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Rules for next year

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by laflaca laflaca, BSN, RN (Member)

laflaca has 5 years experience as a BSN, RN and works as a Public High School Nurse.

7,875 Visitors; 279 Posts

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Well, I'm finishing out my first year as a school nurse (high school).  Thanks to you all, I've wised up and plan to set some clear expectations for the fall...

1)  Ice pack?  Sure!  But you have to sit in my boring office to use it so that a) I can re-assess appropriately, b) there will be no public flaunting of ice packs,  and c) I get my reusable cold packs returned.

2) Vaseline, chapstick and lotion:  not a nurse thing.  Never heard of 'em, never saw 'em, don't have 'em.  See also sewing kit, glasses repair, hair ties, gym shoes, water bottles.

3) Snacks are for diabetics and kids who need to take meds with food, and the occasional kid with food insecurity at home who is getting help from our social worker .  If you just came late, or didn't eat the free breakfast here, or are my coworker: the cafeteria opens at 11:30.   

[I have noticed that since I got rid of the sugary granola bars and started offering carrots,  apples, a cheese string, and/or a pack of almonds...snack requests plummeted]

4)  Health office is strictly one at a time for confidentiality.  No friend visits, no twin complaints, no socializing.

5) Students before staff, unless someone needs an AED

What else should I add, oh benevolent yet clear-eyed Keepers of the Ice Packs? 

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AutumnDraidean has 20 years experience and works as a Substitute School Nurse.

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I love those rules, If you are in a grade 6-12 setting, resting in a nurses office requires a pass from the class you are out of. As a sub it always worries me that faculty doesn't know kiddo is in the nurse's office. It's so easy to game the sub!

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CanIcallmymom has 4 years experience.

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13 hours ago, AutumnDraidean said:

I love those rules, If you are in a grade 6-12 setting, resting in a nurses office requires a pass from the class you are out of. As a sub it always worries me that faculty doesn't know kiddo is in the nurse's office. It's so easy to game the sub!

YES! I am 9-12, unless it is an emergency: NO PASS, NO NURSE. Buh bye.

Too many hallway malingerers.

Edited by CanIcallmymom

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47 minutes ago, CanIcallmymom said:

YES! I am 9-12, unless it is an emergency: NO PASS, NO NURSE. Buh bye.

Too many hallway malingerers.

I am K-8 and I require passes as well, unless it is an emergency.  I also make sure to send the student back with a pass from me so that the teacher is positive that they did come and see me and not wander around.

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20 hours ago, laflaca said:

b) there will be no public flaunting of ice packs 

 

HAHAHAHAHA!

I totally agree with all the rules! Except, I do allow students to carry out ice packs because they LOVE to malinger in my office and I found that not allowing them to rest with the ice pack (ie, not missing any class) reduced office visits. 

 

An addition: I do not wrap anything (joints, etc). If your pain/discomfort is so severe that you require stabilization, you need to see a doctor who will determine the treatment. Also, if the area is wrapped, I cannot assess it for bruising/swelling throughout the day. IF a student has on order for a wrap (never happened) or comes in with an inappropriate wrap from home (occurs often- too tight or too loose, not supporting appropriate area, etc) I will instruct them on how to adjust it and have them fix it in my office. 

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BiscuitRN has 4 years experience as a BSN, RN and works as a School Nurse.

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11 minutes ago, jnemartin said:

HAHAHAHAHA!

I totally agree with all the rules! Except, I do allow students to carry out ice packs because they LOVE to malinger in my office and I found that not allowing them to rest with the ice pack (ie, not missing any class) reduced office visits. 

The middle school boys here can be the worst malingerers.  They'll try to go around the room and ask everyone why they're in the office, or they'll try to be my assistant and shout out diagnoses and theories from across the room. "It's gotta be the pizza in the cafeteria that made you sick!" "Your head hurts?  Gotta be a brain tumor!"

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laflaca has 5 years experience as a BSN, RN and works as a Public High School Nurse.

7,875 Visitors; 279 Posts

20 minutes ago, jnemartin said:

An addition: I do not wrap anything (joints, etc). If your pain/discomfort is so severe that you require stabilization, you need to see a doctor who will determine the treatment. Also, if the area is wrapped, I cannot assess it for bruising/swelling throughout the day. IF a student has on order for a wrap (never happened) or comes in with an inappropriate wrap from home (occurs often- too tight or too loose, not supporting appropriate area, etc) I will instruct them on how to adjust it and have them fix it in my office. 

SAME.  I have a lot of wanna-be NBA stars here....and the pros look so cool with wraps and athletic tape!  If I started wrapping limbs, I would literally blow my entire budget on Ace wraps in two weeks, and this place would look like a mummy movie :)  I spend a lot of time explaining that compression/stabilization is not the answer to every minor discomfort.

I'm with you - show me a medical order, or suffer the indignity of an Ace-free existence :)

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3 minutes ago, laflaca said:

SAME.  I have a lot of wanna-be NBA stars here....and the pros look so cool with wraps and athletic tape!  If I started wrapping limbs, I would literally blow my entire budget on Ace wraps in two weeks, and this place would look like a mummy movie 🙂 I spend a lot of time explaining that compression/stabilization is not the answer to every minor discomfort.

I'm with you - show me a medical order, or suffer the indignity of an Ace-free existence 🙂

yep! we have an athletic trainer that wraps everything for the students and they all think it's so cool. Then they come to me expecting the same treatment, and it's a hard no.  

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AutumnDraidean has 20 years experience and works as a Substitute School Nurse.

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Oh yeah, no wraps from me without an order or at a bare minimum a conversation with the regular nurse, and that isn't something I'm quick to do. You asked for the day out for a reason after all!

I always say that inappropriate wraps can do more harm than good, without orders I don't wrap, ask coach. 

 

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I'm new to this job and I've been putting an end to lunch time visits without passes unless I sense it's urgent.  Those kids that get through recess and lunch just fine and then have a headache right before class starts...aye.

Edited by ChristmasNurse

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SaltineQueen works as a School Nurse.

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I'm with you on everything except #2...and maybe that's just because I have the littles & my clinic isn't crazy busy.   I feel like every trip to my office is for a purpose.  The kid may say she needs chapstick or has an invisible boo-boo, but maybe really she just needs to build a connection with another adult she can trust.  I'm OK with those mundane types of visits.

I tried #1 at the beginning of the year but wimped out.  I'm going to try again next year unless I think it's a valid injury.

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23 hours ago, jnemartin said:

yep! we have an athletic trainer that wraps everything for the students and they all think it's so cool. Then they come to me expecting the same treatment, and it's a hard no.  

I just think having an AT at the middle school makes more (and not less) work for me since she is only on campus during morning athletics. Most days, she leaves even before practice is over and then they all pile in to see me for every sore muscle because that expectation has been set.

She also never calls parents about anything and they contact me with their complaints. I just think she does not get how the MS mind works and there is no forethought into how much they tend to miss class when they are told to "ice throughout the day". If they need that much wrap and ice - they need to be evaluated so we can accommodate for a legit injury or we can move on and have their hineys in their seat in class. 

Not to mention they always complain about the tape being too tight and irritating and they want it cut off or they lose the ace bandages and want another one. And parents expect that since the trainer has that stuff than I should have it too.

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