GrapeRN

I am in a smaller school.. under 300 kids but high % of kids with special needs/Autism. My district has an RN in every school and a health aide at the high school/middle school level.

Started a little over a year ago, in that time: 1. Severe fracture requiring 911 transport 2. Student with stroke-like symptoms- difficulty talking, one sided numbness, weakness (parents live across the street so they took her to hospital- turned out to be migraine) 3. One epi pen (actually had to give this on a field trip in the middle of the night- scary- called 911 and good outcome) 4. One possible peanut ingestion- no reaction (not really emergency but could have quickly turned into one) 5. Staff member with swelling of airway due to insect bite 6. Multiple asthma attacks, one severe with no inhaler at school- mom got here within 5 min to administer inhaler & took student home after stable 7. Seizure (non-emergency, student had IHP in place) 8. Large contusion near groin from student falling on monkey bars- student went to urgent care and referred to ED for CT scan- good outcome 9. Multiple concussions- follow up care important 10. Multiple sprains/strains/possible fractures- early communication with parents is important- do not need to be picked up but stress that you do not have Xray vision and they must follow up if pain/swelling/tenderness persists. Never say it is or it isn't broken- we do not diagnose. Sorry this was long, but these are the top 10 "events" that I learned the most from this year. Hope this helps!

I was not expecting much, but got flowers, THREE nice cards, chocolate, a Kohl's gift card ($50) and a Babies R Us gift card (I'm currently pregnant). I had to choke back tears.. what great motivation for finishing off the year in a good mood! To those of you who didn't get anything- I agree with the send yourself flowers next year.. make a big spectacle out of it so it's never forgotten again

This is also my first year as an elementary school nurse. We have had ongoing lice since the Fall- there is no end in sight. I have come to terms that it will always be a problem as long as the parents do not properly treat it. I have educated extensively, even given free lice kits, but that's about all I can do. Try not to stress over it- there are way bigger issues to focus on!

Also want to add... I tried taking a break in the faculty room once and got bombarded with nursing questions (my mom is in the hospital with xyz, what do you think?).. so it was not really a break. I would much rather use my 30 minute break to walk.. I get alone time & I don't feel "cheated" out of my break!

http://www.aspamerica.com/_resources/common/userfiles/file/Airpurge%20Published%20Info/Peripheral%20intravenous%20infusion.pdf

Like many of you, I eat at my desk. Lunch/recess is the busiest time, so I will usually eat either early before lunches start or after the last recess ends (1:15). Because I think it is important to get out my office daily, I take a walk every afternoon (a few laps around the inside of the building) during my slowest time, around 2-2:30. Each lap takes only a few minutes, so I am back to my office within 5 minutes if I have a "visitor." I have been in SUCH a better mood at work since I started walking.. I wear a fitbit and almost always get to 10,000 steps. It also allows me to see the kids who were complaining of stomachaches and headaches jumping around in the halls.. good ammo for when they come back!

FF: "My (insert body part here) hurts from (insert nonexistent week old injury here)." Me: "So what has your mom/dad/grandma been doing it for it at home?" FF: "Nothing." Me: "Well, it seems like that's working!"

I always do. Your time is valuable and unfortunately a lot of that time is spent checking heads. I look at it as job security- at the end of the year I submit a report with all my visits to the state. Hope this helps.

This happens to me all the time (usually from the same 1 or 2 teachers). Usually it is end of the day headaches. I explain to the student (elementary) & teacher that I will not give them medication right before getting on the bus as I will not be able to assess how they react to it. Also, a lot of parents don't answer their phones & have no voicemail, so how will I be sure they don't get another dose of Tylenol right when they get home. Explaining this helps somewhat, but it still happens. Very annoying.

I feel your pain. I spend SO much time & energy on lice, and it is really frustrating when there are real issues to deal with. I started last year in a school where classroom-wide checks and panic ensued when one child had lice. After a lot of education (and re-education) I finally have *most* teachers on board that no, every child does not need to be checked every time a child has lice. That being said, I am in PA where we exclude for lice. I really wish they would change that law, but I also know it would open a whole other can of worms! Hang in there!

I squirt the sunscreen into the child's hand and they apply it (only for field day and outdoor camp). My school is in a very low income area, and many students do not have sunscreen at home. The benefits outweigh the risks to me.

awesome Jen! Thank you very much!

Thanks everyone. I did speak with the physician and have specific info on this child as far as my care goes. Was looking more for resources to give to teachers- how to prevent infection, handwashing, etc. I want staff to know the importance of this without giving away too much information on the child. Thanks to all!

Hello all, I have a new student entering kindergarten next year who had an organ transplant a few years ago. Does anyone have a care plan or other resources (educational materials for teachers, etc.) for immunosuppressed students? Anything would be helpful. Thank you!

Hello! In my district we have a fabulous administration- we have one RN to every building. That leaves me with about 350 students, 10 of which take meds. I document electronically and on paper, keep strict inventory counts, and do not allow anyone else to give meds. If we have a sub, I have a few checks in place to make sure the right student is getting the right med. I have a daily schedule printed for all medications ordered. Next to the order, I have a picture of the student with the name, grade, dr's information, and instructions. The sub initials on the med card and writes her full name on the back of the card. The only time we run into issues is on field trips when the nurse is not going (very rare). In this case we have to train a specific staff member (usually teacher) to give the medication. We make sure they have knowledge of the medication before going (reason the child is getting the med, any possible side effects, etc.). The teachers in my school are great about this. We do not send standing order OTC medications on field trips as (in my opinion) that requires a nursing judgement call. Let me know if I can be of any assistance!

thanks everyone.. it has been almost a month now and things have definitely improved. I pretty much call for anything that will "leave a mark," any head injury (even if it is just a minor bump), and any multiple visits (c/o sore throat in the am & afternoon, etc.). I err on the side of calling. However most parents do not pick up the phone :) Thanks for all of the support. This site has been a life-saver as an inexperienced (school) nurse!

Hello all, I am making a sub folder and updating the awareness list. What do you guys include in the awareness list for subs? ADD/ADHD? Autism? Or do you do more of a "critical" list like food allergies, asthma, etc.? Thanks for the input!

Maybe you can talk to your principal about holding off on the after-school programs until next year? I am new as well, and they have me doing some of the duties of the previous nurse (bus duty, may fair, etc) which is a lot of added stress, especially because I am new to the district and the role. Either way, I wouldn't go back to the hospital if you paid me a million dollars! I talk to my friends who still work there and I have NO regrets about going into school nursing. Hang in there- as you get more comfortable it should get easier!! Good luck!

That's my problem. I bring lunch, but can't make it down to the faculty room to heat it up! So most days I end up not eating or just eating an apple or something. I have an extra microwave from years ago that I want to bring in! I don't even care if other people use it, it would make my life easier!

Random question.. do any of you have microwaves in your office? I am thinking of bringing of bringing one in but don't know if there is some sort of DOH regulation against it? I don't have any "patient food" in my office (there's a refrigerator that some teachers keep their lunches in, no meds or student food). Let me know!

thanks everyone for the support. I spoke with another nurse in the district this morning and she said the same stuff you guys are. I have moved on from the "guilt" and realized I did what I should have, and from now on I will call that mom with every bump and bruise (and loose tooth and scratch). Thanks again guys- this site is a big help for a field with little resources!

Thanks. She felt I should have sent him home as soon as he came in. It wasn't an obvious fracture, so without an X-ray there was no way to tell. I appreciate the support! Ready for week 2..

Thanks. She felt I should have sent him home as soon as he came in. It wasn't an obvious fracture, so without an X-ray there was no way to tell. I appreciate the support! Ready for week 2..

Thanks for the reply. I think I need to toughen up a bit- people are (rightly so) protective over their kids & a broken bone can be a stressor for this student & mom. I think I just took it personally because I was trying so hard to do everything right! In the ICU I got yelled at by families all the time, but the next shift they were gone. Being in the school I have to form relationships with students and families that will last years. Lesson learned and I will take it day by day! Thanks for the encouragement :)