Loose teeth letter - thought I'd share...

[Marlene39]

I know you all know my pain! I get way too many students in my office for stupid stuff (loose teeth, bug bites, invisible injuries, etc) and so far I've come up with a letter for loose teeth. There are so many reasons to not send healthy kids to the nurse's office for no reason. It is really helpful to have the administration on board with keeping kids in class to promote learning time. BTW, I haven't seen a kid in my office for a loose tooth since. Next I will tackle bug bites (Really? Stop scratching!) and the kid who comes into the office 15 minutes before the end of school with a 2 week old abrasion that happened at home and you can't even see anymore. Come on teachers, get a grip!

Dear Teachers and Staff,

I have had several students come to the nurse's office since school started with loose teeth. I cannot do anything about loose teeth and it is a natural process that happens approximately 20 times in every child's young life. Students are missing valuable learning time to come to the nurse's office (often accompanied by another student who is also losing valuable learning time) to tell me about a loose tooth. Play-time, lunch, exercise, music and art are also valuable to student's learning. And most importantly, student's who visit the nurse's office are exposed to viruses and bacteria that cause illness.

Unless they are bleeding from the mouth, please do not send students to the nurse's office with loose teeth. I am happy to provide teachers with containers for lost teeth for those happy moments when the teeth actually do fall out.

School Nurse

[mc3, ASN, RN]

.................sigh.............

mc3

[RNsRWe, ASN, RN]

I'm sorry you lost your faith in the the assessment skill of school nurses, by no means do I condone that nurses' actions however I stand by my fellow school nurses. Sometimes as nurses period we may miss something, this makes us human. Often, injuries don't become visible for a few hours post injury. Is it possible there was not sign of visible injury at the time of the nurses' assessment? Yes, it is possible.

I'm hoping it was a learning experience for the nurse, and I hope you don't really think all of us school nurses are bad. School nurses face challenges every day and we often play a big role in the lives of our students. We are their advocates, their voice, and do what we can to make sure they are taken care of both physically and emotionally. Don't judge us all by one nurse. Hope your daughter is feeling better.

I wonder if I missed something major here......you're posting as though YOU are a school nurse, but didn't I just read your posts elsewhere saying you are a new grad in an ICU? I'm not looking for a fight (and I do agree with your sentiments here) but it seems odd to me that you're posting as though you, yourself, are a school nurse...when you aren't?

[RNsRWe, ASN, RN]

To the OP: LOVED that letter! A friend of mine is a school nurse, and she shares with me stories that make me shake my head--sometimes laughing, sometimes in shock.

A whole different world from the adult one I nurse in, and I find it very interesting :)

[Marlene39]

Of course I don't feel all school nurses are bad. They're human just like the rest of us including myself. I'm just saying there may be more to all those "complaints" than meets the eye. Don't dismiss them just because it seems as innocuous as a loose tooth because there may be more to the story.

All injuries at my school are sent for assessment in the nurse's office. My letter was in regards to normal, common loose teeth which happens naturally. Sorry this happened to your child, but it has nothing to do with loose teeth. I can't speak for everyone, but I am VERY careful in assessing the children who come to my office. However, I don't enable learned helplessness.

[timmedico]

It's a ploy for the kids to get out of class. If little Johnny wants to miss part of his class, that loose tooth is, to him, a way out (and why not bring Billy along too). I applaud your letter! You've just eliminated one more way of getting out of class. :) Only a legitimate issue should guarantee a visit to the nurse.

[VivaLasViejas, ASN, RN]

To the OP: LOVED that letter! A friend of mine is a school nurse, and she shares with me stories that make me shake my head--sometimes laughing, sometimes in shock.

A whole different world from the adult one I nurse in, and I find it very interesting :)

It just goes to show that nurses in EVERY setting have to deal with people who think every little bump, lump, or bruise is a Federal case. Just today I had no fewer than three different people (NONE of whom work in the clinical area) tell me that one of our residents kept nodding off in the library and saying silly, nonsensical things when she was awakened. :icon_roll This resident is a) 99 years old; b) demented; c) prone to UTIs, and d) habitually sleepy in the afternoons.

The non-clinical reporters were a bit miffed at how casually I regarded this situation; I told staff to obtain a UA and went on with the 500 other things that needed my attention at the same time. What the deuce am I supposed to tell the EMTs when I call 911 for an ancient Alzheimer's patient in no acute distress---I want to send her to ER with lights and siren because she's happy!? Oh, sure.....she could be having TIAs and getting ready to throw the big one, but I'd have been laughed out of the profession if I'd sent her in with nothing out of the ordinary but a little extra goofiness, which I'm 99.99999% certain is another UTI manifesting itself.

Gotta love being the only nurse in a place, ya know?

[Spidey's mom, ADN, BSN, RN]

Thanks for that letter - we keep the little treasure chests in the office so maybe handing them out to the teachers instead is a good idea.

Re: broken arm. No nurse has xray vision so unless there is a deformity or it is a compound fracture with bone sticking out, we can't tell if it is broken. My rule of thumb if the student falls and hurts something is if the kiddo keeps crying and/or it keeps hurting, I call the parents. I had a young boy fall from the monkey bars last year, no deformity, but he kept crying. I called mom, she took him to the ER, it was broken.

The same thing happened with my own daughter - she fell over at the end of one of those tiny pre-school slides and started crying. Nothing seemed broken so I let it go. The next day she still complained that it hurt so in to the doc I went and yes it was broken.

As a parent I'm more skeptical . . . as a nurse, I err on the side of being very careful.

[Kooky Korky, BSN, RN]

I think you should make sure there's no history of trauma or some underlying disease (some kids have serious illnesses) before telling teachers to ignore all loose teeth.

[Kooky Korky, BSN, RN]

How are you sure that it's a ploy to get out of class?

[Kooky Korky, BSN, RN]

The one 5th grader asked me to call her dentist. Right, I'll get right on that...

ROFLMBO At least she didn't request a call to the proctologist!

[redhead_NURSE98!, ADN, BSN]

I lost my faith in the assessment skills of school nurses that day.

Huh. That's funny, I'd have lost my faith in the assessment skills of that particular nurse that day.

[mustlovepoodles, RN]

I'm not so sure it's just a ploy to get out of class. Nothing worries a child more than having a wiggly tooth at school. And they're doubly upset if there's blood(which there always is!) I don't pull teeth--I didn't pull my own kids' teeth, not even my severely mentally handicapped child. They're on their own for that part. When kids come to the clinic with a bloody tissue in their mouth, I give them a small piece of gauze and send them to the restroom to try to wiggle it out. If it's not out within 2-3 min, I have them wash their hands and send them back to class. Before they go I dig out my batch of tooth necklaces and I make a show of putting one in my desk drawer "just for you". I invite the child to come back later if the tooth comes out, but they're not allowed to come back just to wiggle it again.

I figure I'd rather look at the teeth than pass it up. It's not like I'm seeing a dozen per day. Besides, it gives me a chance to get a good look at the health of their mouths.