Why do you send a student home?

mitzi · May 21, 2008

I send the ones you mentioned but am firm re: stomach aches. I take their temp, ask if they've eaten, if they feel like they're going to puke...of course they always say yes. If all the above are in order I have them try class. Especially if they are a frequent flyer. I call a parent if a child is having a major meltdown and I can't get them to calm down. Sometimes I'll call the counselor to help with that agenda. I've sent kids home with suspicious rashes to have evaluated before returning. I send kids that poop their pants home. We are not permitted to clean them up. I send kids with asthma home if they don't respond to their inhaler or nebulizer treatment. Hope that helps.

wannabeeverything · May 22, 2008

When I was a school nurses aid we only sent students home if they were vomiting, fever... For stomach ache we gave them a couple crackers and let them lay there for a few minutes. If they came back I would call the parent. I had a student come in during lunch with a mouth full of food holding his stomach and then spit the food out in the trash and tell me he just threw up, he was a frequent flyer and had tried this several times. I cant believe how creative they get.

whiskeygirl, LPN · May 22, 2008

For instance, if I had a kid that threw up because he got smacked in the stomach playing soccer, would you send him home? The issue is pretty much resolved after he pukes. There wouldn't be any fever.

I just worry that sometimes I am sending them home too quickly or that I am being to much of a hard nose.

ItsyBitsySpider, BSN, RN · May 25, 2008

For instance, if I had a kid that threw up because he got smacked in the stomach playing soccer, would you send him home? The issue is pretty much resolved after he pukes. There wouldn't be any fever.
I just worry that sometimes I am sending them home too quickly or that I am being to much of a hard nose.

I would not send a kid home for puking r/t getting hit with a soccer ball. On good days (most) I am very picky about what goes home. My office is very busy and I have alot of FF. Suspicious ortho injuries ("jammed" fingers, wrists, ankles, etc) will go, suspicious rashes, ear pain (legitimate), tooth pain if there is an obvious problem, also will go. I know there are more but those are the most frequent. On bad days I will sometimes send them all home. I know it's a bad idea but the school I work for is filled to the brim with alarmist, freak-out on a hangnail staff that I sometimes don't have the energy to battle.

I am a strick believer in these students needing to be in school if they can. Often a quick nap, snack, or hug will "cure" them. Hope this helps!

sChOOLRN48 · May 27, 2008

All the obvious ones I send home.

After that I have learned to let it be the parents call. I let the student call on thier 2nd visit. I will not say they are sick, I will talk with Mom & Dad and say that thier child says they are sick and tell them what the temp was. I also say "student says they threw up in the BR" If I didn't see it or see evidence of it, shakeyness, sweating, pale, blah blah blah, it didn't happen. (I am a hard nose!)

Many times I call parent after the child has left to inform them of what went on. Like if a kid jammed his finger has full ROM, minimal swelling, no deformity...RICE first then call mom and let her know and then it her call to make & the kid is not in my office to be all dramatic. If its not life threatening and it doesn't warrant a call to 911 chances are they are going back to class!

I have 6th graders...this type of a policy may not be the greatest choice if you have little kiddies!

Flare, ASN, BSN · May 27, 2008

As previously stated - i send home the obvious ones. Diarrhea almost always goes home, save for a few children with celiac disease or IBS who know that it's just part of their condition and would rather stay. Vomitting is usually sent home unless it can be connected to something such as the soccer ball example or the other example of the child spitting food up for dramatics.

I also take a quick peek at then student's visit log. If I haven't seen a student all year I am more apt to think that there is really something up than I am for the frequent fliers. Good credibility goes a long way in my office.

can.scl.ns · May 28, 2008

I'm notoriously known for keep students here in school for as long as I can. I do not send kids home for no reason. For most kids with stomach aches, I generally keep in school, sometimes it's because they didn't eat, or the bumpy bus ride to school, or they're trying to get out of class or a test. Usually they get better as the day progresses. Unless of course, there's other symptoms. It depends.

SchoolNurseBSN · May 28, 2008

All the obvious ones I send home.
After that I have learned to let it be the parents call. I let the student call on thier 2nd visit. I will not say they are sick, I will talk with Mom & Dad and say that thier child says they are sick and tell them what the temp was. I also say "student says they threw up in the BR" If I didn't see it or see evidence of it, shakeyness, sweating, pale, blah blah blah, it didn't happen. (I am a hard nose!)
Many times I call parent after the child has left to inform them of what went on. Like if a kid jammed his finger has full ROM, minimal swelling, no deformity...RICE first then call mom and let her know and then it her call to make & the kid is not in my office to be all dramatic. If its not life threatening and it doesn't warrant a call to 911 chances are they are going back to class!
I have 6th graders...this type of a policy may not be the greatest choice if you have little kiddies!

I agree with the hard nose bit. I have 6-8 graders and we have a bad truancy problem. You better be really sick to get a pass home for me. And. after 2:00 (school gets out at 3:30) you are only going home if you go via ambulance.

I also have to take into consideration the population I am working with. Most of my parents won't even come if an eyeball is hanging out of the socket. Many a broken arm have I had to use the CPS threat to even get their attention. They sure are not going to come for a tummyache with no fever or vomiting.

99% of my students who allegedly vomit make it to the restroom, have no odor, no shirt stains, no tearing of the eyes, no red face or pale face, etc. Then, they are fine in the clinic. Hmmmmmm, not enough to convince me!

I agree with another poster. I pull attendance records and look at how many times they have visited the clinic before I will make a final decision on those iffy cases.

rph3664 · May 28, 2008

I'm not a nurse, let alone a school nurse, but the school nurse we had when I was in high school did not dismiss students for ANYTHING. There was a pregnant girl who thought she was in labor (she turned out to be correct) and the nurse wasn't going to let her leave. She walked out anyway, as did lots of other kids.

They often had doctor notes to prove they weren't truant. Same thing with kids who had vomited in class, although half the time it was because the kids were drunk, especially when the drinking age was still 18.

luvschoolnursing, LPN · May 28, 2008

Administration said I am to call parents if student wants them called. Due to this, many more kids go home than necessary, But I guess admin. figures, if I don't let them call home, they just leave my office and call their parents on their cell phones, anyway. About half the time, by the time they get to the health office, they have already texted parent who is on the way to pick them up!

I do tell parent my objective assessment-no temp, color good, throat not red, no cough, etc...whatever is related to their c/o. End of the year is really hard. The kids were "done" about 3 weeks ago.

psalm, RN · May 29, 2008

"Menstrual cramps" that may actually be a tubal pregnancy or PID would be another condition to consider with girls 6th grade up. UTIs?

Frequent flyers may have hunger pains...it amazes me how many kids don't have breakfast before school and don't eat lunch. Headaches and stomach aches may be hunger.

Kids avoiding bullies by hanging out at the nurses' office?