School Nurse - Calling Parents

k1p1ssk, BSN, RN · Mar 11

My rule is if you have a respiratory illness or stomach ache without a fever, vomiting, or diarrhea, you only get to go home if you have given the day a good try (meaning you make it to lunch) and then and only then, if your parent agrees to it.

A typical day for the kid with a minor cold who wants to go home goes like this:

They show up in my office generally within the first 15 minutes of the school day saying "I wasn't feeling well, but my mom told me to try and to come see you if I wasn't feeling well." Temp is 97.8; no cough, throat looks fine, just subjective symptoms reported. I tell them "You've been here for x-minutes; when your mom said "try", she meant at least a couple of hours." I don't even allow the conversation to go to "I'll call your mom" at the first visit. I then offer supportive measures - cough drop if they're allowed, salt water gargle, vaseline/aquaphor for their chapped nose/lips, warm pack for the belly ache, ice pack for the headache, etc... If they have gym before lunch, I offer for them to rest in the office instead of going to gym or recess. 99% of the time, they make it through lunch and realize they'll be good the rest of the day.

If they show back up before lunch, I recheck them, and in the absence of excluding symptoms, I call home and I let the parent know that I am not sending them home, but they are saying they don't feel well enough to be here, and would they like to come pick them up. The response to that is 50/50. Often they ask to speak with their kid, and again, after that, they either reassure or give in. But this way, the onus is on the parent - they can't be mad at me for calling when they told their kid to come see me...

Knights_RN BSN · Mar 11

k1p1ssk said:

My rule is if you have a respiratory illness or stomach ache without a fever, vomiting, or diarrhea, you only get to go home if you have given the day a good try (meaning you make it to lunch) and then and only then, if your parent agrees to it.

A typical day for the kid with a minor cold who wants to go home goes like this:

They show up in my office generally within the first 15 minutes of the school day saying "I wasn't feeling well, but my mom told me to try and to come see you if I wasn't feeling well." Temp is 97.8; no cough, throat looks fine, just subjective symptoms reported. I tell them "You've been here for x-minutes; when your mom said "try", she meant at least a couple of hours." I don't even allow the conversation to go to "I'll call your mom" at the first visit. I then offer supportive measures - cough drop if they're allowed, salt water gargle, vaseline/aquaphor for their chapped nose/lips, warm pack for the belly ache, ice pack for the headache, etc... If they have gym before lunch, I offer for them to rest in the office instead of going to gym or recess. 99% of the time, they make it through lunch and realize they'll be good the rest of the day.

If they show back up before lunch, I recheck them, and in the absence of excluding symptoms, I call home and I let the parent know that I am not sending them home, but they are saying they don't feel well enough to be here, and would they like to come pick them up. The response to that is 50/50. Often they ask to speak with their kid, and again, after that, they either reassure or give in. But this way, the onus is on the parent - they can't be mad at me for calling when they told their kid to come see me...

Thank you so much for this!

Cattz, ADN · Mar 11

You will get it figured out. It's pretty much a skill that comes with time and experience with kids you are describing.

If a kid is persistent and on the bubble in my nurse brain- I call the parent. Tell them a run down of how the day has gone and ask them to talk to the little. I explain this as getting a "mom feel" (or whatever the relationship is). The mom/parent/whoever can usually cut to the chase and decide if the little can stay or not. This takes it off my back- it's the parent's decision at that point.

Most of the time- kids just want to know they are heard. Looked in the eye and have a conversation/a little break from class. I believe them until they give me a reason not to.

If the visits persist with any given kid- I suggest a check up with their Dr.

Good luck!

You are doing great!

a

Glitternurse, LVN · Mar 11

In these type of situations I tell the student I don't see any reason to send them home at this time, but if they aren't better at recess time they can come back during recess to rest instead of going out to play. If it's after recess, before lunch I tell them to eat lunch first and if that doesn't help to come to the health office to rest during recess. It is extremely rare that I see them back. If they do come back I let them rest while I observe them, if they are chit chatting and seem fine they go back to class after recess, if I am questioning how they feel, I call home and let the parent decide. If they show up after recess. I let them know they were OK to participate at recess they will be OK in class. We have a 3 part health pass the teacher has to fill out, 1 copy goes home to parents, 1 copy goes to the teacher, so everyone is in the loop.

sergel02, BSN · Mar 12

This was a tough things when I first started (and still is). Nurses in my district don't always run the health office either so we can get rusty.

One of my schools wants to call for everything, and another rarely calls. Some have certain health conditions we call parents for otherwise minor things. This is how I prioritize:

1. If they have a fever, threw up, or diarrhea, I call parents to have them picked up for the day. Our policy is usually a full 24 hours for infection control unless we're sure it's not infectious.

2. Usually I bargain with the kids and see if they can manage to recess or lunch. Most are fine but many do come back in, and then I let parents know and let them decide after they talk to their kid.

3. If they are transitional kindergarten (a California thing) or Kinder, I usually call parents since some get upset if they aren't notified for everything. I tone it down come 1st and beyond.

A colleague told me, at the end of the day, it's the parent's choice. We can assess and let them know what we recommend since they can't see them, but it's sometimes best to put the onus on them since they know their kids best.

MiCULove · Mar 14

Oh wow