http://www.wtvr.com/news/wtvr-school-nurse-uses-epipen-to-help-fifth-grade-student-20120214,0,2056654.story (http://www.wtvr.com/news/wtvr-school-nurse-uses-epipen-to-help-fifth-grade-student-20120214,0,2056654.story)
The first article seems more accurate than this one, since it seems it was at lunch and not a snack time---unless it was a class Valentine's Day party with pizza.
www.wric.com/story/16939893/local-student-saved-by-epipen (http://www.wric.com/story/16939893/local-student-saved-by-epipen)
I'm glad this had a happy ending. Certainly more things seem "right" here than in the case that preceded it.
But still-- an allergic reaction is in progress in a child with a peanut allergy, and the school nurse calls THE PARENT??
NO, NO, NO. :rant:
That's the kind of thing I'd expect a school secretary or classroom teacher to do. Someone who felt out of his/her depth. Unsure. That should NOT be the case with a school nurse. Sure hope that was not actually what went on here. :-/ Because if it was, then this school district has missed learning one VERY important lesson from that little one's death.
According to one story, the symptoms were still one body system. That would call for a call to us according to our plan unless that one system is mouth or throat GI Tract.
According to that story, the nurse saw the escalation, called the mom and told her she was going to epi. Now you're right--if the nurse has determined it's what needs to be done epi first, call 911 them call mom.
But I think overall this went well, although I hope the kid had a buddy go with him to the office. Or should have adminnes the epi there and then called the nurse if he self carries. As we know, being on the feet is not a good thing to do, but this child recognized what was going on and did something about it. His mom should be proud.
Except that this was a suspected PN ingestion, yes? Hard to know what symptoms were, exactly, since the two stories are somewhat conflicting. I'm not sure that "itchy" head, shoulders and neck is just hives-- or that the administrator reporting it is entirely correct. The other story seemed to indicate that the child realized pretty much immediately that he'd eaten something that contained pn-- which almost certainly means oral symptoms.
In most kids with PA, that kind of actual/suspected ingestion calls for epinephrine administration-- period. I guess not in someone without anaphylaxis Hx, though it seems unlikely that a child with that kind of history would have the training and presence of mind to do what this boy did. It's hard to know.
Good for this child for knowing what to do. :heart: You're right, Mac-- his parents should be very proud of him. :yes:
It makes me pretty grumpy to know that this was probably the direct result of unsafe candy being handed out willy-nilly for Valentine's day, though. A fair number of 5th graders are not yet capable enough to determine safety, particularly when you add in the mix-ups of lookalikes and size/packaging quirks in holiday candies. Ugh.
Oh, you both are so overshooting the temperment of even a "good" school nurse. A certified one even. School nurses just don't "do" time sensitive emergent field work. If you're a nurse, and you do have both the temperment and skill set to handle emergent situations or continuously manage an unstable patient (and I DO mean in the healthcare sense of classification) then that's where you'll find work if your license is worth the watermark it's printed.) School nurse pay isn't A THIRD of what even the surliest barely english speaking import with reciprocity can earn in ER, Surgery, Cath Lab, or a Critical Care open heart unit. That and a school nurse is minimal daily hours and probably not five days a week even.
It's not their primary function. If it were, they'd have equipment on hand to start at least an iv.... But they don't. Nor will they ever. It's a trick bag. For a number of reasons.
but I digress.
what you're asking for is someone for whom it's second nature.
You're not going to get that when 99.9 % of their time their primary function is submitting eye exam paperwork or going over dental hygiene with kindergarteners.
Just two days ago, the sub nurse called me at home to come pick my daughter up because her eczema was "itching" and her eyes were red. Um.....I told her if I was going to take her home for that.....get ready to pay for summer school and a homebound instructor. I went over anyway, washed the tempera paint off her little mittens with her favorite soapless body rinse, patted them dry, and applied a prescription moisturizer. her eyes were a tad red at the outer lower lid, but skin intact and in general just looked like "allergy shiners".
In the meantime she was sounding flustered when her personal cell phone rang and she blurted out to the person on the other end: "I can't talk now, my office has FIFTY people in it."
Oh, f***, princess, your office had THREE children in it, ONE of which was mine that I took off your hands, and the ONE seemed to be managing himself after you loudly complained we were using the bathroom (to wash the paint off my daughters hands) he typically used for whatever it was you wanted us out of there for. The other you addressed as "my diabetic" to me when you dismissed my inquiry if she could head back to lunch (after I gave her a little personal attention and some mommy love----you are SO not the nurse she was expecting for her daily jaunt/large motor break to the nurses office to shoot the breeze a few minutes during lunch).
that's like me telling someone who wants me to come see their family member: "I can't, I have to do "x" for my "small bowel obstruction". ~)
But yeah, only TWO kids there she had to do anything with and the one seemed to be waiting for someone to pick them up.
Egads. MY LUNCH BREAK IS BUSIER, if I get one.
"FIFTY".
fifty.
fwiw, I obtained permission for my daughter to go back to lunch from the office secretary. ;D
... but truly, in that case, Ark-- why is having school nurses in buildings "essential" if managing emergent care isn't something that the average one is any more capable of than, say, a cool-headed kindergarten teacher?
(That's a serious question, by the way. I'm definitely not disagreeing with your observations, since I've seen that myself too many times to discount it.)
Quote from: CMdeux on February 15, 2012, 01:49:07 PM
... but truly, in that case, Ark-- why is having school nurses in buildings "essential" if managing emergent care isn't something that the average one is any more capable of than, say, a cool-headed kindergarten teacher?
you've answered your own question because that whole mindset is what ends up clustering core/fundamental rejects into the school nurse slots.
when the pay is
commensurate with the expectation, then you'll see change. when "essential" is defined as "every day, each day, all day, in every school building" and not "Tues, Wed, Friday, every other week, you'll see nurses tripping each other on the way to the interview. When a school nurse doesn't tell me to my face: "
my boss told me I wasn't involved with the marching band, it's an extracurricular", you might get a set of nurses HIRED in the first place who wouldn't dare let a principal dictate their scope of practice. When practice, not politics, is held in regard, expect change.
But yeah, I'm not counting on it any time soon in the current economy, but "essential" is defined more often than not by budgets.
the best school nurse I ever had the pleasure of having a school relationship with was in 8th grade: Retired Navy Nurse. :evil:
She's now the district nurse (in a little over two years in the district). She's so COOL!!
Regular kinder nurse is full time and pretty adept, but I wouldn't want her walking into a ccu unit and titrating cardiac gtts, mixing amniodorone, pushing etomidate and succinycholine, or administering Mannitol, YK?
truthfully, I think everyschool should have TWO nurses daily as peer oversight is a pretty good motivator. There's a lot to be said for brainstorming in a crisis. It works. ;D
but yeah, TWO nurses, not one. It's too easy for the casual RN to slink off to a corner.
Quote from: Arkadia on February 15, 2012, 02:11:21 PM
the best school nurse I ever had the pleasure of having a school relationship with was in 8th grade: Retired Navy Nurse. :evil:
She's now the district nurse (in a little over two years in the district). She's so COOL!!
Regular kinder nurse is full time and pretty adept, but I wouldn't want her walking into a ccu unit and titrating cardiac gtts, mixing amniodorone, pushing etomidate and succinycholine, or administering Mannitol, YK?
Of course not...
but shouldn't a school nurse in possession of epinephrine, glucagon, and insulin be
adept at evaluation and management for both bG and anaphylaxis?? At the very least, I mean.
It just really troubles me that school staffers are basically expecting PARENTS to make an
over-the-phone evaluation when a child is in distress during an allergic reaction. It's far too often a feature in fatalites, speaking bluntly, and it
delays proper care. Personally, I consider it the #1 reason why I'd never give a school permission to speak with a child's doc; I'm afraid that they'd try to call him, too, instead of relying on protocol and EMS. :-[
CM--it may not have been in the child's plan to epi upon rcns from known ingestion.
And Ark--some people do a job because they love doing it. Not because they are mercenaries. It's why people go into education in the first place. Just because the setting is a school doesn't mean that school nurse is any less qualified than one with the same credentials as one in a hospital. Or that a hospital nurse is better.
Our Houston area elementary a school nurse was an RN, sharp as a tack, and an unbelievable advocate for DS. And she recognized as a rxn these symptoms: falling asleep on play ground after lunch and a lower blood pressure. She rocked. She'd worked in an allergist office but loved getting to know the students anda having holidays and summers with her kids.
Yeah, the fact that they called the parent when they saw the reaction escalating just irks me to no end.
WHY?? if your house is on fire do you call your momma? No, you call for qualified help. What is the mom going to do? She's not there! OH it drives me crazy. Give the epi pen, call for emergency help. That way, if the epi pen doesn't help or reaction continues, help is on the way.
Quote from: CMdeux on February 15, 2012, 01:49:07 PM
... but truly, in that case, Ark-- why is having school nurses in buildings "essential" if managing emergent care isn't something that the average one is any more capable of than, say, a cool-headed kindergarten teacher?
(That's a serious question, by the way. I'm definitely not disagreeing with your observations, since I've seen that myself too many times to discount it.)
I agree.
The fact of the matter is that school nurses NEED to be more adept at handing these types of emergencies. Because as we see, they are becoming more and more likely.
And, with the many stories of reactions AND deaths in the school setting, if you're a school nurse and not up to date on exactly how to handle a situation like this, you'd better figure it out.
Quote from: Macabre on February 15, 2012, 04:48:17 PM
CM--it may not have been in the child's plan to epi upon rcns from known ingestion.
plans don't supercede
good practice. Or scope of practice, for that matter. Even when there is a physician's name attached to them.
ask me how I know. ;D
QuoteAnd Ark--some people do a job because they love doing it. Not because they are mercenaries.
that's a lovely notion, but the field I work in you not only have to love, but KNOW WHAT YOU ARE DOING. Good intentions and a touchy feely "I just LOVE helping people" attitude doesn't cut it.
Actually, it
doesn't even have to be your first career choice. Nursing is littered with folks who decided they needed a job that they not only could tolerate and were good at, but paid the mortgage, too.
QuoteJust because the setting is a school doesn't mean that school nurse is any less qualified than one with the same credentials as one in a hospital. Or that a hospital nurse is better.
Survey saaaaays:
you're wrong. http://books.google.com/books?hl=en&lr=&id=ighVBJY_y7AC&oi=fnd&pg=PA247&dq=floating+nurses+guidelines&ots=PJXz1NJ-GS&sig=pE582WlYC5986j9R5DZ8ZfEnk8E#v=onepage&q=floating%20nurses%20guidelines&f=false (http://books.google.com/books?hl=en&lr=&id=ighVBJY_y7AC&oi=fnd&pg=PA247&dq=floating+nurses+guidelines&ots=PJXz1NJ-GS&sig=pE582WlYC5986j9R5DZ8ZfEnk8E#v=onepage&q=floating%20nurses%20guidelines&f=false)
Even critical care nurses won't float to Labor and Delivery or an Oncology floor. At least not nurses who have a speck of sense. Not unless they have EXPERIENCE in that field, and EXPERIENCE in the LAST YEAR. It's a rapidly evolving field all the way around. Or would you want a nurse who hadn't worked in Labor and Delivery in five years monitoring you and your unborn child/administering treatments while you were in labor?
Not only is
experience tantamount to defining the
scope of a nurse's practice, lawsuits are PREDICATED on it. You aren't invited to practice in emergency medicine without the credentialling or three month orientation. (minimum) I'm continually having to get recertified and inserviced in my field. We may hire new grads, but we require them to work side by side with another experienced nurse for three months minimum, full time, and then, we don't assign them patients who need a more experienced nurse. Sit in at bed/board and you'd know that.
Fresh hearts don't go to just any critical care nurse, they go to one who is
open heart certified. QuoteOur Houston area elementary a school nurse was an RN, sharp as a tack, and an unbelievable advocate for DS. And she recognized as a rxn these symptoms: falling asleep on play ground after lunch and a lower blood pressure. She rocked. She'd worked in an allergist office but loved getting to know the students anda having holidays and summers with her kids.
Ya don't say? Nice change to hear around these boards...but I bet she had more background/experience than an office nurse in her previous life. Maybe even more pay or moonlighted in an ER. Our jr. high nurse was a retired navy nurse, and while she might not have minded the pay, she probably was collecting a retirement stipend on top of it. but see, that's something I know, as an insider in the field. I associate people who care about the $$ they trade their skills for in order to provide for their family with
high quality nursing care. I don't want some
mope caring for my loved one, YK?
Just because you plant epi in the school nurse office, don't expect the incidence of death to decrease, unless steps are taken to ensure your school nurse is not only comfortable using it in her scope of practice, but understands the BIG PICTURE. She needs to understand the pharmalogical kinetics, pathophys, and aftercare. She needs to understand her ROLE. She needs EXPERIENCE. And also, a community that respects that degree of AUTONOMY. Even if that
culture is one District Nurse. I mean, have you ever had ONE paramedic arrive on a scene? NONSENSE. There are always TWO, if not THREE. Peer review/collaberation is a BIG DEAL in emergency medicine.
Things will need to change regarding school nurse recruitment if you want the situation to improve.
Quote from: Mfamom on February 16, 2012, 08:31:49 AM
The fact of the matter is that school nurses NEED to be more adept at handing these types of emergencies.
you aren't going to attract anyone "adept" with 14-17 dollars an hour in a field where new grads can be mentored in a hospital setting and their practice enriched with valuable experience starting at 32-40 an hour. Experienced nurses working registry tack on another 8 an hour + differentials. Don't even ask me about agency. It's obscene.
The entry standard is already a Bachelors degree, unofficially. Expect it to be official in the near future, nationwide. People who invest in a four year degree, in a healthcare career, eventually want their masters, if not to become a Nursing Practitioner. They want EXPERIENCE, because that's what gets them into those slots. It not only ENRICHES their practice, it's a requirement for an advanced degree.
Most of the people you deal with in offices aren't even RN's at this point. They usually keep one on hand to administer medications and treatments that need one, by state requirement, to administer. But really, it's not where you'll find them, unless they are a Nurse Practitioner seeing patients in a physician's place.
Experience makes a nurse....a better nurse.
Quote from: Arkadia on February 16, 2012, 10:40:43 AM
Experience makes a nurse....a better nurse.
experience makes most people better at most things, don't you think?
Quote from: Mfamom on February 16, 2012, 12:50:29 PM
Quote from: Arkadia on February 16, 2012, 10:40:43 AM
Experience makes a nurse....a better nurse.
experience makes most people better at most things, don't you think?
apparently, to a most of the school community, nurses aren't those people. LOL!
In some states there are ancillary benefits for being a school nurse. Like great benefits, summers off, tenure, and pension.
School nurses generally DON'T have a background managing emergent situations let alone it being second nature. Their assessment skills aren't anywhere near those of a
well seasoned critical care career professional. Again, a major influence in attracting that level of care is $$. Sure, you'll run across an occassional anomoly, but hands down, it's not the skill set you'll find in the RN office of a school building.
It's knowledge and skill you NEVER get from an inservice.
from the link:
QuoteIncreasingly, legal opinion has indicated that nursing should be viewed as a profession, like medicine, with distinct specialties. 8,9 As Regan 10 has noted, "Indiscriminate floating in hospitals reflects an administrative mentality that still subscribes to the hackneyed notion that a license to practice nursing is a license to do anything within the legal definition of professional nursing."
Italics/bold added.
Overwhelmingly....I read account after account HERE, on these boards of people who fail to administer, to their own child or themselves, and horrifyingly wait a reaction out. (eek)
Don't expect your school nurse to do any better. If they do, count yourself lucky.
here's a news video naming the School Nurse a Hero.
It also says the reaction occured during a vd party.
The solution in their eyes is to have epi pens in all VA schools, but alongside that, how about removing food from the classrooms and non food parties. anyone think of THAT? :tongue:
As someone else mentioned, I'd love to know if anyone escorted the child to the nurse etc. Funny, our plan in elem called for the nurse to come to my ds for known ingestion. (along with laying him down, feet raised, all kids cleared from room.)
She says as soon as she saw the symptoms, she administered the epi pen.
I'm happy for the positive ending, but really it seems like every time there is an incident like this, the districts cannot seem to put together a balanced plan for preventing in the future. In this case, they want to be sure all schools have epi pens. Great start, but not enough!
(emergency plans, elimination of food in classrooms, etc)
Hey, it's cool to see y'all loving up nurses for a change, but again (and I've been saying it for TEN effing years) school nurses need to ATTEND formal 504/IEP meetings for a healthcare need as THE PERSON MEDIATING/LEADING/DIRECTING IT. Generally it's a social worker or school psychologist for developmental needs.
This whole "I don't need to be there" bs has to end. They will better realize their role when they are the one's conducting the meeting.
Quote from: Mfamom on February 16, 2012, 02:36:41 PM
here's a news video naming the School Nurse a Hero.
It also says the reaction occured during a vd party.
The solution in their eyes is to have epi pens in all VA schools, but alongside that, how about removing food from the classrooms and non food parties. anyone think of THAT? :tongue:
As someone else mentioned, I'd love to know if anyone escorted the child to the nurse etc. Funny, our plan in elem called for the nurse to come to my ds for known ingestion. (along with laying him down, feet raised, all kids cleared from room.)
She says as soon as she saw the symptoms, she administered the epi pen.
I'm happy for the positive ending, but really it seems like every time there is an incident like this, the districts cannot seem to put together a balanced plan for preventing in the future. In this case, they want to be sure all schools have epi pens. Great start, but not enough!
(emergency plans, elimination of food in classrooms, etc)
Shoot! forgot to post the link to the video. BRB
http://www.wric.com/global/Category.asp?c=190525&clipId=6747025&topVideoCatNo=92150&autoStart=true (http://www.wric.com/global/Category.asp?c=190525&clipId=6747025&topVideoCatNo=92150&autoStart=true)
Well, that is certainly not entirely in keeping with the earliest reports, but I'm glad that the nurse acted quickly in any case, and VERY glad that this story had a good outcome.
Still, I had the same sense that you did, Mfamom; that this was mostly about "we're just repsonsible for treating kids if they have a problem" and "we can't know what we can't know" rather than any kind of ownership that most of these "problems" are avoidable to begin with in kids with known allergies.
Total disconnect on prevention. Bummer.
And no, I do not think that most school nurses (or nurses, in general) have a CLUE when it comes to that side of this equation. Treatment? Absolutely, I think that a competent school nurse ought to be taking the lead. Sounds like this one may have (though I'm still troubled by the "call mom and dad" in light of a possible ingestion of pn and a reaction in progress), but that neglects preventative measures like not having the allergen present in the child's classroom during a break in daily routine. :disappointed:
I'm so curious what the candy was and who provided it? Wonder if it was an outright nutty candy like valentine snickers or something?
Wonder if there's a class mom or two taking it all in and feeling lucky their vd party didn't kill someone.?
Since Tuesday was Valentines Day this does sound like it occurred during the classroom party during "snack time". The reporter could have been more thorough there! Reporters or FAAN, if you're reading -- please look into that. Many schools no longer allow food attached to Valentines. This said it was a "candy" so that is what it sounds like. Shared food at celebrations must be safe for the children in the class with LTFA, and attaching candy is just not safe -- "regular" parents (those not having a child with LTFA) cannot safely pick out safe candy (hence my child getting snickers, milky way, and other chocolates on his valentines in Kindergarten!). PTO class moms can get crazy with this stuff, and many teachers are not assertive.
Candy should not be allowed, because parents do not understand food allergies and risk. All it takes is one bite of the wrong candy. These are little kids that cannot be expected to know not to eat it, as these candies are usually unlabeled, parties are chaotic, and there is peer pressure to be like your peers and enjoy the party food.
There have been quite a few reactions lately resulting in death, comas, and lucky cases like this one with a severe reaction and good outcome, thanks to the Epipen (which doesn't always work this well!). I hope schools are getting the message. PREVENTION and eliminating risk via non-food celebrations is the key to avoiding reactions at school.
our district nurse comes to my 504 meetings and she gets it, the school nurse (every day person) gets it but not as happily......I think she rolls her eyes behind my back hahahaha.....not really
but she is not warm and fuzzy, but she is smart as a whip and competant....
our nurse also attends504 meetings. elem and ms
our ms nurse is great. my name for elem. one was nurse rachet.
Quote from: Arkadia on February 16, 2012, 02:51:11 PM
Hey, it's cool to see y'all loving up nurses for a change, but again (and I've been saying it for TEN effing years) school nurses need to ATTEND formal 504/IEP meetings for a healthcare need as THE PERSON MEDIATING/LEADING/DIRECTING IT. Generally it's a social worker or school psychologist for developmental needs.
This whole "I don't need to be there" bs has to end. They will better realize their role when they are the one's conducting the meeting.
No way. The 504 is not just about safety; it's also about inclusion.
The Sped Director of our school district has performed this function--leading the 504 meetings. Until this year.
Our current school nurse isn't so on top of things as that Houston-area elementary school nurse was.
But Ark, people
can and do have callings to be in education. Just because you didn't, just because no one you work with apparently has--doesn't mean you can speak for all nurses. Goodness.
Quote from: Macabre on February 19, 2012, 04:45:37 PM
Quote from: Arkadia on February 16, 2012, 02:51:11 PM
Hey, it's cool to see y'all loving up nurses for a change, but again (and I've been saying it for TEN effing years) school nurses need to ATTEND formal 504/IEP meetings for a healthcare need as THE PERSON MEDIATING/LEADING/DIRECTING IT. Generally it's a social worker or school psychologist for developmental needs.
This whole "I don't need to be there" bs has to end. They will better realize their role when they are the one's conducting the meeting.
No way. The 504 is not just about safety; it's also about inclusion.
and who better to talk about "inclusion" related to a healthcare need than a nurse? ???
Quote
But Ark, people can and do have callings to be in education. Just because you didn't, just because no one you work with apparently has--doesn't mean you can speak for all nurses. Goodness.
who the hell are you to tell me I'm not working in my
calling? I've been gainfully, and
steadily employed in a job most of you SWEAR you wouldn't do for ANY amount of money for 17 years. 15 at the
same healthcare system. When YOU can tell me THAT, then you MAY have earned the right to judge. :) I've never said I do it soley for the money. The money is good, but I could make THAT amount in a number of fields I'm currently QUALIFIED in.
I could make that as a waitress....
Personally, I think ANYONE who can make it as a nurse IS in their "calling".
I don't even need my name above a door....but I know some people do. They get a big charge out of it.
...I'm still laughing at the notion that nurses, people who routinely put their careers on the line for their patients, advocating for their rights, taking on healthcare system giants, aren't *snork*, qualified to lead a discussion that revolves around INCLUSION. E-GADS!
Don't twist things.
I didn't say that you weren't following your calling. I said that it's possible that some nurses have a calling to work in an educational environment. Even if they make $12 an hour. I said just because that is not your calling doesn't mean it's not someone else's.
I also didn't say that nurses aren't qualified to lead a 504 meeting. I said that they may not be the most appropriate to do so. But then again, in some schools, they may be the perfect person to do that. But it's not the case in mine.
And hey--you were disparaging of school nurses on the first page.
Quote from: Arkadia on February 15, 2012, 01:23:56 PM
Oh, you both are so overshooting the temperment of even a "good" school nurse. A certified one even. School nurses just don't "do" time sensitive emergent field work. If you're a nurse, and you do have both the temperment and skill set to handle emergent situations or continuously manage an unstable patient (and I DO mean in the healthcare sense of classification) then that's where you'll find work if your license is worth the watermark it's printed.) School nurse pay isn't A THIRD of what even the surliest barely english speaking import with reciprocity can earn in ER, Surgery, Cath Lab, or a Critical Care open heart unit. That and a school nurse is minimal daily hours and probably not five days a week even.
It's not their primary function. If it were, they'd have equipment on hand to start at least an iv.... But they don't. Nor will they ever. It's a trick bag. For a number of reasons.
but I digress.
what you're asking for is someone for whom it's second nature.
You're not going to get that when 99.9 % of their time their primary function is submitting eye exam paperwork or going over dental hygiene with kindergarteners.
{snipped stuff}
Quote from: Macabre on February 19, 2012, 05:28:48 PM
Don't twist things.
I didn't say that you weren't following your calling. I said that it's possible that some nurses have a calling to work in an educational environment. Even if they make $12 an hour. I said just because that is not your calling doesn't mean it's not someone else's.
I also didn't say that nurses aren't qualified to lead a 504 meeting. I said that they may not be the most appropriate to do so. But then again, in some schools, they may be the perfect person to do that. But it's not the case in mine. And hey--you were disparaging of school nurses on the first page.
Quote from: Arkadia on February 15, 2012, 01:23:56 PM
Oh, you both are so overshooting the temperment of even a "good" school nurse. A certified one even. School nurses just don't "do" time sensitive emergent field work. If you're a nurse, and you do have both the temperment and skill set to handle emergent situations or continuously manage an unstable patient (and I DO mean in the healthcare sense of classification) then that's where you'll find work if your license is worth the watermark it's printed.) School nurse pay isn't A THIRD of what even the surliest barely english speaking import with reciprocity can earn in ER, Surgery, Cath Lab, or a Critical Care open heart unit. That and a school nurse is minimal daily hours and probably not five days a week even.
It's not their primary function. If it were, they'd have equipment on hand to start at least an iv.... But they don't. Nor will they ever. It's a trick bag. For a number of reasons.
but I digress.
what you're asking for is someone for whom it's second nature.
You're not going to get that when 99.9 % of their time their primary function is submitting eye exam paperwork or going over dental hygiene with kindergarteners.
{snipped stuff}
how do YOU know what my calling is? How do you think I know what school nurses make?
I've looked into it. I'm qualified to be a school nurse. If I wanted to be a Certified School Nurse, it would be a snap to get the cert. I have four children classified as special education, I have 16 years critical care experience, and 18 direct patitent care. CLEAN experience. My license is spotless. I know my way around the school system, and am METICULOUS with paperwork. Children and adolescents like me, I don't mind them, lol, I prioritize well, and can be autonomous in my care delivery. I know. my. boundaries. Both personal, and professional. That said, I'm a loner, don't give a bleep about politics in a community, and don't need the principals permission to do what my practice dictates is a necessity.
but
that pay. The culture. A calling isn't defined by how big a MARTYR I'm willing to make of myself. That pay tells me they DON'T CARE what quality person they receive in that application bin. I had this discussion with the middle school principal regarding the 8.00 an hour they were paying their EDUCATIONAL AIDES at the time. He said THE PAY was why they
couldn't get one that didn't have serious flaws in one way or another. Or, as I observed, didn't dress like they were the Saturday Night Special at a strip club, showed up Monday morning, or could spell ask as "ASK" instead of "AXE". We went through four that year, if I remember correctly. I settled on the person who couldn't spell or use grammar correctly in my son's communication notebook. (I still have it) She was a para professional. What the certification supposedly entails, I can only wonder. I settled on her because she seemed a bit more informed on using the epi pen, but I got burned. That was the woman who had a daughter with asthma, BUT, who ended up leaving my son to run the mile out in the cold, the day he returned from a 10 day absence post pneumonia.
I mean, YOU'D THINK people had more sense that that. You'd think she would have advocated for him as he VOMMITTED phlegm all over the field, YOU'D THINK she'd have advocated to the PE teacher for him, as his PERSONAL AIDE for a health care need to be seen by the nurse as he pleaded for an inhaler.
He ended up CALLING ME FROM THE FIELD asking me to talk some sense into these ADULTS on his behalf.
I better quit typing about that now, before I say something reprehensible about ALL involved. ABOUT THAT 8.00 an hour for EDUCATIONAL AIDES. But back to pay rates and getting quality people.
They erroneously THOUGHT requiring PARA PROFESSIONAL certification would change that, but it didn't. People took their certification elsewhere or said: "Oh, crap, that's not worth getting."
My friend was one of them. She decided her time was better invested in getting her TEACHING degree. (and she has a para professional certification and ROCKS at what she does).
FIELD RETENTION. It's not going to happen with sh***y pay.
Sure, we lucked out in Fourth grade with a teacher in training who was on the eve of being hired as a teacher in the fall. But you shouldn't have to "LUCK OUT" in who is your child's aide, right?
But that, apparently is the STATUS QUO in the field of SCHOOL nursing. You're damned right.
I was disparaging. There's not a day that goes by where I don't hear a nurse, myself or others, who question an order, advocate for their patient in order to deliver appropriate care, get the training they need, the HELP they need, research something to see if it is within their scope of care, or read some kind of educational offering on our break room board that is MANDATORY. My home mail box even. It's constantly evolving, and as I can see, there are serious FLAWS pertaining to how the field of school nursing is preparing individuals to serve the population. Particularly in how they manage children with a higher acuity of care. Particularly in that I've had more than one school nurse refer me to NON MEDICALLY TRAINED individuals, ie: their "boss", as to what THE NURSES ROLE was in the DIRECT CARE my child receive for a health related need.
Speaking professionally?
THAT'S BIZZARRE. It doesn't matter WHAT FIELD of nursing you're in. Or at least it shouldn't.
It speaks to why a nurse SHOULD have specific experience that TEMPERS their judgement prior to turning them loose, ON THEIR OWN, in a field where they will rarely have ANYONE else who is SIMILARLY EDUCATED on hand to COLLABERATE with.
It's what lawsuits are predicated on. :
What another similarly trained, experienced individual with the same education would do. And dears, until those
demographics CHANGE, until THAT CRITERIA moves towards the other end of the spectrum, BY WHATEVER FORCES INFLUENCE IT....then DON'T think the system is going to change because <SCOFF>
more children with a food allergy are in school, or <SCOFF> they give the nurse an epi pen to use at will. That just means you might be even more greatly dissapointed.
they could give me laser knife, turn me loose in a surgical suite, but it doesn't make me a brain surgeon.
And like I said. Four children, ten years moving them through special education, 18 years direct patient care, 16 in critical care, 12 in trauma. Hell, waitressing. I'm a
people person. The director of special education of the entire cooperative has referred to me in direct meeting as a "knowledgeable individual" not only wrt to my child's needs, but wrt to the special educational process, and in MY FIELD which, btw, is THE TITS as far as classifying my scope of professional experience.
I know what I speak of. School nursing is a prehistoric beast, obsenely sheltered by politics and a pervasive lack of initiative, and something has to give....unfortunately, we continually have examples on a regular basis of what that is:
A child's life. While there are token changes, things that seems to garner publicity, there certainly doesn't seem to be the rate of change that is necessary, let alone the adjuncts necessary to implement those changes, and AAMOF, cutbacks still seem to threaten the mere existence of a nurse on a regular basis in a school building.
The presence of an epi pen in the school nurse office as defined by recent legislation isn't going to keep a nurse on full time in everyschool building, any more than having AED's in schools did, let alone an experienced one with the ability to function in a crisis adequately.
http://www.huffingtonpost.com/2011/04/05/school-nurses-budget-cuts_n_845053.html (http://www.huffingtonpost.com/2011/04/05/school-nurses-budget-cuts_n_845053.html)
If money and associated personal risk wasn't an influence on CALLINGS then EVERY SCHOOL BUILDING WOULD HAVE AN
RN IN THEM ALL DAY, EACH DAY, EVERY DAY, who was a
VOLUNTEER. :coffee:
And you.....I remember you complaining about not feeling 100% about the job you were taking. But you took it. Why? Oh, survival, probably. Turned out pretty well from what I've read. It will turn out great again. Remember that when you apply. It's what you make of it. My CALLING is to be good at what I do. I never imagined myself doing what I do today, but to a point, it defines me now. With that knowledge, I'd proceed to another opportunity, if I had to. I could turn waitressing into a CALLING if I had to. I did at one point.
Our district nurse (RN) runs my DS's 504 meeting...kind of. A few years ago the "unique learners coordinator" ran the meetings, but it was a disaster because she completely did not understand how LTFA relate to the classroom and necessary accommodations. She was stuck on the "how does this impact learning" argument. We also have a principal or assistant principal sit in on the meetings along with the building nurse (LPN) and a main classroom teacher.
We are in the middle school this year (5th) grade, and although it has gone significantly better than elementary school, there is still too much food in the classrooms and lots of room for mistakes to happen. Thankfully DS has taken a very active role in the management of his LTFA and calls frequently before eating something or brings it home for me to check. Just last week (Valentines) he brought home a Mr. Goodbar. :rant: Thankfully he knows not to eat anything chocolate (or really anything that didn't come from home) and showed me the candy bar before eating it. I do see an accident waiting to happen, but DS and I are doing are best under the circumstances.
I am hoping that, while his environment is not as controlled as it was in elementary school, he is making great strides in being responsible for his own body and his needs, including washing hands, wiping his own keyboard, and overall making good choices.
I know that any 504 coordinator, teacher or nurse will ever care about his needs as much as I do. It has been a long journey to accept this fact and in fact....I think I RUN THE MEETINGS most of the time. He He....
;D