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jnemartin

jnemartin

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Content by jnemartin

  1. Advice please - I have an asthmatic student who has labored breathing, was wheezing but no longer, dizzy, fatigued. BUT sating at 98-99% RA. He's used his flovent and proair several times so HR was high but is currently down to 120s. Yesterday he was same, but also pale and tripoding, mom picked up and took to hospital for RT and steroids. He's been in my office today, symptomatic, for an hour and mom can't come to p/u for another hour. As long as he's sating ok, is it ok to keep him here, or at what point do I call an ambulance? Of note: he is a bit of a "flopper," so I have to put a lot of weight on my assessment of good/improved vitals, decreased wheezing after TX.
  2. jnemartin

    Current Situation: Symptomatic Asthmatic

    Yes, and I come from an acute care background, so it takes a LOT for me to call in backup. Once, this same student desated into the 80s but was asymptomatic and after using inhaler, vitals returned to normal... and I know many SNs would call out for that.
  3. jnemartin

    Current Situation: Symptomatic Asthmatic

    thank, you palli! as I read this the light switch clicked and I was like, No I cannot manage this here in school with no resources (other than those we have tried).
  4. jnemartin

    Current Situation: Symptomatic Asthmatic

    Thanks for the advice everyone - it was helpful to get the immediate feedback when I felt I was in a gray area. Of course when he had a "condition change" as described above, I knew I had to call, but before then I felt it was a toss up - he was stable, but could decline at any moment (and DID!). And yes, mom got there 5 minutes after the ambulance after telling me it would be another hour. ugh. I feel bad for them, though. It's been a rough couple days for their family.
  5. jnemartin

    Current Situation: Symptomatic Asthmatic

    So here's the update - as I said, he was vitals-stable, presenting better than yesterday but still symptomatic despite using his school-approved inhalers. He told me he was very fatigued (normal for an asthma attack) and then was squinting his eyes like he couldn't keep them open. I re-checked vitals and HR was up again and desat down to 84%. I called 911 (OF COURSE IT IS LUNCH TIME AND A MILLION STUDENT OBSERVERS) and they arrived in 10 minutes. In that time, I actually walked him to a more quiet area for them to eval him and that helped his sats and breathing I think (I was super worried about doing it, but it ended up being good). His sats were 95% when they arrived but BP and HR elevated. Mom met us all here and took him to hospital. omg.
  6. jnemartin

    Current Situation: Symptomatic Asthmatic

    Thank you, there has actually been a change in condition and I am calling now.
  7. jnemartin

    Salting my ice now

    This is how my kids are, too. I hand out ice packs (not actual ice, but the frozen packs) and ask them to bring it back to me or drop at front desk. About 25% of them are returned, which I'm fine with. 99% of the time the injury/issue does not require ice or any treatment, but I know the placebo affect is helpful for them.
  8. jnemartin

    Staff Needs

    Oh I forgot... I also have recently had two male teachers who requested eye drops and then proceeded (separate incidents) to act super dramatic about instilling them. One told me that he had never used eye drops before. Another said he "may have to ask for my help." ABSOLUTELY NOT. Call your wife if you need a helping hand.
  9. jnemartin

    Staff Needs

    At the beginning of the year (my first SY), I had a teacher and admin worker come into my office and relay their entire health history, in great detail, to me. The teacher told me that the previous nurse would take a daily BP and monitor his cardiac med administration (RN kept it in her office and dispensed it daily to him, along with this vitals check). The staff member took no meds, just wanted me to be fully up to date on her myriad health issues. Look, I know the school nurse is serving the whole community, but a couple of 50-something y/o able-bodied and A&O adults can admin their own meds and take their own daily vitals. It's called participating in and managing your own care. My 86 y/o grandparents do it with their heart meds INTERESTINGLY.... both of these individuals were let go at the start of the year after a very poorly-timed round of lay-offs (week 2 of student SY). I couldn't help but wonder if part of the reason was the drama-queen personalities. IF they had stayed with me over the year, I would have instructed the teacher to purchase an easy-to-use wrist BP machine, and advised him to keep his meds on his person.
  10. I saw this and laughed so hard. So... if there were a School Nurse Starter Pack - what would be in it? I'm going to make one!
  11. jnemartin

    C'Mon Now!

    Is is summer yet? Here is a visit note I just wrote. On one hand, I'm so proud of the teacher for trying to divert the student from an office visit. On the other hand... C/O SUPERFICIAL SCRATCH, NO OPEN SKIN, ON RUA, AFTER SCRATCHING AREA AGAINST BACKPACK. STATES SHE WASHED AREA WITH SOAP AND WATER PER HER TEACHER'S INSTRUCTION BUT IT "STILL STINGS." I ADVISED HER SHE HAS TAKEN THE APPROPRIATE STEPS, AND THE PAIN/STING WILL DECREASE WITH TIME.
  12. jnemartin

    Managing allergy symptoms

    update, I'm sending out the letter with a few edits to include info on headaches. along with this photo and caption: (Actual photo of a student just before visiting my office – hah! Just kidding J) I hope they get the humor. I'm going out on a limb, here. A pollen-rich limb. LOL
  13. jnemartin

    How many students do you see per day?

    I used this study (link below) as part of my "I am asking for a raise" package. It states that the average American school nurse sees about 3-4% of the total student body each day (including daily meds/treatments). At my very small school of about 280 students (middle and high school, 2 T1D, 1 student with daily med given at school, no daily treatments), 4% of the population would be about 11 students. My median daily visit count is 25 (accounting for/removing half days and a few extremely high visit days of 30+). http://www.shankerinstitute.org/sites/shanker/files/Manuscript Albert Shanker study school nurse 2 17 15 Final_1.pdf
  14. jnemartin

    Managing allergy symptoms

    Welp, the PE teacher, who is holding an outdoor class today, just sent me THREE CHILDREN AT ONCE: c/o HA, sore throat and "feeling out of breath," respectively. Looks like I will be sending this letter out today!
  15. jnemartin

    hot glue guns

    The bane of my existence.
  16. jnemartin

    Texas school sets dress code for parents

    I read an interview with the principal who stated that the code was put in place to help foster a "real world" atmosphere in the school - i.e. this is not a place to goof around, going to school is serious and is meant to prepare you for college/workforce/adult responsibilities. In response to that, I would say that being exposed to a variety of styles, wardrobes, self-expressions, and ethnic or racial standards of beauty IS fostering a "real world" atmosphere. Kids should be exposed to it all, and they can form their own opinions (especially HS-age). On another note, everyone has pretty much hit the points that resonate with me as wrong about this code, but some of the language seems to directly target black women, and the code does not account for emergencies or enforcement standards. It's problematic at best and racist at worst.
  17. jnemartin

    Sample Deodorants

    I should have mentioned: the Proctor and Gamble program is FREE. They do include coupons/marketing materials in their packaging, though.
  18. jnemartin

    Sample Deodorants

    I ordered from the Proctor and Gamble "always changing" school program (their puberty program)and the 5th grade boys pack they sent me is all sample deodorants.
  19. jnemartin

    Countdown to SUMMER!

    There, I said it. 28 working days for me (not including today... today is already done in my mind )
  20. jnemartin

    Nosebleeds

    Just curious - if you have a student with a nosebleed, barring any unusual circumstances or history - do they stay in your office until the bleeding has ceased, or do you give them instructions and send back to class after some observation?
  21. jnemartin

    Current thoughts on Zika

    Just curious, what are your offices recommending to pregnant women RE travel to Puerto Rico? There have been no reported cases of Zika so far in 2019 (https://www.cdc.gov/zika/reporting/2019-case-counts.html), so I'm wondering if providers are loosening very conservative recommendations to avoid it.
  22. jnemartin

    How many diabetics do you have?

    2, both T1D. Strangely, the entire student body is only about 300
  23. jnemartin

    Orienting/Onboarding

    Haha! Me, too! I was told the wrong orientation date by the HR lady, so I was never briefed on the payroll/PTO/benefits side of things (actually, she told me it was for teachers so I "didn't need to worry about it"... smh). As for the actual duties of the SN - I emailed my local SN professional organization with a list of questions and started googling the state regulations/requirements. I had long conversations with Dept of Edu and Dept of Health Nurse liaisons, posted a BUNCH on here, and basically figured it out myself. This weekend, I am going to a one-day SN conference particular to my state, and they hold a two-day conference closer to the start of school. It's out of my price range, but if I would have known about it last year it would have absolutely been worth the $$$ (I have to pay for my own conferences). If you can find something like that local to you, I'd highly recommend it. You can also get contacts from colleagues that you can call upon later when you have questions!
  24. jnemartin

    Countdown to SUMMER!

    our state requires 180 academic attendance days and we have 188 total. Our holidays are standard bank/federal holidays plus winter (2 wk) and spring (1 wk) and fall (2 days)
  25. jnemartin

    Countdown to SUMMER!

    May 24
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