Quick Question School Nurses

Published

Specializes in School Nursing.

Just pondering this and want your feedback please.

If a student comes to you with an old cut that is covered with a bandaid, or an arm wrapped in an ace bandage, and these injuries all occured while at home, and the teacher or parent wants you to unwrap and evaluate. Do you do it ? Or do you just leave it and chalk it up to home injuries. I mean, we are not MD's and cannot diagnose. What would you do ?

Thanks to all for your feedback.

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Praiser

Specializes in School Nursing.

I'll unwrap ACE bandages or take off dressings if the student hasn't been seem by a MD and the parent put it on. That way I can evaluate for s/s infection or (to the best of my ability) determine if an area probably needs an x-ray due to possible broken bone. I follow up with a call to the parents to let them know if I see anything that warrants a trip to the doctor. Especially in my area, where community acquired MRSA is such a big thing right now, I refer any wound with pirulent drainage for a culture whereas before I just might put some neosporin on it and let it go. Why are the teachers asking you to look under bandages?

I, especially, am happy to rewrap aces if asked (and if not applied by a doctor) because so often they are applied improperly at home. I've seen circulation almost compromised by tight aces.

I will unwrap and evauate the cut if the doctor didn't place it there. But I will not keep evaluating it if they haven't been to the doctor and are using me in place of one. I tell the students that I am not their home supplier of bandaids. And with parents so uptight about the staph and mrsa, I place the burden on them to seek help immediately if there are s/s of infection. They should not be allowed back to school unless seen by a physician. I tell them 2 things: 1. keep hands washed and 2. keep your wounds covered. But I can not evaluate 900 students old wounds on a regular basis, impossible. Parents should take responsibility and I inforce the ones I know about. It's impossible as I told one parent to have knowledge of every student at school that has a sore or cut. They won't all come and tell you this.

Specializes in school nursing, Dr. office.

I will remove old band aids and bandages if placed by a parent or the student, evaluate and recommend. I also tell students that if they need more than one band iad during the day, that they need to bring them from home. I have a 1 a day limit on bandaids unless they come off during gym, etc. or are re-injured. And in my area schools, we are not allowed to apply Neopsprin, it contains a medication, and the only way we can apply it is to have a non prescription medication form filled out by the parent and on file for the current year.

After contacting the parent, I will remove bandages with permission and if it seems necessary. I only remove bandaids if they are soiled or the student complains.

Specializes in school nursing, ortho, trauma.

I will also redress most home injuries. My pet peeves about home are improper dressings - such as a child who came into me and could barely walk because Mom treated a blister on studen't foot by wrapping it loosely with an ace wrap (a filthy ace wrap), and also filthy old bandaids that you know have been on for days. I am sure like the rest of you, I won't needlessly disturb a "professionally" dressed wound.

Specializes in School Nurse-ran away from med-surg fast.

I agree with the above posters - do not disturb something that was placed by a physician. I will look, redress, etc. if it was did at home. However, I will only do this once. The staff / parents at my school think I should follow every kid with every booboo everyday. With 1100 students, this is just not possible. The staff feel they need to tell me about every illness or injury a kid ever had.

It gets to be too much when you are treating everything!! I get kids sent to my clinic for things in which they are already under the care of a physician for, parents know about, they are already on meds for, etc. What else do the staff think we can do at that point??

Specializes in Most all.

Honestly, it totally depends on what time of the month it is, what kind of mood I am in, what the circumstances are and who the child is!!!!!

Some days I am very loving compassionate and take time to fix hair and paint fingernails. Other days I bark loudly and chase them back to class.;)

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