ArryOtter

I've dealt with scabies twice now in two years. The first one we had one staff and several students confirmed. I did send home a letter and explained that we would be proactive and send home any and all rashes/bumps/etc and require a doctor's clearance to return. Explained what to look for, etc. The second time we only had one case that was parent's word, but no doctor's confirmation. We didn't send home a letter for that, we just kept our eyes out for anything funky in that classroom.

We go by a Medication Authorization form signed by the doctor, cannot be strictly parent's word. Students travel to me so I don't walk all over campus with ritalin in my pockets. Most of my meds are morning and noon, but I have a few seizure and asthma meds scattered through out the morning.

We drop ours off to the health department.

Can you explain to the mom that the staff is having some difficulty and ask what she does at home? For some of our special needs kiddos we've had mom come in and physically show us what they do at home to make sure the student is as comfortable as possible. If they're incontinent and not using the toilet at all, we'd generally just change on a cot.

She's not someone I'm friendly with or know very well at all. I think that definitely added to my hesitation. She ended up having another teacher do it in the classroom, and didn't place the syringe in my sharps box... Man, it's been a Monday.

Have you ever had a staff member approach you asking for a shot? Someone met me as soon as I walked in and said over the weekend her doctor prescribed her B12 shots. She asked if I could give her one. It kind of made me feel uncomfortable, she's not my patient, I'm not covered to really do anything for her so I said no and she got a little huffy. I asked if her doctor had done any patient teaching and shown her how to do it and she said no, that she told him she had a school nurse that could do it... I may have over-reacted, but I just can't imagine asking my supervising RN to give me a shot.

I love this!

For a clear doctor's note, I do not call. Unless it's something we're unable to do and usually I call the parents first and explain and see if they can handle it. If they can't then I step in to help, but it's been rare. The only time I called was when a kid with live lice and nits came back the next day with a note from the doctor stating there were no live lice and nits. I could see nits without even checking his hair and could see lice moving (he had blonde short poofy hair, easy to see scalp). Even then it didn't help.

Same! And for the first time this year I don't have any expiring within 30 days either. It's a rare occurrence for sure.

Also, depending on the district, schools will place non-nurses in clinics of schools, (sometimes as the sole clinic person, and sometimes as a nurse's aid) if there is no diabetics or students who require diastat. That may be something to check in to as well.

I started right out of school as well, but when I was hired there was an RN and another LPN on campus full time as well. Since then we have dropped down to me being the only nurse on campus (we're a small special needs charter, approx 250 kids). My supervising RN has about 5-8 other schools she is over as well. She's always there for more difficult questions/cases, but not available for an immediate presence usually. I wouldn't have wanted to start out alone right out the gate.

I am a School Clinic Nurse in Florida. LPN for now. FL does not require you to have a school nurse cert as an RN, but it is a definite bonus. I am pretty sure my supervising RN has only worked in school health and she seems to still have a great support system, although that will vary with the location of course. Check with your local district and see if they have any agencies they use for subs to get some experience while applying.

Are you in a position that is typically filled by an LPN? In our district, if you work as an on site clinic nurse (even as an RN) you are paid LPN scale. If you're a district nurse you receive RN scale. I feel like its a strange policy.

I have a very small clinic and it's pretty busy in here. I do 4 caths a day and I get called out a lot to other areas on campus. I have said students can't wait in the clinic and if they must a para from the room must stay (special needs school). Sprains/fractures. I give ice and let them sit for 10-15 minutes. If pain is still present I contact parents and let them know there may be a bigger issue and may need to be seen. My son attended my school last year for preschool and broke his arm. Lots of fun. Still my only actual break at work (knock on wood a million times). Little stuff. I send out an email with Classroom Medical Procedures and let them know what they can and can't handle in the classroom. I also set up CLOSED hours this year for my heaviest traffic times and for my lunch period (although I still rarely get a lunch break). I also try to nicely say, "Do you need band aids in the classroom? you don't have to make a trip to the clinic for something small like this!" and most of them get it. A few still bring them up for every little thing, but there has been a vast improvement this year.

I work at a special needs school, we do change/clean up the students. We always make sure there is a witness. Majority of the time parents don't come when called for extra clothes so it's either we do it or they don't get cleaned.

This is just so odd to me. You didn't diagnose and shouldn't have to report. I'd include a rebuttal as well.

That's another thing, she didn't have a crazy incessant cough either which kind of supported the dr's note for return. Mild cough, she was a little more tired than normal but nothing crazy. She's in our PreK room and she laid around a bit more than usual.

Depends on the time of day, if it's the first thing in the morning, recess, or lunch I generally send back to class if there's no fever and to let me know if it happens again. Our official policy is three times and they MUST go home, but I usually call at 2 times and tell the parents to head our way. If they've had vomit in conjunction with diarrhea (even if it's 1 bout of both) I call home and request them to pick up. ETA- Also if they're diagnosed with reflux we don't send home unless they have a fever. We are a special needs school and have a few that will frequently vomit due to their reflux and meds/feeds/direction of the wind. Also if they're habitual vomiters, anxious vomits, etc they stay. If it was one time and clothes/hair are soiled, they go home.

Do you all have a policy where the nurse can decide a student is too sick to stay at school? Even if there is no GI upset or fever? With a Dr's note? Can I see some examples? I'm trying to come up with some verbiage to add to our policy. We had a parent bring a child (staff-child at that) come in saying the child had croup, but the doctor's note said they were OK to return as long as they were free of fever for 24 hours. She didn't have a fever and according to mom hadn't had one at all. So per the note, she was OK to return even though I thought she needed some more time at home (she still acted/looked/seemed sick). Principal ok'd it. Yada yada. Come to find out, mom wasn't exactly truthful about the fever and now we have more cases of croup with one in the ER for it. Just trying to see what we can change to hopefully prevent this in the future. We're a small charter and currently, our policy is to just follow our local district's guidelines (which their stance is it's OK to return with Dr note) and follow state statutes. Thanks for your guidance! I just want to make sure we're doing everything we should be.

Our district has LOADS of double work. We require original prescription bottle with instructions, Medication Authorization form filled out and signed by the parent and physician. We have Paper and EMAR that both must be filled out. I feel like a great deal of my time is charting things either electronically or on paper that have already been charted the other way.

Our school has a strict No Nits policy. They're to be picked up ASAP if possible, to return they must either have a Doctor's note clearing them or I re-examine in the clinic to clear them. I think it's silly, but even though we're a charter we follow our local district's policies.

It's not something I enjoy to do, but as a special needs school with a medically intensive classroom and severely immunocompromised kids, it weighs on me. this is something important and necessary. I don't mind helping out occasionally, but when you have to chase down parents/doctors offices weekly it does get a little... frustrating.

I was actually coming to make a similar post! A friend of mine had said I needed to pick up a REAL NURSING PRN job over the summer at a LTC/SNF so I could gain some real "clinical" experience. I'm just tired of the condecension. Not every LPN needs to go into a nursing home.

We're a special needs charter that also provides PT, OT, and Speech so we do have forms where all parents sign off on medical releases to the school. So technically I can call and request the info and have a release to do so, I just feel like parents should have responsibility at some point. Especially stuff like this. If they were in a typical school they would.

This is what my letter says, but nicely of course. Still have some that send the kids in, with no records, and then won't pick the kids up and admin says for me to call the doctor.