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RNTadaaaa

RNTadaaaa

Registered Nurse
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Content by RNTadaaaa

  1. RNTadaaaa

    Medical room goodies?

    Oh I smiled at the kiss stamp. Very cute! Thank you
  2. RNTadaaaa

    Medical room goodies?

    I'm planning for next year and wondered what inexpensive perks I could add to the office for the visits. I serve K-8. I know the K-3 crowd looooove stickers. 3-6? Pencils with cool erasers or feathered tops? 7-8......uhhhhhhh attitude adjusters? lol J/K. I don't know what to get this age group. Any suggestions for items? Any precautions I should take besides no choking hazards, fragrances or anything edible?
  3. RNTadaaaa

    Medical room goodies?

    I have no problem saying no to the kiddies. But I have on occasion wished I had something to give.
  4. A family that I have sent multiple request to submit medication and forms, sent in medication today. I was not aware of what type of health care provider wrote the order so I ended up searching for their license number in my state. Cant find it. A different physician is listed on the pharmacy label. I called the pharmacy that filled the order, they say that both providers work in the same office. Looked up the MD. First initial and last name. License expired. I'm going to call back the pharmacy for MD full name and address...to verify. Not sure why my state does not require prescribers to include their license numbers. Anyone experiencing this?
  5. Hey grammy1. That makes sense especially considering your population. And you have a local physician signing off. Double good! My family has been here for more than two years(teachers tell me) and is slow to bring in Albuterol and Epi. Not sure why they would still be requesting meds from physicians that are several states away. NYC schools wouldn't take orders from health care providers not licensed in NY. My current state's laws seem to support that protocol but the wording is muddy. I ended requesting that the parent provide a local pedi they last visited that I could contact for orders.
  6. I have to notify the parent that I can't accept it unfortunately. My state lists authorized subscribers "as persons licensed under (my) state law to provide healthcare to individuals and prescribe medication". I only called the pharmacy because the Prescriber that entered the script was not the same one that wrote the school medication administration order and I was not familiar with the credentials. I can't verify that they are in the same practice either. I would've preferred to speak to the Physician or NP directly but they are several states away... It stinks because the student should have the med available and I've been working on this for a while. Parents are not very transparent about what the issue is in obtaining the medication the kid needs.
  7. Thanks so much! I was here second guessing myself. When I called the pharmacy, they gave me an NPI number. When I looked it up, the provider's office is from out of state.
  8. RNTadaaaa

    NYC school nurse

    Hello! I worked as an NYC school nurse for a couple of years. I started off as an agency nurse in a contracted position and then was hired after applying during a DOH hiring event. I can't answer many questions about per diem work but there were per diem agency nurses that covered for us when we were out sick. (I think Favorite was one and white glove also? ) Liking the agency...well, I dont know how to answer that but they should train you before sending you to cover a school. You will be referred to your Nursing supervisor for your district if you have questions about care or policy during the school day. That supervisor will make or break your experience based on how supportive they are. DOE is salaried and pays better however you have to answer to/acquiesce to the Principal more often. DOH pays less (no REAL summer pay as of 2018) however there are more trainings or in-services during the year. I never saw 1:1 nurse coverage. I only experienced RN's covering the medical room.
  9. I just found out that the online system my school uses for entering attendance/medical/immunizations/etc is not HIPPA compliant due to the fact that they are not a covered entity and because the PHI stored on their server is considered Education Records. I have been writing student notes in the medical portion of this system. When I called customer support to find out who has access to medical info they said the Principal, VP and registrar. At my previous location all of our online documentation was HIPPA compliant and if access to notes were needed, they needed a subpoena. Not sure how to feel about whether to continue documenting on the online system or to begin documenting on paper forms instead and filing in student medical chart? What format do you use to chart? As an aside, who do you go to, to ask legal questions that come up over your nursing carreer?
  10. RNTadaaaa

    When do you call?

    Just went through something similar on my campus. I had one day with over 25 children on the same grade level and several in other grades inundate the medical room with ILI symptoms. I would have thought I was part of a prank if they didn't each look so miserably ill. Most didn't have a temp over 100.3 but several did. Because of the similarities in symptoms, grade/classroom, volume of students and the fevers, I felt it was reportable. Unfortunately I didn't find much support initially at the local health department when I contacted them on the same day. There was no protocol for private schools it seems. The initial actions were taken by myself the Principal and VP. I could not find a local public school policy on what to do. I used to work with the dept of health in a large city and while I couldnt contact the person that was in charge of investigating clusters in schools, I went to the CDC website for steps to take. We notified parents of the increased incidence of student illness and symptoms, what symptoms to look for at home and when to keep kid home and alert their Health care provider. We closed the school and had a company come do a terminal clean. After I faxed the list of students/symptoms to the local health department, I was then transferred to the communicable disease nurse who did find it a reportable cluster and has been great in helping with suggestions going forward. We did end up having 5 cases of flu but it was hard to determine if there were more due to many parents treating symptoms at home. It's ongoing and there's a ton of communication necessary from the nurses office to parents, administration, staff and then students.
  11. I have had parents bring medication to the school so I can give it to their kids. I have to give my speech " According to state law and our student handbook, medications cannot be administered without an order from your health care pr......on and on. Am I missing something? I mean people are shocked....SHOCKED that a Nurse would need an order from a Health care provider to give medicine to the kiddos. It must be different state to state? I had a parent say "Even for TYLENOL?!?!?" Yes. Yes, even for that in my district. I need to lie down.
  12. RNTadaaaa

    Lack of Manners

    I have a 3rd grader whose normal talking voice is a whisper and she is a 5 star ninja. I cannot hear her walking in my office. I just felt someone watching me, turned around and BLAM she was 2 inches away from my eyeballs whispering "Nurse, my tummy hurts". I almost passed out the first time she did that! After the third episode I locked my door so I can hear her coming in.
  13. RNTadaaaa

    Administer OTC medications or No?

    Good Day All! I'm a couple of weeks into working at a private school and I noticed the previous nurse gave OTC medications if the parents signed a form giving permission to administer. The form has Acetaminophen, Ibuprofen, Benadryl (topical and oral) Tums, Hydrocortisone, Antibiotic ointment, cough drops. New form created before the previous nurse left includes the same meds but adds a line for the physicians sig and that the nurse would follow the dosage instructions on the box. My previous school nurse position preferred that OTC medications be given outside of school hours unless there was a specific need. We also needed a medication administration form filled out with a PRN order, MD signature and the medication provided with pharmacy label. I do want to help the kids feel better, and I want to avoid parent uproar, however the thought of following this current school's OTC form makes me nervous. (litigation:unsure:) Am I being a nervous nelly or do you feel more schools should implement a process like this?
  14. RNTadaaaa

    Administer OTC medications or No?

    Also I love your name!!! LOL! Yessss.
  15. RNTadaaaa

    Administer OTC medications or No?

    I like this plan as well. The part about nurses being expected to take care of kids who should probably be at home crossed my mind as well. Its great that this was thought about at your school. Thank you for this suggestion.
  16. RNTadaaaa

    Administer OTC medications or No?

    So I found this today from the department of health website. I'll have to read it again later because my brain is suffering from end of day fatigue. Thank you all for your assistance. I love this site. "Administration of OTC medication must be conducted in accordance with the guideline for prescription medication. The only exception is if the local school system and local school health services program has adopted "physician directed nursing protocols" for the administration of OTC medication in compliance with Board of Nursing regulations. If the local school system and local school health services program has adopted "physician directed nursing protocols" the following should be incorporated in the policy:The LSS and the Health Services Program shall identify which OTC medications are to be administered under its policy; ï‚· Parental consent is required annually for the administration of the identified OTC medications; ï‚· Administration of the identified OTC medications must be part of a nursing protocol which has been approved by the LSS, the supervisor of health services, and the medical director; ï‚· Only RNs may make the assessment and the decision to administer an OTC medication (therefore the LSS and the Health Services Program's "physician directed nursing protocols", may only be used in schools that are staffed by a fulltime RN); and ï‚· Medications administered under the LSS and the Health Services Program's "physician directed nursing protocols" are not to be given for a problem/health concern diagnosed by the child's primary care physician. The guideline for prescribed medication must be followed when this occurs. In the absence of an order from an authorized prescriber for a medication that is included in the "physician directed nursing protocols", the LSS and the Health Services Program's "physician directed nursing protocols" may be followed if parental permission is obtained. A student's specific medication order from an authorized prescriber shall take precedence over the LSS and the Health Services Program's "physician directed nursing protocols". OTC medication must be brought to school in an original, unopened container."
  17. RNTadaaaa

    Administer OTC medications or No?

    Woooooow! Thats awesome! Thank you for the suggestions. Good idea to reach out to another nurse! I did but I didnt understand that the counties sometimes have different protocols and so I had to be mindful of that going forward. Would it be ok to ask you some questions regarding creating protocols for your school? I think going the route you took would be benficial for my site as well.
  18. RNTadaaaa

    Administer OTC medications or No?

    LOL! soo true
  19. RNTadaaaa

    Administer OTC medications or No?

    Hmmmm good point! I didnt think of it that way. Thank you for this perspective. I don't have a doctor covering or standing orders but I like this idea too and maybe that's a suggestion I can present for discussion and implementation
  20. RNTadaaaa

    Administer OTC medications or No?

    I read the office of school health website but I didn't see much pertaining to my search. I will do what you suggested. Thank you!
  21. RNTadaaaa

    Administer OTC medications or No?

    Thank you. I think I will have to brave the storm and not implement the previous form!
  22. RNTadaaaa

    Administer OTC medications or No?

    Yes! Feels like the specific med authorization form is the way to go.
  23. RNTadaaaa

    Maryland delegating nurse course for school nurses

    Thank you! I did check but not much info was given until I become a member. I will become one soon, just not in a position to do so at present.
  24. Hello! * I am adding this topic to the Maryland board as well* I am an RN new to Maryland and while reading the MBON site I found that school nurses need to take a delegating nurse course to be in compliance. (if I understand that correctly) I have been calling area colleges however the courses I have encountered are for assisted living RN's and are not approved for school nurses. I called the MBON and I can never get through to speak with someone. Has anyone taken this course and would you be willing to refer me or suggest where I could find this information? Thank you
  25. RNTadaaaa

    Maryland delegating nurse course for school nurses

    Ohhhh that is a great idea! Thank you very much for that suggestion and your help! I appreciate it very much!
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