MisRN

I have not decided what I'm going to do . I'd love to go back to cardiac nursing, but now we are moving about an hour away from where we are and so I'll be starting from scratch to find a job. Wish me luck!

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Thanks for this! What a great reference tool for a lot of things! ?

Thanks for this reply. Part of the issue is that I am at a private school, therefore, no district policies in place - only best practices. We also have a school counselor who is part time, and not even on campus everyday. Fortunately, the day this student came to me, our counselor was here and came right away. I do have some experience with dealing with people in crisis from working in EMS and the Emergency Room, but I didn't realize there was a rapid assessment tool. Good to know! I'm definitely going to look for one to use. I wish we had a school resource officer (for so many reasons)!

Just curious what are your procedures/steps you take when a student (middle or high school age) comes to you (the nurse) and states they've been having suicidal thoughts? Specifically interested in smaller schools who do not have a full time counselor on campus. What role does the school nurse play in maintaining a student's safety? Thanks!

This is what I have in my office and when I started several years ago, I noticed that piece was cracked (if it's the end you hold that you're talking about). I threw some "waterproof first aid tape" around it to hold it in place and it's been that way for 4 years. I also purchased a non contact thermometer this year, but really it's for the littles (3-5) year olds who are scared to put the thermometer in their mouth. I could have used it the other day but I forgot I even had it. I don't think they're very accurate.

In my states (VA), nurses, school counselors, and teachers are all considered mandated reporters. I've had teachers come ask me my opinion about situations. I'll ask them questions to help them dig a little deeper and tell them what I know about the process. I have printed out a guidance book from the state Department of Social Services, and I will help them look up things to try to determine if something is reportable (i.e., what constitutes neglect, abuse, etc...). In the end, I remind them they are mandated reporters (I conveniently have that state statute printed & tucked in the Social Services document) and that they can remain anonymous. Are we not just reporting our concern over a child's well-being? Why wouldn't you? I'd much rather be wrong and have SS find nothing, than to not report and find out something terrible happened to that child and wonder if it could have been prevented. Why are people so scared to make the call?

I am in a small private school and when I was interviewing for this position, they had asked if I would be willing to get certified as an instructor. Many years before I had it so I didn't think twice about it. I think it ran about $400 for the instructor course (maybe $450) which my school paid for. What they didn't realize is that we need supplies that ran close to $1800 for 2 sets of mannequins, masks, trainer AEDs, books, etc... The other option was to rent the equipment about $100/day. Finally after 2.5 years, they agreed to purchase the equipment. I do First Aid and CPR, so it takes the full school day. I have to arrange for a sub nurse to come in and cover my office. The faculty all have to arrange for a professional development day & sub coverage as well. I enjoy teaching CPR so it's worth it, and of course it's a valuable skill for people to have. The problem is now getting my faculty to sign up for it. It's not required like it is in the public school system in my state. I've put out dates for the entire year and have had one full class. You would think they would encourage the faculty to get trained since they spent so much money on it!

I am currently a school nurse and am looking to return to cardiac nursing. My background includes ER nursing, PACU nursing, PCU and a couple years on a CHF unit. I reached out to the nursing director of Cardiac services with some questions about what might be available in a couple months and she laid out 3 options. She basically said to let her know what I want and she'd be willing to train me. I'm a bit torn of which way to go between two of the options. (The third is cath-holding and I know what to expect there... I think). The options are between Cath Lab and EP lab. There are things to consider that are job specific too (call, weekend requirements, FT vs PT, etc....) but a better insight to each position is what I'm looking for. What resources (online or in print) would you recommend for brushing up on cardiac rhythms, a/p, etc...? Thanks in advance for your input!

I regularly tell my students that I don't send home for tummy aches. And especially if they aren't willing to do the things I suggest to help themselves feel better (poop, lay down in the positions I tell them to, eat a snack, drink a ton of water because really- aren't they always dehydrated? lol). Glad you got a resolution quick as you did! Some can be very persistent for days and or weeks. I dealt with a student last year who had retching and sometimes made himself vomit from it. Multiple conversations with mom, many days sent home, and several doctor's visits later (allergist for food allergy testing, pediatric GI office visits, endoscope, and a scheduled regimen of Hyosayamine, etc... ) Finally mom came around to my idea that it was a manifestation of his anxiety, which I had suggested from the beginning. Once he learned that he wasn't being sent home for it, it finally started to subside (knock on wood!).

Just an update on this situation.... First I want to say a huge THANK YOU!!! to all the contributors on this thread and the advice, insight, and information shared! It truly is invaluable! So here's what happened at the meeting.... They came up with a plan on how the teachers should respond when this student was sharing her news with them, which was to refer her to talk to the school counselor and/or me (the school nurse). The administration seemed very intent on getting the student to talk to her dad (whom she lives with) to inform him, almost to the point of pressuring her. I basically told them that this issue is a private medical condition and that really it's up to her and not our business. They seemed to want to use the crutch of "but she's in crisis" in order to push her to tell her dad, to which I reminded them pregnancy is normal. It was because of posts on this thread that I was able to stand up for her and her rights, and not get sucked into the drama. It ended up that she finally was able to take s 2nd test, which was negative. Yay! Now it's a non-issue! Thanks again everyone!

Oh my goodness, I WISH we had a process that is clearly outlined like this! It's waaaaayyyyy too easy for parents to opt out!

When I first started as a school nurse, we had a parent who had 3 children and had most of their childhood vaccinations done, but when the baby had a delay in speech, mom stopped all vaccines (see where this is going???). She had the notarized Religious Exemption form done for each of them. When the measles outbreak happened in California a couple years back, she decided to take them for their second MMR. Our administration and the outgoing nurse had been up in arms as to if they were still considered exempt on religious grounds or if this negates it all together. What we learned was that (in Virginia) the laws are so loosely written, that we couldn't enforce anything. She could essentially cherry-pick the vaccines she wanted to have and hide under the guise of "religious" exemption for the ones she didn't. It was so aggravating!

We are a small college-preparatory school with an enrollment of 350 students (PK- 12th grades). I heard that once long before my time, there had been a student who got pregnant, finished that school year, delivered over the summer, and did not re-enroll the following year. I think it's fair to say, we've not dealt with pregnant students before, at least not under the current administration.

Yep, this is one of the issues... She says her period is 2.5 weeks late. She says she took a pregnancy test at home. She says it was positive. She also says she wants to take a second one to confirm it. She has no money to buy another. She has no transportation of her own (she's 15) to get to the Health Department. She has no family in the area other than her dad, whom she's not ready to tell until she gets that 2nd pregnancy test. I'm not sure what the administration are worried about. Possibly all the drama that goes along with 15 year old girls? We are a private independent school so we don't have district policies to refer to.