I recently committed myself to being a school nurse at least a little bit longer, and then: the 2014-2015 school year has been continuing to happen. This has been the craziest, most stressful year I've ever had, by far. I have answered work emails from home more often than ever, I have screened nearly 60 students for IEPs in 1/4 of the school year (compared to a typical 100-120 for an entire year), and I just can't seem to please teachers or parents. The first aid aspect of my job used to have slow days; now it seems there is a steady stream all day long of pink eye, sore throats, and vomiting, no matter what school site I am in.  August is always a rough month as an employee in the education system, but that seems to be continuing still and it's almost November.

Some highlights off the top of my head:
1. A gnat flying around in a girl's eye. We flushed it out but I don't think I'd ever seen a live bug in someone's eye. 
2. I missed a broken foot, and if there's one thing that makes you feel crappy as a school nurse, it's letting a child walk out the door of your office with a serious injury. In my defense, the student said he was okay and didn't want to call home - and he actually walked out. This was a Friday, Monday I was called into the principal's office and put on speakerphone with the dad, having to answer to him as to why I let his child walk out of my office with a broken foot. Thankfully, the principal (who has a reputation for not doing this for her nurses) defended me, calmed dad down, and all was okay. But an UGH kind of morning that was, for sure. 
3. Spitfire's blood sugars are out of control: her meter cannot even read them, so over 500, on at least 2-3 days per week. 
4. I have been training an LVN to help cover my schools and diabetics, which is incredibly time consuming and after she made what I believe to be a huge mistake, I'm not sure it's at all been worth my time. (This is an in-progress situation, so I will just leave it at that.) If you want something done right, you have to do it yourself...except that that's impossible when your workload is greater than what one human can accomplish and stay sane. 
5. Screenings and more screenings. We need to screen Kindergarten, 2nd, 5th, and 8th grade students, and now that I have three elementary schools and a middle school, that is a LOT of students in my case. I have done a good portion of these, including the 5th grade screenings at one of my school sites that I have been at since I started this job. I met the 5th graders when they were 1st graders, and I recognized more than just a handful of them. It's a good feeling when you see them light up with happiness because they know you remember them.
6. Today I was called in to stand as a witness while a teacher took photographs of a student to provide evidence of physical abuse for a CPS report she was preparing. He was bruised and clearly beaten, a special education student clutching a Clifford book tightly. My bleeding heart nearly bled out. 
7. I screened a girl with Down's Syndrome that I had met once briefly before, several weeks ago. She burst in my door and shouted my name, and the fact that she remembered it just completely made my day, week, and perhaps I will just hold onto that moment for the year. 

I will try to return to regular posting now; this place is a good outlet for me that I've been forgetting about in the whirlwind of things. 


Get some Kleenex

A man called me at my elementary school early one morning: he is a single father, he explained, and his daughter had just started menstruating. Could I please check on her and make sure she has everything she needs? He works the night shift and wasn't able to get as many supplies for her as he wanted. 

Sure, I said. Easy. I called the student down: she has Down's Syndrome, as it turned out, and I went over some basics with her and her teacher. Later I found out that the daughter's mother, the man's wife, had passed away recently. As one of my friends said as I relayed this story to her: some people have real problems. 


Exhibit A

Exhibit A: Example of why we need full time health care staff at all school sites. 

Friday was a minimum day at my middle school and I'd told one of my diabetics - Mr. Redhead - that I would see him at lunchtime, which was taking place at 12:30 instead of 11:47 as it normally does. I went to my middle school at lunchtime to meet him as I always do, except he didn't show up. I checked his folder in my office that we keep his logs in and found that he had come to the office and given himself his insulin at 11:42, just like he does every day...Except it was a minimum day, and he would have gone to PE at 11:42 and not lunch. 

I freaked. For all I knew, Mr. Redhead was hypoglycemic and passed out on the steps of the school somewhere. School had just let out, so through the swarms of students, I looked for Mr. Redhead. (It was like reading a Where's Waldo book, but way more pressure to find him.) No luck. I asked the secretary to page him over the loudspeaker while I called his dad, who said he thought Mr. Redhead stayed for lunch and agreed that his blood sugar was likely dropping. I searched the cafeteria, asked the secretary to page him again, and still he did not show. I called his mom, ready to bawl my eyes out and tell her I lost her child. She answered, thankfully, and said Mr. Redhead was sitting across the table from her eating his lunch. Phew! 

The secretary, as I was leaving, said, "Oh yeah, I saw him come in earlier." What?!?! This is the deal with secretaries: they cannot be nurses and secretaries. They are asked to be, but you cannot have a secretary fulfill her duties and meet the health needs of the students at the same time. Mr. Redhead didn't ask for help, and so they let him do his thing on his own, because they don't know the consequences. I do. 

Poor Mr. Redhead got a lecture about it from me today. He said he realized his mistake as soon as he entered it into the pump, and didn't know what to do...so he went outside and went to PE. We talked about the fact that he got lucky - his blood sugar had been high - but that this could have been a really serious matter. I gave him my cell phone number and asked that he call me if I'm ever not in the office when he is again, and also made him promise he'd talk to the secretaries if he needed to reach me. Before Friday's incident, I'd planned on talking to him about going independent like the doctor's orders say that he is capable of. He said before I could that he still wants to be supervised...I suspect his mom may have given him a similar earful about what went wrong on Friday. 

It was a learning experience for many that I hope to not have to repeat anytime soon. 



I received an email from a secretary several weeks ago at one of my elementary schools that a parent had called to report that a student - not her own - had lice. I archived the email immediately, because I cannot believe every parent complaint, particularly concerning lice, where people like to point fingers. 

I received a second email last week that this other parent had called again to complain that the student still had lice, and that she would be calling the district office if no action was taken. This time I replied to the secretary that I would check the student, but it's no business of the other parent's whether or not the child has lice, and she should feel free to call the district office. 

She called again today, and again reported the lice. This time, she spoke with the principal, and informed him she has already made a report to the district office about this. She still wanted to talk to me, though, so with great dread I called her after lunch. She was surprisingly pleasant as I explained that I would not be reporting the results of the lice check to her, but that I had in fact checked the student, and also that the board policy is that students can remain in school with lice. (This was one of those instances where I take no credit for instigating this board policy...) She thanked me at the end of the call, and all was well. 

Here's the craziest part of this whole debacle to me: there was no lice! I did a *thorough* check, assuming if this parent was willing to go so far as to complain to the district office, that there must be a really obvious case of lice, but no. 

Some people are just busybodies. 


Crucial Conversations

If I may toot my own horn, which is essentially what this blog is a platform for doing, I had a really pleasant interaction with a parent this morning. She was upset because I had let her foster daughter call home when she complained to me that she wasn't feeling well. Instead of wussing out, for lack of a better term, I responded, "I get that that's frustrating, you don't want her calling unless she has a fever. The reason I let her is that I have had too many parents complain of their child not being able to call home, so my policy is to let the student work it out with their parents. Now I know that you would only like her to call home in case of a fever, and we will do that in the future. I apologize." She was *so* nice after that, and all it took was some positive communication on my end, instead of being either immediately defensive, or apologizing insincerely. Cheers to me! 

Also, a secretary came to tell me that someone had called and referenced me with, "the pretty blonde nurse" when she couldn't remember my name.
What a nice Monday. 


Chaos, just chaos.

I feel like I've had no time this year, and I just ran the numbers: it might be because I have nearly 3000 students this year across four schools. Usually by the fourth week of school, things are settling down; this year, I see no signs of that happening. 

Today's lunchtime chaos at my middle school was a good sample of how this year is going so far:

I arrived to find a girl in tears in my office. The staff said she hurt her shoulder and bumped her head at PE and mouthed, "Drama" to me behind her back. She wanted to go home; clearly, they didn't think she needed to, but she said the magic "head injury" words to me so I felt like I should let her call even though I couldn't see injury on her head. Her contacts were red-flagged in the computer, which means pay attention to whom we call as there are custodial issues for that student. I got her set up to call while I tended to my first diabetic. 

I think I counted three students that came in and out for ice packs in the next ten minutes before Spitfire arrived to check her blood sugar. Soon after, a teacher stopped by to introduce herself and tell me I need to have hearing and vision assessments done on several of her students by next week. 

Next, Spitfire came back after lunch to count her carbs and administer insulin at the same time three adults came racing in dragging a student. He has a fish allergy and his aide somehow (do not ask me how) missed the fact that he grabbed a tuna sandwich at the cafeteria. We had an Epi-Pen in the office, which I got out while observing him for signs of anaphylactic shock, which, thankfully, never presented. Drama girl stuck the phone in my face saying, "My mom wants to talk to you" while I got out the care plan for Fish Allergy Boy. Drama Mama was none too happy with me as I said that I couldn't see any head injury ("You are the nurse, I don't understand" - to which I responded, "There is nothing visible"). Luckily she was so annoyed she hung up on me, freeing up the phone for me to call Fish Allergy Boy's mom who, rightfully so, asked how he was able to eat tuna for lunch when he is supposed to have an aide watching him. I told her I wasn't sure how it happened, but she needed to come pick him up as soon as possible. Finally, I attended to Spitfire and released her, and sent Drama girl to go get her backpack, so it was just Fish Allergy Boy and his aide in my office. 

I sat on the edge of my seat with the Epi-Pen in front of me, watching Fish Allergy Boy, for the next 35 minutes until his mom arrived. Just as I sent him home, my last diabetic came in. Finally, when I was done with that student, I was able to leave the middle school to return to my first school site. Phew. 

Be careful what you wish for: last year I was wishing I was busier, right now, I'd happily take that assignment over this one. Hopefully things will continue to settle as the school year wears on, and I hope that the middle school aides learned a good lesson today with Fish Allergy Boy (who has many more allergies besides fish).