School Clinic Door

[AshlyMRN, RN]

I work in an Elementary school of 900 children grades K-5. My office is attached to the front office so there's a door that connects me to the front office but there's a second door that is off the main hallway that students enter. For safety reasons our admin has us keep that door shut and locked at all times. The door doesn't have a window. My clinic is very busy and I'm required to answer every time a student knocks and let them out because the door is so heavy most kids need help out. I see an average of 100-150 kids a day. It isn't feasible to be a doorman all day and get everything needed done. I'm meeting with my admin tomorrow to talk about this. Any ideas? 

[k1p1ssk, BSN, RN]

100-150 visits per day?!? How do you get the charting done? I struggle when I see 30 kids... and that's all on top of dealing with your door situation!? You are a force to be reckoned with, I can tell.

Just to clarify, it's the hallway door that has to be kept shut and locked? What is the safety reasoning for that - in the event of an intruder? Are all of the classroom doors shut and locked at all times, too?

I would time how long it takes to go open the door for a kid and multiply that x2 (entry and exit) and then multiply x150 and demonstrate to admin how much time you are wasting just opening and closing a door. 

I would also bring up the point that with the door closed and locked, you are not necessarily able to run out of your office to an emergency. I'm envisioning the kid who is having an asthma attack and is sent to you, but cannot manage to knock on the door... I imagine your school is busy enough that kids aren't going to go unseen for long, but still. And what if you get called to an emergency but need something from your office - now someone is going to have to deal with the door to get back in? IMO, the health office should be an open, welcoming place and a big, heavy, locked door without windows is a barrier to care.

I personally have an open door policy. My door only gets shut when I need to have a private conversation or if I am going to be gone from it for an extended period of time.

[Red Shirt 6, CNA]

The school may be in violation of ADA requirements. 

[k1p1ssk, BSN, RN]

Red Shirt 6 said:

The school may be in violation of ADA requirements. 

This is also a good point!!

[Eleven011]

I have pretty much the same office set up - back door to the office, front door into the main hallway.   I only shut the main hallway door if I am gone, or at lunch.   I can't imagine opening and shutting it all day long!   I don't understand safety reasons?  People have to be cleared to enter the building through the main offices, so its not like there will be meandering visitors out there.   And if its to keep students out....if they knock....I'd let them in??   Not sure of the reasoning there.   

[scuba nurse, BSN, MSN, RN]

When I had a set up like that at another school my hallway door was open unless I wasn't there.

Also, you need to cut down that amount of visits! That is insane! I'm not sure why you have so many, but you need to set limits with the teachers. That is out of control. Why so many? 

[icepackstat, BSN, RN]

I would request that all the students go through the office and into your office that way.  Admin will be able to see how busy you are and the door can stay open.  

[AshlyMRN, RN]

That's actually what we started doing and it's so much better ?