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halohg RN

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halohg has 25 years experience as a RN.

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  1. halohg

    Common clinic visits (elementary)

    -“stomachache” with no fever, vomiting, diarrhea. ?s- when did it start? What was your last meal? Point to where it hurts. Any nausea? Last BM? Send to bathroom, hydrate, rest up to 10 min then back to class - “headache” with no fever or other symptoms ?s- when did it start? How much water have you had today? Inside or outside pain? Injury? Seasonal allergies? Hydrate, wait 30 minute, deep breathing exercises, rest up to 10 min with heat or ice if they want. - smelly kids that teachers send First contact on this should come from the teacher, sometimes social workers and school psychologists could also assist. But I have called home and just plainly stated the facts as they are given to me.  - “ chest pain”- with zero other symptoms, vitals look perfect, they are not in distress. always have them point to where it hurts, many times it is not the chest. Ask how long, inside or outside pain, asthma, any medications at home. Inspect area, listen to heart and breathe sounds, pulse oximeter, hydrate, evaluate for emotional reasons, rest up to 10 min. - extremity “injuries” that kids are totally playing up lol. Aka walk to the nurses office and as soon as they get in here they are suddenly limping mine are told if no redness or swelling then no ice and since no pain is sticking out to walk normally. BA BYE - teachers that send students for literally anything and practice no common sense/judgement.  well that’s a million dollar answer, ask the teacher why they are so willing to let their students to miss class time for non issues? Be direct. I was once surprised to learn one did so because once she didn’t and a child’s finger was actually broken or the most common reason seems to be parents giving teachers such a hard time they are just always covering there butts. I remind them my job is not to cover their butts or kiss them but when in doubt to send them. Make sure all teachers have a zip lock bag of bandaids and a guide of what they can do in the classroom prior to sending children to the nurse for common complaints such as stomachaches and headaches or any concern that ‘just started now’. Also empower the children to understand when is and when is not an appropriate time to seek care from the nurse. Good Luck
  2. halohg

    Do you keep clinic door open?

    I would close the office door, don’t worry about offending.
  3. halohg

    New school nurse

    Why do you feel you would panic? There should be a medical directors orders for these and other medical emergencies as well as individual health plans for medically fragile students. There are also multiple web site that review these medical conditions and how to stay safe in schools. Watch some training videos and review the policies and procedures of the district. Meet with individual families of the students to better understand their specific needs if they present with uncommon conditions.
  4. halohg

    Would you break a contract and switch mid-year?

    Are you in a union? They have created a hostile work environment and for that they and the district can be held legally and financially responsible.
  5. halohg

    interview next monday

    Your ability to fit in with the existing team will win over an individual with a higher education. No drama, no sticky wheels, no high demands, someone who will be able to handle demanding parents, and prove sound clinical judgement. Best of luck!
  6. They can either sit on the outside bench and be observed by lunch staff or stay in the cafeteria and be watched by another class monitor. Last opinion is to sit in main office with secretaries.
  7. halohg

    Seizure Dogs at School???

    We have one in kindergarten, the student was responsible for walking with the dog, however he did have a 1 on 1 so that helped as did the fact the dog was a standard poodle so allergies were not an issue.
  8. halohg

    Advice for New School Nurse

    First year is always the hardest. Maybe the principal has had previous experiences with this student and was “helping”. Having really thick skin is a must. Remember you cannot expect teachers and staff to assume the role of a medical professional relationship like in the hospital, you have to adapt to being in their world. Start off just by being a voice of reason and advocating for your students on why or why not their symptoms are just for exclusion. Grow from there...this takes time.
  9. halohg

    Incident Reports

    This is a pet peeve of mine... “ I’m sending so and so to you to document an incident”. Not an injury...my last one was one where a student open mouth touched another students shirt...not skin, kinda bite at his shirt only. I told them they should as being first hand witnesses, I would only document with quotes what they asked me to do. And simply state no findings of medical significance, does not mean injury did not occur, just no clinical observable findings at current time.
  10. halohg

    Screenings

    How about personal letters of thank you with contact info and permission for you to used as a reference for potential new employers. Or a simple letter of recommendation they can use in a similar fashion.
  11. halohg

    Special Education Nurse in middle school?

    I was always told you are hired by the district not any one specific school or position. For me it would be a tough transition it takes lots if patience and a demeanor fitting for the population. My wheelhouse is the middle school kiddos but I have been with the littles for 4 years now...love it but so over all the bathroom accidents and lice...and they never get my sense of humor not to say anything of the staff politics. What I’m trying to say, everyplace has there own stuff, pros and cons. The grass is not always greener but it is grass.
  12. halohg

    PEs With Missing Info

    Yes, and the DATE! C’mon now
  13. halohg

    New School Nurse Feeling Overwhelmed...

    It will come in time, the first year is always the worst, by year three it starts to fall into place. You know the teachers, kids, parents, and make best practices. As far as the charting don’t think of it as hospital charting. Real brief, less is more. It’s a serious injury that’s a different story. You don’t know what you don’t know and that’s okay, continue to ask questions. Yes write up the IHPs, the above advice of the other plans are correct. Is this a private school? Hopefully you have a medical directors orders to help with building your confidence on decision making. Continue doing what as a nurse you have been trained to do and the admins will eventually come around. We are not use to an environment where our medical judgement is questioned however the school environment is different and everyone feels they are an expert and feel they have a right to question yours. Just be you, this comes in time. We practice by evidenced based proof, the rest of your staff give opinions based on feelings. as far as the rude guidance counselor , I would try an engage them and open up about your lack of training and first time experience as a school nurse. They can become your biggest supporter and a great relationship with this group is vital for the care of your students. They are in the business of also helping others so hopefully that can be turned around. Keep in touch.
  14. My first thought is to request a transfer within your district, but the grass is not always greener. But really my thoughts are to advice you to focus on the kids, that is why after all why we do what we do. It’s great if you have supportive administrators and friendly staff, but the real wins come from being there and making a difference in these students lives for 7 hours a day. Yes the parents can be a challenge but not all of them. Control what you can and try not to over analyze what you cannot. For some students your care might be the only smile they see all day and the only time they feel safe. Not easy, not at all.
  15. halohg

    OTC meds for staff

    I like the idea of moving the existing supply to a cabinet in the staff lounge. Maybe ask the sunshine fund to make donations to the “med closet”. I don’t stock, and refer them to the main office staff to see if anyone has anything they are willing to share. I do take BPs if requested but always refer to their primary care. We do not have access to everything for a complete health profile to give an opinion.
  16. halohg

    Grants

    This is a great question, in the meantime I would recommend writing letters to your local general managers of big box stores, like Lowes, Walmart, Target, etc. even smaller ones like Walgreens. I would also recommend watching Facebook marketplace for items that match your needs and let the seller to know if they do not find a buyer and need to move the merchandise you would accept donations for your office. I have done this and received a new desk and file cabinets.
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