I am in my 1st year of school nursing and truly do love it so far. I read 100's of posts on here to get as many tips from you all that I could (THANK YOU!!) so I don't get in here and start feeling like I can't handle it. So, here's the deal --> I am seeing 35-40 students every single day. It's nuts. Most kids have to come to the health clinic with a buddy so then there's an additional 2 kids with each child that needs my assistance. There are times it's a madhouse in here. I have sent letters to the whole staff telling them things like a lost tooth or paper cut do not need to be sent to the nurse. I made each and every teacher (specials included) their own first aid box with supplies (bandaids, tooth boxes, etc.), but they still send kids that need nothing more than a band aid or a tooth box.
I can (maybe lol) handle the high clinic traffic, but I am expected to have 99% immunization compliance by November 1st and there are days I don't have time to even enter 1. I think the only way I will get them all in is to bring them home and do them there. I'm also nervous about when flu season comes and when it's time to start screenings. With this many students coming to see me every day I'm nervous I am not going to be able to get the "other stuff" done that I am required to do.
Have any of you fought this battle (asking knowing the answer is yes)? How do you deal with it? How do you get everything done while still seeing kids?
What do you do when it's the principal that mandates the teachers send students to the nurse for any and everything. And I mean everything. One student throws paper at another student, the student says, "ow". Teacher says, "Go to the nurse". That's the kind of nonsense I'm dealing with. Loose teeth, paper cuts. old already healed scars, scratches that happened at home however nobody thought it emergent enough to give bandaid, suddenly needs immediate attention at school. It really has me rethinking this whole school nursing thing.
I am a bit late to the party here with a comment, but we have two nurses here (MS, 900 plus students) and last year we saw...brace yourselves...150 students a day. Yowza...the other nurse has been here quite some time and she would put out an entire snack buffet for the kids, she had closets full of clothing, she would let them come in and fix hair and/or make up, she would let them come in and JUST. SIT. AND. TALK. Not a student in crisis who needed counseling, mind you, but just come in and visit.
Well by June I had enough and had come to the conclusion that what I was doing wasn't nursing, so I left the job. Circumstances are such that I find myself long-term subbing in the same school, in the other nurse's position, and the new nurse's mentor came in and absolutely demolished the clothing and shoe stash, and is teaching the new nurse not to feed them, not to give them mints or cough drops or lip balm or bottles of water...we see maybe 30 a day of legit health problems.
And this new nurse is AMAZING and we work well together and I am so so sad that I am but a sub and will have to move on eventually but that is another story for another thread. The point here is, they are like cats. If you offer food and clothing, they will show up in droves. If you just get rid of stuff like clothes and shoes and your answer every time is "I don't have any", they will stop showing up and you can focus on actual nursing.
The teachers are slowly getting the message. Patience.
I can not fathom 150 a day! I can't fathom half of that!!! 30 is my sweet spot (1000 kids HS).
Reasonable Expectations for Self-Care in Classroom:
As the new school year begins, it is a good time to educate the students as to when it is appropriate to come to the nurse’s office. This will help prevent students from misusing their education time by spending it in the nurse’s office for minor complaints.
Our mission is to provide a safe, healthy learning environment in our school and to keep the student in CLASS for optimal learning. All students sent to the nurse’s office MUST have a Nurse Referral Slip filled out with both first and last name, primary complaint and room number. We understand that emergency situations occur where this is not possible, but is the expected daily procedure.
According to the School District Blood Borne Pathogens guidelines, each classroom teacher will be given a Ziploc bag of gloves, band-aids, gauze pads and other items to allow for minor cuts/scrapes to be handled in the classroom. If you are in need of band-aids, gloves, etc please notify the nurse and she will provide them. Each teacher will be informed of students in his/her classroom with chronic health conditions or potential for emergent conditions.
Questions to ask students before sending them to the nurse’s office during class: Have they used the restroom? Hungry? Tired? These are not emergent reasons to see the nurse.
Students should stay in class:
-Approximately the first 45 minutes of instructional time UNLESS they are vomiting, have hit their head, are having breathing issues (including known asthmatics), broken bones, pink eye, loss of consciousness or seizure, lice or bleeding profusely.
-When an old, healed abrasion (scab) is merely sore or itches. This is part of the natural healing process.
-When there is soreness from an old injury. If no bump, bruise, swelling or redness or it is more than 24 hours old- no ice should be given- it will not help at that point.
-If a student has a bandage that was applied by a physician-I am not able to reapply or change it (without doctor’s written orders) I can only reinforce it.
-When a student regularly finds excuses to leave class and rarely has to go or stay home because of illness.
-When a student frequently asks to go to the nurse at the same time of day.
Reasons to call Nurse to site/location for assessment:
-Serious falls/accidents that involve head/neck/spine.
Valid reasons for leaving class and coming to nurse’s office:
-Signs of allergic reaction: Swelling of mouth/lips, hives, vomiting, nausea, hoorificeness, wheezing or abdominal pain.
-Vomiting (not just spitting up phlegm)
-Bleeding (minor scrapes can be handled in the classroom)
-Breathing difficulties (wheezing, shortness of breath)
-Bone/joint injury (I can come to location if needed)
-Undiagnosed rash.
-Splinters- imbedded splinters cannot be removed, but will be cleaned/covered.
-Nosebleed- student should pinch own nose closed with Kleenex, breathe through mouth and walk to clinic.
-Suspected head lice/excessive head scratching.
-Human or animal bite.
**Of course there are always exceptions.
*For students who complain of headache or stomachache, and it is close to their lunch time (these symptoms may indicate thirst or hunger): 1. Give them a drink of water, 2. Have them put their head on desk for a minute or two (if possible) and when time, 3. Have them go to lunch. 4. If they continue to complain after returning from lunch/recess, then the classroom teacher should send them to the nurse’s office.
Sorry it's so long. (tech challenged.) It's geared for the k-3 grades. Hope it helps.
Guidelines for Nurse’s Office
amsolomon
2 Posts
What do you do when it's the principal that mandates the teachers send students to the nurse for any and everything. And I mean everything. One student throws paper at another student, the student says, "ow". Teacher says, "Go to the nurse". That's the kind of nonsense I'm dealing with. Loose teeth, paper cuts. old already healed scars, scratches that happened at home however nobody thought it emergent enough to give bandaid, suddenly needs immediate attention at school. It really has me rethinking this whole school nursing thing.