School Nurses: Stinking, So-So, and Spectacular

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What makes the difference?

I mean, the Full Time School Nurse (RN) at my oldest cubs school (population approx 1040) is [i]very energetic, vibrant, experienced, intuitive, academic, proficient, and thorough[/i]. [img]http://uumor.pair.com/nutalle2/peanutallergy/biggrin.gif[/img]

Haven't known her very long but some things that spoke to me:

[i]Every morning, she [i]assess[/i] my cub. Via his subjective statements and via her objective assessment. She's knew about the bruise on his side, under his shirt (tripped out of bed in the middle of the night and fell on a toy). She is alread familiar with many obvious, and not so obvious facial, upper trunk moles, bumps, and markings that are [i]particular to him[/i]. She requested several medications (over the counter) be available and with accompanying prescription to be administered PRN based on his health history. (not all emergency meds either) She has also arranged to be able to contact me *prior* to their administration in order to [i]confer[/i]. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

In addition to his morning assessment, she checks on him intermittantly and discretely throughout the day.(as well as a multitude of other children daily with a multitude of different needs)

She has gotten to know his *baseline* and is already able to pick up on [i]subtle changes[/i].

She has developed her own paperwork and methods of [i]documentation[/i] and record keeping in addition [i]to that already provided by the district.[/i]

She utilizes assistive personnel, technology, and has provided numerous methods to communicate with her as well as maintain contact with the population she serves. (I would venture to bet she has enough documentation to support the need for the same).

Even from brief conversations, although we can talk at length [img]http://uumor.pair.com/nutalle2/peanutallergy/biggrin.gif[/img], I have ascertained she is [i]academic[/i], and values maintaining a [i]current and proficient Standard of Care[/i]. Even when many may think it may not be entirely necessary. I can tell she is aware of the value in redundancy and multiple check systems.

On many occasions, she has openly advocated on behalf of my son. [i]Even if she wasn't sure or knew *I* might not entirely agree with her[/i]. She erred on the side of [i]caution[/i].

Case in point: She [b]insists[/b] I or my husband be present on field trips my cub attends. Regardless of what his *rights* are. She feels I am his best advocate and it is in his best interest that I attend.

In no way do I feel she is saying the district is not capable of maintaining a Standard of Care, but, I will have to agree:

[b]*My* cub is [i]safer and better[/i] off with me or my husband present.[/b] All things considered, in my own personal, highly individual, and unique situation..............[i]There is no substitute.[/i]

Don't know if she would insist on *other parents* in similiar situations going with, but she actively worked to ensure that all parents of *Special Needs* children be [i]allowed[/i] to attend such trips. Regardless of the district [i]obligation[/i]. She has helped me past rules, regulations, and rights in order to see *The Big Picture*.

(ps....I would have never let him go alone, just kept thinking about and wanted to advocate on behalf of parents who weren't in *my situation*)

She trained and inserviced school personnel as necessary on the recognition of the need for and use of the Epi-Pen. Not saying all persons were willing to be trained, but she assessed such situations and [i]worked around it in order to maintain a Standard of Care[/i]. I mean, there is always someone with him who was willing to be trained. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

She met with my cub several times prior to the start of school. Despite a physician letter indicating certain skills my cub could demonstrate, she assessed his abilities and planned accordingly.

[b]I completely understood and expected it[/b].

It was the highlight of my year, and one of those *you had to be there moments*, but the smile on PappaBear's face and my own was indescribable as cub demonstrated the indications for and use of *his* Epi-pen. I mean, [i]I cried happy tears[/i]. I think she almost did too. [img]http://uumor.pair.com/nutalle2/peanutallergy/biggrin.gif[/img]

just a few highlights.

I could list more, but I'm interested in what others have to say. [img]http://uumor.pair.com/nutalle2/peanutallergy/biggrin.gif[/img]

General disclaimer: I am not offering advice in any manner or form. Just describing my own personal, highly individual, and unique situation.

On Sep 17, 2004

Our school nurse is practically non-existant, she's actually the district nurse. AFAIK, Jason has never met her. Other staff and faculty members are the ones we rely on to keep Jason safe.

On Sep 17, 2004

Quote:

Originally posted by solarflare: [b]Our school nurse is practically non-existant, she's actually the district nurse. AFAIK, Jason has never met her. Other staff and faculty members are the ones we rely on to keep Jason safe.[/b]

My son's IEP/OHI states he needs the services of a school nurse at school in order to attend school. (paraphrasing)

I, too, rely on "other staff" [i]in addition to the school nurse[/i] in order to keep my cub safe at school. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

General Disclaimer: I am not offering advice in any manner or form. I am just describing my own personal, highly individual, and unique situation.

On Sep 17, 2004

hmmmmmmmmmmm. very few responses. Gotta ask myself what they say about solutions.

Let me ask *this*:

How many persons would like [i]at least one[/i] [b]*Spectacular*[/b], Full Time RN, Certified School Nurse, every day, all day, in their child's school building?

On Sep 17, 2004

Just adding:

A few years back, a different "school nurse" at a different school was absent from the healthcare related meetings at school that involved my cub. We voiced our dismay and shock. [i]We were adamant this would not happen again.[/i]

This year, *My* cub's school nurse, a *different* school nurse, at the school he *now* attends was present and an active participant in every IEP/OHI/504 meeting (eligibility or otherwise) we have had at [i]the[/i] school to date. She *demonstrated* what Case Management and Care Plans were about.

On Sep 18, 2004

Quote:

Originally posted by MommaBear: [b]Let me ask *this*:

How many persons would like [i]at least one[/i] *Spectacular*, Full Time RN, Certified School Nurse, every day, all day, in their child's school building?[/b]

We have that! [img]http://uumor.pair.com/nutalle2/peanutallergy/biggrin.gif[/img] In fact, we have 2 of them at my son's school.

On Sep 18, 2004

Quote:

Originally posted by e-mom: [b] We have that! [img]http://uumor.pair.com/nutalle2/peanutallergy/biggrin.gif[/img] In fact, we have 2 of them at my son's school.

[/b]

[i]falling prostrate in supplication and unworthiness......[/i]

Would that thou tellest us when they first appeared to you, that tho counted not one, but to two, proceeding not to three, yet subtracting nothing from the sum of [i]two[/i]? Yea......[b]indeed[/b] [i]two[/i] persons of the Title: "RN", not being [i]an apprentice or a helpmeet,[/i] but verily...................."RN"?

Would that the lineage include also:

[b]BSN, and Certified School Nurse[/b] of them both????

ps...........year's going good?

[This message has been edited by MommaBear (edited September 18, 2004).]

On Sep 20, 2004

I think our school nurse is absolutely wonderful.

She is competent, intelligent, social/easy to talk WITH (notice I didn't say to), open to suggestions, etc.

We have one full-time nurse and one nurse's aide in Ryan's elementary school with a population of about 1400+ and growing (sigh...).

On Sep 20, 2004

I think that a spectacular school nurse would be educated and up to date on all healthcare issues. She/He would work with parents within reason to ensure a safe environment for children at school and would have good judgement. My son's school nurse is a control monger, arrogant and difficult. As I've become more acquainted with parents at his school, I am beginning to realize that she is not always using good judgement. I have heard incidents where children have minor problems (scraped knee, minor cold etc.) and she's calling parents and making a big deal of it. On the flip side, I've heard incidents of children with fractures, symptoms of Appendicitis, asthma attacks being told that they are trying to get out of gym or school and to return to their classroom. I have asked these parents why they didn't report her and the incident. Many apparently have, but she was not penalized in any way that we're aware of. With regard to my son's peanut/Tree nut allergy she is not cooperative in telling me what her procedures are for keeping him safe. She sees it as a criticism if i even ask a question. This is not good. I have finally had to involve the school super and director of special services because she is so difficult. I am wondering if nurses in public schools are untouchable or protected in some way after some of the incidents i've become aware of.

On Sep 20, 2004

Quote:

Originally posted by saknjmom: [b]I think that a spectacular school nurse would be educated and up to date on all healthcare issues. She/He would work with parents within reason to ensure a safe environment for children at school and would have good judgement. My son's school nurse is a control monger, arrogant and difficult.[/b]

Did you once raise a question regarding the school nurse, benadryl and epinephrine and the layperson discerning indications for each in a crisis situation? I mean, fine tuning emergency assessment, diagnosis and treatment or laws pertaining to the same in a particular state?

[b]As I've become more acquainted with parents at his school, I am beginning to realize that she is not always using good judgement. I have heard incidents where children have minor problems (scraped knee, minor cold etc.) and she's calling parents and making a big deal of it.[/b]

This afternoon, my youngest cub will be seeing the physician for a swollen, infected eyelid. Last week, he came home from preschool with a fresh cut above the eye. About 3/4 inch by 2 mm. Under the eye was a bit longer mark, welted up, no break in skin. Later that evening the area inbetween the two marks (his tear duct) became reddened. Next morning I took him to the doctor for examination. By then the area below the tear duct was a reddened streak with some discharge from the duct. Eyedrops were prescribed. It cleared a bit, and his physician ok'd his return to school. When I dropped him off, another child motioned at his face in a claw like manner. I noted it.

A few days later the entire lid is now swollen. He cannot open it. Like I said, we are returning to the physician. Maybe it's just me, but I would have preferred it noted and documented. It turned out to be "a big deal". I mean, I never say never as a nurse. It's not *my* place.

General Disclaimer: I am not offering advice in any manner or form. Merely describing my own personal, highly individual, and unique situation.

On Sep 20, 2004

I'm happy with our school nurse. Last year she was the relief nurse, and the head nurse went back and forth between the two elementary schools. This year, that nurse is staying at the other school, and they hired another nurse to cover the mornings. Last year's relief nurse covers afternoons, when ds attends. When I met with the teacher and principal before the year started, all three nurses came to the meeting, which I thought was great! They all were very on board with what we wanted in place, and honestly, just about everything I requested was already being done. They were all very supportive. The only *complaint* I had was that none of them have ever used an Epipen - luckily, there has never been a situation arise at the school where one was needed. (And since they've had PA/FA kids in the school before, I take that as a good sign!) They did request that when I have expired ones, to bring them in so they could practice with real ones as opposed to the trainers. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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