bluebonnetrn

I have had EMS give the parent a choice on a 2nd grader with retractions and sats in the 80s without oxygen! Bologna! (Turned out to be a post-flu pneumonia) And another case with a 7th grader HR in the upper 190s to 200s for >30 min with a known previous cardiac history. They gave mom the choice and mom said no to EMS and THEY LEFT HER THERE WITH ME IN THE CLINIC. I was furious Needless to say... I don't trust a lot of what EMS does

YES! - I had a nurse parent stand in my office and say to my face "oh, I should get a cake job like this" ? yes, she did

For the most part my parents have been incredibly kind, understanding and grateful. They sometimes express frustration but it is clear that they are just venting and it's not directed at me. There have been a few jerks but only a few. I feel like the parents have been more grateful this year than ever before (or perhaps they have just been more expressive about it) and for all of the crap this year this part has been really nice.

I COMPLETELY AGREE! I am there to evaluate if they are stable or if they need medical attention. If they want proof of substance abuse they need to do lab testing. That said, our district makes us do the assessment as part of their evidence gathering for the student's discipline hearing. I hate it that they use us to provide "evidence". It's wrong for so many reasons. We had to take a "DiBrep" assessment training given to us by a state trooper (in other words, not a clinical person - I don't need two hours on how to evaluate nystagmus hmmm-mmmm thank you). It has very little medical value, gives absolutely no proof whatsoever of substance abuse or not and is used as someone already said for establishing probable cause on the side of the road. Yet we have to do it. And every single last friggin' time one of the admins will ask me "So did they take something? What did they take?' And EVERRRRY time I explain to them that this assessment tells me squat. We use a different form but it has all of the same information that was linked in the PDF files above. To make it even better I have even had to do these assessments on someone TWENTY FOUR hours after they had taken a ew sips of tequila. ummm....OK..... not sure what you think this is going to do 24 hours after the fact. It's a dumb waste of time and puts us in a bad spot.

NSV (non school victory) My hair mysteriously changed from straight to curly (yay hormones!) and I have been learning how to care for naturally curly hair. Big learning curve!! I am proud to say that I have finally got a routine that leaves me with somewhat decent hair so I don't look like I am homeless. I have even watched a few hair care videos while sitting at my desk ?

YUP! All of this. Before we had kids back in person I had some time to get my clinic super organized and take care of some cleaning/purging/organizing tasks that had been neglected. So that was nice. But now it is all of the above. Even though I have less visit numbers per day each visit is a much bigger deal and taking more time. I find myself with very little down time.

Yes, I am also having to call and check on any student absence due to illness whether they are in person or virtual. Our kids can choose to do virtual even if they are an in-person student. I think we are getting a lot of "I don't want to do school today" illnesses and we are also getting a lot of "oh they weren't really sick" explanations after they realize they will be excluded from school. Are they telling the truth? I have no idea. It's going to be like this all year... and I am already tired

We use our Dr's orders as the IHP. Asthma Action plan = care plan Food allergy action plan = care plan plan Seizure plan = care plan The only ones that I write up are the T1D kids and if they have some other unique/unusual situation.

the wisdom that comes with hindsight!!

I understand your anxiety. Your observations are spot on! However, school nursing is a very high level of autonomy. The normal, daily stuff you could learn and manage. But when the SHTF it's YOU and a bunch of teachers... I would not have had the ability as a new grad. Very carefully consider that choice and perhaps buck up and get the hospital experience first. You will be a better all around nurse for it. Good luck and best wishes!

YUP! At the end of February I had 2 N95 masks (one for me and one for my assistant) The next week our director asked for a supply count in the clinic and my masks were GONE. Someone did steal them and the most likely person (easiest access and knowledge of supplies in the clinic) was the custodian. But could I prove it? no

Here is a great screening tool to share https://www.sanantonio.gov/Health/News/Alerts/CoronaVirus

Just curious - what do your office hours consist of? Are you assessing students? Are you doing some teaching? Just talking and listening?

So - I really don't see how we need to be "trained" to screen people. We already do that. We already triage people. -"You're fine, go back to class" -"You should go home and let mom and dad take care of you at home" -"You are sick and need to be seen by a doctor" - "You are really sick and need to go to the hospital" OR we provide necessary interventions until EMS arrives We already do this people and this situation is really not any different. I can't tell someone if they have strep but I can tell them if it's something that should be checked into further. In this case we just add a few extra questions: Where have you traveled in the last 14 days? Have you been in close contact who has tested positive? Other than that we are all still checking the same things: temperature, respiratory status, symptoms, medical history From there, we already know how to shuttle them in the right direction.

We were on Spring break last week and today should've been our first day back. We are closed this week and they have not announced regarding next week (or after) that yet. Today they announced our big state assessment tests are canceled this year so you can kinda guess where that is going. Meanwhile, today and tomorrow admin staff are in schools. That includes nurses... Wednesday the teachers and paras are supposed to join us on campus. Our hourly staff are guaranteed pay through this week but no news for after that. I have developed a tracking log for quarantined staff. I have called each of my regular clinic kids to ensure that they are healthy, have what they need and are stocked for meds and/or supplies at home. I am finalizing my state screening data. We do this anyway but usually not yet. No idea what I will be doing the rest of this week.... or after that for that matter

I was once asked by a parent to call EMS for a fractured finger. After I explained that the ambulance would bill the family and not the school it was agreed that it wasn't necessary. I did have to call for EMS assistance once for a dislocated patella. This child was in a lot of pain and between, mom, dad and I we could not get her into the private vehicle for transport. When I called 911 and explained the situation they asked "how old is this child" and I replied 12 and was scoffed at. ummm... sorry but this 12 year old is bigger than I am and 3 adults weren't able to get her into the car. Anyway, the EMS guys came, understood the situation and eventually were able to get her into Dad's car. So it took 3 firefighters to get her in the vehicle! They were very helpful and totally understood why I made the call.

I also really like what Dr. Hodges has to say on this topic. He is a pediatric urologist and got into this topic because he determined that most often the cause of bedwetting and daytime accidents was not the GU system but constipation. If you read through his materials what he says really makes A LOT of sense. I have had some kids who had issues with daytime stool accidents and his info really helped the parents understand the problem. Many pediatricians don't understand this which is really sad. https://www.bedwettingandaccidents.com/

I agree that the GI doc is the next stop. But you can have regular BMs and still be constipated. A look at the good ol' Bristol stool chart can help with that. http://pediatricsurgery.stanford.edu/Conditions/BowelManagement/bristol-stool-form-scale.html

This is what I do: Calculate carb ratio just based on carbs Calculate correction dose based on BG level Add 2 numbers together then round

Declaring it a global health emergency is just about getting funding to deal with the outbreak.

I hate this BS! I actually have a mom rushing to school to pick up her son with a temp of 98.6 because "that's a fever for him" nope ?

So true! Now....about that opioid epidemic ?

I think this is a fabulous idea. I am also frustrated with pedi offices in the area. You know that these kids likely go to this school district so it saves everyone time if you can provide what the district requires. I have recently had TWO different pedi offices try to argue with me about what immunizations were required. I happily sent them a copy of the state requirements with the contested immus underlined, circled and starred! Like seriously... why am I having to explain that to you? As far as the orders go... I usually write the order myself, fax it back with a note that says "Please sign these orders for Suzy Smith because the previous orders were written incorrectly" and include the copy of the erroneous orders.

THIS Yes, this is why I have no problem being an ice pack nazi. I will gladly give an ice pack when it's warranted and I will withhold one when it isn't and gladly explain why. I think of this issue right here as a big part of my job and I am not in the business of handing out placebos.