Massmagic

I am out this year. I did school nursing for 4 years. It was the hardest job I have ever had. However, I do appreciate the support everyone on this boards has given me. This is a terrific place to seek advice and garner wisdom from experts in the most difficult field of nursing - school nursing. Wow, what a wonderful group in this forum - Experts +++ I really never had the administration's support or appreciation and this did not help me stick with it. I landed a job in March working with elderly doing clinical eligibility for state home care services. Love it. I miss the summers off though, but I am happier and less stressed. I really want to thank everyone on this board as you all are great nurses - dedicated to a field of nursing that is extremely difficult with an overwhelming responsibility. No one realizes this until they actually do this kind of work. Thank you over and over - Massmagic

I do screen students with glasses. I like to make sure they are for distance and not just "reading glasses." I check vision with and without glasses. I do send home a referral and call the parent if they fail the screening with glasses. This year, I have so many who have lost their glasses - I still screen and refer just to have the screening documented and to let parents know that their child still needs to wear glasses. This age group - tons of lost glasses - I have 3-6 graders. I am finding that many of these parents were not planning on getting their child another pair. Strange. So, my phone call and the referral paper helps to give them a little push towards the eye doctor. One student told me that they lost their glasses and then said, "I don't have to wear them anymore, even my mother said so." Well, he failed the screening, and I called mother. She said, "I am so glad you screened him as he keeps telling me he can see fine without glasses, and I wasn't going to bring him to get another pair." I do refer those with glasses who fail - I guess I like everything documented.

I use the sponges as well. At the beginning of the year I have reusable cold paks, but those last me only a few months. Youi can get the sponges pretty cheap at the dollar store. They work well too and last longer.

The training that I use for food allergies is great. The link is below. There is a training for staff through the computer with a certificate upon completion so that you have documentation on who has done the training. The Mass Department of Public Health recommends this training for staff. My only complaint is that the training is a little long. However, the link is great to give to staff so they can review it whenever they feel the need. AllergyHome - Your Home for All Your Allergy Needs -AllergyHome.org Schools @ AllergyHome.org - Helping Schools Manage Allergies Hope this helps!

It is so difficult when you talk to those parents who don't immunize their children. Most tell me, "I want my child to get them naturally." I have to restrain myself with all my might when I hear that. I want to say - "Are you crazy - out of your mind or where is your mind?" I do not have many refusals - but I do keep a list readily available so if there is a case of measles those little darlings with out protection can stay home for 2 weeks with mother. That virus will seek out those not immunized.

Granny RRT - I agree with you about the inhalers being readily available to students. We have a rule in our district that all doors need to be locked when out of the room. I do not lock my door when I go out of the med office as Inhalers HAVE to be available to all asthmatic students at all times. I have argued with other nurses about leaving door unlocked when not in office, they feel as if they just can't do that, and plus they feel like it is a medication that should be locked in their med cabinet as well. I feel differently as inhaler access is essential. I keep inhalers in an unlocked cabinet and not in my med cabinet. I have the cabinet labeled in BIG letters and inform all students that their inhalers are in that particular cabinet. I have many asthmatics but I have one that is a problem and mother fails to recognize the importance of daily long term inhaled medication (advair, flovent,etc). When I try to tell her that her son needs this daily, she gets angry. I think she feels as if I am telling her that she doesn't know how to take care of her child (even though she doesn't). I have resorted to teaching the student (6th grade boy) that he needs to step up and take responsibility in taking his Advair daily - every day even when he is feeling fine. When he is having difficulty with tightness, his pulse ox ranges from 96-98%. A low pulse ox is a late sign of not getting enough oxygen. This boy knows how he feels and I can tell he is having difficulty by just looking at him. I always call his mother when he feels as if his chest is tight and having difficulty breathing. I tell her that I have done everything that I can for her son -rescue inhaler/nebulizer, and that he continues with chest tightness. I then let mom talk to her own son and I let him tell her how he feels. This has worked much better than me telling her what she should do. (Some parents are just hard to deal with). She always comes and gets him. She has never not come to get him. I try to do the best I can with each TYPE of parent. The mother making the decision has helped in this particular difficult case. School nursing is a challenge - I do like this site as many of you school nurses have so much to offer. I learn so much from everyone. Great site.

Britrn04 Your news is not surprising to me. I wish you the best of luck. The education degree is a great idea, especially if you are young enough to use it. Congrats!

I know that we all have those frequent flyers daily. My school has increased in size this year as one school closed and the kids are stuffed into my building. I have Grades 3-6. I have experience with frequent flyers, but it is just getting to me right now. I see the same 30 kids with the same complaints everyday and sometimes 3 times a day. I know this is common for all of you. Has anyone found anything new that will keep these kids in class? Suggestions …..help…please….suggestions? Thanks.

BritRN04, I am in the same boat as you as far as having a downright MEAN secretary. Just this one person can make work miserable. What I have resorted to is to try to get along without the secretary and try not to go to her for anything, but there are things that have to involve the secretary or secretaries. I feel for you and know just how you feel. I often go home crying ..all because of one mean person. I am like you … nice and will go out of my way to help anyone, so to have people be so mean just plain hurts. The secretary thing….I have tried everything. This is totally not like me but for my survival, I ignore the secretary. I do not say good morning” to her or anything. I used to try the nice things like saying good morning” but I would just get a nasty smirk and no reply back – that really hurts. It is the most difficult thing in the world, and plus ruins the job. I am sorry, as I know what it is like. I go into work with a good attitude…happy and smiling and conversing with others and try my best to ignore the secretary. I pray daily that she will change and like me….I know it will come...it just needs to happen sooner. I have found, like the others, that school nursing is somewhat lonely as we are not teachers, so we are always on the outside. I deliver fluoride rinses weekly to the classrooms before school and take that time to chit chat with the teachers and sometimes I go see a teacher right after dismissal to discuss a student that they may have sent to me. This helps to build up a rapport and a friendship with the teachers. I try to focus on those who are nice.

In Massachusetts, Diastat can only be administered by a registered nurse. I have a student with a Diastat order. I have to go everywhere he goes – meaning, if the school walks to the neighboring school for buddy reading – I have to go. If parent can not go on a field trip with him – I have to go. When his class walks to deliver food for a food-a-thon – I have to go. We have a Halloween walk around the square – I have to go. Yas, no one but a registered nurse can give Diastat, insulin, benadryl (allergic reactions) and EpiPen for undiagnosed students. Trained staff can give EpiPen to students who have an order, but not to students who are undiagnosed. I can't designate staff to give benadryl for allergic reactions as it takes assessment (per DPH). We have to take a med delegation course and renew it every two years in order for us to train and delegate Epipen, medications, and inhalers to staff for field trips.

In our school district, we use paper logs to sign off medications that we give and use a computer program for all documentations of student visits. Most programs have immunization logs, screening results and dates, etc. Each school district varies, depending on the computer program they are using. There are so many different computer programs – some good and many not so good.

Blue Moon, Just another note…I am a dental hygienist also and one of the dental assistants that I used to work with took a job teaching Dental Assisting in a Tech School. She loves it. She has been doing it for like 14 years now and loves it. I think I read one of your posts stating that this would be in a Tech School. I think you would enjoy it. …that is my opinion.

Hi Blue Moon! Well, I had added stress from doing both jobs - running out when someone in gym needed an inhaler or ice pack and finding time to do my screenings and prep for classes. I enjoyed the classroom setting. There were some classes that I enjoyed more than others, as some had more discipline problems. I taught 3rd and 4th graders. I found that kids are very interested in science, health, and physiology. I was not trained in the discipline part and quickly learned that each teacher had their own discipline system, and that I was just left hanging there with no discipline plan. The problem was that when the teacher came back in, if I had a system where a misbehaved student warranted disciplinary action, the teacher was not happy as then they had to handle the discipline. I think if I had to do it over, I would try and get some sort of discipline plan that would not involve the action of the classroom teacher. If you have your own room and students come to you for the lesson, I think you could develop some kind of plan. On the other hand, there were some classes where the students were fully engaged, and highly interested. That experience was delightful as they really love what I was teaching. Wow, a toss up……. All the fake complainers trying to go home all day long, every day, and fighting with them every day ….or…. teaching all day long. I think I would say the teaching. I would grab the teaching now that I really think about it. I found that kids like action work and experiments. They loved experiments and hands on medical things. I think that would be an advantage as the subject matter can be much more creative than the regular curriculum of reading and math. I would go for it - just make sure it is legal with the Dept of Ed in you state before you bite.

Yas, the letter home to parents never works well for me. It is like mass hysteria when a letter goes home. Plus, the kids think they are sick or going to get sick because they are hearing about it. Just recently our Tech teacher was out sick and when she came back to school she told all her class how sick she was and her symptoms…..well, I had so many kids come in thinking they had what the Tech teacher had because she was in their classroom the day before she became ill. Or they told me My tech teacher said she was dizzy and I am dizzy, I think I am getting what she had.” The GI bug goes around all the time. I do not get upset as there is nothing that can be done. I never get upset or react as the kids pick up on it. It is very hard to stop that virus in a school setting or any setting for that matter. I just keep telling the kids to wash their hands. People over react and I am not downplaying the illness as it is not pleasant as we all know, but the kids pick up on the fear and anxiety of it all.” There is really nothing you can do….encourage good hand washing…that bug goes around all the time. Don't sweat it…it too shall pass.

I do very similar to FLARE and I also keep a written list of daily med takers times, grade, teacher and med as a fast cheat sheet. But I make a log sheet for all medications, even the PRNs I place the students with Daily Meds in a binder in the very front and I clip the LOG Sheet with a student picture, Doctor Order and Parent Consent together. The PRNs are then placed in the notebook similar way but in Alphabetical order for easy access. I do make a cheat sheet and I use a cheat sheet for myself daily. I always have. I guess it is what people get used to. I find that it is easier for me to keep the sheets under my desk blotter and cross meds off as I give them and then log them on the log sheets. I know that when I used to sub I love that paper cheat sheet - the only problem is that it has to be kept up to date. In my sub folder, I place emergency plans or Care Plans on students with emergency meds in the opposite front pocket of the sub folder so that they are sure to see it.