rollernurse365

Did you read the linked article? Fantastic! It should be required reading: Top 5 Reasons Why 'The Customer Is Always Right' Is Wrong | Alexander Kjerulf

Hey, we can only do so much right? I sleep just fine at night.

I had this experience when I worked in pediatric oncology. I had a parent single me out in the hallway with patients, families, doctors, colleagues.... just EVERYONE! She reamed me out LOUDLY. She called me names. She was plain awful. I was so pissed, embarrassed, frustrated, you name the emotion and I had it. It takes a lot to make me cry but this did it. She was pissed because I opted to treat pain with non-pharmacologic means first before giving the opioid medication. It was too early per the order to give the medication and the child just arrived on the unit. My plan was to get the child settled, do what I could to make him comfortable, and by the time I got all that done, I could get the IV opioid needed.... By the way, the child's respirations were TWELVE and shallow... That would require a reassessment before admin and a call to the doctor based on protocols... I got the charge nurse to call the doctor for me to get an order and to let them know what was happening. That mother stalked me everywhere, even to the medication room. She stood outside the door while I and another nurse went through the procedure to get the medication. This is so incredibly dangerous! I couldn't hardly get out of the medication room because she was in my way. She kept on and on while going back to the room. She got in front of me, continuing to chew me out while I had the drug she wanted IN MY HAND READY TO BE GIVEN. I politely asked her, "Do you really want me to give the medication, because I have it ready?". This was one of the worst experiences of my nursing career. My charge nurse, supervisors, and colleagues felt horrible about the whole ordeal and all offered their support. Sadly, instead of setting some boundaries, the administration chose to smooth it over by placating the parent. I understand the delicate nature of the field. A lot of these kids are saved. This one was a poor prognosis. I get that whole heartedly! I cried for this kid at home on more than one occasion. It is truly sad though when administration does not have those tough conversations with families about inappropriate conduct. Anyway, all this to say I am so sorry this happened to you. Hopefully you reach peace with it. We on this forum support you!

The ones used at other districts are the kind with a break-away built in. They are used in k-12.

Our school still does not allow kids to carry their inhalers despite being allowed to by the state Here are some handy items to help kids keep up with inhalers at school: Star Allergy Alerts - Asthma Kids – Asthma Cases & Inhaler Carrier| Asthma Inhaler Carrying Case & Cover The lanyard!! Schools in our areas are requiring students to wear their student ID on a lanyard (not our school). They could hang their inhaler on it too with the case shown on the linked page.

And this: http://www.nasn.org/Portals/0/statements/joint_resolution_NASN_NASSNC_School_Nursing_Services_Data.pdf

Here is an interesting read: http://www.nasn.org/Portals/0/positions/2014psehr.pdf

I did. They really didn't have to change anything. I told them to use the paper log and I will log it into the computer when I get here. There is no reason not to move forward at this point. I think these two office staff persons have been given the run of things for too long and the principal does not want to lose them. Office staff should have no say over how the health clinic operates. Unfortunately, this is what I have to deal with. I can't believe a principal would cave over such a non-issue. The principal didn't even bother to clarify anything before she dropped the ax, hence "the feelings". I'll tell you all one thing, if they want someone to just sit in this chair and pass out bandaids, they have chosen the wrong nurse.

I agree. The fact they haven't given it any time to see how things work is even more frustrating. Nothing I can do. I'm at a loss.

I wish. The office staff has a lot of pull because they have been here a while. They do not understand what I do and neither does my Principal (shocker). The Principal said no.... The buck stops there. What a waste of time and effort! This just adds to the growing list of crap I have to deal with in my little 4hr/day job.

The secretary and business manager only document when I am not here. I work 4 hours a day. They fill in the rest. Admin will not extend my hours.

Not far from it! I even explained that if our visit logs were subpoenaed we would be handing over records for every student on the log, not just the one in question. Also, it doesn't help track data for individual students. If you want to figure out how many times one student came in, you have to flip through pages of paper to tally it up. Paper logs are also not very helpful in identifying trends..... It is ridiculous.

Yep. I totally agree. I am not coming back here next year. There is no hope for change and I cannot work like this. They want a warm body. I can't live with that.

I am not ordinarily an emotional person. Today is the exception. I put considerable amount of work into bringing this health clinic out of the dark ages. I will not itemize everything done in my short time here, but it is more than has been done in many years. My latest endeavor was to transfer immunization and screening information from paper to electronic records. I also figured out how to record individual visits and medication administration. I completed the whole school. It was quite an accomplishment. Today I was told we were not going to continue with computer charting. WHAT?!! After all the work I just put in?! You cannot be serious! Keep in mind, many others in our district are already switched over and there really is not any reason to continue with paper records. I suspect the secretary and business manager have something to do with this decision. They pushed back when I showed them how to record office visits. It is the most efficient use of time, however whining ensued. I cannot understand for the life of me why administration is content to accept the status quo. I have shown all the evidence on how the electronic system is really in our best interest. We already pay for this functionality so why not use it? I am tremendously upset you guys. I feel like I am taken for granted and am not valued. Thanks for listening.

You did the right thing. Those little ones can turn on you very fast. Trust your gut. It's usually right.

If unlicensed staff are able to give medications, I would hope there are explicit instructions and guidelines to help staff identify if the PRN anxiety medication is needed. There should be some training in advance. I think you did the right thing in this case. It sounds like things turned out ok. It can be used as a "teaching moment" and a means to open a dialogue about this topic since there doesn't seem to be a protocol in place.

Having a bad day? This should at least give you a snicker. I am known to be a good quality nurse and use a sense of humor to break things up when stress is high. I am a school nurse. There was a serious incident on campus this week which has staff even more stressed than usual. One particular teacher has a habit of picking on me whenever walking by my office. Great! I love that and take it in stride. Wednesday, I had a student napping in my office with "tummy troubles". And it smelled like it. After the child went home, the aroma lingered for a good while. This particular teacher came in with the usual teasing remarks..... OPPORTUNITY! I extended the invite to come in my office where I pinned him in so as to fully experience my job in all its fragrant glory. SUCCESS!! That teacher is now resolved to never enter my clinic again. Happy Friday! I hope this made you smile. Take care all!

YES! Also, pull up your scope of practice. Print and highlight the portion you would be in violation of if you follow through with what they are asking you to do. If that doesn't help, take it up the chain to the next person in charge. While you are doing all of this, dust off the resume and start looking in case it cannot be resolved amicably. Sometimes it is just ignorance and/or laziness. They cannot ignore it though if you hand it to them in black and white.

I do not know any good nurse who hasn't made some mistake with potential to cause harm. Whatever happens with the Superintendent, do not leave the profession. We need nurses with integrity who can learn and teach from their experiences, good or bad. I wish you all the best.

Again, this relates to a thread I started a few weeks ago. Nurses, quit being crazy makers with other nurses trying to care for your children at school. If you are that concerned, get the kid treated appropriately elsewhere. Don't send the kid to school with illnesses and injuries and expect your school nurse to ignore their needs. Sorry, you will be asked to come get your kid, receive a phone call, or the child will be treated in the health clinic as the nurse deems appropriate. Get over it. Welcome to parenthood. This behavior is happening all too often and not just in school nursing.

A kid with SPO2 of 80% would typically present with more symptoms than just an elevated heart rate. Could your pulse oximeter need calibration or new battery? Just a thought. It sounds like you checked for other key indicators and your findings do not match what the pulse ox is telling you. When I have a questions about accuracy, I will take a manual pulse rate and see if it matches the heart rate indicated on the pulse ox. I will check if fingers are cold and if there is nail polish that needs to be removed. Some pulse ox monitors also take a minute or two to register the true reading so I typically leave it on for a bit to make sure. I don't know. Just a few things to consider. I know I am confident in believing what my eyes and ears tell me and question if those handy gadgets do not correlate. They are great tools but not perfect.

Precisely! It truly drives me crazy. I wish there were something else I could do regarding social media but I'm afraid this is the world we live in now. Things calmed down for now. Hopefully this is the last incident with these parents this year. We shall see.

In general, if I see a trend in a particular class or 10% of our total school population is affected, I will send a notice home. It simply says _______ School is seeing an increase in _____. List symptoms. Assure proper cleaning measures are happening at school. Reiterate policy on when children may return to school. That is it. This way, I have performed my professional duty and parents are on the hook to some extent. I keep a running list for myself on things like flu and strep which helps track total numbers and identifies if a pattern is emerging. I'm not saying this will fix your issues but it does give you some written verification of communication with parents and staff.

I wish I could get someone to obtain a screen grab of the thread. I could be good to have if anything else happens down the line.

I was going to do something to address it but the principal thought it best to let it die out. I was somewhat disappointed by that because this is the 3rd incident with one lady wanting to debate validity of the temp readings.... Even after reiterating it was checked multiple times with multiple thermometers (way more than necessary). I learned after the first incident she may try to cause trouble so I covered myself by overdoing it. I don't think I will do that again though. It is what it is lady. Deal with it. I have tested my equipment on well and sick ones to make sure they are functioning properly. I changed the batteries. They stay cleaned. I use good technique. This is not a hospital or urgent care center. What we have is totally fine to screen for elevated temps. Honestly, if I had NO thermometer I could probably accurately weed out students who should not be on campus based on other assessment skills. 9/10 times my gut is right on. Come on, most of us can look at a kid as they walk in the door and know if they are brewing something. It is an instinct developed over time after dealing with thousands of sickies, whether in a school setting or otherwise.