Vision/Hearing Screenings

[SnowyJ, RN]

I have 500+ students to do vision and hearing screenings with each year. It can be very time consuming, especially for the K students who need Distance and near vision screening, test for color blindness, and hearing screening.

This year, I decided to ask the teachers to hold any non emergent visits during K and 1st grade screenings.

I was pretty much ignored. Saw the usual volume of students all day. I only asked to hold non emergent visits from 8-10 AM.

So, I am just curious...Do you keep your office open when doing screenings? What is your plan of action?

[RatherBHiking, BSN, RN]

Some ideas:

Could you set up screenings in another part of the building so you could announce in the morning no nurse in her office from 8-10? I've found if I leave my office I do better.

Do you have any trained aides that could cover for you while you do them?

You could always just put a big sign on your door you aren't available and turn students away until 10am after letting teachers know you are busy.

What about screening the last hour of the day? If kids have made it all day chances are they can make it that last hour.

I'd definitely do an all school intercom announcement right before you do them so the teachers are reminded and the kids know not to ask to see the nurse.

[Jolie, BSN]

Our state requires a health exam, including vision check for incoming Kindergarteners. For that reason, I decided to delay vision screening for that age group until later in the year, when the little ones were more knowledgeable of colors, letters and basic concepts such as up and down, or pointing to one side or the other. I found that delay made Kindergarten vision screening go much faster. In the meantime, I did hearing first, before cold and flu season set in, leading to questionable results and multiple (avoidable) re-screenings.

Are there other nurses in your district? When we have a significant number of kiddos to screen, we all gather for a few hours at the building in need and get it done quickly and efficiently. The building nurse then does the recording and rescreening.

[SnowyJ, RN]

I like the idea of leaving to do the screenings, but my Principal would never go for it. He expects me to be there always. I don't leave for lunch either.

I usually wait a bit to do K screenings too, but this year so many had never had their vision and hearing checked ever. (Many have at least had it done at the MD in prior years.) I did find 2 students with some potentially significant vision issues. I'd hate to have them struggle through the year not being able to see well.

I do have subs that can help, but often they are not available.

[peacockblue]

I have nearly 1400 kids on my caseload between different schools. We are permitted to get a sub nurse in to run the health office while we do screenings. Otherwise, I'm not sure they would ever all get done. I don't mind doing the high school ones but the elementary ones take forever. That in addition to all the 504 plans that need written and updated is a bit overwhelming.

[JenTheSchoolRN, BSN, RN]

I close my office all day to non-emergent visits. Do teachers listen, even with a reminder (or 3) that morning? Nope.

My door stays closed, with a sign on it stating "the nurse's office is closed today for screenings. If your issue is an emergency, please knock. If not, please return to class." I include the attached emergency vs. non-emergency chart.

Do kids see the sign? Nope. They knock. I call out to read the sign. Then footsteps as they leave. But at least I can go right back to screening...

[OldDude]

Are there other nurses in your district? When we have a significant number of kiddos to screen, we all gather for a few hours at the building in need and get it done quickly and efficiently. The building nurse then does the recording and rescreening.

This is what we do. It took all day but we screened 550 kids last Thursday. It is hard to find subs.

[Flare, ASN, BSN]

i get a sub in to help me with screenings for the few days that I try to get them all done in and I send an email out requesting that the teachers refrain from sending minor complaints to my office. For the most part this request is honored, but for some reason, fate seems to deal me a raw hand every single time and i get some odd ball emergency at least one of the days that I have to handle - that God for my sub!!

[tining, BSN, RN]

I have a sign on the door as well, but mine sends them to the office. My office will turn away the silly visits and or have the student return at a later time if they really need to see me (except the truly serious). The teachers always 'forget' hearing and vision times even though they have always start after announcements.

BTW, when I have a student I think is faking - I gently remind them that rechecks are during recess - this almost always stops the shenanigans!

[GmaPearl BSN RN]

My district has always used trained parent volunteers to do initial screenings. Last week we did over 500 pairs of eyes and ears in one day. I do the vision re-screens in-between the ebb and flow in the health room and the district audiologist re-screens the hearing fails with her advanced equipment. Works really well for us :)

[NiceShot]

My School Health Services department contracts with surrounding colleges for a group of students to come in to each school and help for a day. You split them up between hearing and vision and move the students through. The nursing programs now, usually want the new nurses to get an experience in the field out of a hospital. This satisfies a student's community nursing assignment. So they organize the students to come (in our district you can't just schedule them yourself because of liability, it has to go through our supervisor). Just a thought. Works great for us.

[Spidey's mom, ADN, BSN, RN]

Wow, I'm jealous! You guys have help with H&V screenings??

My real office is at the D.O. and that's where I do paperwork. I don't have a "clinic". The school secretaries are basically the medical folks on all 11 campuses.

To do H&V's, I have to go to each campus and find a quiet room - after 5 years I've pretty much got that covered. I would never ever in a million years split up the hearing and vision parts. It takes a lot of time to screen and I do them both at the same time.

I also wait on the Kindergarten screenings but I'm doing them now because I'm leaving as of Nov 1. I do these by myself. So, I go to the K classroom with my list and get two kids at a time. After the screenings, I write a note home, walk to the office with the kids, copy it, give them a copy to take home to parents, walk them back to their classroom. Takes forever to do Kindergarten - and I have two elementary schools.

Still no new school nurse hired and that worries me especially about the diabetic 4th grader with a pump. I see him twice a day for insulin.

Are you guys sure you don't want to move to CA and take my job over by November 1??