I work in a Middle School and get multiple requests for ice daily for a myriad of reasons. They seem to view ice as the cure all for bumps, bruises, aches, twisted limbs, jammed fingers, smashed fingers, stiff necks, insect bites, allergy eyes, canker sores, pimples, headaches, etc.......Some teachers even directly instruct the student to "go to the nurse to get ice". For the most part, after an assessment, I generally comply, regardless if I think they really need it or not (some kids are so "soft" these days), because it gets them back to class and everyone is happy. I do deny a few, especially when the request is totally out of left field and/or visits become habitual and I want to nip it in the bud. I think some kids request ice packs just to get attention.
I do recognize that melting bags of ice can be a safety hazard. And yesterday a student told me that some kids are putting holes in their ice bags and sipping on the water. I've had no complaints from teachers, but I'd like to revisit my ice policy. I once worked with a school nurse who had a motto - "No Redness, No Swelling, No Ice". I know of other school nurses who do not let ice out of the clinic, which cuts down on the number of teachers who send their kids for ice. What are your thoughts on providing ice packs?
I'm pretty stingy honestly. (A student complained to a teacher I didn't give them out enough, and why was I hoarding them because they belong to the school and not to me! ) I have the reusable gel packs too. I don't make students stay in my office because they don't get therapeutic boredom (seriously, most could sit and stare at the wall all day). I do however make them sign them out, and they come back more often than not at this point.
I have an icemaker in the cafeteria which is across the hall.
I fill up my beer cooler every morning and make little Ziploc ice baggies when asked. I don't put limits on ice packs. I'd rather give you an ice pack than medicate you anytime.
Ice packs for all!! And, yes, you do have to come to me for an ice pack. I don't do house calls.
I don't make students stay in my office because they don't get therapeutic boredom
The only time I make students sit in my office with the ice (if the injury is minor) is on field day. Man, do those injuries resolve themselves quickly when there's a bounce house around!
What really gets me is the kids who are injured at sports outside of school coming in for ice. I ask if they iced it post injury and 99.9% of the time, the answer is NO. WTH???
I always ask "How did you treat this at home?" and mostly the kids look at me like I'm nuts. Why on earth would I treat this injury at home??? It's only bothersome during math class.
Specializes in Med-Surg, Home Health, Hospice, School.
I used to give out ice packs freely until word got around and I had every Tom, Dick and Hairy coming for an ice pack for any and everything they could think of. Now, if there is no redness, swelling or bruising noted to a FRESH injury, they don't get ice; or if the injury is more than 24 hours old, they don't get ice. That may sound harsh, but I just don't have time for it. To me, it's not a matter of just handing out an ice pack, I have to stop and document that insignificant, no ice needed complaint as well. I work with junior high students now, but used to work with elementary aged students and was much more lenient in handing out ice packs to the babies. They have to learn at some point that there isn't always a "cure" for every little ache and/or pain they have.
gahhhhhh! I can honestly say that I had never iced one of my own children for an injury. (just never needed it). I came to work here and OMGoodness it is ice for EVERYTHING! I give it out freely also because that is what these kids are used to. It's a cure-all and really good attention getter. I have asked several kids if their moms have ever made them an ice pack at home and all have sheepishly admitted NO. I guess I really don't mind, though, because I would much rather make an ice pack for nothing, than use the AED or Glucagon or Epi pen...
I used to let my middle schoolers take their ice packs to class. Then, I got so many complaints of them being found melted all over the floor, or the kids slurping on them and disrupting class that I stopped (especially after a teacher slipped and fell on one).
Unless totally contraindicated, I let them sit in clinic. Now, for those invisible bob boos, 5 minutes will do them well. It is basically a placebo. However, at least they won't go home and tell their parents I did nothing.
Now, if they want ice for something that is not lumped, bumped, bruised, etc. and they state they have had that pain 3+ days - they get a medical referral instead.
As for the by proxy thing - no, I have to eyeball anything before providing treatment. I had a kid ask me for a Band-Aid for his knee a few years back. I could have just handed him one but I had him show it to me. Big draining wound present......Staph!
I got a counter-top ice-maker this year and I LOVE ice now that I don't have to trek all the way across the school and down a flight of steps to the athletic training room to refill my ice buckets.
I used to give out ice packs freely until word got around and I had every Tom, Dick and Hairy coming for an ice pack for any and everything they could think of. Now, if there is no redness, swelling or bruising noted to a FRESH injury, they don't get ice; or if the injury is more than 24 hours old, they don't get ice. That may sound harsh, but I just don't have time for it. To me, it's not a matter of just handing out an ice pack, I have to stop and document that insignificant, no ice needed complaint as well. I work with junior high students now, but used to work with elementary aged students and was much more lenient in handing out ice packs to the babies. They have to learn at some point that there isn't always a "cure" for every little ache and/or pain they have.
For an insignificant injury or issue I am stingy with the ice. This is an educational moment. Ice decreases swelling or bruising, it does not take pain away. I do give them my patented cold wet paper towel if it is 'not ice pack worthy.' Kinder, maybe even first grade will probably get the icepack. Kids need to learn to self sooth. "Teacher wants me to have an ice pack' - only if it is worthy. I have never had any complaints.
DEgalRN
454 Posts
I'm pretty stingy honestly. (A student complained to a teacher I didn't give them out enough, and why was I hoarding them because they belong to the school and not to me!
) I have the reusable gel packs too. I don't make students stay in my office because they don't get therapeutic boredom (seriously, most could sit and stare at the wall all day). I do however make them sign them out, and they come back more often than not at this point.