intheweeds

Obviously, you should check to see what your district guidelines are and abide by those, but when I first started in school nursing I found the Illinois school nurse handbook to be a really helpful reference (even though I am not in Illinois): Loyola Univ. Health System - IL EMSC - Resource Manual for the Nurse in the School Setting ...then click on the .pdf link.

I try to be as nice and keep it as light as possible if I see students one-on-one. I also try to keep it general, even if it just me and the student ("The teachers have noticed a lot of kids having hygiene issues in your grade, so we're speaking to some of you. This is a really common issue for kids your age..."). I also really like the advice of asking how things are going at home...

How deeply unfair. I certainly would not pay a dime back at this time. Hopefully you will hear from your union soon. I would consider quitting if I were you as well. On a side note, I get annoyed when per diem/part-time work is not "counted" toward various things, like experience to recieve a pension, pay incrase, promotion, etc. It really hurts working mothers.

This issue has weighed heavily on me lately. I am from an area of the country where many people take great pride in gun ownership and have a whole host of associations about family and country tied up in gun ownership. To a degree, I understand their perspective... I can't help but feel, however, that we need to make some common-sense changes to gun laws. Obviously, that alone will not solve the problem of violence in this country, but it can be part of a multifaced approach that involves mental health, law enforcement, and supporting troubled families, among other things. Despite having many friends and family members who take great pride in gun ownership and scoff at *any* further restriction, I am deeply upset that the most recent legislation didn't pass. I don't understand why people are so dogmatic and cannot make even the most minor changes--ones that will impact their private gun owership in minimal ways, if at all. I also appreciate what a previous commenter said about more "routine" handgun violence against urban youth. At my school, a child (teenager, honor roll student) was killed in street violence a couple years ago. He was the only child of a single mother--I cannot imagine her pain. This is all too common in the area where I work. These kids go unmentioned in the national media. They need a voice, too.

I have JHS and HS kids. I also love the high schoolers. They are funny and fun. I agree with a previous poster, though, junior high aged kids can be tough. They are very needy, very emotional, and just old/smart enough to be a little manipulative if they want to be! I just take a deep breath and try to remind myself that it can be a very tough time to be a kid... lots of transitions for them.

My daughter is 3rd percetile. I'm aware and ped is aware and we're not worried. I wouldn't mind an 'FYI' letter or call AT ALL. We don't do BMI measuring at my school, but I think a letter stating something to the effect of "There may be many reasons for BMI to be outside the norm, but we recommend that talk to your pediatrician if you have not already done so" would be pretty inoffensive.

So sorry. That sounds like an anxiety-provoking situation... while it's not so uncommon to have kids like this, having a principal that won't back you up makes it a much bigger deal. What happens with the kids when you're not at school--is there another nurse? If wheezing persists and you can't reach the mom, what do you do? I would try to force the issue with the principal and try to schedule a mtg with the parent and principal. I find that being extremely direct helps (e.g., "I am extremely concerned for the safety of these kids and am worried that an emergency will occur in the near future. I don't think we can put this issue off any longer.") You may need to warn the mother that you will need to call 911 if the kids are wheezing and she is unreachable.

One of our custodial staff came to me today and told me she got cut yesterday while taking out my bathroom garbage. Apparently, she went to the principal after the incident and he cleaned it out with her and sent her on her way. Sigh. We have several diabetics in our school who are self directed (high school kids) and test in my office/bathroom. I have a sharps box they are supposed to use, of course, but am now worried that she was stuck with a lancet one of the kids may have thrown in the trash (The wound appears to be a little puncture wound and I can't think of what else might have been in there). I told her to immediately tell her boss at the cleaning company, and see a doctor and get a tetorifice shot and an opinion about what to do. I don't even know if it was a lancet stick--but I worry, and now worried that my concerned reaction might have worried her. She speaks little English and probably has no health insurance. I also worry that somehow I will be in serious trouble for this maybe needle stick, and that the kids will all have to have their blood tested (nobody has anything that I am aware of), and I feel awful for her. I am so overwhelmed with keeping 800+ kids safe during my limited hours at school, this is ONE thing I had not obsessively worried about... until now. Anyone have any experience with this sort of thing?

So sorry to hear all of that. If I were you I would take a night, write down all of your concerns and the facts as you know them, meet with your nurse boss again, and then set up a meeting with your bosses again to address your concerns about your job. I'd try to be as detached as possible emotionally (easier said than done!). Ask to outline a protocol of who you need to inform and how (can you just inform the principal's secretary if 911 is called and he is not there? If he is not in school, should you call his cell phone?). It can be hard when you have many administrators, assistant principals, and their staff involved--not to mention sorting out chain of command after an adrenaline-fueled situation. Personally, I think that it is silly that you don't really have authority over your nurse's aide, and can't assign which jobs she can and can't do--but that may not be the battle you need to fight now. If you are in a union, I'd contact them too and have a rep with you for further meetings.

According to the CDC, it looks like flu is widespread here in New York. I haven't really been seeing it the office lately, though. I saw a bunch of respiratory illness with high fever in late winter and early spring. Despite having a flu shot, I had a pretty bad flu-like illness myself around that time.

Great job! What a difficult and scary topic to talk about with such little kids. I agree with what the other posters have said--make sure there are meetings with the parents, and all kids who are suspected of cutting should be referred to a mental health professional (or their ped, who can find someone for them). It's scary how dangerous copy cat behavior can spread. Hopefully this stops right now!

This happens probably once a month at our school. Sometimes it is pens. I also wash it, give a cool pack, etc. If the wound seems VERY painful or if the student claims it feels like there is something in there (that I can't even see), I call parents and refer to their ped. Maybe that's overkill, but I also am not going to go digging around with tweezers!

I LOVE our teachers and staff, but some of your peeves really ring true! One to add: While I do let teachers have Advil from my stock supply, please do not abuse this! You do not need 8 Advil for your headache/back ache/cramps. It's not good for you! Do not hastily woof down a handful of pills after I yell at you "Don't take that many!" I've started giving it out by hand myself, and they beg for more and get mad after they are denied. Why do they ALL think they need far more than the recommended dosage? It is like an epidemic here. I'm going to have to stop giving it out--period.

Thanks so much for all of your input!!!

Do you guys train staff on the AEDs at your school? Our principal has asked me to train staff on them but I have told him I am reluctant to do so. While ours are SUPER simple, and I'm sure I could give a basic training, I am not certified to train on AEDs and I wonder about liability. I can call the company and see if they send trainers, but I don't think they do. I'd rather they shell out the $$ to certify more staff on CPR training that includes AEDs. Your thoughts? Do you guys show staff how to use them? Maybe I am overthinking this.