RNTadaaaa

They want the student to go.....however, it isn't that simple.

I am in a private school. I am assessing whether a 6th grade student could be allowed to go on a 3 day outdoor class trip. No Nurse is present at the trip site. Parent does not want to chaperone. I would prefer and have requested a chaperone as the student should not be restricted from attending and I feel it would be safer. Student takes no insulin but is prescribed non- insulin diabetic medications to control blood sugar levels. One of the medications is a pre filled once a day injectable. No in school carb counts (brings lunch from home), student's medical order includes FSBS checks only when student feels symptomatic. FSBS have been within the therapeutic range with one low (60's) for the school year. Seems like the student is well controlled, however I am not sure as to how that will play out when the student is independent on the field trip. Parent proposes the student will self monitor FSBS, administer medication to self at breakfast and check FSBS when symptomatic as usual. I have prepared an Emergency care plan which I will review again with teachers attending the trip, I have prepared log sheets for medication and FSBS results, I have requested a glucagon emergency pack for the trip, I have asked the cafeteria at the trip site for their menu for the three days, I have researched the hospital closest to the trip site which is a 10-15 min drive and a level 3 trauma center......aaaaaannnnd I still don't feel like it is a good idea to send the student without a chaperone. Am I overreacting?

Awesome Idea!! Thank you!! I am going to look into this right away. (sorry it took so long to respond! Campus has a DOH immunization visit today ?)

Helloooo! Happy New Year!! Last year I arranged for the local dental hygienist to come to talk about dental hygine for K-3. K-3 thought it was great. This year I'd like to expand and do a bit more. Does anyone have a dental day at school as well? Any ideas you'd be willing to share please?

You are just stating the facts. I see no grinching! ? The MD offices 'round these parts seem to send replies by horse and carriage. I can't seem to get timely responses else I'd jump on that!! Great idea Rubyjane! I didn't know anything about the toilet rolls as spacers and so I will incorporate that for the students who don't have them. This is why Nursing is great. Always learning something new!!

That is such a great suggestion! Voila indeed!!

That is my kind of pricing!! Than you JenTheSchoolRN!

LOL! Yes! I haven't had to do that just yet but thank you for mentioning it! Also thank you for school nurse supply recommendation.

I'm finding some of my Kinders with asthma have inhalers with no spacers. Unfortunately some parents do not seem to be able to afford them. Or Health care Providers don't order them....which....is a story for another day. I was surprised at the cost the pharmacy gave me for my kid's spacer. 50.00! In my past school, the Office of school health sent extra spacers at the beginning of the semester for students who might need it. Do you have this problem at your school and if so, do you buy spacers? If so, please recommend your site for ordering. I am also looking it up and so far I see 23.00 a spacer. Thank you!

Jeeezz! Thats terrible. Where's the filter on these middle schoolers? God forbid we dont have our sweet voice on one day and suddenly we have an administrative meeting with parents. ?

My fellow Nurses, Thank you so much. I don't know why I let that statement get under my skin when I heard it. I have tweens living in my house, surely I know how irrational they can be!. ? Thank you for the experiences shared and encouragement. It really helps to see that we experience a lot of the same things.

@ruby_jane YES! I haven't been able to secure a time during the prep week staff meeting (that's a whole other story) but I am definitely going to do it this upcoming semester. I love that you have charts and metrics!! What do you use for charting? I do chart but I have been thinking about how to improve my charting to show trends and percentages etc.

@MrNurse(x2) Thank you! I am sorry your staff is so unappreciative of your hard work. They're going to be shocked by the amount of things they will need to cover when you've moved on. @Cas1in72 Ilaughed out loud at "consider the source" !! So so true. Thank you very much. I definitely will not cave. Might do a short educational 5 min talk on what they can expect when visiting the school nurse.

Oh wait! I just saw this article right after I posted. ? https://allnurses.com/what-school-nurses-really-do-t554939/#.Xc6r4KQOEI0.link

My son is in middle school at the K-8 where I work and he told me a couple of his classmates discussed that I don't do very much when they come to the medical room. I told him to ask if they could give specifics on things they would like to have done when they come to the medical room. Maybe I can educate them more on what a School Nurse does? Of course I know that I do everything that I can for the students but it still stung a bit to hear that. I have come across this type of feeling mostly with middle and high school. K-4 think we're angels on earth and 5th grade hasn't made up their minds just yet. Have you experienced this in your school nurse career? If so, how do you fix that perception if at all?

I am researching this very thing for Maryland.

We miss you so!!! Thanks for dropping by to say hi!

BEACHYNURSE! Those plans are awesome! Thank you so much for letting me view them.

Good 'ol NY! Thank you MHDNURSE

Morning all! After reading about the Emergency Care Plans some of you have implemented, I would like to initiate this at my school also. Do I need to have the student's Health care Provider's input/signature on the form, or can the parent and I complete the EAP I choose after receiving the medication and medication order forms? I see some forms with a space for Provider signature and others with just the Nurse and Parent. Also, would you be willing to link to any forms for asthma/diabetes/seizure/anaphylaxis that you find most useful? Thank you so much!

Depends on the school and the state....and the type of records they're requesting. The school I worked in previously had a form and a procedure for immunization records and such. If the parent wanted medical record data from our EMR (notes vitals etc) that was a big thing and usually the supervisors handled that. (needed subpoenas and such) Current school will release physicals/immunization record back to parents as long as they are listed as the custodial parent. Not sure about medical records outside of that.

Good morning Nurse Dew. Do we work at the same school? ? Same over here. Seems like you've done well by using all modes of communication. How supportive is your administration (Principal, VP etc)? I find that the majority of schools that have success with this have specific processes in place and admins that assist you with incentives for parents. I've heard some schools wont allow students to complete registration without health forms, some wont allow for classes schedules to be distributed until health forms are submitted, no sports unless forms are submitted...etc. Would they help you in this way? What is access to medical care is like in the community you serve? In my last job, access to services, cost of medication and no insurance were big. Fortunately we had several public hospitals nearby and MD's and NP's working in the medical room to offer sports physicals, renew medication orders and etc. Although that was very helpful there were STILL parents who did not supply medical orders and or medication for their children. In certain cases and after parent meetings we had to involve social services for medical neglect. Someone suggested to me to request a medical meeting (maybe it needs a better name) with the parents who do not bring in the required items, show them what you need to keep their kid safe and maybe they will share what the difficulty is or bring it in? Seems like a good idea but I'm an introvert so this terrifies me a bit. If all fails then document document document all your efforts.

Ohhhhh myyyy goodness! Thank youuu Peak! Here I was thinking I was being too particular about the peak flow meter and you confirmed I was headed in the right direction. I have several other Asthma Action Plans and I will see if I can get my own reusable peak flow meter because I am having significant parent resistance to bringing a meter in. It seems as if this isnt being discussed in the Drs office. I even had one physician ask me what I needed a peak flow meter for when I called to clarify. Inside I was thinking, well you wrote the order! Do you suggest a reuseable meter (with disposable mouth pieces) or should each child have their own? Do you use it before and after treatment ? I am going to look up some videos on how to use it. Again thank you so much!

LOL! People look at me so funny when I use the band camp reference. I guess they had to be there huh? Definitely documenting. Today mom told me she doesn't want the peak flow meter and I am ok with that! Dr wrote a different order and we are clear.

Thank you KKEGS. I do the same. No delay. I haven't ever used a peak flow meter. However, the order has parameters according to the student's peak flow. Im not following it if I am not checking what it is. If I am not misunderstanding something, I think I will leave it up to the parents. If they don't want to provide a peak flow meter then I can return the form that requires its use and use the traditional PRN form.