What are some of your office policies?

[scuba nurse, BSN, MSN, RN]

We are finally going back in person, hybrid, in March. I need some office policies. What have you implemented?  My school is K-6, and we have a medical waiting room (covid only), but for non covid visits I need to put some policies in place.

So far I have been thinking that daily meds will be by appointment time only.  Teachers must call me before sending anyone down. Only one student in office at a time (my office is small). 

What else do you do?

What about students who have to use the nurses bathroom? And how are bathroom visits done in your school in general?

Thanks for any help! I realize I am late to the party!

[Flare, ASN, BSN]

I have gotten word out that I will no longer be handling non-medical issues.  This means I no longer will see a kid for an earring that's fallen out, forgotten glasses (which I can't do anything about anyway), yogurt spilled in backpack, covered in mud, or any other nonsensical visit.  I have put a stop to my bathroom being used as a "monitored" bathroom for the children that can't behave.  

I will take more than one child because my office is decent sized, but they need masks and have to distance.  

[JenTheSchoolRN, BSN, RN]

My office is a call ahead service only. You cannot send kids without connecting with me first. Any COVID-like symptom, nurse goes to the classroom first. Regular scheduled non-COVID visit (meds, diabetic check-in) can be sent.

First aid kits is classroom being really stocked with things like feminine supplies, bandaids, little packs of chapstick so those visits are cut down. Every classroom also has SO MANY extra masks so that isn't something I get called for either. 

[scuba nurse, BSN, MSN, RN]

Great ideas! Thanks!

[k1p1ssk, BSN, RN]

I second what @JenTheSchoolRN wrote; their plan is very similar to mine; My one big change is that I go to the diabetic student in my building, and deliver meds to my regulars, unless the student is close by. But all visits require a call ahead for triage and to determine availability. If a kiddo is sick, I ask the adult who is calling to have them wait in the hall outside their classroom while I gown up. I do a quick assessment in the hallway, and if their symptoms are truly concerning, bring them with me to the MWR and the admin asst. calls home for me.

I have been letting the kids whose only symptom is a belly ache or headache come to my office, especially if it is a frequent flyer, as 99.9% of the time they aren't actually sick. But that's only because I know these kids so well. But again, it's all call ahead.

[Flare, ASN, BSN]

I tried to enforce call ahead, the teachers were really good about it at first, but some are not.  It hasn't been the biggest hassle, but we'll see how it goes after we return to  "normal"

[ajessrn, BSN, RN]

We are super small. less than 400 kids. I didn't really change much. I use a conference room close by for my covid suspect or students waiting for pickup that have been contact traced. if its open and available. with less visitors allowed its not used a ton but sometimes it is needed to be used for testing in small groups so some days I have to wing it and put kids wherever I can find a spot to stick them. we are small though and im high school so usually I don't have too many kids at once. They have been really good about not coming to school if they are having symptoms so its not been often I've had a student sent home for symptoms. 

my district came back in person in august then had to go to e learning over thanksgiving break then went to hybrid for secondary after christmas break and are working our way back to full in person. loving the hybrid because way less kids get traced because we can actually distance them better. thankful out community numbers are getting better, but worried about how that could change after Spring break. 

[BrisketRN, BSN, RN]

I do a lot of hallway visits.  Teacher will phone me, I'll assess the child in the hallway to determine if they're staying in class, going to my office, or going to the isolation area.  The first few weeks were the hardest because parents were still sending sick kids in.  After about 4 weeks they all finally understood that we will find out your kid doesn't feel well and we will make you pick them up.  I do not care if you think it's just a cold.  COVID test or 10 days off.  I've also had to delegate quite a bit to my wonderful, sanity-saving desk receptionists when I'm trapped in the isolation room.

[Flare, ASN, BSN]

For the most part, the parents have been pretty compliant with not sending in sick children.  There is still a small amount of sick vs. mathititis going on, however, I find that a covid test or a quarantine clears that right up.  Has a nice long term effect on malingering as well.  I had a little friend this morning come in with a sore throat.  I had determined that he hadn't had ANY water this AM, only coffee.  A dixie cup later, he was happily skipping of my office.  

[tining, BSN, RN]

Big one is no one leaves early with parent without asking me first. 

Middle school kids call and say they are sick, parent comes "I'm here to pick up my sick kid". Staff knows to ask "Have they seen the nurse?"  If no, I assess and explain why this is a crucial step during Covid. 

Most of them are just trying to get out of school.  Some parents have left them here!

[tonih79, LPN]

This is what we will be using...

KCPS Nurse Office Decision Tree Teacher Appendix C (2) (1).docx

[Flare, ASN, BSN]

On 3/4/2021 at 2:54 PM, tonih79 said:

This is what we will be using...

KCPS Nurse Office Decision Tree Teacher Appendix C (2) (1).docx

That is lovely!  I think I may steal it. Thanks for sharing!