Kim O'Therapy

Wow! Wonderful post. I am wrapping up my third year of school nursing and you've hit the nail on the head. I have been deciding if I want to go back next year, but I really feel that the worst day of school nursing is still better than a good day on the floor. I think my favorite part of this job is that I'm independent, virtually my own boss. As you stated in point #3, as long as there are no complaints about the clinic or the care the students receive, everyone leaves me alone. Thank you for your great post. I really needed it today.

Just like any type of nursing, school nursing requires prioritization. Most days (99%), I would not have time to teach a child how to put in an earring. I've got diabetics and emergencies to take care of. Yes, there are moments where I can (an enjoy) helping with the "small stuff", but most days, no.

I agree. Under normal circumstances, I would probably help with the earring. However, under the circumstances described in the OP, I would have done what the OP did.

I can understand your frustration. I had to draw the line when a teacher sent a 5th grader to me because his nails were dirty. He wrote me a note asking me to clean and cut the student's nails. With the principal's permission, I sent an email out that afternoon and it has not happened again.

Our school district is rather large; therefore, all the nurses are receive Red Cross training and are certified to teach CPR to those employees required to get training.

I understand where you're coming from. My famous quote around my school is "the nurse is always the last to know." Yesterday, I told the AP that if I had to produce an IHP or 504 documentation, I wanted to be at the meeting. On a positive note, at least the registration clerk now gives me copies of the absence excuses that have any pertinent information written on them. Yes, it make sense for the nurse to know that little Johnny was in the ER 48 hours ago with a severe asthma attack. Ya think?

I would be curious regarding the doctor's visit. Do you think they are telling you the truth about taking her? Unfortunately, I have parents lie to me all the time when I advocate for the student. Last year, I had a second grader that kept defecating on himself and I had to go through CPS to get anything done about it. Had to do it this year for a little one who had the worst tooth decay I have ever seen. Good luck with your student. I know you will find the best way to solve the problem.

I am on the P & P committee for my district. I would advise making immunization requirements a priority. It is pretty basic because all you have to do go by your state health department's requirements. Health department communicable disease exclusions are a fantastic outline for campus exclusion policies. I'm still a fairly new school nurse, but I hope this helps.

You're welcome! I may vent in frustration sometimes, but I love my 802 kids! My own 2 at home and the 800 I help out whenever they need it.

I have asthma too. I'm talking about the kids that come running down the hall into the clinic just to tell me that "mom says I need to take my inhaler twice a day in the clinic". How do feel now? Fine, but she says I need it. I also had a child coming into the clinic several times a day for albuterol neb tx. I called his mother and advised that his asthma medications may need changed because he is needing tx too frequently. Maybe his asthma is not being controlled correctly? She made an appt with the doc and called me a few days later to tell me that her son had been on the wrong medication and now that it was changed, he was doing much better. He has only had to come in once since then. Maybe I came across harshly (as I do when venting), but I would never throw a child to the wolves in that manner.

They wanted to pull me for other duties in the morning (getting bus riders to class, car pool lane, etc). So, I pulled a report for all the visits I get from children coming in right off the bus (before the first bell) and the kids that come in on their way out from school. You know, those last minute asthma attacks, the headache that waited all day and NOW Johnny decides to come in on his way to the bus. Of course, I also have to assess kids that got into physical fights on the bus, walking to/from school, and....well you get the picture. Once my principal saw that I would never be able to stay at my post, she let me out of extra duties. To make up for it, I try to make the coffee every morning between students.

I've done bone marrow transplant (critical care) and now school nursing. Each requires its own set of special skills and critical thinking. School nursing involves a lot of compassion and toughness and excellent assessment skills. Last year, I had three kids I sent to the hospital and each required an appendectomy. I had a fractured arm that required surgery and a fractured foot X 2 (both staff members). I've hounded parents whose children were wetting themselves every day because "they won't get potty trained" until they finally took them to a PCP, to find kidney or bladder issues. You cannot be stupid or lazy and do this job effectively. I agree that I may not have "life or limb" threatening issue on a weekly basis like I did in BMT, but I still have them. When I have them, I am on my own with no support (and trying to calm everyone else down), until EMS arrives for transport and we confer on the child's condition. And just like most nursing jobs, we are overworked, under paid, and under-appreciated. The first six months I worked in the school system, I thought I was over-qualified and bored with the job. Time taught me otherwise and now I can't imagine doing anything else for a long time, if ever. Just my two cents for the person yawning.

I have around 800 students at my school and around 75 staff members. Somehow, I take care of them all! I do a dental hygiene teaching or have a dentist come in to do it for K through 3rd graders. I do a growth and development (hygiene, menstruation, etc) for my 4th and 5th grade girls and 5th grade boys. Last year, I also had the Red Cross come to the school and teach water safety. I do little health tips on the announcements in the morning. During WATCH week, I go to the cafeteria and pass out stickers to the children I find eating their fruits and vegetables. I dressed up like Cindy Lou Who (from the Grinch That Stole Christmas) for our literacy parade and the kids loved seeing me in costume! :redpinkhe That is just to name a few things. I do some bulletin boards and various other small projects when time permits throughout the year (which is not often)! During the month of October, some of the teachers decorated for Breast Cancer Awareness and I created a cancer crossword puzzle for the teachers to fill out and they won prizes. Remember, you are there for the staff members too! My favorite day from last year: Our school had "hero day" where the students could dress as their real-life heroes (no super heroes). A large number of the girls dressed a nurses and came to the clinic for pictures with me! I was so touched, i actually teared up! Days like that make all the bad days, nasty parents, and frequent fliers worth it.

What does your school policy say? Unless the older siblings' school is somehow connected with or chartered with your school, I would have to place HIPAA before passing along any information. If the parent were to become angry over the shared information, she/he may have a good case. :argue:

I agree. It seems as though all the other parents want to blame the school, the other classmates, or even me when their child gets lice. I think some of the special parents have been through so much that head lice is insignificant compared to the other burdens they have faced.