Why do you send a student home?

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Ok, so I am curious!

Why do you send a student home? I know all the basics: Lice, pink eye, fever above 100.2, emesis, etc.

A lot of the stomach aches that I get in my Health Room request to go home! Now, if this was my kid- they aren't coming home (by their decision) unless they are vomiting. Where do you draw the line and send the student home?

Thanks for your imput.

Specializes in School, Camp, Hospice, Critical Care.

I send very few home and (usually) only with good clinical evidence of illness. Probably 80% of the kids I see come in with minor or non-complaints (a drop of blood from the nose, invisible blisters, barely scraped skin, 5-day-old bug bites)--they are assessed, comfort measures given as appropriate, and trotted right back to class.

Vomiting (and I have to see the emesis, or it doesn't count), fever, the runs, and obvious physical distress (febrile, pale, shaky) are generally the only tickets home.

I do give teachers leeway in telling me they think a child isn't focused enough to stay at school d/t minor discomfort or fatigue. But I do document the absence of clinical findings and make this absence clear to parents.

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for me as a student:

Elementary school (kindergarten through 8th grade) : we did not have a nurse so if you said you were not feeling well the teacher sent you to the office. The secretary was a mom so she would try to determine if she thought it was real. She would ALWAYS call the parent but might say she thought the kid could stay.

High school: In most cases you needed to vomit in font of her. Or have a fever. The first time I went and asked to be sent home (I had previously gone for pain meds or the similar but NEVER asked to be sent home) She sent me home immediately. It was my junior year and I had NEVER asked to go home so she knew something was up.

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With stomachache, I always try to do palpation for rebound tenderness; if present, home or ER.

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Nurses keep kids in school because of assessment skills.

Wyman (2005) found that 57% fewer students were dismissed from school early when they were assessed by a school nurse as compared to that of nonnursing personnel.

Telljohann, Dake, and Price (2004) focused on the difference in care when a nurse was present. Students with asthma missed 23% fewer days of school if there was a school nurse full-time in their school than those whose school nurse was part-time (Telljohann, Dake & Price, 2004).

Wyman, L. L. (2005). Comparing the number of ill or injured students who are released early from school by school nursing and nonnursing personnel. The Journal of School Nursing, 21 (6), 350-355.

Telljohann, S. K., Dake, J. A., & Price, J. H. (2004). Effect of full-time versus part-time school nurses on attendance of elementary students with asthma. The Journal of School Nursing, 20(6), 331-334.

Absenteeism affects acheivement:

http://e-research.tnstate.edu/dissertations/AAI3007621/

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