I am extra lucky my district has a pretty awesome orientation so I spent the day working with the nurse who is leaving. But she did a few things that I'm not sure are just common in the world of school nursing or just her way of doing things, so I figured I would check with the wonderful minds on here.
1. Letting kids stay for over 15 minutes.
We did have a few kids that needed the extra time to be cared for (I never knew a child could break out into full body hives from cold weather until today) but most of them just were hanging out because we weren't moving them along. There were three who even got to nap for an hour each. I feel like if they are well enough to tell me about their soccer game, and their vitals are fine, then they can survive their sore throat in class.
2. Letting the littles into the med cabinet unsupervised.
I'm at a k-5, so I get that the 5th graders are a lot more competent in their medication routine...but something about them running behind my back while I'm assessing another person just makes me uncomfortable.
3. Charting at home
She explained how I should just be charting at home so I won't be late picking up my daughter...but I feel like if there wasn't so many bodies just taking up space in the office, I could've finished a lot more. But is charting at home normal?
It's rare that I let the kids linger. Sometimes I'll give them a solid 20 to ice or if I know that they are in a class that I don't think they should be in anyhow like PE or doing recess i may let them spend that time with me. There have also been times that I have been the eyes on / cool down for a student in emotional crisis. This is a whole nuther tale and mostly used because i'm trained to manage it. A lot of times if i can get out of the office with the child and they are calm we take a walk to get a book or some work or something constructive. It's boring to watch me work.
Kids are not allowed into my cabinet. It's under lock and key anyhow. The only thing out and accessible are the epipens.
My charting is done at work. It's web based so there has been an occasional super rare time that i've gotten home and remembered something important that i've forgotten and knew i'd forget so i popped it in from home, but i don't take work home with me.
I agree with all of these responses as well. Except, I will take home my hearing/vision/spinal screenings and enter them in on my own time for a few reasons:
1) I'm only part-time and can only stay for a max of 6 hours a day, 3 days a week.
2) I'm the only person entering this information in for approximately 700+ students and 6 hours a day is not enough time to enter those in on top of my other duties. You throw in traveling the hour drive (one way) to my other two campuses and charting these screenings at work is virtually impossible.
3) This is the ONLY type of charting I do at home, everything else is done in real time, and I enter what I can of my h/v/s at work, when I can.
4) My school provided me a lap top for this reason, among others, so I don't access any student's info on a personal computer.
Welcome to school nursing by the way! Its FANTASTIC here!! Definitely learn as you go but nothing as stressful as the hospital!!!
Specializes in School Nurse, Pediatrics, Surgical.
I work at a 3-12 grade school and at a 9-12 grade school.
My 3-12 (600 kids) grade school no one naps. The kids are highly capable and don't want to miss any time in class. They don't even like to go home when they need to be. My 9-12 (2300 kids) grade school is a completely different story.
We give them 10 minutes mostly but there are special circumstances. we don't allow students in the medicine carts.
I've been moving kids through the office faster and so far I'm having more trouble with the teachers not liking that I am doing so. They send the kids back with notes saying things like "still sick" "did you call mom/dad?" "They aren't acting like themselves".
And I will admit that as the new kid on the block, I don't have a baseline for these little ones. But if they have been in my office three or more times and I spent 99% of that time trying to get them to stop jumping/climbing/rambling/playing the others and are showing no signs of illness...I'm sending them back to class!
Hey everyone--I am still fairly new at this school nursing thing (2 years) and I see that I must have the right idea....I have had to correct a lot of things the old nurse allowed and were expected of me. I'm K-4 and while I sympathize with the "needs a nap" thing, there are some teachers that ask for a student to come in, lay down, want me to dim the lights...I have mostly gotten through to them that I am not a bed and breakfast.
As far as getting into my meds, no way, no day. The inhalers I keep in a shoe organizer on the back of my med closet door but I allow them to get it themselves after notifying me they are in my office. Kindergartners are on the top row where they can't reach for a reason :)
I did chart from home a bit my first week or two, because I had trouble doing real-time charting and keeping up with the demands of my day. I don't do it anymore. My time with my own kids is precious. I walk out at 3:45 with the charting done every day, with rare exceptions for a busy day. We generally have 6 weeks to correct charting.
They send the kids back with notes saying things like "still sick" "did you call mom/dad?" "They aren't acting like themselves".
That sounds like a culture that sends discipline issues to the nurse to calm down to avoid the hassle of writing up. I would do what you are doing, sticking to your guns and changing the culture. If a student comes to me frequently and shows no signs or symptoms that warrant going home, I tell them bluntly that I am calling their parent and explaining that if they choose to come take them home, that will be unexcused. That normally negates the call and stops the visits.
I've been moving kids through the office faster and so far I'm having more trouble with the teachers not liking that I am doing so. They send the kids back with notes saying things like "still sick" "did you call mom/dad?" "They aren't acting like themselves".
And I will admit that as the new kid on the block, I don't have a baseline for these little ones. But if they have been in my office three or more times and I spent 99% of that time trying to get them to stop jumping/climbing/rambling/playing the others and are showing no signs of illness...I'm sending them back to class!
When I get the snarky "still sick" notes from teachers, I usually give them a call to let them know that little Timmy has been bouncing on my cots, giggling, and chatting up everyone that walks in and I see no clinical signs of illness. I love to add "Maybe it's more of an avoidance issue"
Also, please keep in mind that you are not psychic. You will send a kid back to class who will then vomit all over the place and that's okay! It happens, do not let the teachers use that against you. (I have 1 teacher who still mentions that time a kid ended up with pneumonia after Thanksgiving break all because I saw her for a cough and "did nothing" more than a week before break even began)
Had the go back to the nurse thing yesterday. If the symptoms fit we will call parent. If I sent everyone home for sinus pressure headache we would not have anyone left in school. I do a full - this is why you feel bad spiel complete with pictures. Your nose is irritated with something. Your nose makes buggers to get that thing out. When you don't blow your nose the buggers drip down your throat (picture of throat/nose here) and back up into your sinuses (picture of sinuses here). I know you feel miserable, and this may take several days, but it will go away. Blow your nose and drink water - this will not cure you, but hopefully your symptoms will not get worse when you do this.
1. Depends in the kid & depends on the day. You'll learn who really needs a little more TLC & who's BSing you pretty quickly. Pretty much my rule is, no fever gets 10-15 then booted back to class.
Specializes in CVICU, SchoolRN, MICU, PCU/IMU, ED.
What I was told from the beginning was each nurse will run their clinic differently so personally I don't like a lot of kids in here unless they are legit sick. I am not the hang out spot and am a control freak so to say. I come from direct observation so I don't mess around and like control. The previous nurse let the kids run amuck. Nope...not gonna happen.
Kids typically don't stay in here longer than 10 mins unless it's a head injury or vomiting.
Kids are NEVER allowed in my meds. If something happens I'm responsible.
Charting at home...Nope. I don't get paid at home to chart. I'll chart at work where I'm supposed to.
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OldDude
1 Article; 4,787 Posts
Yea!! What they said!!!