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

[Cattz]

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.

[Cattz, ADN]

Perhaps you can find a couple of studies that support your position and give copies to the Admin parent. It won't guarantee that he will keep the child home but you will have made your point.

Haha...funny thing it. It was the Admin. that came to school sick with the fever (and admitted it in an all-staff email!!)

[Cattz, ADN]

Sorry- this just keeps getting better. A new newsletter from the Admin is going home with the kids. This is the last sentence of one of the paragraphs.. "If your child has a temperature, please keep them at home so we do not have germs spreading."

I. Just.....ooooh...never mind...it is FRIDAY !! :)

[RunnerNurse09, 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?

I think the point is that they are 1)trying to mask that their kids are indeed sick and 2) putting a band-aid on the problem.

[RunnerNurse09, BSN, RN]

The kicker is that I actually worked in an emergency department that knowingly allowed one of its nurses to care for patients while ill with a stomach virus. They acutally medicated her with tylenol and zofran so she could work. But apparently due to the tylenol she wasn't contagious...lol

[LessValuableNinja]

Sorry- this just keeps getting better. A new newsletter from the Admin is going home with the kids. This is the last sentence of one of the paragraphs.. "If your child has a temperature, please keep them at home so we do not have germs spreading."

I. Just.....ooooh...never mind...it is FRIDAY !! :)

Please only send your child if they are 0°kelvin.

[blondy2061h, MSN, 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?

Give them the tylenol, then don't send them to school. If your kid requires antipyretics to control their fever they don't belong in school.

[Mini2544, ASN, RN]

I'm not a good person to get advice from because I am passive aggressive and I would give her a full on nursing school lesson on why simply reducing a fever, does not reduce the transmission of any bacterial infection (or viral for that matter) I wouldn't insult her intelligence though, use big words. :)

[Lisa2.0]

I feel your pain....I also work in school health and I can relate to this ongoing ignorance! Sigh.....

[Cattz, ADN]

Interesting article on the subject- Am I the only parent who follow the twenty-four hour rule? - MBA Mom

[Cattz, ADN]

I loved the response from another school nurse to this article. Sometimes it is difficult not to get frustrated when parents send their little ones to school too soon. Life is really complicated. Walking a mile in the parents shoes is hard to comprehend sometimes.......... Here is the response:

I know everyone shares the frustration of a child coming in sick when they should not have-"my mom made me come" is often what they tell me. Then they are throwing up, laying sick in my office, touching everything, and soon the illness is all over the building. Lots of times I cannot reach a parent, they have no transportation, or they simply will not come to pick up the child. Then, I have a few who throw up or say they have thrown up, on a regular basis. Sometimes it is stress, sometimes it is the long bus ride, sometimes just the junk that they eat and drink. I know who these ones are after a while, and though I do notify parents nothing changes. Sometimes there is only so much you can do.

Sadly, we also know that the sick child is spreading infection even before there are symptoms, and after the symptoms are gone. Even 24 hours is not enough for Norovirus.

I sympathize with this parent and wish all parents were the same. At least she is trying! But reality is that people work, people are unable to take off, and often children have such complicated lives that let's face it, we are their only continuity, their only reliable person to count on to act in their best interest.

As you mentioned- we see only one point of view. The nurse is not able to answer from his/her point of view as to what is going on in the building and with other children. And really, it is none of this mother's business anyway.

I only hope that the parents who can keep their kids home when they are sick read the article and realize that they are contributing to the spread of the illness by not nipping it in the bud with their own child. And to the other parents who depend on the school for child care so they can work, I sympathize and I am sorry that this has become our society. I hope I can always try to be patient and understanding when their child is in my office and should be home in bed.