Reducing visits to the nurse

  1. I am currently a first year school nurse at two elementary schools. Both schools have approx. the same number of students. One of my schools averages twice the number of visits as the other. I need ideas of how to reduce unneeded visits to office. Students are missing quite a bit of time sitting in my office waiting their turn in line to see me - only to be sent back to class after I assess them. Thanks!
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    About alexis98

    Joined: Mar '09; Posts: 2


  3. by   Flare
    How many of the visits are not necessary? Sounds like most of them. Have a meeting with your principal and discuss establishing some guidelines that make it necessary for students to leave emergently for a visit to the health office vs. visit during a free period or less academic time vs. not needing a visit at all. If you paint the picture as trying to maximize academic performance and lessen time out of class it will be better received than you stating that you feel like you are too busy.
  4. by   mmmiller
    Talking to the student's teachers can be helpful too. I had two fourth graders that came to my office at least twice a day for a while. After the second week of that, I talked to the teacher and said how many times I had seen these students that month alone and the teacher was shocked! She had no idea the students were going that often, and definitely was not giving permission for them to see me that often. We set up a pass system for these two students, so if they came to my office without a note from the teacher and did not have an emergency, they got sent back to class immediately. That definitely has helped!
  5. by   rmbt418

    I am a school nurse at a middle school of 250 kids.

    My two strategies are as follows:

    Once a month (or as needed) I send a "frequent flier" lists via email to all staff, administrative and teachers.

    This list is those who come in frequently and are usually non-needed visits. These students are the ones who usually and frequently miss class to come to the nursing office for a non-need. This way, everyone in the building is aware of the issue and assist me in keeping the kids in class.

    I usually ask that if any adult is unsure (on any level) if a visit is truly needed to please call me at the health office and I will assess if a visit is truly needed. Often, the student is simply trying to get out of class (happens frequently in middle school). Of course each situation is different and we handle each visit as such.

    I have reduced my non-needed visits by half since starting these emails.

    The teachers can (if appropriate) relay the frequent visits= reduced class time= lower grades to mom and dad as well. Often, if the parents are aware of the issue, it is enough to at least reduce the issue. I do call parents as well, but only if I am unsuccessful at getting through to the kids myself.

    The second tactic is to use the story of "The Boy Who Cried Wolf".
    I sit with each student, one on one, and have them read the story. After reading the story, the student tells me the story in their own words. Then, we as a joint effort, talk about the story as it relates to that student and their current behavior. I let them know that they are causing "care fatigue" in me (to them) and that when they truly do need me, I will not take them seriously. This has worked about 90% of the time. The trick is to take each case individually. It has worked well for me.

    As a plus for the kids, they stay in class more which usually also improves their grades as well.

    The teachers have been very pleased with both tactic so far!!
  6. by   caregiver1977
    I am an assistant in a 1st grade class. We have every child's medical sheet on file in the class. We also have a first aide kit that contains bandaids, anti-itch cremes, antiseptics, etc. We use those things as needed, and since we have the medical sheets, we know who is allergic to what.

    If it is stomach pains, then I will have the child to go to the bathroom first.

    We send very few students to the nurse, but I don't know if what we do in my room is possible in a room that does not have two adults.
  7. by   autumnmom
    I just had a student sent to me because his shoes were tied together in a knot. I guess you need a nursing degree not a teaching degree to get out a knot. **
  8. by   NutmeggeRN
    I will address it with the kid to start....I use MMS (Modular Managemnt System) where I can access their schedule, attendace etc. I will will look for patterns and tell the student I am here for them but they need to come at the beginning or near the end of the class and not smack in the middle! or during a study hsll vs academic time. Sometimes a great conversation somes out of that, sometimes not. i will also cal the parent to advise that I am concerend that I am seeing their child so frequently..."Am I unaware fo something?".... a heads up tp mom and dad is often the cure! f not then I will talk to guidance, sometimes things are going on at home that I am not privy to.
  9. by   NutmeggeRN
    I also type better when I am not so tired...forgot grammar and spell check, my apologies!
  10. by   Tina, RN
    Quote from autumnmom
    I just had a student sent to me because his shoes were tied together in a knot. I guess you need a nursing degree not a teaching degree to get out a knot. **
    I got this same scenario once!!! The knots were insane.

    Another time, a little girl was sent to me because her plastic headband snapped in half. I had to ask the girl twice, because I couldn't believe my ears. But, indeed, the teacher sent her to me to "fix it". *sigh*
  11. by   NutmeggeRN
    That's because we can fix torn clothing ( I have a thread and needle and duct tape).

    Re dress them when their skirt and shorts are higher than than their naval!

    Have an un-ending supply of crackers.

    Know that peanut butter will take gum out of hair.

    Because we also know that when a kid who has corn rows manages to break a plate glass window with their head, the best way to get the glass shards out are with an industrial vaccuum cleaner.

    We also know that Fantastic will get a stuck ring off a hand....

    Need I go on?

    We are frickin' awesome!!!!!!!

    For those of us who are on vacation! Cheers!
  12. by   SchoolNurseTXstyle
    WE ARE freaking awesome! Can you imagine those banana heads being able to critically think through anything? Funny thing is, nobody ever asked to see my nursing license when buying safety pins!
  13. by   Nurse ABC
    All the above plus keep track of all the kids for a couple weeks or a month and which teachers sent them. It's interesting how some teacher send very few while other send tons. Then share that info with the teacher and ask why they send so many more and explain how you're concerned how much class time their students are missing. Maybe they are afraid to not send any student that asks for fear of being sued-that's a common one. Then you can explain what is serious and what is not, give them bandaids, etc and work with them. Also share that with the principal. Also explain to the staff your guidelines for sending kids home so they can explain to their students that they don't go home for vague complaints like a stomachache, that they have to be running a fever, verified vomiting, diarrhea, etc. We did that in one of our schools and it made a big difference because the teachers could just tell their kids it's policy-sorry and you've already been checked so quit complaining. Also get to know the teachers and develop a relationship with them because then they will be more willing to work with you.
  14. by   SchoolNurseHolistic
    You're allowed to put peanut butter on your kids?! Our 100 acre campus is nut-free. No employees can even bring nuts in their own lunches.