Vomiting policy

[zombieghoast]

In my school's handbook it says students who have been vomiting need to be kept home for 24 hours from the last bout of vomiting. My nurse supervisor said this is meant as kids who have a stomach virus and cannot stop vomiting. This is not about kids who throw up once (not including kids who throw up food). At my school certain teachers are super strict about this policy. It doesn't matter if it is mucus they must go home and if they come back to school the next day they send them down to my office to be sent home. I always give a parents a call to let them know and ask them if they want them to finish out the day or if they want to pick them up. How do other school policy's work and I am I in the wrong? If a child doesn't have any other symptoms I don't see why we should send them home.

[huffmannurse]

Just this year, I changed some of the wording to allow a little common sense with the issue. It now goes something like this: That if a student vomits 2 or more times in 24 hours, they may be excluded. This allows for if little Johnny ate too much sausage and drank 3 boxes of chocolate milk for breakfast, to stay at school, if he appears to be ok otherwise. It also covers if Susie vomited in the night due to sinus drainage or whatever. If she seems ok to come to school and does ok...great. If she vomits at anytime during the day, she goes home and stays home the 24 hours from the last vomiting episode.

I explained this at the beginning of school at some of my teachers in service days. And, I must say, I got some of the same dumb-founded teacher-looks that I get/have gotten when I explain how lice will be handled. Annnd...I am happy to report that those looks for lice are getting less frequent. :)

Hey Farawyn- How did I do with the use of the dot,dot,dots?? :) ...

[Flare, ASN, BSN]

I say there is always room for interpretation and common sense in policy. My special needs children that force themselves to vomit - not sending them home because that will only reinforce that behavior. The child that spit up a drop of phlegm but swears they just puked up the world - nope - they can rest, have some fluids and i'll make a call to a parent just as a FYI (if the parent chooses to come and pick up, it's their right, but won't necessarily be excused). Same for the kid that ate their weight in tacos then decided to see how fast the "spinny toy" could go at recess. That's not sick, just poor judgement.

On the other hand, the kid spent 90 minutes in my office with her head in the trash/ toilet the whole time that is promptly sent in the next day because she "was fine" ticks me off immediately.

[lifelearningrn, BSN, RN]

My administration is huge on attendance, so vomiting without a fever or other symptoms is rarely enough for me to send a child home. We have so many that just eat too fast, or too much, they puke and then they're good to go back to class. The teachers in my school know that without a fever (or other symptoms) chances are the kiddo is going to be sent back to class.

[chasinRT]

Teachers here would like it to be 24 hours. I use common sense and eval on a case by case basis. I'm sure I'm often the topic of conversation in the teacher's lounge. I'm pretty sure some of them don't even realize I went to college.

[tining, BSN, RN]

I explain the vomiting problem at the beginning of the year to the teachers. "I may not send a student home the first time -without other symptoms - kids throw up for many reasons and not all of them are "stomach bugs." I also tell the parent - if the student continues to throw up when home = stay home the next day. I am immediately annoyed with the teacher announcing she has a "stomach bug" in her class. If they really knew what norovirus looked like...

[SnowyJ, RN]

24 hours here too. And a lot of the parents hate the policy. They will still send the child to school, and inevitably the child will tell their teacher "I threw up last night." Of course the the child is sent immediately to me.

I like the policy. With all the issues we've had with stomach viruses, it helps contain it. I hate to say this, but some parents just don't have the sense to keep their children home otherwise.

Of course, there are always exceptions. The child who vomits with a migraine, the student who was twirling on the rings in gym class and pukes, etc.

[SchoolNurseTXstyle]

We have the 24 hour policy. However, I take each student on a case to case basis. I have kids that throw up due to anxiety, reflux, bad decisions as someone else mentioned, migraine headaches, etc. I exclude only if I feel it is a contagious illness. Do I get it wrong sometimes, sure!!!

And goodness, the whole throwing up all nice and neatly in the bathroom with no witnesses and they look perfectly fine. Sorry, no - I need more proof than that1!

[JenTheSchoolRN, BSN, RN]

I see a lot of anxiety-related vomiting. Vomiting x1 without any other major symptoms is also not an automatic send home for me. If it was, I'd have a lot of absent kiddos.

Also: vomiting must be witnessed and/or have concrete evidence (i.e. the student that reeks of vomit breath after reporting vomiting in boys/girls room).

The 24 hour rule for us is active vomiting, which the nurse's judgement can determine, thankfully.

[Farawyn]

huffmannurse said:

Just this year, I changed some of the wording to allow a little common sense with the issue. It now goes something like this: That if a student vomits 2 or more times in 24 hours, they may be excluded. This allows for if little Johnny ate too much sausage and drank 3 boxes of chocolate milk for breakfast, to stay at school, if he appears to be ok otherwise. It also covers if Susie vomited in the night due to sinus drainage or whatever. If she seems ok to come to school and does ok...great. If she vomits at anytime during the day, she goes home and stays home the 24 hours from the last vomiting episode.

I explained this at the beginning of school at some of my teachers in service days. And, I must say, I got some of the same dumb-founded teacher-looks that I get/have gotten when I explain how lice will be handled. Annnd...I am happy to report that those looks for lice are getting less frequent. ?

Hey Farawyn- How did I do with the use of the dot,dot,dots?? ? ...

Beautiful. Those are some righteous dots.

[OyWithThePoodles, RN]

I'm mean... I make them puke more than once. If they come to me and say "I threw up in the toilet." I usually have them eat a couple of crackers, drink water, if still no vomit I send them back to class. I always say "If you throw up again, come see me... and make sure someone see's you throw up!" Now if they have a fever with the one time vomit I will send them home. When I was in high school I would vomit at least twice a week in the morning due to sinus drainage. That's what a lot of the kiddos do here as well. Eat a cracker, dry it up, move on.

[MrNurse(x2), ADN]

I had to come up with a policy since we had none prior to my arrival. I am a bit conservative, as a true norovirus outbreak would close our small school. The observant students have become keenly aware that vomiting = home, only fell for that twice. I have told students and parents that if I didn't see it, it didn't happen, so that weeds out a lot of single episodes. There is a strict 24 hour policy and most parents are respectful of it, a positive to the private school environment.