Dear coworkers, I'm not your mom (or free PCP)

  1. Hey all -

    New school nurse here - previously worked in public health and a hospital ED.

    I like the job, I like ruling my own roost, I like the kids (high school), the pay is OK and the hours are amazing...one thing I can't figure out is my coworkers, the teachers and aides.

    Our district has a clear policy that work-related injuries are to be called to the occ health triage nurse, and then if needed the employee reports to the designated urgent care or ER. I was very firm about setting those limits from the beginning - nope, I'm not looking at your injury - and that part is now going OK.

    Apart from that though, the teachers and aides are in here constantly....they want ibuprofen, they want me to look at a bug bite, they want an ace wrap, they have a cough and want to know if they should go home. For OTC meds I generally have an overabundance (we can only order large bottles; our school is small and meds generally expire before I can use them up), so I will say, "I don't give medical advice or recommend medications to coworkers per district policy, but if there's something in this cabinet that would be useful to you, you may take it."

    I'm a pretty direct person. Asked to look at someone's stitches, I said, "You should call your surgeon if you have a concern; I don't want to give you bad information" Asked if I think a teacher should go home sick when she had a cough, I said, "That's up to you - you should do what you think is best. I'm not your boss and you don't need an excuse from me. I hope you feel better."

    And yet....this continues. It just seems really weird to me. These folks have good insurance and it's hard to imagine how to express myself more clearly. Does this happen to you? What do you say??
  2. Visit laflaca profile page

    About laflaca, BSN, RN

    Joined: Nov '10; Posts: 217; Likes: 230
    Public High School Nurse; from US
    Specialty: 5 year(s) of experience

    51 Comments

  3. by   OldDude
    It's been that way as long as I can remember and isn't likely to change. It's a balancing act. You need to remember most of these people have never lived life outside the walls of some kind of educational institution. I'll leave that at that.

    I offer nursing assessments on a regular basis to staff (however frustrating it is) but I don't step over the line to endanger my nursing license. Pick your battles. There is one of you and a bunch of them. They would not be asking you if they didn't look upon you as a medical authority. So, keep everything in perspective and try to move forward for the collective good...know what I mean?

    Welcome to school nursing!!!
  4. by   laflaca
    Quote from OldDude
    It's been that way as long as I can remember and isn't likely to change. It's a balancing act. You need to remember most of these people have never lived life outside the walls of some kind of educational institution. I'll leave that at that.

    I offer nursing assessments on a regular basis to staff (however frustrating it is) but I don't step over the line to endanger my nursing license. Pick your battles. There is one of you and a bunch of them. They would not be asking you if they didn't look upon you as a medical authority. So, keep everything in perspective and try to move forward for the collective good...know what I mean?

    Welcome to school nursing!!!
    Huh. Well, good to know. I'm not tearing my hair out about it...I just couldn't figure if this was something particular to my school. And coming off a recent stint in the ED it's kinda hard to get in the right perspective... They're so anxious sometimes, and they are (fortunately) SO not sick!
  5. by   NutmeggeRN
    Quote from OldDude
    You need to remember most of these people have never lived life outside the walls of some kind of educational institution. I'll leave that at that.
    This ^^^, sums it up perfectly!
  6. by   Farawyn
    What OD said. The lack of common sense is kinda scary among many of my teacher colleagues.

    I look at it as, they trust me. "So, I usually look at what they have and say, if it doesn't heal/clear up, go see your doc."
  7. by   BiscuitRN
    I get teachers and staff in my office all the time. We order extra ibuprofen and Tylenol just for them. They come in and ask for it, and I point to where I keep it. I'm not giving medical advice outside of my scope. I also get a lot of carrying two boxes of medication into my office and "can I take these together?" That's a teaching moment about reading the ingredients list on medicine boxes or asking the pharmacist when you're picking up medications at the drug store. Fun times!
  8. by   ruby_jane
    Quote from laflaca
    Huh. Well, good to know. I'm not tearing my hair out about it...I just couldn't figure if this was something particular to my school. And coming off a recent stint in the ED it's kinda hard to get in the right perspective... They're so anxious sometimes, and they are (fortunately) SO not sick!
    Welcome to the group. I think it's Farawyn who say "One of us! One of us!"

    Yes, the shift from ER to ambulatory care requires a lot of patience and smiling. So, you can do one of two things:

    Continue being firm - there is ABSOLUTELY nothing wrong with that. When you run out of OTC meds...you could consider not ordering more, right? You're right about stitches- anything existing like that goes back to whence it came.

    OR

    You can look at it as an opportunity to create the good communication channels you will need in the future because...at some point you'll send them back a puker who actually does puke in the classroom and they may extend you grace if you've done them a solid at least once... this is only if you have the time to do so.

    It may also be that you're the new nurse; you're a novelty; the other nurse coddled them.....oh so many things. There's no real right answer. Hang in there!

    Neither is wrong. You are spot on in that you cannot diagnose or treat without a doctor's orders (and even then...I'd questions why a grown-up needs treatment at school).
  9. by   CampyCamp
    I encountered this a lot at camp and chalked it up to most camp employees being under 21 and needing more nurturing. If I wasn't there, they literally would call mom for advice or maybe they already did and the worried mom wanted an adult to see it. Sure. It's annoying but it makes sense and I nurtured them while trying to guide them for the future. Imagine my surprise when I came to school and found grown adults acting the same way! These people have kids! how do they manage? Maybe we're just too used to nurses who either ignore everything, it will pass or self diagnose and treat.
  10. by   EnoughWithTheIce
    Happens EVERY.SINGLE.DAY. I have worked in 3 districts and 5 schools and this is the one thing you can always count on. I have learned to balance it out. Sure, I will take a look at it. However.................

    And, i make sure I document on each one just as I would a student. Advised teacher to call PCP, follow up with surgeon, etc. I have a notebook just of staff visits.
  11. by   Flare
    i don't mind an occasional pop in to check a bp or if a staff member is having a medical emergency while on duty. I mean I am the medical professional on site. If someone is having an MI, I don't mind getting involved. But i really don't want to weigh on on anyone's surgical options or anything like that. There are some staff members who don't know my name. To them I am just "the nurse" just a walking, talking lab coat who better be in my office when they need me (see: Flare's comparison, school nurses and fire extinguishers. )
  12. by   LikeTheDeadSea
    Latest craze,
    "I think my scale at home is wrong."

    ...nope, my scale says the same thing. Thanks for popping in.
  13. by   linda1959
    A topic near and dear to my heart! Attending to staff injuries or medical issues that occur at school is in my job description. So if someone is having an issue that has come up while at work, I will do an assessment. If it's an injury, I can send to Workman's Comp if it needs additional attention. But yes, I get the "I fell at home four days ago and my foot still hurts." I might look at it and acknowledge "yes it's swollen" but always, call your doctor.

    And this year, because the visits for ridiculous things or the desire to NOT see their doctor got so crazy, I announced in our orientation staff meeting, that I will never give medical advice and ALWAYS refer you to your doctor. It has cut-down on the visits. I won't do Blood Pressures for "I just want to know what it is" if there are no symptoms. But I recently had a favorite. An agency TA who has only been with us two weeks asked "Can you tell me what kind of vitamins to ask my doctor for so I can gain some weight?" Ummmmm, no ........ call your doctor, or see a nutritionist!
  14. by   BiscuitRN
    Yesterday I had a staff member show me their swollen ankle and said "if I've done this before and the doctor just told me to ice it and take ibuprofen then I really don't NEED to go to the doctor this time right? I don't want to spend money to hear the same thing again." So I said "you're an adult so you can make that decision, but if you were a student I'd call your parents and recommend they have a doctor check it out." Then he stares at me and says "so I can just not go to the doctor?" You do you booboo.

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