Sending Home Any Covid Sx?

Posted
by schoolnurse1118 schoolnurse1118 (New) New Nurse

Do you plan on sending every kid home with even just one Covid symptom? Our school nurses in the area have been telling me that’s their plan. I would be sending SO many kids home. With allergies and flu season, everyone will be affected pretty much! The list of symptoms is so long and so similar to multiple other illnesses

I wish covid was more obvious....why can’t you get a purple tongue with it?!

SaltineQueen

SaltineQueen

Specializes in School Nurse, past Med Surge. 913 Posts

We are told that one sx is enough to send someone home. BUT we have also been told that we can use some judgement. So my plan is to try to make a quick 10-ish minute decision, especially if it’s a kid we know has a history of being a FF or allergies or something. But, yes...I think there will be more kids sent home than normal. Especially early on in the year. On the flip side of that though I worry about the burden that will put on families going back & forth to the doctor for an alternative dx note or lost work type issues. This year is going to be so hard.

nursetlm

nursetlm, ADN

Has 10 years experience. 171 Posts

Agreed- will be difficult at first.

Keeperofbandages

Keeperofbandages, LPN

Specializes in School Health. Has 8 years experience. 129 Posts

My admin and I agreed upon any sx of COVID they go home and must be sx free for 10 days and fever free without meds for 3 days before returning on campus. This was based off the recommendations of our health department.

JenTheSchoolRN, BSN, RN

Specializes in School nursing. 3,021 Posts

3 minutes ago, Keeperofbandages said:

My admin and I agreed upon any sx of COVID they go home and must be sx free for 10 days and fever free without meds for 3 days before returning on campus. This was based off the recommendations of our health department.

In my state, they must be tested and can return if negative and no symptoms for 24 hours without the use of meds. If they choose not to test, 14 days at home before return, unless there is a doctor's visit stating it was medically determined that a test was not needed.

I'm mulling over if we take it any further in our school; I have another discussion scheduled with my school physician next week.

Keeperofbandages

Keeperofbandages, LPN

Specializes in School Health. Has 8 years experience. 129 Posts

23 hours ago, JenTheSchoolRN said:

In my state, they must be tested and can return if negative and no symptoms for 24 hours without the use of meds. If they choose not to test, 14 days at home before return, unless there is a doctor's visit stating it was medically determined that a test was not needed.

I'm mulling over if we take it any further in our school; I have another discussion scheduled with my school physician next week.

We have no school physician and my administration at my school chose to follow what our district is basically doing ( I work in a charter school)

Jedrnurse, BSN, RN

Specializes in school nurse. Has 30 years experience. 2,776 Posts

On 7/29/2020 at 8:44 AM, Keeperofbandages said:

My admin and I agreed upon any sx of COVID they go home and must be sx free for 10 days and fever free without meds for 3 days before returning on campus. This was based off the recommendations of our health department.

I don't get the lack of any testing in this equation. As previously mentioned the list of potential sx has expanded enough to include almost ANYTHING up to and including pregnancy.

Has common sense left the building, or did it ever reside there at all...?

schoolnurse1118

schoolnurse1118

7 Posts

On 7/29/2020 at 8:44 AM, Keeperofbandages said:

My admin and I agreed upon any sx of COVID they go home and must be sx free for 10 days and fever free without meds for 3 days before returning on campus. This was based off the recommendations of our health department.

Our health dept is saying the same thing lately.

Seriously though, if a kid has a cough and congestion they’re going home and not returning until they’ve been 10 days symptomatic? Then they return to school and allergies hit or flu season and I’m sending them home again......

nursetlm

nursetlm, ADN

Has 10 years experience. 171 Posts

Yep- I’m thinking this is going to be a s**t show. Forgive me, but hard to think positive when I can only envision the parents who will be upset (understandably) when their child has a common cold or other s/s that may or may not be COVID- but has to be picked up and possibly miss so much school. Testing for COVID is hard to come by where we are (small town) and expensive for many.

JenTheSchoolRN, BSN, RN

Specializes in School nursing. 3,021 Posts

On 7/30/2020 at 8:14 AM, Keeperofbandages said:

We have no school physician and my administration at my school chose to follow what our district is basically doing ( I work in a charter school)

I'm at a charter as well. But we do have a school physician (that I championed for a few years ago - I realize how lucky I am that my school listens and respects my medical knowledge and position).

The MA state guidance has thankfully included the following:

"Students/staff should stay if they have any of the symptoms listed:

  • Fever (100.4 degrees of higher), chills, or shaking chills
  • Cough (not due to other known cause, such as chronic cough)
  • Difficulty breathing or shortness of breath
  • New loss of taste or smell
  • Sore throat
  • Headache when in combination with other symptoms
  • Muscle aches or body aches
  • Nausea, vomiting, or diarrhea
  • Fatigue when in combination with other symptoms
  • Nasal congestion or runny nose (not due to other known causes, such as allergies) when in combination with other symptoms"

The "when in combination with other symptoms" is helpful to a degree. And in my contact tracing, I didn't come across anyone with just one the three symptoms they list above and nothing else. However, the sudden loss or taste and smell? BIG time. That one and I just go YEP. Get tested. It was most common in younger folks I worked with.

Cas1in72

Cas1in72

Specializes in school nursing/ maternal/child hospital based. Has 28 years experience. 186 Posts

On 7/31/2020 at 10:11 AM, Jedrnurse said:

I don't get the lack of any testing in this equation. As previously mentioned the list of potential sx has expanded enough to include almost ANYTHING up to and including pregnancy.

Has common sense left the building, or did it ever reside there at all...?

I feel this comment so deeply! Its going to be a very challenging year. Wish there was a symptom that screams "Hey its Covid" but thats not happening. I am all for sending kids home with just 1 symptom, I don't see how we can do it any other way. I've been working with Covid patients this Summer, KIDS DO NO PRESENT like adults. I keep telling people this and feel like Im beating my head against a wall. I even heard from my admin that we " cant send everyone home" UMMMMM until we don't and that runny nose and red eyes turn out to be a COVID case and I sent them back to class. The parents and teachers will flip- rightly so!

This is causing me some pretty funky nightmares, we have 2 weeks to go until school starts, Im hoping we go online. Numbers here continue to climb and other school are opting for online only until October.

Thinking of you all and cant say enough how much I appreciate this forum and support we all have for one another.

MUCH LOVE!

JenTheSchoolRN, BSN, RN

Specializes in School nursing. 3,021 Posts

17 hours ago, Cas1in72 said:

I feel this comment so deeply! Its going to be a very challenging year. Wish there was a symptom that screams "Hey its Covid" but thats not happening. I am all for sending kids home with just 1 symptom, I don't see how we can do it any other way. I've been working with Covid patients this Summer, KIDS DO NO PRESENT like adults. I keep telling people this and feel like Im beating my head against a wall. I even heard from my admin that we " cant send everyone home" UMMMMM until we don't and that runny nose and red eyes turn out to be a COVID case and I sent them back to class. The parents and teachers will flip- rightly so!

This is causing me some pretty funky nightmares, we have 2 weeks to go until school starts, Im hoping we go online. Numbers here continue to climb and other school are opting for online only until October.

Thinking of you all and cant say enough how much I appreciate this forum and support we all have for one another.

MUCH LOVE!

I'll be sending home a kid with just one symptom. And in my state, they have to get testes, be negative, and symptom free (without aid of fever reducing medication) for 24 hours.

If they don't get tested, 14 days. No if, ands, or butts there. I explained this to my admin and we have built a plan that if the student is well enough, they will flip into our remote cohort during quarantine period.

We are also going to drop $$$ on a pre-screening tool. It won't be perfect, but I can see who didn't do it, pull those kids/staff, screen them right there. My focus and goal is really this: be the gatekeeper of your health. I work with kids in grades 5-12, though. I can perhaps actually get truth and some ownership out of HS kids. But I can also get lies, so it goes both ways....