Teachers and Staff Want To Be Taken Care Of

Cattz, ADN · May 16, 2023

I am so sorry, this is a difficult spot to be in. Can you explain a little more about how agency nursing works in the school setting? Do you go by the policies and procedures of the agency only? You are employed and paid by the agency?

k1p1ssk, BSN, RN · May 16, 2023

I'm not an agency nurse, but as a school nurse employed by my district, I often face similar challenges. Staff often see us as an easy way to get advice without going through the more appropriate channels. They see how we operate with students (assessing, treating, and making judgement calls) and feel we should do the same for them. I find that it's best to be consistent with everyone and remind them I am not a doctor, so I cannot diagnose them. I tell them they need to see their own doctor if it is anything more complicated than a bug bite or a papercut. I also like to throw in there that I am a PEDIATRIC nurse and so, adult health care is not my area of expertise. If someone asks me nicely, I will happily do a blood pressure/VS - as long as it doesn't interfere with student care.

With all that said, my #1 pet peeve is when teachers come in and ask me to check their temperatures or ask if they should go home due to their symptoms. It annoys me to no end because these are the same people who often complain that sick kids are sent to school too often, and yet here you are, puking in the staff bathroom, or coughing up a lung, and you are wondering if you should go home? I've often thought about setting up a "self-serve" health station in the staff room with an automatic BP cuff, cheap-o thermometer, bandaids and cough drops.

NursePals · May 16, 2023

As k1p1ssk said, it's an impossible situation. I try to think of it like this... I am here for the staff for emergency events only. I am not an Urgent Care. I don't have access to pertinent health information like I do the students. My training and experience are with pediatric populations and not adults. For non-emergency situations, I am happy to take a quick temp but that's really about it unless it's a staff member who goes above and beyond to help us nurses. I never give advice and refer them to their PCP.

jonnysangel777, LPN, LVN · May 16, 2023

Wow, I don't have any teachers who come to the office like you mentioned above. I have had a teacher come in after being bitten by a black widow and I provided general first aid and then sent him to the ER/Urgent care to be seen. I have had a counselor that had a cabinet fall on her head and she started bleeding so we called 911 and EMS assessed her and she declined to be taken to the ER so they recommended she go as soon as she can. I also had a staff member report at the end of the school day that she had fallen the previous night and hit her head and she was reporting she didn't feel good. I assessed her symptoms because she was showing signs of a concussion, and I recommended she be taken to the ER. Another staff member took her and turns out she did have a concussion. Pretty much the only thing teachers ask for are band aids.

k1p1ssk, BSN, RN · May 17, 2023

jonnysangel777 said:

Wow, I don't have any teachers who come to the office like you mentioned above. I have had a teacher come in after being bitten by a black widow and I provided general first aid and then sent him to the ER/Urgent care to be seen. I have had a counselor that had a cabinet fall on her head and she started bleeding so we called 911 and EMS assessed her and she declined to be taken to the ER so they recommended she go as soon as she can. I also had a staff member report at the end of the school day that she had fallen the previous night and hit her head and she was reporting she didn't feel good. I assessed her symptoms because she was showing signs of a concussion, and I recommended she be taken to the ER. Another staff member took her and turns out she did have a concussion. Pretty much the only thing teachers ask for are band aids.

I wish this was the case at my school. I get asked nearly daily for ibuprofen, tylenol, tums, menstrual products, vital signs checks, mole checks, questions about bowel habits, you name it. It is often the same people over and over again and they just can't seem to understand that I am not a concierge nurse. I've been interrupted while dealing with an actively puking child for some of these menial things. I really wish I could come up with a professional way to remind them that they are adults and if they worked in just about ANY other setting (even some other schools) that they would not have access to a nurse AT ALL and so the fact that there is a health care professional in the building is a PRIVILEGE and they should not take us for granted.

Tocino · May 17, 2023

Cattz said:

I am so sorry, this is a difficult spot to be in. Can you explain a little more about how agency nursing works in the school setting? Do you go by the policies and procedures of the agency only? You are employed and paid by the agency?

Thank you. Sure, with agency we have less attachment to schools since agency can pull out us anytime unless I really like the school or admin likes my job (I'm not so sure now LOL).

I was informed by my agency that I have to follow dept of health's policy and procedure, if anything medical I can call the agency nursing supervisor if anything related to admin or paper works I have to call the DOH nursing supervisor.

Yes, I am employed and paid by agency, they pay more but no pto, no health insurance or benefits. I will apply directly to DOH once I have more experience.

I greatly appreciate your reply.

Tocino · May 17, 2023

k1p1ssk said:

I've often thought about setting up a "self-serve" health station in the staff room with an automatic BP cuff, cheap-o thermometer, bandaids and cough drops.

Thank you for your insight! I really love this idea!

Tocino · May 17, 2023

k1p1ssk said:

I wish this was the case at my school. I get asked nearly daily for ibuprofen, tylenol, tums, menstrual products, vital signs checks, mole checks, questions about bowel habits, you name it. It is often the same people over and over again and they just can't seem to understand that I am not a concierge nurse. I've been interrupted while dealing with an actively puking child for some of these menial things. I really wish I could come up with a professional way to remind them that they are adults and if they worked in just about ANY other setting (even some other schools) that they would not have access to a nurse AT ALL and so the fact that there is a health care professional in the building is a PRIVILEGE and they should not take us for granted.

This! A kitchen staff asked me for a tums and I said I don't have anything and I'm here for the students only and I was transferred to her supervisor claiming "So you said that you're here for the students only? I've been working here for 25 years and it's the first time I heard this". Maybe I'm too straight forward...

beachynurse, ASN, BSN · May 17, 2023

We are here primarily for the students. but we also do check out the staff, if we have time. It's students first here. If my clinic is busy, and a staff member comes in for a BP check, they have to come back later, or go somewhere after work. I do have 1 staff member that will sit and wait, and keep asking when it will be her turn. I usually have to ask her to leave, and tell her to come back later. This year, I've had a staff member have a stroke, an anaphyllactic reaction, and a few minor injuries. I do have a few resident hypochondriacs which takes up quite a bit of time. I have 1 teacher that I think would live in the clinic. The current illness that she is concerned about is a brain tumor. I keep telling her to go see her MD, because I certainly can't diagnose, or even help her with that. Every so often I have to go to an administrator for her, and it's getting close now.....

I help with Workers Compensation injuries', and the paperwork involved. Now, that's a lot of work.

LikeTheDeadSea, MSN, RN · May 17, 2023

I had a similar sounding year after some staff shuffling where I got a new building assignment. Halfway through the year I had "had it up to here" with staff complaints and visits that were not necessary. I ran a report of visit amounts and at the next staff meeting very briefly stated the amount of staff visits that have occurred so far that year, and I mention that when my nurse hat is on, I'm required to chart what I'm doing, so even a quick papercut becomes a much more detailed and time consuming task than most would assume. Most were surprised that there was a paper trail of how many times they swung into the office that could be referenced.

I also bring up that my budget for the year is less than $3 a child, so coming in to use over the counters regularly is taking directly from my supplies. Budgets are something staff understand. I've said - once I'm out, I'm out. I don't mind helping if you're starting with a migraine and left your purse at home on accident, but regular usage absolutely can't happen.

Our procedures actually state that more than 10 med administrations requires a private doctor's note instead of the standing orders. I would lean into that way of thinking, too. As a nurse, I can't in good faith of my license give you medication for reoccurring complaints without a private physician's order to show that this is the prescribed treatment plan.

jonnysangel777, LPN, LVN · May 17, 2023

I think what needs to happen is that for staff who have certain conditions and who need medication during the school day, they need to fill out the same form the students fill out for medication administration in school with a Drs order and signature. Also, staff as well as the administrator need to know that school nurses can assess but we cannot diagnose, and that we can provide basic first aid, as well as CPR. The health office is not a doctor's office, that needs to be made clear at the start of the year. The district office also needs to get involved and make it clear to staff and administration.