What is your absence policy ?

[RNqueens]

The school I am at has a policy that for 3 consecutive days absent in addition to parent written reason, the student is required to have a doctor's note with a return date to school in order for the absence to be excused (this is under the excused absence bullet in the policy). The unexcused bullet gives examples of unacceptable reason.

With that being said some of the teachers are insisting that I send students home if they have no doctor's note after 3 days, that's the "policy". I think they are interrupting the policy wrong as I have no problem sending a student home who has been out or 3 more days without md note and still appears sick while demanding a note. However, if the student appears well no s/s of disease I don't not feel that I should send them home just because they do not have a note so that they can miss another day of instruction.

I do however give the students a formal letter of the policy that they are to return the next day and/or call to find out what happened to the student. Most of the time they were on vacation. I have discussed this with my principal who is okay with this but, some staff feel it is their duty to give me suggestions. I am at a new school in which they are use to their previous nurses way. I do not think I can legally exclude a child who appears well just because the do not have a doctor's note (what if they did not go to the doctor at all). The school has a high absenteeism rate and the exclusion should come from the principal if the student is deemed well enough to stay in school based off of my assessment.

What is your policy?

[Jolie, BSN]

I agree. It is not the nurse's job to make or enforce attendance policy as it relates to excused or unexcused absences. Your job is to promote health and wellness and enable students to attend school by managing health needs that might otherwise impact attendance.

The policies you set would be those that indicate health conditions for which a student should be excluded from school, such as vomiting, diarrhea, fever, etc. & the conditions that must be met for the student to safely return to school (such as being symptom free for 24 hours without medication.) If those conditions are met, it makes no sense for you to continue to exclude the student.

I suspect that the administration has set the 3 day limit as a means of enforcing attendance, believing that parents won't keep a student out for non-health reasons if a doctor's note is needed. It won't work. If parents are going to pull their kids out of school for a vacation or other elective reason, needing a doctor's note won't change their minds. It will only create issues of excused versus un-excused absences, which are not your problem.

If you are convinced that a child is returning to school safely, without a health condition that poses a risk to himself or his classmates, turf the enforcement of this policy back to the school administrators, where it belongs. You are the nurse, not the truant officer.

[BeckyESRN]

The teachers are being unreasonable. If a kid is out for 3 days and comes back healthy, they stay at school. Not all issues require a doctor's appointment, just a few days at home to recover. The note is only to change the coding of the days missed, it says nothing about fitness to be in school. Obviously, if you specifically told the parent that the student must be cleared to return to school(chicken pox, weird rash, ect.) you'd not let that kid back without documentation. Tell the teachers to worry about teaching, you'll handle health, and admin can handle truancy.