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laflaca BSN, RN

Public High School Nurse

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  1. laflaca

    just a Thursday vent

    Oh man, I love that one too. They're not overly paranoid about bed bugs here (thank you, universe) but usually insist that I look at various "spider bites." Yep, that's a tiny little papule in a vast ocean of completely normal skin, with no respiratory, gastrointestinal, or circulatory compromise. My current favorite response is to launch into a long talk about the many helpful things that spiders do, and how they get unfairly blamed for biting. ("They eat agricultural pests! They eat household pests! They play an important part in our ecosystem! And yet they ask so little of us in return...") Both the student and the teacher conclude that I'm nuts, and they leave. When it comes to Vaseline, I flat-out lie. Vaseline? What's vaseline? I don't have any.
  2. laflaca

    What do teachers think about school nurses?

    The things they associate with nursing (vomit! lice! Ace wraps! I need a pad!) do not require an RN or LPN. The things I think are important in my role, the real nursing contributions (careful assessment, advocating for families, emergency preparedness, medication safety, mental health intervention, knowledge of vaccinations and infection control, familiarity with community resources, case management skills, ability to provide health education on everything from wearing a motorcycle helmet to vaping to knowing your medications).... ....they don't even know I do it! I don't really expect them to "get" us. Truthfully, I like them but I don't totally get them either. Plus there are advantages to being in the background doing our own thing - it can be lonely, but on the other hand we get to manage our own little nursing world, which was never possible in acute care. I think we just have to have that strong internal compass, confidence in our skills, and the support of colleagues at other schools and online. You sound like an amazing coworker
  3. laflaca

    Rules for next year

    SAME. I have a lot of wanna-be NBA stars here....and the pros look so cool with wraps and athletic tape! If I started wrapping limbs, I would literally blow my entire budget on Ace wraps in two weeks, and this place would look like a mummy movie :) I spend a lot of time explaining that compression/stabilization is not the answer to every minor discomfort. I'm with you - show me a medical order, or suffer the indignity of an Ace-free existence :)
  4. laflaca

    Rules for next year

    Well, I'm finishing out my first year as a school nurse (high school). Thanks to you all, I've wised up and plan to set some clear expectations for the fall... 1) Ice pack? Sure! But you have to sit in my boring office to use it so that a) I can re-assess appropriately, b) there will be no public flaunting of ice packs, and c) I get my reusable cold packs returned. 2) Vaseline, chapstick and lotion: not a nurse thing. Never heard of 'em, never saw 'em, don't have 'em. See also sewing kit, glasses repair, hair ties, gym shoes, water bottles. 3) Snacks are for diabetics and kids who need to take meds with food, and the occasional kid with food insecurity at home who is getting help from our social worker . If you just came late, or didn't eat the free breakfast here, or are my coworker: the cafeteria opens at 11:30. [I have noticed that since I got rid of the sugary granola bars and started offering carrots, apples, a cheese string, and/or a pack of almonds...snack requests plummeted] 4) Health office is strictly one at a time for confidentiality. No friend visits, no twin complaints, no socializing. 5) Students before staff, unless someone needs an AED What else should I add, oh benevolent yet clear-eyed Keepers of the Ice Packs?
  5. laflaca

    Staff Needs

    HA! I've had this twice as well. My answer was: "If you can't get 'em in, they're not going in."
  6. laflaca

    Staff Needs

    This very morning a staff member asks me for a bandaid for himself. I hand him one and he says, "I got bit by my dog this weekend." I can see a small wound on his index finger. I ask no questions, not even the reason why an adult man with a full-time job and awesome health insurance can't procure his own bandaids or medical advice. "I got bit by my dog!" That's a bummer. "What should I do for it, do you think?" Hopefully you washed it? Keep it clean, make sure your tetanus is up to date, go to the doctor right away for any increasing redness/swelling/drainage; you might need antibiotics. Mouths are full of bacteria and funk. "Tetanus? Will I get tetanus if I don't get the shot? I don't want to get shots." Well, it's good to have tetanus up to date anyway. If you get the Tdap it also helps protect the babies in your family from whooping cough. It's covered by our health insurance too. "But will I really get tetanus though? I don't think I really need a tetanus shot. I'm not getting that. But I won't get tetanus, right?" twomoreweeks twomoreweeks twomoreweeks twomoreweeks
  7. laflaca

    Non-beside nursing jobs?

    School nurse or public health! Great people, great hours, great work, easier life (and yes... less money. You can't have it all!)
  8. laflaca

    Happy Nurses' Week, my loves!

    I feel the same way. (You'll notice there's no "orthopedic surgeon appreciation week"...) Nonetheless, when I was offered half a leftover bagel and some cream cheese that had been at room temperature for two hours after the teacher appreciation breakfast, I still took it :)
  9. laflaca

    Moral Injury

  10. laflaca

    Arizona unions?

    Arizona is a right to work state, not remotely union friendly. I am not aware of any hospital here in Phoenix where nurses are unionized in the private or public sector (unless VA nurses are, maybe?). I'm from Minneapolis where most nurses are represented. I'd rather be in a union setting myself; the reality is that pay, benefits and staffing are almost always better for bedside nurses and other front line workers. Many here are vigorously opposed to unions though they have no actual experience with one, just political thoughts. You even bring them up, it's like you casually mentioned having brunch with the devil.... people freak out. All that said, there are still good places to work, and you can make a living. Don't let that one issue hold you back if you really want to be here. Good luck!
  11. laflaca

    When nurse is needed outside of the clinic

    Every day, all day. I don't want them to triage for me or decide to call STAT vs "when available" because they only see body fluids as an emergency (loud "vomiting," a tiny drizzle of nosebleed)... on the other hand, an unexplained loss of consciousness by an adult with chest pain didn't concern anyone but me ("it only took a minute before he woke up"). So I've tried to explain that I'd like a 1-3 word description. Busted lip, twisted ankle, fainted, feels dizzy, pinched her finger, seems confused, broke a tooth, etc But then they just use unhelpful short phrases like "on the ground" (pulseless? Chatting with a friend?) or "allergies" (seasonal? Or allergic to bees and just stung?). Or the classic "I don't know but they said you should come." Sooooo yeah. They don't distinguish between me running with an AED vs handing Kleenex to someone. It's all COME NOW. If someone else knows the magic answer, please share!!
  12. laflaca


    They stay in my office until the bleeding stops, even though it's a high school... because otherwise I will get panicked radio calls from every single teacher or aide who sees the kid in the hall/bathroom/classroom carrying a Kleenex with any trace of blood. And then I'll get more calls, asking for hazmat suits and vats of bleach some battles are not worth fighting!
  13. laflaca

    Nurses that “only do it for the money”

    You might want to read a classic book called "The Managed Heart," by Arlie Hochschild, from way back in the 1980's. She talks about how people in service oriented jobs (which like nursing are traditionally female) - from flight attendants to coffee baristas - are required to not only perform their stated job tasks, but also perform emotional labor to make their clients feel liked, appreciated, interesting, worthwhile, etc (no matter if the clients are acting like giant a-holes, and no matter if the worker has to suppress and hide her own completely understandable true feelings, in many cases tolerating abuse). In my opinion, this service industry mindset has infected nursing practice, not improving our working conditions one bit. My job is to keep people safe and healthy, and I do so with respect and professional practices. Just as I would if I were an electrician or a lifeguard or a neurologist. But I don't accept that I have to prove my altruism to you or anyone. Not must i tolerate abuse and crappy working conditions in the name of being a "caring nurse," or make apologies for actually wanting a paycheck. Part of supporting our profession and our nurse colleagues, to me, is calling this stuff out and reconsidering our assumptions.
  14. laflaca

    Arizona state/government hospitals

    State nursing jobs would be in the state psych hospital, state prisons, state-run LTCs, and occasionally some assorted administrative or regulatory positions with DHS (.https://azstatejobs.azdoa.gov/ ). The county hospital in Phoenix (Maricopa medical center/MIHS, https://jobs.mihs.org/ ) is technically separate from county government but participates in the same state pension and has the same benefits... Jail nurse and public health nurse positions are county jobs in Maricopa county https://www.governmentjobs.com/careers/maricopa (not so in private detention facilities like those run by CoreCivic).. There are a number of hospitals, clinics and public health units throughout the state for Native people. Some are run by federal Indian Health Services, others are run by a specific tribe and have their own setup different from federal benefits https://www.ihs.gov/jobs/ . Public school nurses are employed by individual districts, which generally participate in the state pension plan but work on contracts and have insurance, benefits, and pay scales that can vary widely. Can't comment on the VA or counties outside the Phoenix metro. Good luck!
  15. It's almost four years since I wrote that post... still not sorry I left the hospital (though I did doubt myself and "relapse" to the ED for a few months, only to realize I had been right to leave). I went to public health, then school nursing. The money's less, but it works for me. Good luck! The first few months are weird and "boring," but then you get used to life without constantly anticipating disaster