Non-compliance procedure

Specialties School

Published

So we just got SNAP (had Health Master) and we are doing immunizations and are finding non-compliance in a lot of students all over the District. The Supervisor would like us to call to MD's office and clarify the record, and if required, tell them that student will need a booster etc.. Then the MD's office gets hostile with you and ignores your request. Then we have to contact the parent and let them know, and in some cases (with the live vaccines), tell them we have to exclude them from school until it is completed (mind you, this is for all grades). This obviously takes a tremendous amount of time we don't have.

We want to just send a letter to the parent stating they are non-comp and leave it up to them to contact their MD. I'm tired of being the immunization cop, my name is not stamped on the physical saying everything is up to date.

Just curious how some of you handle the process.

Thanks!

Specializes in IMC, school nursing.
YOU HAD A MONTH TO DO THIS!! Also, any days missed due to lack of immis are unexcused.

Had this issue with one family this year. My first time being this close to the deadline. I kept telling them to tell the pediatrician they were going to be excluded and they would make an exception. After a month they still didn't have them done, despite weekly reminders, and were panicking. I told them they could go to urgent cares to do it. Mom was ticked this was happening, but she didn't do anything. I called and found the urgent care she could go to. She got them done, but it wasn't over yet, they got ticked they had to pay a copay because it was an urgent care. Amazingly, they were quick about getting us to write a letter for the insurance company to cover their costs and kept calling us and bugging us about this letter.:banghead:

Specializes in ICU/community health/school nursing.
Amazingly, they were quick about getting us to write a letter for the insurance company to cover their costs and kept calling us and bugging us about this letter.:banghead:

Oy vey. How is this the school's problem???

Specializes in IMC, school nursing.
Oy vey. How is this the school's problem???

We are a community school, we are a little more family centric than most. We go a little over and above for our families.

From a parent standpoint, it would be really bad form to immediately exclude based on new found information. I think administration should give some leeway. Like, alert parents not that there is an issue that was just found and give them until the first day of next school year to be in compliance.

Interesting that they are given as long as a whole year to comply.

Giving so much time to get into compliance doesn't seem like it would be helping the cause of protecting everyone.

Or am I misunderstanding what you are saying? Thanks for any clarification.

Same. I only contact the doctor's office after I get nada from a parent and suspect their kids is actually up to date and request the immunization report. 9/10 they are and I get the paperwork and I'm done.

Same here.

Specializes in School Nursing.

This kind of stuff just gets me all riled up! It is NOT my job to call a doctor's office and inform them that a student needs immunizations. Nor is it my job to track down immunization records. I do have access to our state database and if I can find some information there then great. But I do not go out of my way to track down records for parents. It is the parent's job to provide the documentation to the school.

Each year we send a series of 3 letters letting parents of non compliant students know what is missing, what options a parent has for completing the requirements and what the consequence is (exclusion) if they do nothing about it. As we get closer to the exclusion date I will have my principal call the parents directly to let them know that we mean business when we say we will exclude the student.

Specializes in Emergency Medicine, Women's Health,School Nursing.

Ugh we went through this nightmare at the end of last year and the first week of school this year. Due to our states vaccine laws changing (requiring a dose of polio after the age of 4) The good news was majority of the kids had it however a lot of the doctors offices did not document it as given on the vaccination record (for instance typically the TDAP and polio are given together as Kinrix BUT the physicians were only checking off TDAP on the immunization record that was handed into the school). So I sent letters home to all the parents who's kids were missing the vaccine, this resulted in them calling the doctors offices who would look and say 'oh no your child is definitely up to date"...then parent would call the school and say "the doctor said their up to date"...well thats not good enough we still need documentation. The local physicians office was not happy with us (the nurse would get snippy with me until I finally called her out on it by saying "whats one of the first rules in nursing school? If its wasn't charted it wasn't done"...that shut her up)

Do you have access to your state vaccine website? I received access and certain doctors office and hospitals use it as a database. It might be a super easy way for you to check and see if the student really did receive all the vaccines required. But yeah so we send a letter home (physically mail it instead of sending it home in the childs backpack). Then we do a phone call to followup. Then the child is excluded until complete (and some parents still send them to school and I am stuck 'babysitting' until the end of the day).

Specializes in School health, Maternal-Newborn.

I caught one of these phone calls, senior needing meningitis shot. I knew the mom, thankfully, I knew the pediatrician's habits as well. However I can clearly see where this could get ugly. The shot is needed for the survey but we have a pedi saying No, not until next year, sorry.

I have no idea how the story ended, but I'm sure it was....interesting.

+ Add a Comment