Teachers not sending passes with kids

[Nurse ABC]

I've been assigned two schools this year that I've never been at. The schools had the same nurse last year and it's the same at both schools. The teachers are sending kids all day without a pass and for stupid little stuff. I wrote a memo asking the teachers to fill out a pass and even provided the pass with checklists. They still aren't doing it. Half the time I can't understand the student's name or they don't know their last name, some don't tell the truth, sometimes i want to write the teacher back,etc. My question is do you think it's ok to send the student back to class for a pass if they come without one? I don't want to create animosity between the teachers and me already but I do want them to know I mean business. Does anyone have any better suggestions? Thanks!

[mc3, ASN, RN]

For the "stupid little stuff", I send the child back with bandaids for the teacher after taking care of their tiny, miniscule cut. Some teachers will send their students up for every-single-little-thing, either because they're scared of the liability (understandable!) or they're tired of listening to them complain I plan to take the opportunity to talk to my faculty at the next staff meeting about general policies of the clinic.... (Fever, vomiting that a teacher sees, diarrhea etc are valid reasons vs. "stupid" reasons ("I got punched in the stomach over the summer and it just started hurting again"). Yes, that happened earlier this week.... I encourage them to use their common sense, and most do. A few don't, and I just deal with it....As far as the passes, you could give them each a small supply to start with and explain that you don't know all 950 children by first and last name yet (), so could they help you out by filling these out? One time, I sent a student (who wasn't ill, and didn't have a note) with a note to the teacher saying ("I don't know who they are, or why they are here") Never had that problem again!

Now, if I could get the teacher to give me a little more info, such as "Johnny was fine all morning until he just decided he wasn't" or "Jane has had her head down all morning and didn't eat lunch" that would really help me!

Ah well, I can always hope...

[aTOMicTom]

Do you guys have to document injuries with pictures? maybe show some papercut pics at the staff meeting, to show what the kids are missing class for...

And yes, I realize paper cuts are painful; in fact, my son, who can play at home while dripping blood, goes to the nurse with every paper cut. It's embarrassing. The nurse (RN-Paramedic) is a personal friend of ours so my son loooves an excuse to go to the nurse and have a little social visit with him, and talk about the latest time he had to run the lights & siren!

there are only seven kids in my son's class... we were worried about the lack of social interaction from this, but I think I like it better than the 950 kids per school scenario...

Sorry to ramble...

Tom

[Nurse ABC]

I don't know about anyone else but we don't document with pictures because that would mean the school district would have to provide a camera to all the schools and that's just not in the budget at this point. We do have to document on each student's health card every single time they see us which is why it's important to be able to know their first and last name. That's also why it's a pain if they come in for an old tiny scratch from a week ago-we are supposed to write all that up which is very time-consuming. That brings up another good discussion-how much do you document? If I get super busy I let some of the minor things like that go. We still write out our health visits longhand and even though it's quick and easy to pull out a card and see how much they've been in, it's a huge pain to handwrite a long narrative. Still wondering if I should send a student back and demand a pass before checking them out...thanks for the advice so far!

[SaoirseRN]

I don't know about anyone else but we don't document with pictures because that would mean the school district would have to provide a camera to all the schools and that's just not in the budget at this point. We do have to document on each student's health card every single time they see us which is why it's important to be able to know their first and last name. That's also why it's a pain if they come in for an old tiny scratch from a week ago-we are supposed to write all that up which is very time-consuming. That brings up another good discussion-how much do you document? If I get super busy I let some of the minor things like that go. We still write out our health visits longhand and even though it's quick and easy to pull out a card and see how much they've been in it's a huge pain to handwrite a long narrative. Still wondering if I should send a student back and demand a pass before checking them out...thanks for the advice so far![/quote']

I am not a school nurse, but I would think explaining it as you need the pass for the children's full names so you can accurately keep records seems like a reasonable explanation, and maybe add that you will start sending students back for their pass if they arrive without one, so that when it happens they can't say they weren't warned.

[JenTheSchoolRN, BSN, RN]

Things like this make me lucky I am at a charter school - no pass, students get a demerit. (Though I do have a few teachers that don't listen to that - they get nurse extra passes in their mailbox when it happens and they are learning). The passes don't always contain the child's full name, but luckily I ask and get it. What ages are you working with?

Part of the back to school orientation for all staff at my school includes a brief discussion of what to send the student to the nurse's office for. I have some teachers that call down with questions before they send a kid on their way. Perhaps there is a meeting or professional day you could ask to have a few minutes at to convey your nursing office visit policies?

I also provide each classroom with a basic first aid kit. It's just a plastic bin filled with gloves, bandaids, gauze, a couple of pads/tampons (only for emergencies - I work at a middle/high school), alcohol wipes and moist towelettes. This cuts down the number of students I see for simple cuts as the teacher just reaches into their kit and hands the kid a bandaid. No class/learning time lost.

[smrslr]

Can she just bring it when needed? We have to have an Asthma Action plan signed by a physician in order to keep inhalers and give neb treatments. If the kid does not have what they need, mom will have to come to school if needed or call an ambulance.

[Nurse ABC]

These schools are pre-k through 5th gr. I will do the bandaid idea. I sent the teachers another note (since it's going to be a month before our next meeting) and explained it as a safety issue and gave them the option of calling or bringing the student in if they really don't want to take the time to write out a pass and it went better today. Thank you for the ideas and advice! I'm open to any new ideas as well!

[Jennifer Campbell]

I'm a school nurse. My sister's a teacher. She told me not to fuss at teachers for not sending the Clinic Pass or filling it out incorrectly. Teachers have 30 kids, behavior problems, learning disabilities, and usually the clinic is not as busy as a classroom. You catch more flies with honey than with vinegar, too. :) I put a small stack of clinic passes, bandaids, gloves, 4x4's in a Ziploc. I put a nice note about how to use the clinic pass, and why we use/need it. I attach a small piece of chocolate and tell them I'm happy to answer health questions and be a resource for them, because I know they have a hard job. If a particular teacher has trouble following our policy/procedure, I may send out a reminder email to her grade level, thanking them for something (find something nice to say) and REMINDING them of something as a group. Good luck!