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jnemartin

jnemartin BSN, RN

Registered User

Posts by jnemartin

  1. Yesterday, a teacher sent a student to my office when he developed a bloody nose during a final. He had a bloody nose in class, but after wiping it with tissues it stopped almost immediately. When he arrived, he was holding the bloody tissues (spotty, not saturated) and says:

    "My teacher told me to come up here to throw my tissues out in your garbage can." 

    I had to restrain myself from writing a crazy email to said teacher, but gracias a dios, she is not coming back next year so I let it go. 

  2. It's finals week for my HS-ers. I've had two come in, IN THE MIDDLE OF EXAMS, asking for bandaids. One for a papercut, another for a scrape, incurred 2 days ago, on his arm which he asked to be "wrapped." No. Please return to your final. 

  3. 15 minutes ago, jess11RN said:

    Think of it this way...when there is a position open for a sub teacher, does the principal or HR dump that on the teacher? Of course not. So, why do they think that it is acceptable to dump it on the nurse? 

    I know - you are totally correct. I just talked to HR and said I will try to pre-screen the candidates before next Friday, which is my last day, but after that I will be on summer vacation and unavailable to help much more. He was totally fine with it. Next week I'll update him and tell him to feel free to invite me to the interviews, but I may be out of town. 

  4. 1 minute ago, jess11RN said:

    This is my solution:

    Enjoy your summer and take care of you and your baby. This is not your problem nor is it the other nurse's problem 🙂

    Honestly, this was my first thought... but the principals both emailed us back and washed their hands of it. So who is going to do it? LOL. Maybe I could talk to HR and ask that he invite me to the interviews. I don't mind coming in for a couple hours over the summer, but dumping this on us with 6 school/work days left is pretty ridiculous 

  5. A student just came in asking for "medical tape" for her teacher. They are doing some sort of art project. 

    I wanted, WITH EVERY FIBER OF MY BODY, to say that my office is not the art supply store, but I did not want to take my frustrations out on the poor child. So I gave her the thinnest, dinkiest roll of tape I had. 

  6. As I mentioned a while ago, I am pregnant and just officially announced to all my family and boss this week! I am 13 weeks, so this is pretty much the normal "professional" timeline of letting your employer know around the start of the 2nd trimester (I am not really showing and haven't had any symptoms that would require me to spill the beans earlier). 

    Our school system has two campuses and a nurse on each campus. Although our campuses are separate, our leadership does everything together and I work closely with the other nurse. Both us nurses have had a hard time finding Sub coverage so the other nurse had her boss post for a sub nurse position. So when I told my principal (boss) I was pregnant, I mentioned that maybe when they're interviewing for the sub nurse, they could gauge interest in a maternity leave position. TO MY GREAT SURPRISE, she had no idea that a sub nurse position had been posted, leaving me to feel a bit gossipy and undermining... but I simply assumed the other principals would have told her (I am always the LAST to know anything, so the fact that I knew before her is very weird). 

    Anyways, she agreed that would be good, and I took the steps to loop everyone in via email. Both the elementary and my principal replied to the emails saying that they are too busy to be involved in hiring a sub/maternity nurse and would like the nurses to be in charge. 

    Here's the issue... we haven't gotten any responses yet from the posting (newly posted) and us nurses are done next Friday. So... I'm not sure what's going to happen with the hiring process. I want to be involved because we all know how bad a bad sub can be, but I also don't want to spend my whole break managing this process, scheduling interviews, basically working HR. 

    Any good solutions you can think of?

  7. 2 hours ago, mombat1 said:

    I have become legendary at the middle school & high school for asking kids complaining of a headache "what have you eaten today?".  9 times out of 10, their answer is "nothing".  Crackers & peanut butter or cheese for you! I even made the high school's newspaper for "things teachers say" - with the writer stating "you could break a leg & the first thing she's going to ask is "what have you eaten today?'". Surprised them when I said - no, that would be about second or third down the list, because if you need surgery for that leg, the anesthesiologist needs to know.  Lol

    This is great! When kids come to me with c/o HA I ask what they've eaten, where is their water bottle/how much have they drank today, what class are they in, etc. For almost all of the middle schoolers, I will advise them to drink a bottle of water, move their desk from under the overhead lamps, and eat lunch or a snack (if it's around lunch time), or if it's near the end of the day I remind them that they are almost done and I have faith they can make it.

    Maybe one or two have ever come back to re-complain of HA after I give these instructions. NOT because I believe they have followed my instructions and they have helped, but because I believe the c/o HA was not a true concern to begin with... that is really why I avoid quickly giving prn OTCs (we are allowed a small list of pre-approved meds with consents from parents) 

     

    I trust HS kids more and they don't tend to ask for meds unless they need them, so I will dispense more quickly but also give the instructions for self-care. 

  8. On 10/31/2013 at 7:05 AM, RNlove17 said:

    I've had to do so much education (aka damage control lol). They are also shocked we don't send letters.

     

    I've had about half a dozen confirmed cases of strep this year (with a total student body of about 300). When the parents call to let the school know their kid is out with strep this is usually how my notification goes:

    Front desk lady: Mrs Soandso called to say LD has strep, so I don't know if you want to send a letter out to parents, or....

    Me: Ok, thanks for letting me know. 

    Front desk lady: Should I tell his teachers?

    Me: NO! 

    lol. The first time this happened, I tried to educate her about reporting requirements, but I finally just gave up. 

  9. Our school has a field trip protocol in place and one of the steps is that the lead chaperone must email the entire faculty with a list of the kids going, what time, etc. Other steps in the protocol are: first, getting the trip approved by principal, alerting the secretary who puts it on our online calendar, collecting permission slips, etc. My notification comes in the form of the mass email to all staff, and this is almost always sufficient. 

     

    There is ONE teacher who always forgets the mass email step and every time plays dumb about how I could not have known in advance. There is another teacher who chaperones a group of kids who actually set up the whole trip themselves (a recurring thing), so he is sometimes quite late with getting me names because the students are a bit disorganized. But other than that, no issues. 

  10. On 11/20/2018 at 1:39 PM, scout mom said:

    I don't know how many times a day I hear "My teacher told me to come get an ice pack. My teacher told me that I need my temperature checked. My teacher told me ________________."

     

     I get annoyed when kids say things like this because I am trying to teach them how to communicate their needs clearly, and these types of statements make them a passive non-participant in their health. More likely, they were complaining of pain and the teacher said "you should see the nurse for an ice pack or something." When they blame their visit on their teacher I always have a lot of follow-up questions like "what were you doing that made your teacher say that?" etc. 

     

    I do have one teacher in particular that sends kids for Tylenol. Another thing I'm working with kids on is trying non-pharm interventions before using tylenol/ibu, so it really annoys me when they come in and say "Mrs Soandso sent me up for some Tylenol." No. 

  11. Just now, palli said:

    All good, its hard when they de-sat so quickly, 2/3 of my sons had had respiratory issues, where me ,mom as a nurse even wondered if i need to do the ER at 2am...but then I thought,, what the heck am I questioning myself..
     

    a little Racemic nebulized helps...

     

    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. 

  12. 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. 

  13. 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. 

  14. 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. 

  15. 1 minute ago, NutmeggeRN said:

    I actually keep a spread sheet in my google sheets. I break down each exemption by  how many (if any) of each dose, and whether or not I have paperwork on file to support. This can then be reached remotely when school is not in session and answers may be needed.

    I have a spreadsheet, too - with names and what is missing. But it might be helpful to have a visual when I'm looking at the physical files. 

  16. I have a good relationship with the teachers and staff, but because of my crazy-high office volume I don't get to socialize with them much. So my relationships with them are not very "Deep." 

    I know it's sort of par for the course, but it does annoy me that all they ever talk to me about is their health. Like if I say,"Good morning, how are you?" They reply with an update on their recent cold symptoms. lol. 

  17. 2 hours ago, Keeperofbandages said:

     

      Any student with a religious exemption is marked religious exempt on the top of their label and put in the very top drawer before my kindergarten records begin (that way if for some reason I need to exclude students due to an illness, they are in one location). 

    That is a great tip! I think for next year I am going to distinguish the exempt kids and any kids that are not UTD with a sticker or different colored folder. 

  18. 3 minutes ago, laflaca said:

    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 🙂

    yep! we have an athletic trainer that wraps everything for the students and they all think it's so cool. Then they come to me expecting the same treatment, and it's a hard no.  

  19. 20 hours ago, laflaca said:

    b) there will be no public flaunting of ice packs 

     

    HAHAHAHAHA!

    I totally agree with all the rules! Except, I do allow students to carry out ice packs because they LOVE to malinger in my office and I found that not allowing them to rest with the ice pack (ie, not missing any class) reduced office visits. 

     

    An addition: I do not wrap anything (joints, etc). If your pain/discomfort is so severe that you require stabilization, you need to see a doctor who will determine the treatment. Also, if the area is wrapped, I cannot assess it for bruising/swelling throughout the day. IF a student has on order for a wrap (never happened) or comes in with an inappropriate wrap from home (occurs often- too tight or too loose, not supporting appropriate area, etc) I will instruct them on how to adjust it and have them fix it in my office. 

  20. On 5/10/2019 at 5:15 AM, CampyCamp said:

    My kids just don't work that way. They will sit out their perceived injury in the health room even during recess. If I let them sit in the sick room, they get too cozy. If I put them in the waiting area, they act as walmart greeters and triage nurses. If I have them sit near me, they stare as I do paperwork or eat my breakfast. So if it's recess, they stay but any other time, they can hold ice in class. I presume it ends up neglected on the desk. 

    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. 

  21. 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. 

  22. 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.

  23. I always go in to interviews with a few pre-prepared scenarios that I can loop into various questions. For example, I might think of a specific scenario where I had to think on my feet and assess/intervene, or a specific scenario dealing with difficult patient/parents. These stories can be used for both the soft skills questions and hard skills/technical questions. 

    I try to pick "middle of the road" stories/scenarios, not the most extreme case. For example, once VERY early in my career, I was asked about how I handled a conflict with a coworker. I gave this SUPER dramatic story in full detail (I'm cringing now!) and needless to say, didn't get the job - I probably looked like a drama queen! This might sound like an OBVIOUS piece of advice, but when you are on the spot, your mind tends to go to the most obvious, strong memory. So practice answering those "negative" questions so that you come off as measured and always end it positively. 

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