1st day questions

SWimbish, BSN, RN · Jan 21, 2017

Following...I start as a new middle school, school nurse 2/13

Eleven011 · Jan 21, 2017

This is only my 2nd year as a school nurse, but I'll answer as best I can!

1. Each day and each kid is different but I have let kids stay longer than a few minutes if they seem to need it. I've let kinders take a 1/2 hour nap. If I have a chatty kid in, I'll usually engage him and ask lots of questions for about 5 minutes and then say "well it looks like you can probably make it though the day, why don't you go try class now" and 99% of them skip on out back to class.

2. NO, absolutely NOT! Kids are not allowed in my med cupboard or even to touch their own med bottles. I am responsible for those meds from the moment they come into my office and I will be the one to give them.

3. Again NO! I chart visits as they happen, and if I get really busy, I'll make notes and chart when it slows down. I will chart as the kids rest on the couch. It is usually quite at the end of the day, and I can get caught up if I'm behind. My computer records the time I input information and I'm sure it would be frowned upon if It was noticed that I was accessing private information from home and while I wasn't working.

Hope this helps and good luck!

GmaPearl BSN RN · Jan 22, 2017

#1. My job is to make sure the child is doing his job and that is his behind in the seat in the classroom. If he is sick, then he needs to be at home. If there is a social or emotional issue that is different and can take different amounts of time to deal with. Sleepâ€¦ unless it is a very special circumstance at home preventing the child from sleeping at night or a TBI recovery kid, they sleep at home. Power naps in special cases can last 30 minutesâ€¦ if they are not into the rest mode, then back to class.

#2. NO NO NO No student goes into the med cabinet, supervised or not. Period!!! Sheesh.

#3 NO charting at home! Get the visitors, chatters, and class avoiders OUT of the health room and do your charting during work hours.

If it has been a totally crazy day and you can not stay 15 min late to finish, then chart the next morning from your notes.

Best wishes as you begin a totally awesome job!

JenTheSchoolRN, BSN, RN · Jan 23, 2017

I deal with the older ones, so you better be pretty sick or in an emotional crisis (I handle a lot of counseling overflow if our counselor is already handling another crisis) to be in my office for an hour. Even the rare very fatigued kids that I let rest get 20-30 minutes tops. I don't have the space or the time.

I was told I was way meaner than the previous nurse by my middle school kiddos because I want them to return to class. I took it a compliment .

I stay late to chart more often than I wish (and I try to keep up, so really it is adding additional details because I have charted the ins and outs and medication administration), but I can usually get it done with a solid half-hour of no interruption after school. I was super slow at documentation when I started. Now I'm a speed demon and figured out how to create drop-downs in my EMR for the basis visits, etc. You'll get there, I promise!

Oh, and the only meds I let my older kids (I deal with the MS/HS crowd) get on their own in their inhalers which are in a show organizer on the wall and within my direct eye line. Everything else is in my locked cabinet and goes through me.

grammy1 · Jan 23, 2017

I've been in a jr. high school for 13 years. They will come in tired (most likely because they were up playing video games late into the night). Our motto is, you play, you pay. No coming into the clinic to sleep because you're tired, unless there is an underlying condition.

I have NEVER allowed a student into the med drawers. One of our daily med students tried to get his own one day, never tried that again! We encourage all students with inhalers and epi-pens to carry them with them (with physician consent). 95% of ours do.

I have only charted from home once, because it was an insane day and due to an emergency I was going to be out the next few days, it was the only way to get it done. We start an hour before the students, so I get a lot of my charting done then. It goes very quickly when there are no interruptions.

I really hope you love your new job!

Amethya · Jan 23, 2017

1) Only if they need a few extra minutes or if it's something extreme.

2) Charting? I do it when the child is here. All I do is bring up their profile, and type in what's going on.

3) I do it myself, but if the kid can do it, I'll let them take the reigns. It's the older kids I'm confident about, but the smaller kids? You do it yourself.

tining, BSN, RN · Jan 23, 2017

If she was this permissive with students, I am sure parents & teachers got away with things too. Good luck, set boundaries, all will soon bend to the new regime!

AdobeRN · Jan 23, 2017

1. Only rare occasions do I allow a child to sleep in the clinic - so no to naps. I will allow them to "rest" for 10 minutes - I have a little egg timer I set if I am having a busy day, I will tell the kid head on back to class when the timer goes off. Most of the time the kids get bored and leave sooner. When kids come in my office to rest - I do not allow them to read or do any activities (Ipad stuff) either - if they are able to do those things they can be in class doing their work.

2. Kids are not allowed in my med cabinet. I will hand them their meds, inhalers etc. Last year I had 6 5th grader asthmatics that would routinely come in before recess and/or PE - I laid their inhalers out on the counter for them to grab and administer quickly but other than that, the kids do not get their own meds.

3. I don't do any work related things from home or my off time. My charting gets done as I go thru the day, I don't think I have ever had to stay to finish up charting at the end of the day. We chart in Eschool - so I have a basic drop down menu to pick the complaint, interventions & outcome - there is a space for writing detailed notes if needed. But when kids come in for minor things like abrasions, pencil sticks, nosebleeds, routine meds, etc - I don't write a detailed notes on them, I just pick from the drop down choices and move on.

nursetlm, ADN · Jan 23, 2017

No, no and no.

MrNurse(x2), ADN · Jan 23, 2017

#1 My average visit, through my daily log, is 3 minutes, unless it is a head injury or vomiting. My concern is to fix 'em and get 'em back in the fight.

#2 The meds in that cabinet are my responsibility, that they have the correct count, the correct dose and the other 4 rights. I don't allow adults access, no way kids.

#3 I do all documentation real time, or as close to it as possible. Best practice, period

Sorry that she set a poor example for some things, but now you can make it yours.

NutmeggeRN, BSN · Jan 23, 2017

Hey everyone!

1. Letting kids stay for over 15 minutes.

Sometimes they need more time, you will figure out pretty quickly who abuses that.

2. Letting the littles into the med cabinet unsupervised.

Nope, Nada, Never.

3. Charting at home

With Google docs there are some things I can do at home, but just because I can doesn't mean I will!