KeeperOfTheIceRN

And blocking it seems like she is trying to do! She won't even give us dad's contact info to speak to him about anything. All communication is done through her.

We have told her that since before school started when we found out about this kiddo. She just kept telling us they didn't need a 1:1 nurse and that she would get documentation stating that. We have received absolutely no MD documentation related to this trach. All documentation we have has been written by mom. We *think* she may have been trying to get one of the doctor's the kid sees to write orders for no nurse but none of them would do it. That is unconfirmed though. After our meeting yesterday, she said she would get orders but she's said she'd get orders since all of this began and we have yet to see any. I don't have any emergency action plans for the kid.

Hello all! I'm looking for some guidance on a situation. I have a new student with a trach in place. Student is self sufficient with almost all care (they are unable to re-cannulate on their own). However, all documentation that we have received from previous school states they are to have a 1:1 nurse to assist with all trach care. These orders are a few years old and mom is adamant that student doesn't need that level of care. BUT, she refuses to provide any new MD orders/documentation and she refuses to give consent for me to speak with MD about student's trach care and emergency plans. As it stands right now, the only information we have received, related to the trach, is CPR (ya know, mouth-to-stoma, not mouth-to-mouth) and that re-cannulation needs to be obtained within 90 seconds if it comes out. That's all. Anyone dealt with this situation and have any advice on how to navigate it?

I ask them if they want to go outside for a little while. Mental health is not my strong suit by any means, but I'm a huge fan of getting them outside when they reach this point. Especially with the older ones. I've noticed the fresh air, change of scenery, and sun light (even on cloudy days) does wonders for them. If they want to walk, we walk. If they want to sit, we sit. If they want to talk, we talk. But I let them do what they feel they need to, within reason/safety parameters, and I just meet them there. I also have this jar that I made with glitter glue, sequins, and water. I'll have them shake it and then watch the glitter and sequins swirl around. I'll ask them to tell me some of the shapes they see (there's unicorns, stars, geometric shapes etc. etc. in the jar). This works best with my middle schoolers though.

I walked into a kiddo sitting in my office before announcements had even been made...I was grumpy from dealing with a difficult parent the ENTIRE day before too. Imagine my absolute shock and instant emotional mess when I saw a potted lilly plant and a gift basket sitting on my desk from my PTO for me!! I'm not an openly emotional person (I prefer to keep my tears private ? ) so I had to close my door while I went through my gift and just appreciated the absolute consideration that was shown to me today! My campus principal came in shortly after and said "we haven't forgotten about you, we just wanted to spread our love to you on national school nurse day which is NEXT week!". So to know they were already planning and aware is all I needed. I genuinely love my school!

Ya know, its sooooo easy to get stuck in your own mindset, especially this year! My husband and I tend to think completely opposite of each other so I truly appreciate his point of view on almost everything because he is so good at bringing to light things I hadn't considered yet or that I had just forgotten. You just did the same thing for me, Flare. THANK YOU!! On this particularly tough morning where I was feeling just exhausted and weighed down by my responsibilities this year, your post brought a very valid and much needed reminder that THIS IS NOT OUR FAULT NOR IN OUR CONTROL. You turned my day around, Flare!!

Yes, and honestly, my admin is extremely supportive and has had no problems discussing things with the teachers. I'm just so tired of them doing their own thing "when no one is around". I move around a lot this year to minimize unnecessary visits so I'm popping into classrooms more frequently than my admin is so I see it more.

One of my kinder kiddos called me a "Mask Monster" last week and originally, I laughed. Today, I'm feeling like a "mask monster" because it seems like everyone dreads when I walk in the room. I also feel like the ONLY one on my campus who is actively reminding kids to put their masks on. I have teachers who do not require them in their classroom but make sure to tell the kids to put them on if Nurse Keeper walks in. I'm over the blatant disregard for this policy that is quite literally out of my control. Ugh. My responsibilities feel heavy today.

OK, great! Thank you!!

We do not have a school physician ? that would make getting stock epi much easier!

All of your "typical" school nurse duties ? I maintain all health records, perform all State mandated screenings, provide training to staff for various topics, handle all office visits (when on campus), perform all health related data entry, I travel to each campus periodically, communicate with parents etc. etc. And, new this year, I am the "COVID contact" for my district. I will add, I was recently given the green light to hire help on one of my campuses so I now have 1 extra nurse, but they are part time.

Yes, it's definitely something that has been on my radar for a while. But with it just being me, myself, and I for my entire district, I just haven't had the time to really sit down and get it all done. ?

Goodness! I didn't even think to check their BP but will definitely add that in the event something like this occurs again. I don't know about anyone else, but this week has been nothing but office visit after office visit! By the time this one got to me, I felt like I had been running nonstop in a marathon! Thanks Kidz!

Trying to see if you guys would have done things differently... Had an afterschool staff member approach me today stating they felt like they were having an allergic reaction to the dipping sauce they ate with their chicken wrap. They stated they had NKA and had eaten this meal before. Face was flushed but no swelling. C/o scratchy throat. They were located in another building so we walked back to my office after they stated they felt OK to do so. O2 sats were normal. They denied SOB, difficulty breathing, or feeling like their throat/tongue was swelling. HR was normal. Lungs were clear. They did not appear to be in any distress. I administered 25 mg of Benadryl and had them stay in my office for observation. Approximately 10 mins after the meds, they stated they were feeling better. O2 sats were sill perfect, HR was still normal (I kept my pulse ox on them the whole time) and their face was no longer flushed. At the 15 minute mark, they verbalized continued improvement. I encouraged them to call their roommate to come pick them up as I did not want them driving home since they had taken Benadryl. Friend arrived right at the 30 minute mark after meds and they stated they were feeling much better and were ready to leave. I did instruct them to go to the ER should the symptoms return or worsen to which they verbalized understanding. We do not have stock epi on any of my campuses but I do have one set of pens that was abandoned that I held on to. It was last checked at the beginning of the year and was still good at that time. I was hesitant to use them as the first response, but was ready to do so at the first sign of decline. But I'm curious...would you have used one or opted to go the route I took?

55 days! We've been in person since we started back and truly, I think it went the best it could have gone! It's been a year, and parents have been mean, but y'all. My kids have done AMAZING with the mitigation processes we have in place this year. I'm so proud of them!

I'm returning, no doubts. I'm hoping they approve my request for a raise (we hired 2 new nurses this year which makes me a supervisor) but will be happy to return if they don't. I legitimately love my job and this year has made me (and my admin!!) realize how important I am.

I don't keep them for staff. I have my own supply and will occasionally share, but I don't have a problem saying "sorry, I'm out" with a full bottle (that I bought with my own money) sitting in my desk.

Thank you all for your comments!! I feel a little better knowing you all would have done the same thing. I did ask the student if they wanted me to leave the boot on and they said no. However, that part did not make it into my charting ? everything else that I did DID make it in though. I will be adjusting my documentation to make sure I have all of my bases covered for the future.

Hello all! I'm looking for some guidance I suppose. I had a high schooler hurt themselves at the end of last week. They jumped over a small stream while walking outside in class and apparently landed wrong. Got them up and to my office where I removed their boot and noticed some swelling. No bruising. Able to move toes without any issues. Pedal pulses present and strong. Kiddo not in any distress. Elevated the foot and put an ice pack on it. Had mom pick them up and encouraged her to have them seen by a physician for proper imaging. Today dad called and asked for our insurance as he stated he wants the school to pay for the treatment of the ankle. I am unsure how that is going to play out but now I'm second guessing my decision to remove the boot. My admin assistant is a retired athletic trainer and is certain I didn't do anything that could have exacerbated the injury but, looking back, I'm questioning if I should have removed the boot. I'm hoping to learn from the situation so any opinions are appreciated.

If I'm present when the fall occurs, I assess, call EMS if needed, fill out the incident report, recommend MD follow up, and then report the fall to principal and super. They usually take it from there. I guess what threw me for a loop was that I was notified so long after it occurred that I was starting to talk myself into thinking I was supposed to do more??? I'm not really sure!

Thank you all for your help! I didn't think I needed to do more but then I starting thinking I was forgetting something and was starting to panic a little because I had no clue what I could be forgetting. I appreciate you guys!

Hi all! I just found out about a fall that occurred early this morning on a campus that I am not housed at. Because of this, I did not assess the teacher after their fall. The principal filled out our incident report form and then reached out to me this afternoon after our super told them to. I feel dumb for not knowing exactly what else I am expected to do from my end. No EMS called. Faculty member denied any injuries, stated they were OK, and stayed at school to teach all day. I have never been involved with worker's comp. Any advice?

Good morning friends! I had to clear my cache yesterday due to some technical issues and am struggling to find the Sight for Students info I need. I have a student who needs new glasses and parents get get them right now due to finance struggles. Have I missed some updates on this program? Thanks for the help!!

Another Texas nurse here, and while I can't offer any better guidance than Ruby did, I'm relieved to know I'm not the only one who struggles finding specific guidance via the BON!! There have been multiple times that I have not be able to find the guidance I needed and its super frustrating. I hope you get the help you need and congratulations on your new baby!!

IF (and I stress IF, as you really do not know if you're not directly related to the case or contacted by the individual) "Re" has been in close contact with a known lab confirmed case, this would make "Re" a close contact, and quarantining/testing would be indicated. Since "Re" is a family member of "C" and is clearly around them, this would make "C" a close contact of a close contact and quarantine protocols do not apply to them nor the students/faculty/staff of the school. IF "Re" is tested and receives a positive result, this then makes "C" a close contact and they would then follow quarantine protocols. If information has made it's way to your wife about a certain situation, your wife can call the family to try to clarify the info and then perhaps she will receive the information DIRECTLY from the affected family as opposed to hearing it "through the grapevine" or by proxy (since it sounds like you all kind of know each other). I do not recommend she exclude a student from campus because she "knows so-in-so, and they're positive for covid and you have been around so-in-so which means you are violating your quarantine". That doesn't hold up very well. Schools are small communities and they all have someone who knows everyone. And for clarification: QUARANTINE: what one does when they have been exposed and are waiting out their 2-14 days when they could *potentially* develop symptoms/illness. One does not simply "go about life as normal" and should remain at home during this time. ISOLATION: what one does when they HAVE a lab confirmed case and are maintaining their distance so as not to expose others. Again, one does not simply "go about life as normal" and they should not only remain at home, but in a room away from family members, if possible.