Thought I had been punked. I. Can't. Make. This. Stuff. Up.

[Cattz, ADN]

So, this is a follow up to the thread last week when I asked for help with wording on a note to go home about parents not sending kids to school after giving them Tylenol/IB to reduce fever and help them feel a little better temporarily. I sent this home last Thursday (to the school I was at that day.) --

Dear Parents-

Over the past few weeks we have had several kids come to school feeling just barely well enough to stay at school. In general, we usually ask them if they had medicine at home that morning. It is very alarming, and happens pretty frequently, that we can determine that they most likely had Tylenol or Ibuprofen. This only reduces their temperature temporarily, but DOES NOT, reduce the risk of passing their illness to others.

We, of course, want students to miss the least amount of school as possible. However, we also know that students best recover from illness at home.

*** For the safety and well-being of students and adults: prior to school, please do not give them fever-reducing medications (Tylenol, Advil/Motrin, or any single ingredient or other combination over the counter cold/allergy medications that contain acetaminophen or ibuprofen.) Students must be fever-free for 24 hours without use of the above medications to attend school.***

Our current outbreak of illnesses cannot be contained without the cooperation of all families.

As a school, we are doing our part in increasing disinfecting of common surfaces, encouraging all to cover coughs/sneezes with elbow, and sending kids home who have a fever over 100*, and are exhibiting symptoms of illness, according to protocol and policy.

If you have any questions or concerns about your child's health, I would love to visit with you.

Sincerely,

---

On Monday of this week - I got a group e-mail from and Admin. in one of my other buildings...explaining that she had a fever of 101., and had come to school...but she wasn't contagious as long as she was taking Tylenol.

---

This is still my expression..... and I am still Speechless. I haven't seen that Admin yet this week. Trying to figure out how to address it in a tactful way. That Admin. is a Dr...but not the kind I most closely identify with.

[tining, BSN, RN]

[BeckyESRN]

Just wow...

[halohg, RN]

Maybe the good Dr. meant to say she was on an antibiotic, not Tylenol. Give the benefit of the doubt and if not my response would be "your an idiot"

[grammy1]

I really shouldn't respond to this, I'm not known for being tactful. I'd just tell her she was wrong, yes she was contagious whether she had tylenol or not. And that is why I should probably not work with the littles.

[OldDude]

It reminds me of the old joke about a farmer buying a mule from another farmer. The "purchaser" brings the mule back and tells the farmer who sold him the mule he could not get the mule to follow commands. The farmer who sold him the mule told him to hit the mule in the head with a 2 X 4. "Why?" the other farmer asked. "You have to get his attention first."

So, I don't think you need to worry about tact but "hit her in the head with a 2 X 4" (figuratively of course) to get her attention before you explain.

[Cattz, ADN]

Maybe the good Dr. meant to say she was on an antibiotic, not Tylenol. Give the benefit of the doubt and if not my response would be "your an idiot"

I too, try to look on the bright side. But, in this case, I promise...it is the latter.

[KeeperOfTheIceRN, ADN]

This scene from The Grinch comes to mind....

[JenTheSchoolRN, BSN, RN]

[foggnm]

Does your school health policy support you telling parents what medicines to give their children before school? Parents should be able to give their kids medicines for pain/fever. I think the temperature is less of the issue than sending sick kids to school. You can have a nasty cold virus with no fever and spread that. While recommending sick people stay home is a great idea, I think hand washing is by far a more important public health suggestion that not taking apap/nsaids. It is also a bit too much micro-managing of parent responsibilities, even if it is well intended. Also, it isn't as if you're going to actively quarantine kids that are sick and returning to school and only allow them in class if they have a temperature check....are you?

[JenTheSchoolRN, BSN, RN]

Does your school health policy support you telling parents what medicines to give their children before school? Parents should be able to give their kids medicines for pain/fever. I think the temperature is less of the issue than sending sick kids to school. You can have a nasty cold virus with no fever and spread that. While recommending sick people stay home is a great idea, I think hand washing is by far a more important public health suggestion that not taking apap/nsaids. It is also a bit too much micro-managing of parent responsibilities, even if it is well intended. Also, it isn't as if you're going to actively quarantine kids that are sick and returning to school and only allow them in class if they have a temperature check....are you?

A child that has a fever over 100 and is medicated with acetaminophen in the morning to reduce it to below 100 is going to be in my office miserable after the acetaminophen wears off. Or even miserable before it does. Which is why I say to parents that if their child is running a temp before medication is given and/or the temp returns after it wears off, please keep them home. Or make a plan to pick them up, which one may be surprised some parents do not have.

I expect parents to have common sense. I sent home a child today 30 minutes into the school day whose parent sent that child to school after they vomited five times at home prior to going to school. Kid was miserable, but said "Mom wanted me to try." Not common sense.

Going to work with a fever over 100 at a workplace where germs can easily spread and thinking acetaminophen magically stops that spread? Not common sense.

[OldDude]

foggnm...I hear what you're saying. As much as I agree hand washing can certainly prevent the spread of illnesses I otherwise completely disagree with you. If not for body temperature what otherwise objective sign of illness would you use to identify someone who is "contagious?" - which is the real target of school nursing. "Sick" is such a subjective term it's not really relevant to the conversation. Otherwise, the nasty cold virus with no fever or the strep with no sore throat and other such examples are exceptions the the norm. Thanks for your post. I do enjoy hearing other points of view.