27.5.15

Ah, kids.

A student wandered into my office while waiting for her very late aunt to pick her up. She leaned over my shoulder and asked what I was eating. It was strawberries that I was dipping in leftover cake frosting, but I didn't particularly want to admit that the nurse was eating frosting by the spoonful. "It's dip," I explained. She was clearly skeptical, but she bought it. Kids...they are so innocent, it's lovely sometimes.

18.5.15

This is the thing.

This is the thing about school nursing: the kids do not care about the personnel drama of your organization. The secretaries, for the most part, don't know about the personnel drama of the nursing staff. And yet, that personnel drama is what will make or break the job. I love some of the school sites I've been at over the years; they are a joy to go to. Others...not so much. But in the case of school nursing, it's not just whether or not the school site is a pleasant place to be, it's the leadership and camaraderie, or lack thereof, of the nursing staff. Even if I don't see them, or maybe because I don't see them, the worst part of my job is the "team" I work with.

So, it's important I separate the kids and other staff I work with from the other...people...I work with, the ones that are the reason I am leaving. I will trudge to work tomorrow and put on a smile, leaving it out from my daily conversation that the LVN that was supposed to "support" me with my impossible caseload this year has been more work than she's been worth. Critical thinking isn't one of her high points - I will never understand the medication error she made early on* - but attendance hasn't been either. Perhaps I am the only one who grew up thinking you're supposed to go to work, school, whatever, unless there's an emergency, because she's been out approximately once a week for the last few months and seems to think that's the norm. But I am even less impressed when she sends me an email with a "P.S. Also I am taking a sick day tomorrow." Not a question to ask if she should find someone to cover her assigned diabetics or if I will, just, this is what is happening.

These situations create a cloud of frustration for me that I need to check at the door, because not one of my secretaries or students will understand, or should have to try to understand, this kind of thing. <Sigh.> I really do like what I do, just not who I do it with (or who I don't do it with). This is why I only have 16 work days left with this district.

*The infamous med error: This LVN administered an inhaler to the wrong student...and not just any incorrect student, but a student that didn't even use an inhaler. Apparently she was expecting another student - one in the special day class, that isn't easily mistaken for another general education student, mind you - and gave this other kid who wasn't having trouble breathing an inhaler. He was in there because he "didn't feel well" and when the school nurse gives you an inhaler, I guess you're going to take it, right? This one still boggles my mind.




11.5.15

Busted.

Spitfire came to my office around lunchtime saying her blood sugar was 471 and her mom wanted her to go home. This is normal these days: kids bypass me using their cell phones and clue me in once everything is arranged. She said she needed a new pump site (which I showed her we had with her bag of extra supplies) and her mom wanted to take her to the doctor's, so she arranged for (one of) her mom's ex-husband's to come get her. 

When the ex-husband arrived, he had a new pump site in hand. I asked if that's all that needed to happen, because,  clearly, I had been left out of the loop. I explained that I had already told Spitfire we had the supplies to change her pump site, but she was obviously hoping to get picked up from school. He was firm with her in expressing his disappointment, and explained that she would be staying at school. She and I changed her pump site while the ex-husband waited. 


Afterward, she checked her blood sugar. It was 141. I looked directly at the ex-husband and commented that it was quite remarkable for her blood sugar to drop 300 points in half an hour with a malfunctioning insulin pump. We asked her to show us the history in her pump meter to, and, unsurprisingly, found no 471. Ex-husband said to her he would deal with the matter later, and left very politely. 


Spitfire sat quietly eating in my office, unable to make eye contact with me. Finally, I broke the silence and said, "Busted." She looked at me with anger, claiming that it really was 471 and her meter was broken. Um...No. 


I have been working with her since she was in 3rd grade; she's now in 6th grade and never have I seen her as mad today as when I called her out for lying about her blood sugar. Our relationship is coming to an end in a couple of weeks and while I am sad that I know she will hold a grudge about this for some time, perhaps the rest of my time with her, hopefully one day she'll look back and see that she needed some tough love. 


7.5.15

Universal Precautions

This morning I had two students in my office, one waiting to go home with pinkeye and the other one also waiting to be picked up as he was feeling ill. The secretaries placed a third outside the door to my office, also waiting for her ride to pick her up as she wasn't feeling well. A fourth student came in to get something to package a tooth in (a "tooth" necklace, yes, they make such a thing), and while he and I were packing it up the third student in the doorway vomited. And by vomited, I mean vomited. [Stop reading now if graphic descriptions of bodily fluids make you ill.] 

I actually thought chocolate milk had spilled, until I smelled it. There was a thick layer splattered around the girl, right at the entry to my office, and some had dribbled onto her pants, down her leg, and onto her shoes. The largest puddle was so thick a paper towel wouldn't stand a chance. The secretary called for the custodian to clean up, and I kept the students in my office in so they wouldn't step in the vomit, or get sick themselves from smelling it, as one green-looking boy said he might. 

Next thing I know, the principal - who has never been particularly warm toward me - stepped over the vomit, and barged into my office to ask me what was going on. I explained what each of the students were doing in my office, including the one that came in for his tooth but was now stuck due to the vomit at the doorway, and that parents had already been notified for everyone. The principal's response: "You need to prioritize a little better," and an eye roll to boot. She was apparently quite irritated that I had not cleaned up the vomit. 

First of all, I don't need eyes rolled at me. We're adults. But second of all, I'm not going to apologize for waiting for the custodian. I do not have the materials in my office to clean up a vomit puddle that size. (And even if I did, I'd still make the kids in my office wait to step on the floor until the custodian got there.) I do not have access to cleaning solutions, rags, mops, or the stuff that you sprinkle on puddles to help mop them up. So, no lady, I will not get on my hands and knees and wipe up a sea of vomit, exposing myself to who knows what. 

23.4.15

Senioritis

I have 30-something days left in the school year, and five days of summer school, and then I am out of this district and into a new one. I am not at all sure the new district will be a better work environment than this one, but I am pretty sure it cannot be worse...I have essentially ignored all the things I find ethically wrong with working in my current position on this blog, because I don't think it'd be appropriate or useful to whine here, but wow, do I feel good about leaving...

Being in the lame duck position has also encouraged a senioritis-type attitude in me. Let me tell you, it is so much easier to get a dentist appointment at noon than it is to get the last one of the day. 


I am soaking up the time with the kids that I do have left, because I was warned in my interview there would be much less of that in my new position next year. Spitfire nagged me for weeks, until I caved in and watched Frozen one night, and she gave me one of her rare hugs in return. Rarely have I seen her as content as she was when I was knowledgeable enough to have a lengthy discussion with her on Olaf. 


My days are a whirlwind right now and this is really only a post to say that I do still exist. I know I keep saying it, but, more later. 

17.3.15

Outward

Two applications, one interview (and the other interview declined) later, I have a "new" job.

!!!!!!

I took this job originally intending it to be a filler, a way to get a paycheck, while I found a "real" job. One year turned into two, which turned into three, four, and now five. What? A husband and child later, I've realized that a) school nursing is kind of fun and b) I'm pretty good at it. Unfortunately, my current district wasn't one I could see myself staying in. One example of why not: just two weeks ago, I emailed my boss to voice my concerns about my caseload. I had never once complained about my workload, unlike most of the RNs I work with, but it became too much with the addition of another diabetic student. I wasn't (am not) able to do anything as thoroughly as I'd like, and besides needing to protect student safety, I have a nursing license to stay loyal to as well. It was a short and, I thought, sweet email that said just that: I'm concerned, and may I please have help. (Most other nurses in our district have been working with LVNs, some two, except for me, which is a whole different story.) I found out from our lead nurse that our boss then had to call her and ask who I am. I've worked for a man for five years who apparently doesn't know who I am...despite, you know, being the movement behind the lice policy change, a CPR/First Aid Instructor, and other resume highlights.

Anyway. I will still be a school nurse but am moving to a district that is twice the size of my current one, has three times the RN staff and about 6 times the LVN staff (seriously). My future boss talked with me at the interview, discussing the differences between my current district and theirs. Theirs, he said, would entail more supervising of LVN staff, less hands on with students, and more case management. It's the first opportunity I've ever had for growth in my career, and I'm taking it.

I start in August but to be officially hired and do the paperwork there, I need to officially resign at my current position, which I plan to do this week. Then I will finish out the school year as a lame duck of sorts. Hallelujah.

4.3.15

Onward

Losing the student last month was rough. As the principal said though: "We can't take them home." That doesn't stop me from wishing I could sometimes. 

I've added a new diabetic to my load, a newly diagnosed, wonderful 5th grader. You can't ask for a better student to work with: responsible, a motivated learner, she has it all. The problem is she's at a different site from my other two sites with diabetic students, so now I travel to three different school sites on a daily basis, and sometimes my fourth school site if they're lucky. Yesterday, I had a meeting at school #1, then went to #2, then back to #1 to see my diabetics, then #3 for more diabetics, then #4 to see my new diabetic. It is utter insanity to be driving around this much, and I'm going to try to leave any comments on my caseload at that.

Being out and about so much has given me the opportunity to see some new sights around town though. They include: chihuahuas walking unaccompanied on the sidewalk of a busy, four lane street, a man with a teardrop tattoos beneath both eyes, and mothers with kids in the baskets of their strollers (converting a single stroller into a double or triple). There's a reason I commute.