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Flare ASN, BSN

school nursing, ortho, trauma

Queen of Quite a lot

Content by Flare

  1. Flare

    Parent Pick-Up of Sick Kiddo

    Unless they're legit sick, I won't usually even let them wait here. If they didn't feel they needed me for the call home, then they are fine to wait in class. Also, I don't generally excuse these kids either. I also don't excuse the kids that came in knowing they were sick only to beeline here to get sent home "excused"
  2. Flare

    What's your record...

    i had a mom call to ask me about one thing and then try to get an opinion about her twenty-something pregnant daughter. Uh, nope. I don't do babies! She is a sweet lady though. When she heard that my daughter wants to play softball she said she'd give me her youngest's outgrown cleats. Sweet!!
  3. Flare

    OTC meds for Staff

    I don't buy stock for staff, but I do keep a supply on hand for them. That supply comes from my OTC meds that have not been picked up, but are still in date. They are welcome t go into the drawer to dose themselves.
  4. Flare

    Uncontrolled asthma.

    Getting the admin involved is more of a CYA move on your part. They can't do anything to make this child better, but if the child should deteriorate under your care, holding yourself to your orders as you should, this acts as a pre-emptive strike. Heaven forbid that this child deteriorates to the point that there is a status asthmaticus situation where 911 is obviously called, but the child still has a complication (or ems takes long.. . etc). It's about trying to keep your name out of the headlines.
  5. Flare

    Uncontrolled asthma.

    Honestly, I would make sure that your admin knows about this situation. There is only so much that we can do with a prn albuterol inhaler. In addition, I would call the dr myself and see if you could have a little powwow. The whole picture may not be getting clearly viewed with the parent acting as a go-between. I may even call upon our district physician for advice. Perhaps this child needs a maintenance medication or different medication maintenance med. Also, is there an order for the albuterol to be given via nebulizer? That may have a better effect. And CHART CHART CHART.
  6. Flare

    "Hypothetical" Situation

    i had a student with a dislocated elbow earlier this year. I ended up calling 911 for emergency transport, but here's why: Student's pain was level was severe. Parent gave no indication of WHEN someone was coming I wasn't sure that we'd get compliance in taking the child for appropriate treatment due to lack of insurance. I waited about 20-25 minutes after the initial call to the parent who stated they'd "call right back after finding someone to get him" to call again. When there was still no definite plan, I called the audible to rely on EMS. From the OPs description, it sounds like that particular case was handled appropriately.
  7. Flare

    Sick of nurses "referring" to our specialty

    It's all fun and games until a kid runs down the hall Porky Piggin' it!!
  8. Flare

    Pink Eye Policy

    @JenTheSchoolRN ooh! i have your green chart hanging on my medicine locker, I haven't seen the blue one before. Printing and hanging as i type! Thanks! If the eye is just red, no goopyness, i usually just rinse and wait to see how it looks in a bit. As far as policy, ours is vauge to "communicable illnesses", so it covers a spread.
  9. Flare

    Chronic Head Lice

    i've had a little with chronic lice the past few weeks. It's evident to me that the child was getting treated, but that it wasn't enough. I advised the parent, after questioning her to ensure she was taking proper steps to treat the house, to take the child to the MD to possibly get a different treatment agent than the OTC stuff. The child does have an open case with CPS, so we also mentioned it to them.
  10. Flare

    Coronavirus concern for incoming student

    I agree with the above. If the student is asymptomatic, then there is little reason not to accept this child. I would imagine that people coming through customs and immigration from get screened a bit closer these days. But... maybe not. I don't know their practices Anyway, here's the NJ DOH stance on it as of right now: January 28, 2020 Novel Coronavirus 2019 (2019-nCoV) Information for K-12 Schools Many K-12 school administrators, teachers and parents within New Jersey are concerned about how the current outbreak of the 2019 Novel Coronavirus (2019-nCoV) in Asia will impact their communities and wish to take appropriate steps to mitigate any risks. The word “novel” means new. The Centers for Disease Control and Prevention (CDC) is working hard to learn as much as possible about this new virus so that they can better understand how it spreads and its associated illness. The New Jersey Department of Health is also working hard by developing guidance and education materials should this new virus impact our residents. What is the difference between seasonal and novel coronavirus? Coronaviruses are a family of viruses and there are different types of coronavirus within that family, much like there are different types of influenza viruses. Coronaviruses in general are not new, they are quite common and are a frequent cause of respiratory illnesses such as the common cold. Coronaviruses tend to circulate in the fall and winter months, similar to influenza. Most people get infected with these viruses at some point in their lives. The type of coronavirus that has recently emerged in Wuhan, China is a new type of coronavirus and is infecting people for the first time (which means that people do not have any immunity to it). What are common symptoms of 2019-nCoV? Information to date suggests this virus is causing symptoms consistent with a respiratory illness such as cough, fever, and shortness of breath. How is 2019-nCoV spread? At this time, it’s unclear how easily or sustainably this virus is spreading between people. Chinese officials report that sustained person-to-person spread in the community is occurring in China. Personto-person spread in the United States has not yet been detected, but it’s likely to occur to some extent. Cases in healthcare settings, like hospitals, may also occur. How is 2019-nCoV treated? Currently, there is no specific antiviral treatment recommended for the coronavirus. There is no vaccine to prevent this virus, and the CDC advises that the best way to prevent infection is to avoid being exposed to this virus. What precautions should be taken for a person who traveled to China? The CDC recommends that travelers avoid non-essential travel to Wuhan, China. Chinese officials have closed transport within and out of Wuhan. If a person travelled to China in the last 14 days and is sick with fever, cough or difficulty breathing they should: Seek medical care right away. Before you go to a doctor’s office or emergency room, call ahead and tell them about your recent travel and your symptoms. Avoid contact with others. Not travel while sick. Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing. Wash hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer if soap and water are not available. If a traveler who returns from China is not ill, they may continue to attend school. What preventive measures should a school take to help reduce the spread of respiratory illness? NJDOH recommends that schools and childcare settings increase education on respiratory hygiene. Staff and children (as developmentally appropriate) should all be taught and asked to follow these steps that prevent the transmission of respiratory infections: Cover your coughs and sneezes with a tissue or into your sleeve, not your hands. Avoid touching your eyes, nose and mouth. Wash hands often for at least 20 seconds, especially after coughing or sneezing. Use alcohol based hand sanitizer if soap and water are not available. Stay home if you’re sick, especially with a fever. Avoid people who are sick. Clean and disinfect frequently touched surfaces and objects. Additional preventive measures include: Adhere to exclusion recommendations from public health. For acute respiratory illness; fever free for 24 hours without fever reducing medication. Doctors notes for return do not supersede public health recommendation. Separate sick students and staff from others until they can be picked up to go home. Provide adequate supplies, including clean and functional handwashing stations, soap, paper towels, and alcohol-based hand sanitizer. Encourage routine surface cleaning through education, policy, and the provision of supplies. Get a flu shot – it’s not too late to be protected! School Cleaning Procedures Special sanitizing processes beyond routine cleaning, including closing schools to clean every surface in the building are not necessary or recommended to slow the spread of respiratory illness. Schools should follow standard procedures for routine cleaning and disinfecting with an EPA-registered product. Typically, this means daily sanitizing surfaces and objects that are touched often, such as desks, countertops, doorknobs, computer keyboards, hands-on learning items, faucet handles, phones and toys. Outbreaks involving novel coronaviruses evolve quickly and recommendations from public health officials may change frequently as new information becomes available. Please check the following websites often for updated information.
  11. Flare

    Vent Sesh

    be sure to get a few sirens in the back ground too - for added drama!! unreal!!
  12. Flare

    Help with a head injury

    This is a tricky one - you don't want to dismiss the kid's pain and symptoms, but at the same time, you don't want to play into it either. What is the student doing for symptom management at home? I ask because I had a student with a similar situation where (imho) a few simple headache management techniques would have been key such as allowing sunglasses or access to pain medication (* my student said he took occasional analgesics - i told them over and over, even sending the med form with him when i knew he was leaving for the dr. he "forgot to ask". ) or ensuring adequate hydration. Point is, often times there are solutions there, but none that are desireable to either the parent, student or both. In my student's case, he ended up getting overwhelmed by all the work he fell behind on and wanted it all just to go away without having to be accountable for any of it.
  13. Flare

    A problem that is also a solution

    I truly do believe that the universe seeks to balance itself. From your posts, you got all the chops you need to waltz into practically any school and take the reins without issue. Are they eliminating your job at the end of the school year? How is this working- Are they absorbing the students into a larger school?? I wish you well in your search for a new position. I hope you find the perfect match for you.
  14. Flare

    Reaching my breaking point with middle schoolers

    Maybe it's because I see a wider range of ages, but in my school it's really not my middle schoolers that are my malingerers. Most of my middle school teachers are pretty good at filtering out the nonsense visits. Most will ask for a baggie of bandaids to keep down the 15 minute stroll for the invisible 4-day-old paper cut. But others will send down kids just because they're annoying them. I'm not saying that i never get a good performance of "I broke it" (the musical) from the middle schoolers - in fact, they're usually the ones who I have to fetch with the wheelchair because they have a bout of nausea and are now struck completely incapacitated. Point is, the drama runs deep in middle school. I expect it. I won't feed into it, but i certainly expect it.
  15. Flare

    Snack Time

    snack is to be parent provided here from pk-4th grade. the fourth grade teachers phase it out mid year and fifth grade doesn't do it, as the middle schoolers eat early and don't have one. While I have a suggested snack list readily available on my website and for teachers to send home, I still see plenty of student who come in with cookies and fruit snacks (thinking that fruit snacks = fruit). I also see a LOT of kids who essentially bring a small lunch as their snack. I just try to fight the good fight and educate.
  16. Flare

    Addressing Student Body Odor

    if i were a kid (or heck, even now as an adult), i'd be creeped out that someone got into my locker to leave me a care package of ANYTHING let alone hygiene items.
  17. Flare

    Vent Sesh

    i am the keeper of the tissues. I don't really care except when tissue runs disturb other higher priority functions - such as a student trying to stop me from leaving my office for tissues to attend to an emergency so they can get classroom tissues. Also - the board office expected me to police them to one box per - i stopped doing that a while ago - take what you want - make sure you leave some for me. I fought to get my OWN private printer and won that battle. Confidentiality rules should give you your own too.
  18. Flare

    private duty nurse in the school setting

    when I had a student with a 1:1, I really only got involved when there was a medical emergency (student has terrible bouts of status epilepticus, among other issues) and even then, i'd only really hand until ems got there.
  19. Flare

    Really Sick

    (knock on wood) i rarely get sick, but when i do, i go all out with high fevers and chills and all that. On the plus side, I usually recover pretty quickly. I guess the constant exposure to all these kid germs over the years has made my immune system pretty tough
  20. Flare

    Mailing Medication

    Same - although the thought occurs to me that I am lucky to be familiar with the PD in the town where I work and drop the meds off. I often wonder how it would look to be transporting a baggie full of pill bottles (some of them adderalls) that have children's names on them who are no relation to me and then get pulled over. If it wasn't a straight shot, i'd print out the med report and have the supe sign a letter stating that these medications were removed from the building for destruction and have the pd sign that i did indeed drop the meds. I may still do that.
  21. Flare

    Masters in Nursing

    tuition at the school i'm getting my degree from is about 360 per credit. it's really one of the cheapest for an accredited school.
  22. Flare

    Masters in Nursing

    in my case, i will get a salary bump after my next class. Then again after the next 15 credits then when my degree is complete. Also, i do get modest tuition reimbursement AND i'm taking my classes at a slower pace so that I can maximize my tuition reimbursement. So far i'm 4 classes in and only out of pocket 500 bucks.
  23. Honestly, I think I've just gotten immune to the teacher opinion or the "Mrs. So and So think I should...". It really makes no bearing on my decision. And if the teachers think that escorting the kids into me is going to help their argument, all it going to do is let them see the massive pile of papers on my desk that still need filing, the queue of kids that flow in and out consistently, and hear the phone ring all. dang. day. long. But please... go on about how you have 6 kids out today and how this one was sick for the last 2 days and probably needs another day off because he is sniffling and doesn't want snack. It doesn't seem like you want to keep reducing your class size AT ALL.
  24. Flare

    Intoxicated staff member

    yikes! I would separate myself from that one as quickly as possible! As a side note - this district nurse would NOT be doing any blow or pee. In a former locale, I was obligated to collect PEE on SUI students, which entailed shutting off water, pouring blue stuff into the toilet then boxing up the sample to go to the lab. No interpretation. Not what I was trained for. I didn't cry when I didn't have to do those anymore
  25. Flare

    Spacers: Do you order extra?

    they don't really give me too hard of a time with my budget as long as I'm being reasonable. If they started getting snippy with the budget then all of the "little things" that I order that really have nothing to do with my officer DIRECTLY - ice packs for sports, aed pads, narcan, ect - would be come major argument points. Epipens too, but I don't pay for those. And I suppose if i felt like doing the leg work i could get the narcan free too, but i don't.

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