Parents get me ! Maybe its just my school... but have you ever had kids come to the HR and say this: " My dad said that if I'm not feeling well then go to the HR and he'll pick me up"
Uh duh ! If you already promise your child that you will pick them up if they are not " feeling well" then 9 times outta ten they are going to come to the health room to go home. The bell haven't even rung before this kid was in my office ready to go home because of what dad told him. He had a SA, his temp was a perfect 98.6. No nausea/ vomiting, or diarrhea.
So what I did I do ? I had to call dad obviously, dad didn't answer but I left a message. But I did send him back to class and told him when I hear from dad I'll let you know. The teacher then gets mad, I can hear her talking about me behind my back to the secretaries because " he couldn't wait in the HR".
Do you ever have kids that come to the HR, ready to go home, based on the promises their parents made ?
We have schools around here that only has an LVN. It would be the same here if I quit. They hired me when I was an LVN and would hire another to keep the cost down. You have to make the decision and assessments if you are the one and only.
Just think - here we are discussing RN's vs. LVN's and nursing students. However, at MANY schools across the country, secretaries and TA's are making these decisions. At least LVN's and nursing students have medical training.
Of course, the Nurse Practice Act of the state does trump everything!
I know for my district, when I am not here, there is a written set of instructions for lay persons to follow. Regarding stomachaches, as in the OP, it states that if there is no fever, no n/v/d, then the student may rest up to 20 minutes and return to class. There is always the option to contact the nurse on call if there are any questions, and of course contacting the parent is a judgment call.
If personnel handling illness/injury in schools (be they RN, LVN, student, or layperson) had to call the parent of every child with a complaint and no clinical signs, we would still be making those calls when the kids are already home! We just have to use our best judgment and our BS meter :)
This happens a lot in my school. Sometimes the kids even have a note from the parent stating to call if Johnny is not feeling better. Here they come with the note in their hands at 8:30. I allow the kids to call home themselves and make sure that they tell the parent that the absence is not medically excused because there are not any symptoms. I'm not letting the parent off that easy--This way they still have to face the student.
Specializes in Community Health,Pediatric, School nursi.
I think that any school that are using lay people (including nonlicensed nursing students) to assess student health problems runs a significant liability risk. I would recommend that if a nurse is not available, parents make the final decision on their child. Anyone who takes on this responsibilty without training,a license and insurance is foolish-I say that after 13 years as a school nurse!
I think that any school that are using lay people (including nonlicensed nursing students) to assess student health problems runs a significant liability risk. I would recommend that if a nurse is not available, parents make the final decision on their child. Anyone who takes on this responsibilty without training,a license and insurance is foolish-I say that after 13 years as a school nurse!
I agree with your statement. Did you know that about 10 years ago my school district used " lay " people who did not have any type of certification ? I'm talking no first aid , no cpr, no CNA, no nothing ! It is scary. Thats why every day before I go to work I pray to God that I act as a prudent person would and that the kids be safe. I've been there through seizures, head injuries, I've detected swollen lymph nodes and the child actually had a really bad infection, I've detected a draining blister that turned out to be shingles and the child had to spend 2 weeks in the hospital ( which the doctor said that was the worst case of shingles he's seen), I've made medical assistance referrals, I've helped kids found doctors, I've made sure kids were seen by the dentist, I've made sure kids were up to date with immunizations. I haven't been perfect and yes I've made mistakes but I do feel as though even though I'm unlicensed I've been an asset to my job.
Yes, I believe every school should have a LPN or RN there but sadly its all about money and they put us CNA's in the health room. Its risky but what can we do ? We do our best. I do my best atleast.
I'm two weeks away from wrapping up my school nurse gig to return to my true nursing love, obstetrics, but since I'm a school nurse for 2 more weeks...
If a student complains of a stomachache, I assess vital signs, N/V/D/C, bowel sounds, any abdominal distention or tenderness to palpation, the type of pain, and diet for the day, which frequently ends up being "I didn't eat breakfast/lunch" or "pizza covered in nacho cheese and hot wings." As long as students' vitals and assessment are normal and they don't appear to be in any acute distress, I always send them back to class. I always ask if they'd like to try to use the restroom before going back, and I've found that small offerings like giving them a few crackers if they haven't had a meal yet that day make them feel like I've addressed their complaint. I feel like a nursing student who is about to complete her degree could adequately assess for these things as well.
This is my first year as a school nurse, so I used to fall for the "my mom said call home if I felt bad and she'd come pick me up" trick 30 minutes into the school day. After I realized it was a recurring pattern, I mailed home a letter to parents that said students will only be sent home sick if they are acutely ill. If you believe that your child feels poorly enough that he might not be able to make it through the school day, keep him home to begin with because I won't be sending him home unless my assessment indicates a medical need. Ever since then, I've had no problem. Students still pull the line on me, but I just explain that I'm sorry they're feeling bad, but their parents were made aware of the clinic policy and that they need to go on back to class.
topsyturvy
43 Posts
And there isn't a thing wrong with choosing your battles!