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shark_nurse14 BSN, RN

school nursing

Content by shark_nurse14

  1. shark_nurse14

    Blood Disorder and Severe Bruising

    Yikes...go with your gut on this one.... Any parent I've had of a child with a true bleeding disorder has made sure I have proper documentation and emergency medication/orders from MD before the child steps foot into the school. Also, student's I've had with bleeding disorders will frequently come to school with bruises to legs, sometimes arms, but RARELY their face. If there was ever a facial bruise/injury, parents would usually contact me with that information before it was brought to me by a concerned teacher. A lot of parents whose children have bleeding disorders are hyper-vigilant, and the lack of concern or follow-up from your student's parent, along with the current CPS involvement, has my spidey nurse senses tingling.
  2. shark_nurse14

    question---How many?

    I just provided a "nursing office breakdown" to administration to share with staff, because I think there is a huge misunderstanding of how busy my office is! I have just under 500 students in my school of 6th, 7th, and 8th graders. So far, there have been 3,300 visits to the nurse (with my 8th grade class being responsible for half of those). This does not include hearing, vision, BMI, or scoliosis screenings. And my work towards ensuring immunization compliance is not represented by my office visit numbers. This works out to just over 50 visits a day, I work alone (no other nurse or unlicensed personnel).
  3. shark_nurse14

    I don’t know if I like school nursing

    When I get frustrated with what seem like "pointless" visits, I ask myself why they might really be visiting the office...do they really think this problem requires a nurse and I can educate on how they can help themselves? Do they need a break from class, and if so, why? Are they struggling with curriculum? Are they having a hard time sitting still? Is there a social situation going on? Or, are they looking for someone to show them love, compassion, and attention? I truly believe that every student that comes into my office is in there for a reason, it just may not always be readily apparent. I find it helpful to be pleasantly honest with my middle schoolers, if I don't think ice will help, I'll tell them and give them a reason. If they are insistent, and sometimes rude about it, I will refuse to give them one and if they have something to say about it, I direct them to the principal to share their concerns (luckily my principal is extremely supportive of my decision making). I will also make comments like "This is your third headache this week, do you think we should call home about it so they can take you to a doctor?" I find that some kids will say no, and then I will stop seeing them for a while. The kids that say yes, their parents usually help control the unnecessary visits with a single discussion once the student is home. Last year the number of visits to my office began to rise, with many unnecessary visits, in the winter. I made it a point to go to each lunch and explain to the kids that I am only one person, and I was having X number of visits a day. I reminded them that it's not just helping them that I have to do, but I also have to write about each interaction and it can be time consuming. I made a hard and fast rule that if I saw any student three times in one week, other than daily medications/chronic condition kiddos, I was going to call home. The kids were made aware of this. I also reminded them that "If it's not bleeding, you aren't getting a band-aid", which kids still quote to me regularly . My last strategy I use is referring "frequent flyers" to our guidance counselors. Why is Cindy seeing me three times a day, for what seems like minuscule problems? Maybe your guidance counselor can see if somethings going on.
  4. shark_nurse14

    MiddleSchool health office

    I'm fortunate to have a large office, equipped with a waiting area, an exam room, a room for resting, and an inner office with a door I can close between myself and those waiting/malingering. Since each space serves a different purpose, they all look a little different. My waiting area has education posters, a bulletin board, and chairs/table. The table has hand sanitizer, books (where's Waldo, joke books), rubiks cube, and puzzles that I wipe down at the end of each day. My office area is where I have the most decoration: Pride flag, wall calendar, 3D butterflies, personal pictures, and cute canvas's with sayings on them I got from HomeGoods...I figure if I'm going to be in there all day, I need to have some ambiance. I also have a bulletin board that includes things I use daily (school calendar, pediatrician phone/fax numbers, emergency plans for lockdown/shelter in place). My exam room has barely anything decorative...this is the most clinical area I keep. I do have references on the wall for my student with diabetes, as well as a handwashing poster near the sink, but that's it. My rest area is outfitted with 3 cots, the cubbies where I keep epipens/inhalers, and a sink/cabinet area. The wall between my office and this room is all window (with a shade that I usually keep open) so there's nothing covering that wall. Because this is an area used primarily for rest, I keep it very sparse with decoration...if there's nothing to do or look at, the kids seem to ask to go back to class sooner. Hope this helps!
  5. shark_nurse14

    PEs With Missing Info

    Yes! Just got a physical the other day that conveniently left out that the kiddo has type 1 diabetes.....big whoopsie
  6. shark_nurse14

    Internship School Nurse Project , HELP

    I agree with amoLucia and think an easier way to go about this would be to pick one topic and adapt it for each audience...this will save you time and effort when trying to get both things done. Some school-related topics I can think of that would be relevant to both groups are: vaping head injuries/concussions reasons to visit the nurse office bullying appropriate/safe technology use hand hygiene
  7. shark_nurse14

    Too Sick To Stay Policy?

    Our policy states continuous coughing that prevents sleep or even a productive cough is reason for child to stay at home. We also have listed nasal discharge that is not clear and rashes with blisters or discharge. Still, there will always be the parents that SWEAR they were fine at home.
  8. shark_nurse14

    ROLL CALL!!! School Nurses 2017/2018

    I'm here! Was at school all summer to cover summer school, enjoying two weeks off (this week for errands, next week at the cape with my love) and then back to school I go! Excited to be at a NEW school this year!
  9. shark_nurse14

    Help is needed

    This is exactly the situation I was in this time last summer, so I totally get it! The first few days focus solely on filing/paperwork. Making sure you are organized from the get will make everything else smoother. Keep a running lit of kiddos that still require necessary paperwork so that you can hand them out on the first day- the sooner in the school year kids/parents get these, I find the sooner (and more likely) they are to return them. Next- know your policies. There will be parents on the FIRST day of school that ask questions- What meds can you give students? Can they carry their EpiPen/inhaler? Where do you keep the medications? What's the attendance policy? My kid has a fever, can they come to school? Everything under the sun, they will ask. Do you know if you will be utilizing a computer based program to track visits, or paper logs? Depending on the answer to this, I would either start to familiarize yourself with the computer system or create your health log and figuring out the logistics of that. Sure, bandaids are important but there is a lot more that goes into a nurse office. Make sure kids have water readily available. Is there a cot? Do you have supplies for girls who may need them during that time of the month? Other things I can think of off the top of my head to stock up on: wax for braces saline solution for contacts eyeglass repair kit flashlight any OTC able to give via school policy cough drops tweezers/scissors/magnifying glass all size ice packs gauze/tape/tefla/coflex cotton balls/qtips/vaseline/tongue depressors cpr mask heating pad ice packs batteries for thermometer/Oximeter Also, as you look through the physicals (remember, I said this is good to do first?) you'll see what your SPECIFIC population of students may need: For example, you have a diabetic student? You should have extra supplies (glucometer/test strips/ketone strips/alcohol swabs/fast carbs) Once you have all of that sorted out, I would start looking into your state requirements for mandated screenings so you can start planning that for the fall. Feel free to PM me with any questions!
  10. shark_nurse14


    Should I be bullied into changing a diaper even when it's dry, to try and "prevent leakage"? Background: Student came in for feed, gave student said feed; diaper was DRY. 6 minutes later aide walks in "So I think you are supposed to change student *every* time (student) comes in to be fed, because now (student) is wet and was JUST in here" *I explain how that isn't really necessary, but student can come back in to be changed now Aide "Well last week (student) leaked through pants so I think we should be changing every time, we have enough diapers to do it" How is one dry diaper better than the other? Also, this is summer school, no aides help me change the student, and the student arrives to school at 8:30 and they are requesting this diaper change for 9
  11. shark_nurse14

    School Nurse Haiku

    Classroom party fun Peanuts, tree nuts, eggs, and milk EpiPens at home Throat red and swollen "Mom gave me pink medicine" Voicemail left on cell Did you poop today? Oh, you say it's been three days? I am not surprised
  12. shark_nurse14

    C'Mon Now!

    Friend tied his shoes together and he fell....somehow he ended up with his ear split WIDE open (surprised the tip of it is still on there) SMH
  13. shark_nurse14


    She would have gotten 10.....10 reasons why I'm not giving her a single one
  14. shark_nurse14

    When is your Spring Break

    Last day before MA February break and this nurse is swimming in a pile of fakers...oh! and my charting system is down. ...deep breaths....only 1 1/2 hours left....then I can get my Wendy's large fry
  15. shark_nurse14

    diabetic question and stuff

    I find my little ones (and some teachers) do really well with reminders! For one of my teachers, they explained they just get side tracked and don't necessarily remember Little One NEEDS to eat RIGHT NOW. We came up with a plan to have a reminder set on her (teachers) cellphone to play 5 minutes before snack. Even if they are in the middle of something, Little One knows her special ringtone (she got to pick it) and will go grab her snack herself. For students that take too long to eat, I've bought countdown timers from the dollar store/discount stores and let them decorate it with stickers/ribbons...this way they can watch as time ticks away and can better manage finishing their lunch. I've also had parents label the foods in lunchboxes with "#1", "#2", "#3", so on....lunch item #1 is the item with the highest carbs, and the student is to eat that FIRST. Usually the last numbered item is the thing they REALLLYY want to eat, so the incentive is there to eat quick enough to get to that item, without a teacher/nurse having to be the bad guy.
  16. shark_nurse14

    Emergency Calls- How long do we wait?

    If a child is not yet diagnosed with asthma or I have no Drs orders/inhaler, I'm calling 911 right away and then calling the parents. I'd much rather deal with an upset parent who wasn't called first than any of the other circumstances that could come from waiting too long to call. For a child that can't speak full sentences without being out of breath (which is what it sounds like from your story) they need help ASAP, and no matter where Mom or Dad is I'm sure an ambulance can get there sooner. I will not apologize for ensuring one of my students is breathing.
  17. shark_nurse14

    Elementary v. Middle School

    I work in a prek-8th so I experience both everyday. Elementary: PROS: Education! I love teaching about the importance of breakfast/hand hygiene/why they need medicine when their friend doesn't. I feel much more needed, everything is a big deal, and I love being able to assure a 4yr old that they will see mom at the end of the day and she will be SO proud of them that they stayed in school the whole day! Also, parents seem to be more responsive in elementary (at least, at my school). CONS: Higher incidences of lice, GI bug, and fevers at school. These kiddos go down fast, and sometimes they don't know how to advocate enough for themselves at home and come to school too sick to be able to have a productive school day. Middle School: PROS: Again, education! The things I focus on with this age group is hygiene/body image/safety. CONS: MUCH less receptive; I feel like I can barely get them to come see me, even when they aren't feeling well. This age group also has much more emotional/social/behavioral problems, which is not my wheelhouse (but, if that's something you'd be into, middle school is definitely the place!) Also, there seems to be a huge disconnect when trying to connect with parents.
  18. shark_nurse14

    how long do you wait?

    I don't get paid after 2:30, and our kids are dismissed at 2:20....so I run into this a lot. Most times if it's a kid with a fever, but no GI symptoms, I'll leave them with the main office. If they have GI symptoms, and I've been waiting with them for >30 minutes, I bring them to our principal who is the only other person in the building with a bathroom attached to their office. I know he stays until 5 most days, and I know the last thing he wants is to deal with a sick kid. I'm on a punch in/punch out system and have gotten reprimanded by being 2 minutes overtime before because I was on the phone with a parent too long one day after I was supposed to have been clocked out. I've tried to explain that I won't always have time to clock out right at 2:30 and my hope is the more kids I leave with our principal the more he'll advocate for me with our contract change for next year.
  19. shark_nurse14

    E-mail for teachers!

    I sent a reminder to teachers that it's the season of the flu and to only send kids who seem very sick or injured as to cut down on spreading anything that might be in my office....I even gave them the example that the other day I had a little one vomiting with a 103 fever in my office when a 7th grade boy came in to ice an "injury" (nothing visibly wrong) from 2 nights before. I always think examples help them understand a little better :)
  20. shark_nurse14

    Ideas for After School Program?

    Hi Friends! My school is looking for faculty/staff who want to provide an after school program to our students and I would love to provide one related to health, just not sure how to go about it...any ideas? Others are doing robotics, debate, things like that. My school is a prek-8th, but ideally I would like to work with the older kiddos so that is less of a babysitting service (as much as I love these kiddos, it's just too much!) and more of a learning experience. Would love to hear your ideas, we've got some smart people on this board :) Thanks!
  21. shark_nurse14

    Ideas for After School Program?

    We are a private school and unfortunately do not yet have a health class (pushing for it for next year) so one idea I had popping around my head was a generalized health class r/t drugs/social media/relationships/healthy eating habits. I guess I have so many options!
  22. shark_nurse14

    New school nurse poll

    clorox wipes....I am forever wiping everything on my desk down because these kids touch everything without even realizing it!
  23. shark_nurse14

    Storing medications

    I use a shoe organizer! Each kid gets there own little cubby, and I keep it in my lockable closet so they are safe and sound. Each compartment, as well as each inhaler/spacer, is labeled with the students name and grade. I also keep an extra copy of all paperwork in with it so it's an easy grab-and-go for field trips, and makes it easier for substitutes!
  24. shark_nurse14

    What is this? Dermatological question.

    Our school would require an MD diagnosis and plan of care outlining possible school exclusion. Derm is hard, and a 6 year old?! They touch everything!
  25. shark_nurse14

    Good Kids

    There's a 7th grade boy that any time he passes by my office door (which is always open and I can see from my desk) he says "Hi Miss *****" with a big wave and smile. Today after he did it, he was still in the hall when someone asked him why he does it. His answer "My mom is a nurse and I know it can be really hard. And Miss ***** always has a smile!" It's a good day.

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