it'snotatumor

Do you send your files on to the next school as students progress through grades (i.e. does the middle school nurse send files to the junior high nurse?) or does each school nurse have a file on students while they are there? It just seems like a waste of time, space, and resources.

Ok, so my title is pretty much anti-clickbait, but what papers (i.e health forms, Dr.'s notes, med administration forms, etc,) do you keep at the end of the year and how do you store them? Our district has no specific system in place currently and the nursing Director said that schools are supposed to keep all documents for their students until they reach the age of 26?!? It seems absurd to keep that amount of physical papers around and scanning everything into our software program would be incredibly tedious.

It amazes me how new things catch on so quickly! Everyone has spinners here in rural MO too..at least they don't annoy me as much as the water bottle flip or eraser challenges did.

Kudos to you for sticking it out for a second year! My quick take is that you are putting the weight of the world on your shoulders; I think most nurses are "guilty" of this from time to time. While your compassion is probably one of the reasons that I bet you are a fantastic school nurse, it can also make you feel drained when you are constantly faced with situations you cannot control. I'm not sure about your school setting, but I am guessing that we deal with similar issues/families at times-l am the school nurse for 7th and 8th grade jr. high in a rural area that serves predominantly low socio-economic students. I am in my second year of school nursing and I have already seen some incredibly tough situations here and it's hard to not feel disillusioned. What has helped me is to find the kids and situations that I CAN help in some way. Here are a few examples: 1. I have a lot of legitimately hungry kids, so I've decided that I will always supply healthy snacks in my office. Thankfully, kids have not abused this yet. 2. I have an anxiety disorder, so I can spot the "I'm feeling stressed, but I don't know how to talk about it," symptoms from a mile away. We are fortunate to have great counselors here, but we all know that nurses are somehow more approachable sometimes and I use those situations to the fullest. Using judicious disclosure, I can connect with a kid who feels completely alone and stuck in the world and teach him or her coping mechanisms in real time. This alone fills me with purpose and meaning(Writing that somewhat surprises me because I'm a pretty cynical gal, so thank you for giving me a chance to self-reflect). 3. Then, for the kids that really need an advocate because they are not getting the glasses or medication that they need, I allow myself to be angry momentarily and then I file a medical neglect case with child services. As an aside, I find that I'm extra kind to even my most annoying FF's on the days that I have to make these calls. As far as legality concerns, as a nurse, a governing body has already deemed your judgement to be sound enough to be responsible for people's lives in even the most acute settings possible. With that in mind, remember that school nurses have students, not patients, and the majority of the school population is young and healthy. Of course there are going to be dire emergency situations that you will face, but they are hopefully few and far between. When in doubt, error on the side of safety and call parents, administrators,or ambulances as you see fit. It is not within our scope to diagnose, plain and simple, and I think a little bit of fear of the "what ifs" keeps us sharp. For me, coming from 13 years of Peds/PICU hospital background, I think 1 kid in 5 either has cancer or will need to be intubated in the next 30 minutes, so I'm still working on changing my mindset too;) And speaking of hospitals, all of my nursing friends that work in hospitals (except for my CRNA husband who loves what he does), HATE their jobs. I worked in a bigger city before this, and my nursing friends from various units have the same bad things to say that my nursing friends here in a rural setting do. Even my friends who have advanced practice degrees or work outside of hospitals in different capacities are not happy. The state of healthcare has changed, and certainly not for the better. As school nurses, we are as far removed as we can be from all of the bureaucracy, with the exception of assisting with a 504 plan here and there. I'll take that over yet another mandatory meeting over some new asinine policy any day. Wishing you the best of luck on your journey!

Jen-Elizabeth,you obviously come from an educated perspective and I agree with your point about wanting to monitor a student who self-administered Benadryl 100%; it's entirely possible that I'm taking for granted that an allergic student would come tell me about an exposure. In the case that I mentioned in my initial post, the student immediately came to me after she took Benadryl, and I'm thankful for that. I'm new to school nursing and I'm learning, but it seems that my students feel the need to come tell me if they so much as bump their arm or have an eyelash in their eye! Your rationale for why OTC's should not be allowed in schools are completely valid, bottom line. Potential for harm DOES exist in allowing students to self-medicate, my argument is that making policies prohibiting OTC's in schools in the name of providing a safer environment is akin to making everyone remove their shoes at airport security to protect us from terrorists-they are both illusions of safety. I think that we can all agree that drug abuse is a complicated issue that is not easily remedied, and one with potentially significant and devastating consequences. I greatly appreciate this forum and I felt comfortable voicing a contrary opinion because of the level of respect and knowledge that I have seen here. Thanks for making this day go by quickly!

As an aside comment, school administrators have the right to conduct student searches based on 'reasonable suspicion,' and this right would extend to checking that a student's Ibuprofen really is Ibuprofen if suspicion arose...but I DO agree that schools are a largely unregulated environment with the potential for many problems to arise.

Thanks for posting this article, it was eye-opening for me. I work at a jr. high (grades 7 & 8 currently, approx. 600 students) in rural MO and students grades 7-12 can ALL carry OTC and non-controlled prescription medication in its original packaging with signed permission from their parents. Even more surprisingly, I have standing Dr.'s orders to administer Acetaminophen, Ibuprofen, Albuterol, Epi-pens, Caladryl, Neosporin, and cough drops. Metered-dose inhalers require an additional JHC permission form, for reasons that I don't fully understand, but I digress. I obtain the parent's permission in their health record packet at the beginning of the year and keep it in binders alphabetically. I have not had any issues this year. I have had 3 incidents all year where a teacher has seen a student taking medication and questioned it; it was no big effort on my part to double-check that they were allowed to do so. Of course, I see how students could bring inappropriate medication or dispense it improperly, but these occurrences truly can happen anywhere and that is a separate issue than carrying medication at school. I'm solely here to address the direct issue at hand-should students be allowed to carry medications at school? Let's say for example that a student taking or receiving narcotics were to have respiratory depression at school, for example, sure it would be helpful to know the type and dose of medication, but I can only give supportive care in my setting and scope as it stands. The same student could have taken a massive dose of something before he even got to school; how can I ever really know what a student does, at school or other-wise? I see this issue pragmatically and not callously; I live in an area where drug abuse, prescription and otherwise, is a huge problem. Inappropriate medication use can't be easily monitored-if I was going to take a bunch of non-prescribed Adderall, would I do it in front of school administrators or sneak it in the bathroom stall? We don't go through student's belongings and anyone seeming to be under the influence of anything is sent to me for a sobriety check. If a student is not able to carry responsibly, they don't get the privilege...and policy for anything typically doesn't make a difference to the abusers anyway. I have seen benefits to student medication self-administration. My antibiotic administration alone would be a full-time job if I had to administer every TID dose that my kids take throughout the year. Parents and students can absolutely choose to have me administer those doses, and I'm happy to do so, BUT having self-administration as an option is helpful. Additionally, I have had a student who was carrying her own Benadryl mitigate her allergic reaction to shrimp because she took a dose from her bag the second she felt her throat tingle. I can not administer Benadryl, and the majority of my student's parents live 30 + minutes away, many without transportation, so I cannot rely on them being able to bring medication as it is needed (Yes, they admittedly can however obtain a Dr's note for OTC's to be given in my office and make this a non-issue, but my point is made). Finally, I feel that self-administration is a way to hold students accountable to their bodies; learning how to navigate being sick is a life skill. Medication administration IS potentially dangerous, but so are a lot of things, and proper usage must be taught. I understand the concerns presented with student self-medication, but my argument is that it is not a one-sided issue.

I have ONE student's Epi-pen in my office, yet I have around 30 students with life-threatening allergies at my school, and I'm wondering how the rest of you get non-compliant parents to bring in critical medication or even just return paperwork.