I’ve been watching a lot of posts on social media about school nurses being annoyed when the teachers suggest things that may be wrong with a student or suggest what they think the student needs.
The complaints of teachers feeling foreheads and sending a student to have their temperature checked, teachers noting that a student “looks sick”, teachers suggesting that so-and-so “needs ice” for an injury seem to throw some school nurses into a tailspin of upset that the teachers are “out of their lane”.
I am the school nurse and my literal job is to be here checking temperatures and assessing illness and injury and responding accordingly. My education is in nursing (and a little bit of teaching too) so I feel confident that I can assess students’ health concerns on a daily basis. I’m the one who is supposed to be using my nursing judgment to make health decisions in the school.
Treat teachers like allies, not enemies.
But are we truly so arrogant as healthcare providers that we can’t recognize that we are a team? I’m not spending most of my days with these kids, the teachers are. They see them all day every day and know them well enough to know if they aren’t well. Many of them are already parents and are capable of determining a warm forehead or a fake sickness complaint versus a real sickness, or drama versus real pain from an injury. Many of them have also been teaching for many years and know kids well enough to determine if they need some nursing attention or not.
If a teacher sends a kid with a hall pass that states their temp is 99 (either because they are guessing or because they have a thermometer and checked) is it really the end of the world? You can still give your nursing recommendation and move on. They are still being sent to you to assess and it doesn’t change your recommendation if they guess at a temperature. If the teacher has a thermometer, thank them for taking the time to triage the student and trying to keep them in class. After all, that is our common goal isn’t it?
Personally, I welcome the teachers’ input about the students. Often they are the ones that the students choose to speak to. They are the ones that might be seeing parents at pickup and talking to them. Most teachers get to know their kids and families well and are a great resource for the nurse.
I welcome teachers taking the initiative to help the students. Sure, I’d like to be the one to make the call if someone should go home sick since it is my job and all so there are of course some boundaries to be observed but that is something that can be discussed and easily remedied if that is an issue for you. I have teachers that are happy to text a parent or call because they have a relationship with them already, I don’t mind but would appreciate a heads up in the case that they do. In fact, this happened today when I stopped in a classroom and the teacher offered to call the parent for me. I appreciated it because that took a task off my plate leaving me with time to do other things.
Communicate, educate, collaborate. Everyone works together.
We need to have an open line of communication between the nurses and the teachers. There is no reason that the procedures can not be amicably discussed and an agreement reached. We need to understand their position in wanting to help the students and they of course need to understand our position of trying to do our job.
It’s never too late to establish ground rules that everyone can work with. Inform the school staff that they are welcome to call parents if they want to but please inform you if they are going to do that. As a nurse we know that we need to document all situations that we are involved with. If something comes back to bite anyone it should be documented for you to refer to.
Ask that they send sick kids to you instead of just sending them home – after all, this is what I’m here for. Keep the lines of communication open: if the teacher feels that the student needs to go home or be seen for whatever reason then have a conversation about their concerns and come to an agreement. Part of our job is educating, teachers and staff included. If after you’ve discussed and they have been educated they decide to continue the same actions then kiss it up to god and let it go. I’m rarely one to say things are “not my problem” but there comes a time where you have done what you can and now you step out of it.
At the end of the day communicate, educate, collaborate. Everyone works together for the good of the kids.
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