Featured

I want to Share Your Voice!

Your Favorite School Nurse would like to hear from all of you to see how things are going and hear some input about your experiences so far with this weird school year.

Click the link to the survey and fill out the “interview” for me so I can learn about your experiences and share your voice.

School Nurse Interview

Welcome to The Tooth Fairy Club!

What a fun age: you go to first grade, start learning big things, get real homework, and teeth are falling out all over the place!

As we all know, losing baby teeth is a normal part of life. Some kids look forward to it and others are afraid. Here are some tips and tricks for dealing with lost teeth at school:

  1. Don’t panic: There is nothing to worry about when dealing with losing baby teeth. Often kids get upset over loose teeth because they aren’t used to that discomfort and don’t understand. Many people panic over a small amount of blood – understand that mouths and lips are very vascular and bleed easily but a regular every day tooth falling out is not dangerous.
  2. Saltwater rinse: mix 8 ounces of warm water with about a teaspoon of salt and have them swish for about 30 seconds and spit. Repeat this a few times. This will clean the area and also help with some of the pain if they have any.
  3. Gauze: most lost teeth bleed a little. Unfortunately you might also get the ones that bleed a lot! You should have some 2×2 gauze handy (sterile would be best but non-sterile is ok too), or cotton dental rolls for the child to bite down on to provide pressure to the area. A tea bag also works really well for this (as long as they don’t have an allergy) – soak a black tea bag in warm water for a minute or so and have the child lightly bite down on it. The tannins in the black tea help the blood to coagulate at the site.
  4. Educate staff: regular loose teeth and lost teeth are not a major emergency. Loose teeth might bleed or hurt before they come out and that is totally normal. There isn’t a whole lot one can do to make that better aside from wiggling the tooth, saltwater rinses and Motrin or Tylenol if it’s really painful. Lost teeth and loose teeth can often be managed in the classroom without a visit to the nurse but a phone call to the nurse to check in on the event is warranted.
  5. Save the tooth: The kids want the tooth fairy to visit so try and save the tooth for them in a tooth holder, zip lock bag, or small envelope. If the tooth is lost or swallowed (happens all the time, nothing you can do about it as it won’t hurt the child) no worries, the school nurse can give the child a receipt for the tooth fairy as proof that the tooth got lost and isn’t available.
  6. Celebrate: I’m making a bulletin board this year for the Tooth Fairy Club, and making a stock of certificates to welcome the kids into the Tooth Fairy Club – get yours here: I also have stickers for them if they want one (other stickers).

When is a lost tooth an emergency?

  1. If a permanent tooth is knocked out: this is a medical emergency. If the tooth is intact, place it back in the socket gently and carefully push it back in to place. Be careful not to touch the root area – only handle the crown or outside part of the tooth. Have the person gently bite down on gauze to hold it in place and seek emergency dental care. Don’t try to put a baby tooth back in.
  2. If a tooth gets broken but not knocked out: Try to save the pieces if possible. Place the pieces in milk or saline. Rinse the mouth with warm water and call the dentist right away for evaluation.

Do you have any tips or tricks to deal with teeth coming out? Let me know if you have any great ideas!


Save 20% with code MROSUMMER at MaryRuthOrganics.com 8/2-8/8/21.

And We’re back…

Just over 365 days ago, we got the word that school would be closing for two weeks in order to mitigate this “Coronavirus” thing that was happening. I was so sick that week but we didn’t have any cases in this side of the country so at the time I didn’t think anything of it. I remember telling a friend “there’s no way I’m getting tested for this because if I’m positive them I’ll be on the news and I’m too ugly to be on TV!” I called out that Friday the 13th not knowing that this was it for a year.

A Facebook memory just came up the other day too with a picture of me and the caption read “Do these glasses make me look like I have 2 weeks off work?” How silly of us to think that 2 weeks was the key and we’d be right back to buisness.

Anyway, all of that is for another story because, as I said, after 369 days working in the comfort of my own home, I’m back.

It is NOT the fairy tale it seems like it should be (I’m sure you all thought this would be as magical as I did right??)

A month ago, we stood outside of our schools protesting, holding signs and having a “work out” to protest the return to our buildings under a hastily thought out plan to bring in students back to the buildings with no ventilation or inadequate ventilation, teachers hadn’t been even considered for vaccinations yet, and plans for cleaning and distancing students and staff had not yet been finalized or put in place.

We fought the “fan debacle” that arose as ventilation in old dilapidated buildings had long since failed and would not support a safe return to many buildings. They thought residential window fans blowing air around was the answer. It was not. According to the CDC and many other sources, having a fan blow unfiltered air around a room or directly on persons in the room would actually increase the spread of infection as opposed to decrease it. Furthermore, many classrooms have nonfunctional windows in which to install the fans, inadequate or insufficient electrical outlets to support a window fan. This was simply not the answer. The final answer that was accepted was air purifiers in each space that would be occupied.

We were informed that all buildings supporting pre-kindergarten to second grade would be “deep cleaned” in preparation for welcoming back students (because they hadn’t been already?). Reportedly more cleaning crews were hired, cleaning solutions were purchased, classrooms would be deep cleaned and then set up for appropriate social distancing. We will even work from home on Wednesdays so they can deep clean more after the Monday/Tuesday cohorts have been in. All of this would be accomplished in 157 large buildings over the course of approximately 1-2 months (nevermind the least YEAR??).

The vaccination program is now underway with many teachers having received at least the first if not both vaccines already. Schools have opened in groups – three groups so far with a few left to be finalized and cleared for opening. We’re ready…. ish.

Real time: I’m in the third group to reopen, the two other groups of schools have opened in the last two weeks to a low number of students compared to what was expected or advertised in the news. We are notified on a Monday afternoon that we can plan to arrive at our schools by 8:20 am on Wednesday and the students would be there ready for in-person school the following Monday. Pack up your home offices and get babysitters ASAP because this one seems like its going to stick (for the 4th attempt).

It’s not like we didn’t know this was a possibility but realistically, with everything we have been through in this particular building from asbestos abatement, staff turnover, lack of ventilation systems and having visited a week ago to drop off some supplies and seeing the state of the building, I fully expected that we were not even on deck for any opening for this school year. When I look at the posted list of schools for round 3 I am shocked. We are opening. Schools with newer buildings that have been totally ready and waiting are not listed. There are a lot of tears, panicked texts sent, wine drinking, frantically packing my things, looking for clothes to wear, making lists and spending the evening in panic mode.

Tuesday was better. After some sleep and a clearer mind I can get my Tuesday work done and pack my things I need to take back with me (it’s a lot). I have clothes ready, car packed, lunch ideas planned, it’s going to be fine. I’m actually happy to be able to go back to the office after being at home for so long. It hasn’t been easy working from home with family running around and no access to all of my things.

Now that I’m actually here I am so. sad.

Day 1: My office has not been touched in a year except for all of the furniture rearranged at some point. I think the middle part of the floor may have been waxed. There’s a used paper plate on my desk. Everything is covered with a layer of grime. There’s mouse poop on my desk. My coffee maker appears to be broken. My mini fridge is missing but there is a brand new air purifier in it’s place. My ice machines are dirty and not working. My thingy to open my windows is gone as well as my mop, broom and dustpan. The signs on the outside of all the rooms that are there to indicate how many people may safely occupy the space are all blank (they were filled in later in the day except for mine).

I’m told that even though my room is not listed on any paperwork as inspected or cleared for occupancy that it’s fine for me to be in it alone with no one else as long as I wear a mask and have the air purifier. I’m mad that I protested and fought for this and yet I’m not important enough to spend 8 hours a day in a safe, clean environment.

My secondary sick room I’ve been assigned is loaded with trash, old teaching materials, wads of hair, science materials, textbooks, whatever was left there when we were last here last year and whatever was pushed in there over the year. I have an overwhelming amount of work to do to have these spaces ready for students.

I get to work cleaning, putting things away, moving crates and boxes, moving furniture, and disinfecting everything.

Day 2 – Day 3: Things are set up, fairly well cleaned by me, spreadsheets created and updated, Covid testing supplies and paperwork organized. I even found one of those sticks to get my window open which helps tremendously because the heat is cranked up high! My isolation room is clean and has received an air purifier. Things are looking fairly good!

Fast forward a few weeks, a spring break week, a whole class quarantine and two new surveys for more students to return and here I sit. It’s not so bad now. Many of the students who initially were coming back never came. A few came once or twice and never came back. We have just a few big kids slated to return next week but who knows if any of them are really coming or not?

I have to do Covid tests on the kids which was super overwhelming at first because it seemed like a lot but it turns out that the kids are really cooperative. Even the kids in the Autism Support class and Life Skills Support class are good as gold. The computer work is easy since I’ve done it a bunch of times now. A lot of the regular education students never came so there wasn’t as many as it seemed like in the beginning either.

All in all it’s ok I guess. I miss having my door open and having the kids in the halls. I even miss the kids fighting and running around wreaking havoc on the staff. I miss the chaos. It’s pretty lonely really. There are no in person meetings, very few phone calls, very little interaction with the staff. I think some of the kids found out that it was the same for them – not very much social interaction and very lonely. Everyone hates wearing masks all day.

We shall see what next school year brings but overall, after all the anxiety of returning after a year, it could definitely be worse!

Air Oasis

Your Kid Has an Allergy: What the School Nurse Needs You to Know.

Your child has an allergy to something and you have to send them off to school. That can be scary for many parents but we’ve got your back here at school! Here is some information your school nurse wants you to know about having allergies at school.

What is an anaphylactic allergy or anaphylaxis? Anaphylaxis or allergy to foods/medicines is a different issue than intolerance to foods or substances. When a person has anaphylaxis to a substance it means they have a true allergy which can cause their airways to swell and tighten making breathing difficult, blood pressure can drop causing them to pass out, they get itchy red hives all over or in different places, they may be coughing or vomiting.

Anaphylaxis is a life threatening emergency that requires epinephrine as soon as possible to reverse the allergic reaction. Usually the allergic reactions tend to be worse with each exposure so the first or second exposure may be mild but continuing exposures can become worse each time.

An intolerance to a substance is generally unwanted side effects from a drug or food such as lactose intolerance versus cows milk allergy. Lactose intolerance means the persons body does not process the component of cow’s milk and can give them nausea, diarrhea, or upset stomach but rarely worse symptoms than that. A true allergy generally consists of the above mentioned symptoms. A person may be intolerant to a medication such as Amoxicillin where they have diarrhea or upset stomach or they may have a true allergy that involves hives and anaphylaxis. It’s important to know the distinction as each would be treated differently and intolerance is less emergent than anaphylaxis.

Common triggers for anaphylaxis can include foods like peanuts, various nuts, cows milk, eggs, some antibiotics and other medications, seafood, shellfish, strawberries, and various fruits and vegetables. There is no end to the substances that someone could be allergic to but these are some of the most common ones. One has to be careful to read labels and ask questions to be aware of the ingredients of certain foods as they may have an allergen in them that you were unaware of. One should also be aware if their food is cooked at or prepared in a facility or kitchen that is also using the allergen they are allergic to as the cross contamination could cause a reaction.

What do we do when someone has an anaphylactic allergy? In school, once the emergency is recognized, the Epi-pen will be administered as soon as possible – in my school the Epi-pens are housed in the nurses office and they would call me or radio me to get to the scene with it asap, older students would be allowed to self carry. In some schools the Epi-pen is with the student at all times and the student or the closest adult trained staff member will administer it. The second step is to call 911 because even if the reaction is reversed it can begin again so EMS is needed. If the doctor has ordered Benadryl we will also give that right away if the student is awake and able to take it. Someone will be calling the parent or guardian of the student immediately. The treatment, 911, and parent phone call can all be done at the same time by different staff members.

So what can you do when you send your child to school when they have an anaphylactic allergy to a food or substance?

  1. Communicate. You should let your child’s teacher know, let the school nurse know, let the administrators know, and you can even let the food service people know as well to avoid any accidental exposure at meal times. As the school nurse, I do provide the relevant people information about specific student’s allergies so everyone is on the same page and knows to be careful. This can be done with a phone call, email, or most importantly, a health form from a well check.
  2. Send an Epi-pen to school with your child and include the appropriate doctor’s orders as soon as possible. Check if your child’s doctor wants you to also provide Benadryl to accompany the Epi-pen (some do some don’t).
  3. Check if your child’s school has standing orders and stock Epi-pens – mine does not and the parents must provide it always but many schools have standing orders and stock Epi-pens.
  4. Always be sure to provide the school with correct and updated emergency contact information. If your child does have an allergic reaction we will need to get ahold of you right away. Your contact information and allergy information should be with the student in case of emergency so we can call you as soon as possible.
  5. Consider placing a medic-alert bracelet on your child so everyone is reminded to avoid exposure.
  6. Make sure your child knows what an allergic reaction looks/feels like so they know what to do in case of exposure. They need to know to tell someone immediately if they are able to (some reactions are too fast for them to say anything and some kids just don’t know that anything is wrong until they are in full blown anaphylaxis).
  7. Make sure that your child knows how and when to use their Epi-pen. Most of the time the nurse or adult staff member would be administering the Epi-pen as soon as possible but there may be occasions when the student has the pen with them and is able to react faster. They should know what to do. You can even make sure your child’s siblings and friends know how to recognize symptoms and how to use the Epi-pen (if they are old enough) just to be safe.
  8. Find out what the policies are at your child’s school for managing food allergies. Is the whole school peanut-free? Just their class? Just their special lunch table? Not allergen free at all? You can ask for accommodations for your child if the school policies don’t align with your child’s needs – most likely the teachers, admins and health team will be able to come up with a plan that works for your child.

For school nurses:

What can the school nurse do to help manage and/or prevent anaphylaxis in their school?

Organize your Epi-pens and have them clearly labeled and available so you can grab it quickly and run if needed. Over the door shoe organizers work well for this, or if you have the means they sell really nice medication storage units. I also found this simple cubby unit that would be perfect for storing meds at your fingertips.

Keep all the parents information with the Epi-pens. Place a copy of their contact information, insurance information, health information, action plan, and anything else you might need to look up quickly with the Epi-pen so you can grab it all at once and not have to search for it.

Make sure your staff knows how to operate an Epi-pen, how to recognize anaphylaxis, and what steps they need to know to help manage an emergency. Education is crucial to recognizing and managing an allergic reaction quickly for optimal outcomes. Check out this presentation I made to educate my staff on how to use Epi-pens: Epi-pen

Educate staff on the procedure for handling an allergic reaction. They should know who to call, when to call, where the medications are and how to access them. There should be pre-established roles for who is calling 911, who is calling the nurse, who is calling the parent, and who is tending to the student. If this information is established prior to an emergency the management will hopefully flow better and have a better outcome. Think like a code situation – who’s wearing the red hat?

Make sure you provide the pertinent information about specific allergies to the students teachers, lunch people, and staff that needs to know. They don’t know what they don’t know so if they aren’t looking for it they might miss the beginning of a reaction or miss a possible exposure.

Establish a policy for your school for how exposure prevention to allergies will be handled. Decide if your facility will be completely allergen free – this works if you have multiple known allergies to one specific food (like peanut-free). You can have the students with allergies sit at a “safe table” in the lunch room but consider the fact that this has the potential to make the students feel singled out and possibly embarrassed (in my opinion embarrassment should be second to preserving life – if that is the best option for the students in your school then so be it). This is something to discuss with your administrators to decide how to proceed. In my school we do not separate anyone nor do we limit any specific foods due to allergies. We stay aware of the allergies and students are educated not to share food. Because my school is in a lower socioeconomic area, many students don’t have the choice to choose what foods they can bring and limiting their choices can lead to increased hunger in the students who don’t have allergies. The majority of my students receive the school lunches and breakfasts so the foodservice people are aware of who can’t have certain foods and avoid that. Also, the school meals are generally allergen free to reduce unintended exposures.

Sources: https://www.mayoclinic.org/diseases-conditions/anaphylaxis/symptoms-causes/syc-20351468

https://www.aaaai.org/conditions-and-treatments/allergies/anaphylaxis

https://www.epipen.com/en

Air Oasis

Periods: What the School Nurse Needs You Need to Know.

It’s happening. It’s about that time that your young lady has been waiting for. She got her period. It is a new phase of life for her full of questions, emotions, hormones, and anxiety.

What does the school nurse want you to know so we can all help her live her best life at school?

  1. Let the nurse and teacher know what’s happening. We can best support when we are in the know. We will always be happy to communicate with you and work with your child’s needs but we have to know what you/she needs. Are there any specific cultural needs regarding menstruation? Are there any specific health needs for your child that would affect menstruation? How is she feeling about it and does she need additional emotional support?
  2. Talk to your child about menstruation and make sure they understand how and when to change a pad or see the nurse, what cramps are, and what “heavy flow” is versus light flow. If you don’t know what to say, please let the nurse know and we will be happy to chat with your child about it (with your permission) and answer any questions for you and your child. You can even participate in the conversation if you want.
  3. Talk to your child about pregnancy and safe sex. Whether or not you like it, it is important information that they need to be aware of. They can absolutely get pregnant if they have started their period and they have unprotected sex. Talk to your sons about it too because they need to know.
  4. Talk to your sons about periods too. Boys should be educated because they will grow up to be men and they should understand how to be sensitive to the ladies in their lives.
  5. Provide an adequate supply of menstrual supplies for each day including spare pads, spare underwear, wet wipes (if you use those), and peri bottle (if you use that). Don’t forget a plastic bag or two in case of clothes change. If you don’t have access to supplies please let the nurse know so we can help. No one should go without these important supplies yet many do not have access.
  6. Encourage her to keep a spare pair of underwear and even a spare pair of pants in her bag or locker just in case of accidents. It’s embarrassing enough to get your pants stained where everyone can see it, but it would likely be equally as embarrassing to have to wear the nurse’s spare clothes. Equally as important – replace the spare clothes if they get used because the next time she might not have spare! If one has the means, they do make the new “period underwear” the helps to eliminate leaks and stained clothes which I’m told work well but are somewhat costly.
  7. The school nurse can usually give your child Motrin or Tylenol if they have cramps (assuming the specific school is allowed). Please communicate with the nurse about this if you have questions or concerns. I always call home and ask before I give medications but that may not be the policy for all schools. Follow your school’s policies and procedures if you want to send medication to school for your child.
  8. Consider a book or two that she can read at her own leisure such as this one: “The period Book: A Girl’s Guide to Growing Up”. or “The care and Keeping of You, The Body Book for Older Girls” – there is also one of these for younger girls too!
  9. Here are great articles from Kidshealth.org about how to talk to your child about periods: Kids health – Periods, and another article about puberty: Kids Health – Puberty

Aside from what the nurse needs you to know, I would also like to share some important tips and information that the school nurse wants your menstruating child to know.

  1. Decrease cramps: Consuming salty foods and caffeine can make cramps worse. While we do tend to crave salty snacks surrounding menstruation it unfortunately can make things feel worse. The science: Increased salt can cause water retention which can cause you to feel more bloated and increased bloating can cause increased cramps, plus increased bloating can just make you feel icky and uncomfortable. Skip the chips and soda during your period.
  2. Treat cramps: heating pads are amazing. The science: cramps come from the muscles in the uterus contracting and causing pain. Heat relaxes muscle and helps to relax the uterus decreasing the cramping. Aside from a heating pad you can also try a hot/warm bath at home or a hot water bottle.
  3. Treat cramps: Motrin/Advil/Ibuprofen (all the same thing). IF your child is medically allowed to take Ibuprofen then it is very helpful for cramps. The science: Ibuprofen is an anti-inflammatory and reduces pain and inflammation thus treating cramps well. Consult with your doctor prior to administering medications though, just to be safe.
  4. You’re not losing as much blood as you think. During the average menstruation cycle you only lose a few tablespoons of blood. The science: The “stuff” that comes out during your period is a mixture of blood, fluid, and tissue from the lining of your uterus. More often it looks worse than it is so try not to stress.
  5. You have a few options for supplies. Pads are the most common option, especially for younger people. Tampons are great but have a risk for scary things like Toxic Shock Syndrome or forgetting you have one in. Menstrual cups and discs are great but they can be difficult to use for some and may feel uncomfortable to some people. There is also the “period underwear” that absorbs – I’ve never seen one of these in person so I can’t speak to comfort but I’m told they are great (although maybe expensive)! they can be used for normal flow or extra protection from leakage along with a pad or tampon. Check with your trusted adult (mom, dad, doctor, school nurse) and decide what is best for you.
  6. Change your pad/tampon every few hours. DO NOT leave tampons in for more than 8 hours or so. Use toilet paper in the bathroom or the wrapper for the new pad to wrap the used pad and place it in a trashcan. Do not flush pads. You shouldn’t really flush tampons either but many people do.
  7. You may be irregular. When you are young and menstruation is new for your body it can take months or years for your body to be hormonally regulated. Your period may be every 28 days, or maybe you miss 2 months or it comes again after just 2 weeks. It might also be heavy one month then really light the next month. It might last 2 days sometimes or last 7 or more days another time. It’s all normal.
  8. Track it. There are tons of apps you can use to track when you get your period and how long it is. Personally, I like Ovia because you can put in a lot of information to keep track of. While that app happens to be one specifically for trying to conceive, it is also helpful for tracking your period, moods, symptoms, and many other things. You can also just track on your calendar or planner when it starts and ends. It’s good to know this info so you can be prepared for the next time with supplies, or if you are receiving medical treatment (like an x-ray) they sometimes need to know what the date of your last period was if you are of “child bearing age”.
  9. You’re likely to feel a rollercoaster of emotions from day to day because of hormones. If ever you feel very down and need to talk, find a trusted adult or friend and tell them. You are not alone and those bad feelings will go away.
  10. You. Can. Get. Pregnant. If you have started your period and you are sexually active, you absolutely can get pregnant. Do NOT assume that doing it just once unprotected is ok because it is NOT ok for so many reasons. Do NOT assume that just fooling around a “little bit” is ok because you absolutely can still get pregnant.
  11. Using a tampon or menstrual cup, while not always recommended for younger people, does not take away your virginity. Sometimes using one of those is necessary such as for competitive swimmers. Definitely check with your parent and/or doctor and ask if that is an option for you or if you should stick with using pads for now.
  12. Don’t be afraid to ask questions, this is all new to you. If you have any questions you should go to a parent or guardian, the school nurse, teacher or another trusted adult in your life.
  13. There is nothing to be ashamed or embarrassed of. Periods are a totally normal part of life that almost all females (and some trans males) have to deal with. Learning all the information you can should help you be able to adequately manage it.
Phases of the menstruation cycle

For school nurses:

Check out this awesome lesson about teaching puberty to 6-8th grades: Kids Health lesson

Check out all this great educational info about reproductive health info from Beyond The Pill: Beyond The Pill

Here is an interesting article about the lack of menstrual supplies in impoverished nations

Another interesting article about “period Poverty” and what some schools are doing.

The School Nurse: More Than Bandaids and Ice packs

“Oh, you’re a school nurse? So what do you even DO? Like just give bandaids and stuff?” I hear this all the time. The other big one right now is “Oh, you’re a school nurse? Must be sooo nice to be able to just sit at home and not work during a pandemic!” I could not be more annoyed with this thought process.

Yes, I am a school nurse. I am a certified school nurse which requires me to be a registered nurse with a Bachelor’s Degree in Nursing and many, many additional graduate courses in things like legal concerns, nursing policy, healthcare procedures, public health, immunizations, various computer programs, special education, healthcare management, pediatrics, teaching, alllllll of the health issues that children can face, and so much more. Presently, add to that the hoards of policies related to Covid management and mitigation within communities which are constantly changing. I am also just a few classes away from completing my master’s degree in Nursing Education.

Currently I am participating in virtual learning as my district is closed to in-person learning due to the pandemic. I assure you that I am NOT “just sitting at home enjoying my time”. Just like the teachers, I am out of bed at the crack of dawn drinking coffee and getting ready to work. I am sitting at my computer for hours a day managing my usual workload as if I was in my office at school. I’m calling people, texting people, emailing, tracking down information on immunizations, heath issues and well checks, following up on issues, and tracking and following Covid cases within my school community. I’m creating educational content for health related issues to share with my students, trying to keep up with the constantly changing protocols for my city/state/country in dealing with this pandemic, and trying to be supportive to my students and coworkers by learning as much as I can to keep them all informed.

Oh, and the meetings – Zoom, Google Meet, FaceTime, never ending meetings that I have to get dressed for so I don’t look like I’m struggling to survive. Just about the only thing I’m NOT doing right now is handing out ice packs and bandaids!

Now take all of the above and throw in being at home, with a toddler who needs to eat and be entertained and educated, a house and chores that need to be done, people who need to be driven places, holidays to deal with, pets to care for, and life in general and you will see that this is not all fun and games for the “just a school nurse”.

On a normal, non-pandemic/virtual work day I’m doing all of the above plus adding in bandaids and ice packs, the sprained ankles, the ambulance calls, the fights, the daily medications, the nosebleeds, the pooped and peed pants, head lice, child abuse, bed bugs, pinkeye, random rashes, periods, the hearing screens, vision screens, height and weight screens, the mobile dentist, the mobile vision team, the mobile hearing team, fire drills, lockdown drills, trying to get medications and forms from parents, trying to get orders for things from doctors, tracking down immunization records and well check records, making “house calls” to classrooms because so-and-so is having a seizure or a behavioral episode. Don’t forget all the clerical work of computer documentation, scanning forms, entering stats from the forms, entering the screening info, preparing and sending letters for all the failed screenings and then following up on those. I could go on.

It’s chaos on any given day.

So yes, it’s easier working from home for sure, and school nursing is easier and more enjoyable (to me) than the hustle of hospital nursing (have you tried emergency trauma nursing? Because I have and while I loved that too, it’s a fast burnout) but pandemic or not my job is far more than just bandaids and ice packs. I am not a health aid, I am not a CNA, I am not a parent volunteer, I am a well educated healthcare professional who works damn hard at her job. Before you assume that I am “just a school nurse” stop and consider what that even means.

We All Need a Little CEU In Our Lives.

Renewing your nursing license? If you aren’t in school right now then you’re gonna need CEU hours to renew your license properly. Not to mention that continuing education is paramount to being a good nurse!

I thought I’d help everyone out a little and hook you up with some links to CEU’s, I’m hunting for all the free ones (although there are some really good paid ones out there too!).

  1. Nursing CE by ATI: https://www.nursingce.com/free-nursing-ceus. This one has regularly changing free CEU’s on interesting topics and also a large selection of interesting paid ones.
  2. Intiva health: https://learning.intivahealth.com/Public/Catalog/Home.aspx?Criteria=9&Option=67&tab=2 sign in and create a free account, then you can pick from categories including free CEU’s.
  3. Nurse.com: https://www.nurse.com/ce/free-courses?p=1 this one has tons of good ones including COVID UPDATES!
  4. Incredible Health: https://www.incrediblehealth.com/ceu/ This one was a little bit annoying to sign up for but in the end they have a ton of free choices, an ap, and you can take these CEU’s on the ap on any device. I’m looking forward to giving it a try!
  5. Medscape: https://www.medscape.org/nurses tons of free CEU’s, also this site has a CE tracker to keep a running list of how many hours you have. SCORE!
  6. American Heart Association BLS course: https://elearning.heart.org if you need to recert your BLS, ACLS, PALS etc the online portion gives you 1.75 contact hours. After you’ve completed the online course you can submit for the certificate of CEU.
  7. NASN (National Association of School Nurses): https://www.pathlms.com/nasn/courses?category_ids[]=686 tons of free learning courses and webinars that offer free CEU’s if you are a member of NASN already. If you’re not a member I highly recommend it for many reasons including the FREE CEU’s! I just signed up for 8 CEU courses on here, most are 1.0 contact hours but they add up over 2 years!
  8. ENA (Emergency Nurses Association): https://www.ena.org/shop/catalog/education/free-ce/c-23/c-99 These ones are free if you are a member but pretty cheap if you aren’t a member – $9.95 for non members is pretty good. They offer 1.06 contact hours. Act fast if you’re into emergency medicine because these do expire – there are always new ones uploading though.
  9. Nemours “Pediatric University”: http://www.pedsuniversity.org/Education.aspx all free for everyone. Nemours is one of the premier pediatric hospitals in the United States. These appear to all be around 0.75 contact hours.

I will try to update this list as I find some more good ones but in the meantime, please check out this CEU tracking tool on Teachers Pay Teachers: https://www.teacherspayteachers.com/Product/Nurse-CEU-Tracking-Tool-6138994

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Your Favorite School Nurse Has Been Swamped!

Has anyone else been just swamped with work since school started? I totally have been. I’m all virtual right now and working from home which poses quite a few problems as far as trying to organize and get work done while there are children and pets running around!

Navigating all the Google Classrooms, ClassDojos, Student Information Systems, Online Registrations, emails, online health forms, Google Forms, Zoom meetings, Google Meets, Professional Developments etc etc is all new and added things that I didn’t have to do before.

Throw in trying to decipher all the COVID protocols and procedures that are ever changing by the day, and I’m fried! Anyone else?

I just wanted to apologize to anyone looking forward to content from me because I haven’t been putting out anything good lately but that’s why!

I am going to leave you with some links to check out for various things that may be helpful to you. As always, check out some of my other posts for some good info too!

Here are some links to PPE that seems to be affordable and most importantly, IN STOCK!

Reusable Face Mask

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Working on a new resume? This may help:

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Need to try some self care?

Seelbachs (alcohol. come on, you know you need some!

This post contains affiliate links. If you use these links to buy something we may earn a commission. Thanks.

Don’t Insult The Nurse!

Does anyone else remember that time that the ladies on “The View” mocked the nurse turned pageant contestant for wearing a “nurse’s costume” with a “doctor’s stethoscope”? I was kind of mad. Here’s what I messaged them 5 years ago:

Dear Ladies of The View:

I’m sure by now you’ve see the error of your nasty, mocking comments regarding Miss Colorado, Kelly Johnson “just a nurse with a doctor’s stethoscope”.

I, among others would like to point out a few things to you. I am a Registered Nurse in an Emergency Trauma Center. When your father comes in having a heart attack it is the NURSES who get life saving IV lines, give life saving medications and RUN to the cardiac catheterization lab to give him the best outcome. When your son crashes his motorcycle it is the NURSES in the trauma room who perform life saving procedures, assessments, blood transfusions, etc. When you had a little too much to drink and fell down the stairs and broke your ankle and are in blinding pain, I’m the one there to care for you.

I work weekends, overnights, holidays, and extra shifts. While you are home Christmas morning with your children opening presents, having Thanksgiving dinner, going to soccer games, having Easter dinner, or simply seeing your children and families I am at the hospital caring for your grandma’s stroke, your daughter’s broken arm, your brother’s mental breakdown, your neighbor’s Heroin overdose, and your mother’s cardiac arrest.

While you are sitting around your table chit chatting about the latest fad diet, ombre hair color, or celebrity divorce I am at the hospital doing my job where I am vomited on, spit on, defecated on, urinated on, screamed at, punched, bitten, berated, and disrespected. I do not get bathroom breaks whenever I have to go, sometimes I have to hold it for hours. I rarely get a break to eat, sometimes a 12 or 14 hour shift with no break. After that, I have to rush home, get the children to school, grab a few hours of sleep and get up to do it all over again.

Do any of you know someone with Alzheimer’s? Do you know how difficult that can be for the patient, the family, and the NURSES who spend day in and day out caring for these people? To mock a nurse who works in an Alzheimer’s unit for doing a job that is so difficult and important is absolutely reprehensible. You should be ashamed.

I implore you all to spend just one day in scrubs in a memory care unit, or a busy emergency room, a hospice care center, or riding with an ambulance, and see just how “dumb” our job is. After that you need to have Miss Kelly Johnson on your show to publicly apologize to her for your disgusting behavior. After you’ve apologized your show deserves to be removed from the air.

I would hate to see how you would react if another contestant was a military officer, or a police officer and described their experiences. Pretty dumb compared to your job I guess.

Do You Need to Make an Individualized Healthcare Plan or an Action Plan?

One of the many jobs we have to complete as a school nurse is to make Individualized Healthcare Plans (IHP) for students. Remember nursing school when you had to make care plans for your patients and thought you’d never have to do those again once you graduated? You were wrong!

The IHP is essentially a care plan for your students with health concerns that might warrant one. You do not need one for every single student that has a health issue listed but you should have ones for the students who’s health problem may impact their education.

The IHP is different than a 504 plan. A 504 plan is a legal document between the student/parents and the school district that outlines accommodations for the student as part of the Americans with Disabilities Act (ADA). The purpose is to outline accommodations for the student who’s health concerns will impact their education whether it is a medical issue such as diabetes or a different issue such as ADHD. The student with a 504 plan may not be eligible for an IEP or Special Education but still requires extra accommodations to succeed. https://oley.org/page/IHP_IEP_Difference

The IHP is different than an action plan but some do use them interchangeably, or combine them if possible. I prefer to combine them as both are needed.

The IHP is a long(ish) term plan to manage a student’s specific health issue while in school. It should be redone per school year or if there are changes in the health status. It is basically a nursing care plan including nursing diagnoses, goals, interventions and outcomes. Once you’ve created the IHP you should consult with the parent and student (if possible) to agree upon the plan and hopefully get a signature on the plan.

If one has the means, they can purchase these books that not only has all the information for IHP planning but it also has software included to manage IHP’s on the computer. Click the picture for the link.

 

Another resource for IHP planning is NANDA International. You do have to pay to join the site and receive information (I am not associated with them). I am not a member but if you plan on really going all in with IHP’s then it is available for you. https://nanda.org

Here is a list of approved nursing diagnoses: https://challengesandinitiatives.trubox.ca/wp-content/uploads/sites/601/2018/12/Nanda-Nursing-diagnosis-list-2018-2020.pdf

And of course, The Nerdy Nurse has some very good information about NANDA: https://thenerdynurse.com/nanda-nursing-diagnosis-list/

The action plan is a file listing things to do in an emergency specific to the student’s issue. It should also be redone each school year or if there are changes to the information. This should include doctor information, emergency contact information, medications taken with dosages and timing, and any other pertinent information to manage an acute issue.

I prefer to retrieve pre-made action plan templates from the experts, or the student’s physician can provide one for you.

Asthma: Asthma and Allergy Foundation of America has the best action plans for asthma plus other resources and info. https://www.aafa.org/asthma-treatment-action-plan/

Seizures: The Epilepsy Foundation has the best action plans and resources for seizure management. https://www.epilepsy.com/learn/managing-your-epilepsy/seizure-action-plans

Diabetes: The American Diabetes Association has great resources to manage the care of diabetic students. https://www.diabetes.org/sites/default/files/2019-06/ADA%20Childcare%20DMMP.pdf

Hemophilia: While not super common, I’ve actually had TWO students with Hemophilia! this one is very important to have a good action plan for. Hemophilia Federation of America has all your resources for school management. https://www.hemophiliafed.org/for-patient-families/resources/toolkits/back-to-school/

Anaphylaxis: The Academy of Pediatrics and Healthychildren.org have plenty of info and good plans for students with anaphylactic allergies. https://www.healthychildren.org/SiteCollectionDocuments/AAP_Allergy_and_Anaphylaxis_Emergency_Plan.pdf

Please check out my TpT store for a blank IHP template: https://www.teacherspayteachers.com/Product/Blank-Individualized-healthcare-Plan-Template-6025502

Some of the links in this post are affiliate links. This means if you click on the link and purchase the item, I will receive an affiliate commission at no extra cost to you. All opinions remain my own.

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