Your tax dollars at work

Sixteen million children (21%) live without consistent access to food.  That is a staggering number. And yet...there's this: the state's vision screening requirements in California changed recently, requiring both near and far vision screening for Kindergarten, 2nd, 5th, and 8th grades. Once you screen near vision, it is either a problem or not, and it is ineffective and a waste of resources to continue to screen for it years down the road. Then why are we asking school nurses to screen for it in the later years? Because lobbyists. Seriously. Eye care specialists made sure this requirement passed, which results in increased referrals (i.e. money) for themselves, and more (unnecessary) work for school nurses. Where are our priorities?


Dear Teacher,

I know you really don’t want to have your student with hemophilia come on the field trip to the pumpkin patch with you but, guess what, he is. You won’t find support from me for your idea to exclude the kiddo because of his condition, no matter how many emails you send me. And yes, I have contacted his parents, and no, they can’t go with him on this field trip. Deal with it. Love,
Your School Nurse

It’s been a busy week. The best part was confirming a thought I had about this position: I can work from home on occasion. There is an enormous amount of case management and report writing in this position, and I’ve been wondering why I even drive in sometimes when all I really need is a quiet place to work. Hello, home office! 


Dear Parent,

Just because you are an MD - which somehow you managed to point out to me despite not being able to return your child's emergency care plan until two months later - does not mean I will sign off on the heavily edited care plan you returned to me.

Perhaps your expertise does not include allergy management, because the new recommendation is that if someone has two or more systems involved in an allergy reaction - in the example you gave, an itchy throat and vomiting - an Epipen should be administered. I am not into the "wait and see" method when it comes to potential anaphylaxis. I also can't say I like the idea of administering PO Benadryl for your vomiting student in case of ingestion. The fact that you seem to know his pattern of reaction so well is a concern too, but not something I can base future reactions on. Just because you have been so fortunate as to have his symptoms stop at an itchy throat and vomiting doesn't mean they won't progress further, quickly, the next time.

We are discussing a severe food allergy, and this is the first I've ever come across a parent suggesting less of a response than the standard, recommended treatment plan. Weird...and my gut says no, I just haven't figured out how I will phrase my response to Mr. Pretentious Parent, MD.



Well, check your Cheerios boxes...They aren't all gluten free after all. You could not pay me to work for that company right now, how embarrassing after their giant gluten free ad campaign.

In other news, it's been almost a month since I've written and it's not for a lack of material, it's a time problem. This district is nuts. And I say that coming from a district that I also thought was nuts.

We (the district) are being swamped with refugees from the Middle East. During a screening, I asked what the name "FNU" is that I was seeing all over the place on rosters..."Family Name Unknown." Families are arriving without any documentation, so kids enroll in school with no last name or birthdate, no English, and scared out of their minds. They come to school and are behind a fence from their parents surrounded by strangers, and they cry and cry as they feel they are being taken away from their family. I read health histories and find stories of kids watching family members being killed in front of them, of escaping their home country on horseback, and arriving here with no one to ease them into their new world. Now when I see Middle East turmoil in the news, I no longer click to the next headline, I read through the article and try to get a little closer to understanding what some of these kids have been through. It's heavy stuff.

The heavy stuff, then, makes it that much more special when something a little more light comes my way. A secretary brought a student to me yesterday with "possible ringworm" that his teacher had sent him up for. He had a red ring on his hand, but it wasn't raised, and just didn't look like ringworm to me. "That's not a hand stamp, is it?" I asked. "Yes, it is, it won't wash off!" Ahh...yes, that's why they pay me the big bucks. To identify hand stamps.


Let the world rejoice:

Cheerios are now gluten-free!!

Now all parents of GF children can have the pleasure of having to vacuum out Cheerio dust from every nook and cranny of the car, house, stroller, couch, etc. Be careful which box you buy; they're not all gluten-free just yet, but I can confirm they are presently on the store shelves today.

Unfortunately, I am in no way sponsored by General Mills. I just wanted to broadcast this happy tidbit of news.


The Haves and the Have Nots

I am assigned to four schools, but two are on opposite ends of the spectrum from each other.

One of my elementary schools is located in an incredibly idyllic neighborhood. It’s like the neighborhood in The Truman Show. The campus, unlike all the other ones in the district, is wide open. The school borders a city park, and there is no fence separating the children from the school and the park, and there is a gate that runs from the creek to the park. That’s right – kids could access a stream of running water fairly easily if they want to. Well, they would be able to be near water if it were not a dry creek bed right now…We’re in California, no such thing around here. On the drought note, the neighborhood surrounding the school is full of bright green manicured lawns, a rarity around the city and state right now. The parking lot is teeny tiny, and it’s not a problem because so many parents walk or bring their kids to school in a wagon. Parents answer the phone on the first ring, and arrive within minutes whenever the need might arise. Parent and grandparent volunteers can be found all over campus and the school hosts fundraiser nights for parents to contribute further to their child’s education. When I sent out care plans, I was able to email most, and the only ones not returned were no longer enrolled in the school. In short: parents are wealthy and involved.

Just a short drive away is my Title 1 school. Families hail from all over the world here, some of them brand new to the country after escaping the war zone that their native country had become. The language line is frequently used here, because the Spanish interpreters cover only the Spanish speakers. I received a single care plan back from a mother; I probably had the wrong address for the rest as the population in the area is so transient. Here, I am tracking down parents, asking them how I can help their child get glasses, where at the other school, the glasses are on the student before I even knew there was an issue. My office is near the kindergarten pickup area, so when morning kindergarten is nearing the end of their day, I watch the parents gather in front of my window. It feels like I am watching a little snippet of the world’s people: so many shapes, sizes, and heritages, all in one place. Neighborhood yards are brown, bordered with chain link fences, and people walk the streets with shopping carts filled with their belongings.

It is mind-boggling to me that such different lives are being led in such close proximity. 


Spitfire 2.0, and, phew.

Here I was, concerned about my lack of contact with students at this new job...Hah! I spent three hours this morning dealing with an out of control kindergartner with Type 1 diabetes. His teachers had mentioned he was having some behavior issues, and weren't sure how much of that could be attributed to blood sugar spikes and falls. I kind of rolled my eyes a bit, to myself, when they were telling me this, but I said I'd stop in. Then I popped in this morning, as promised, and could not believe it. Twenty-six kids were sitting in their squares, criss-cross-applesauce with bubbles in their mouths, and the one I went to check on was spinning in circles, crawling on desks, trespassing around the teacher's desk, etc. It was bad. We ended up having an impromptu meeting with dad after school due to a comment the young lad had made: "I'm mad so I better check my blood sugar." I've seen kids manipulate adults using diabetes, but not at five years old...yikes. His blood sugar was completely normal all morning but repeatedly asked to test and said his blood sugar was why he was acting so poorly.

This kid is going to be a problem for my foreseeable future, but ahhh...it feels good to see a blood glucose meter again.