure out how to best utilize it. Data entry to allow us to save all screenings (to print out reports) is cumbersome and time consuming, and honestly sometimes takes more time than doing screening with visual acuity chart. PlusOptix has multiple referral setting, and depending on which setting is selected, the referral rate was as high as 55%. And there were a good number of kids that I couldn't get a reading on. I've had poor results in using it with my young (3 yr old) PPCD kids-very hard to get them to look at camera for long enough to get a reading. What I have done the past two years is used it as the rescreening for the students who failed the visual acuity chart. It helped clarify the initial screening and weed out those who failed the chart because they just didn't "get" it. And I TOTALLY agree that the majority of the "Refers" are due to astigmatism only. It is good for finding the kids with hyperopia that you typically wouldn't find any other way. We are trialing the SPOT screener the next two weeks.....
  11. SchlNrsKrn

    office thermometer

    Welsh Allen Sure Temp. My original one lasted about 16 years......
  12. SchlNrsKrn

    Pet Peeve Friday

    Tining-you can have your computer remember the user name and password so that all you have to do is put in organization code!
  13. SchlNrsKrn

    NCSN results

    Many thanks Kittery! Since you posted I have been stalking my mailman-didn't know about checking the website. And I passed too!
  14. SchlNrsKrn

    NCSN results

    Kittery- When did you get your results? I took it March 5th and still have heard nothing.
  15. SchlNrsKrn

    First Emergency Scare

    I have had 2 syncopal episodes that looked like seizures-arms postured. Big ways to tell-if there was precipitating event...first one of mine was immediately after Hep B shot, 2nd one was when I was 26 weeks pregnant and hadn't eaten. There was a reason to pass out. Length of episode is another-something lasting "seconds" is more likely to be syncopal. Return to consciousness is the other-syncopal are generally fully aware and "with it" immediately after.
  16. SchlNrsKrn

    Plaafs examples

    Plaafp stands for "present level of academic achievement and functional performance" and basically has 2 columns for each subject area/domain. One column has what an average student of that age/grade is able to do, the other column has what that particular student is able to do. It is from this document that goals and objectives are developed. So, if this was for a high school student receiving ADHD medications at school, the first column may say that and average student would independently come to nurses office for medication. Our pretended student doesn't remember and multiple phone calls must be made to track them down. From this, an health related goal could be developed that over the next year, student would come to office independently and may list ways this could be accomplished (phone alarm, etc) That being said, if you are not providing medication or any other regular nursing service for the student, then there is no PLAAFP or IEP goal to be written and even no need for an Individual Health Plan or Nursing Care Plan, because there are no nursing services being provided.

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