Jump to content

The rules apply...until they don't...

School Article   (2,279 Views 26 Replies 1,054 Words)
by NutmeggeRN NutmeggeRN, BSN (Member) Member Nurse

NutmeggeRN has 25 years experience as a BSN and specializes in kids.

2 Followers; 6 Articles; 42,935 Profile Views; 3,886 Posts

What are Some Frustrations Endured by School Nurses?

A quick synopsis of some of my frustrations in dealting with rules and those who choose not to abide them.

The rules apply...until they don't...

Over the past number years, I have encountered an increasing flaunting of policy and rules, both by kids and parents. What changes in school district policy when they move from middle school to high school? Nothing. In my world. In theirs, lots of things!

Cellphones ...

Cellphones are ubiquitous. Even elementary school kids can maneuver a smart phone. This is really mostly since 9/11 and the explosion of technology. But kids have been in public schools for at the very least 150 years, when Massachusetts passed the first laws requiring kids to attend schools. When I started working in public school in 1994, (and having attended public school since 1965), parents were always able to contact the school to get information to a student re pick up., drop off etc. Today kids self-dismiss themselves EVERY SINGLE DAY. They have a little cellular device in their hand they use to bypass the health office and just call for permission to leave. Sometimes they are not sick and sometimes they are. I don’t want them here if they are sick, but I think we would all agree, it is important for the nurse to have an idea about what germs might be floating in the building. Kids seems shocked that I would need to know their business. Parents have emboldened them, for sure. “You just call me, and I’ll come right there and get you!”

There are times when a kid really should see a counselor or an administrator if things are going down. Running away is not the only answer. If there is something contagious going on, it would behoove all of us if I knew about it. I need to have current knowledge of health issues and be able to explain to the next parent that calls looking for info what is actually going on in the building. Like the mom of a kid who has no immune system, They are VERY interested in knowing if there is any influenza in building. Or Measles. Or strep throat. It is important that I be able to assess them. It can actually be an advantage to the child and family when all of a sudden they are missing too much school. I can review my notes and see what my assessment was, as to whether or not they should be in school. I can help them if they are at a precipitous number of days out. Or help them get through the day with a little TLC, or antacids or headache medication.

 But not if they are told to “Just call me and I’ll get you”.

The Necessary Forms ...

Students need inhalers and Epi pens and our state and local law allow (as they should) for the students who can, to carry them on their person. Awesome! They eat something with peanuts, they can take care of any reaction almost immediately. The start wheezing when their asthma is exacerbated by dust in the shop area. Yes! Poof! 2 puffs of their MDI and they are feeling much better. But there are rules around this. The rules include an ANNUAL medication form and asthma action plan. The very same form they needed in 1st grade, or middle school, is the same form they need in high school. Why is it so hard for parents to understand that? They are emailed in the spring with the form attached, asking they be taken care of over the summer. I will even fax the form with the parent signature to the MD, if the child is current and not in need of a visit, to make it easier (on the parent, not me). What changes for the parent that these forms are no longer of any importance? Why is the annual contact information form so difficult to fill out and give back to the child? Why do I have to connect with the child 5, 6 or 7 times? Why is the form ignored when mailed home with a return self-addressed stamped envelope???? Just do it!

Injuries and Policies ...

And the last of this article is when parents, adults who are entrusted to protect their OWN children, work really hard to bypass a policy in favor of a game. Yep, I’m talking concussions here. Your child was observed when they got hit.  They came off the field and were clearly showing signs of a mTBI, because that is in fact, what a concussion is, a mild traumatic brain injury. It is not just getting their bell rung. There is a reason why kids should NOT be retaking any repeat neurocognitive testing while they are still symptomatic, ya know? They need to rest their head for a bit to allow it to heal.

But, wait!! The next game is Homecoming, or a tournament game or the big D1 scouts are going to be there…That is when parents (mostly) and kids lose their absolute minds. I think coaches are better than they used be...but there is still room for improvement. Parents, who, in a normal conversation about kids and concussions, totally support the school policy (which is based on evidenced based state and national policy).

Until THEIR kiddo is affected. That is when head pain is caused by lack of water or food, fatigue, allergies, you name it, because it couldn’t possibly be linked to the field hockey ball that hit them in the head, could it? Or the head to head contact with another player followed by their head hitting the almost frozen ground. All of this witnessed by the athletic trainer. Nah... And when the policy CLEARLY reads that the clearance to return will release them back to the Return-to-Play process, but it really means full contact on the field, right? It means they should not be observed while gradually increasing their physical activity to see if they if they have recurrence of their symptoms, right? All in the name of keeping their child from pouting and being unhappy. The policy is in place to protect the child. And secondarily, the school district.

I could go on, but this has been the start of my school year. Chasing Kids. Chasing Paperwork. Chasing Common Sense.

NutmeggeRN BSN, High School Nurse; Specialty: KIDS!

2 Followers; 6 Articles; 42,935 Profile Views; 3,886 Posts

Share this post


Link to post
Share on other sites

JenTheSchoolRN is a BSN, RN and specializes in School nursing.

2,537 Posts; 23,929 Profile Views

Cellphones are the WORST.

My school bans their use but since every student has a laptop, a new loophole for self-dismissal has happened: I'll email home and ask to be picked up. Without seeing the nurse. 

Our dean is on it to follow-up with discipline (self dismissal is not allowed) but lunchtime detention doesn't stop them. 

Also, now cell phone use is allowed during lunch. The texts and parents showing up to pick their kid suddenly after lunch is just growing. 

Also, even if their kid texts/emails, tell them NO, go to the nurse and if the nurse thinks you need to go home, they can call me. 

Share this post


Link to post
Share on other sites

NutmeggeRN has 25 years experience as a BSN and specializes in kids.

2 Followers; 6 Articles; 3,886 Posts; 42,935 Profile Views

1 hour ago, JenTheSchoolRN said:

Cellphones are the WORST.

Also, even if their kid texts/emails, tell them NO, go to the nurse and if the nurse thinks you need to go home, they can call me. 

Yup!! Because if my child says they are sick, of COURSE  they are....🙄

Share this post


Link to post
Share on other sites

1 Follower; 284 Posts; 1,096 Profile Views

It is a battle that we will never win. We have a very tight attendance policy at my school (which parents sign off on but forget!!!). 

If it becomes routine and they start getting the attendance letters - natural consequences! 

 

 

Share this post


Link to post
Share on other sites

Jedrnurse has 25 years experience as a BSN, RN and specializes in school nurse.

1,388 Posts; 13,002 Profile Views

12 minutes ago, EnoughWithTheIce said:

It is a battle that we will never win. We have a very tight attendance policy at my school (which parents sign off on but forget!!!). 

If it becomes routine and they start getting the attendance letters - natural consequences! 

 

 

What are your school's consequences for excessive absenteeism?

Share this post


Link to post
Share on other sites

BiscuitRN has 4 years experience as a BSN, RN.

549 Posts; 2,280 Profile Views

This happens almost every day at my school.  We're a pricey private school and we have kids who miss well over 10% of days.  It boggles my mind.  Why spend so much when you're going to let your kid stay home once a week?  I've never seen any real consequences for excessive absences unless the student's grades fall below passing.

Share this post


Link to post
Share on other sites

1,147 Posts; 9,481 Profile Views

31 minutes ago, Jedrnurse said:

What are your school's consequences for excessive absenteeism?

I am at elementary - so not much.  Parent and/or student may be required to sign an attendance contract that lays out the rules they must follow; I get dragged into the mix and parent may be required to bring a "sick" child to school for me to take their temp or for me to excuse them (I hate this).   Student may be required to sign in daily at front office. 

If it is bad enough and they get sent to court nothing really changes except that the parent may be required to sign in daily.  At the elementary level things are let go easily - the truancy officers have bigger fish to fry at the high school level.  

Share this post


Link to post
Share on other sites

Jedrnurse has 25 years experience as a BSN, RN and specializes in school nurse.

1,388 Posts; 13,002 Profile Views

5 minutes ago, AdobeRN said:

I am at elementary - so not much.  Parent and/or student may be required to sign an attendance contract that lays out the rules they must follow; I get dragged into the mix and parent may be required to bring a "sick" child to school for me to take their temp or for me to excuse them (I hate this).   Student may be required to sign in daily at front office. 

If it is bad enough and they get sent to court nothing really changes except that the parent may be required to sign in daily.  At the elementary level things are let go easily - the truancy officers have bigger fish to fry at the high school level.  

Wow- bringing them in for you to check them?? I'm old school enough that a doctor's note/excuse was the norm...

Share this post


Link to post
Share on other sites

1,147 Posts; 9,481 Profile Views

21 minutes ago, Jedrnurse said:

Wow- bringing them in for you to check them?? I'm old school enough that a doctor's note/excuse was the norm...

sorry - I will go back and change; bring to me if the parent is refusing to go to the doctor and get a note.  

Share this post


Link to post
Share on other sites

Jedrnurse has 25 years experience as a BSN, RN and specializes in school nurse.

1,388 Posts; 13,002 Profile Views

Just now, AdobeRN said:

sorry - I will go back and change; bring to me if the parent is refusing to go to the doctor and get a note.  

Still, a horrible position to put you in...

Share this post


Link to post
Share on other sites

2 Followers; 5 Articles; 4,091 Posts; 34,925 Profile Views

it's always so comforting to know that we all battle the same demons together.  

Share this post


Link to post
Share on other sites

Hoosier_RN has 20 years experience as a MSN and specializes in LTC, home health, hospice, ICU, ER, dialysis.

3 Followers; 1,595 Posts; 3,368 Profile Views

Y'all make me thankful that I'm not a school nurse. I've almost went that path before, but changed my mind at last minute 

Share this post


Link to post
Share on other sites
×