Today's the first day I've ever covered for another nurse, so I don't know why I was surprised to find my phone ringing at 8:30 this morning with one of her schools calling: everything happens to me, I've come to expect it. The diabetic I'm responsible for today had her pump fall out last night and put it back in this morning, but wasn't feeling well when she got to school. No wonder: her blood sugar was 562, and the school was calling to find out what to do about it. 

What do I know? Who is this girl? Does she have insulin orders? I don't know! I told them to send her home asap, and very apologetically called the nurse who had the day off. She concurred, and it was a great relief to hear the student's mother was on her way to pick her up.

More Friday randomness...



Something I take serious issue with is rudeness. As a camp nurse, I established an "I don't take no crap from no-body" mentality, and it's one I indend to keep and make known for as long as I work. I may be a nurse, but I'm not your servant - kids and adults alike. Respect doesn't seem to be a trait often taught to the kids I work with, and it drives me up a wall sometimes. This kid in particular is a frequent visitor to my office, and he seems to purposefully drive me crazy. One day he spent much of his time rapping to me:

"I'm in the nurse's office -
She's sitting at the com-puter, drinking her coffee." 

If he wasn't rapping, he was tapping his feet, or otherwise fidgeting incessantly. It drove me insane, and if I showed it getting to me in the slightest, he chuckled with glee and brought it on even more.

Today he found his way back into my office again, and I groaned at the thought of spending the day with him (he supposedly has work to do but spends most of the time driving me crazy rather than doing any studying). I left my office for a brief moment and returned to find him staring at my computer. I told him to go back to his desk and he giggled at the fact that I was watching a video on my computer. I explained it was actually the space shuttle getting ready to launch, and he was totally baffled by it. I told him about the space shuttle and the International Space Station as his eyes got wider and wider. When I finished my little science lecture I told him to turn around and go back to work - and he did. The only question he asked for the rest of the day was if "the people left yet." He even said goodbye on his way out - what a difference our talk had made.


I used to think a 9-1-1 call was a bad way to start a day, but today I found something worse: pulling up to school and having a fire truck and ambulance already in the parking lot. Whoops. I felt a little nauseous and wanted to turn around and call in sick, but instead dragged myself into the parking lot. It wasn't serious, thankfully, a kid just had his finger stuck in a bench. They were able to get it out with ample dish soap and were leaving - the kid with his parents, and not in the ambulance - when I arrived, and I walked inside with the principal. I was petrified of what she might say regarding my tardiness; instead she greeted me with a "Hello! He's fine! Are you going skiing this weekend, it's supposed to be fantastic up there!!" 

Thank the snow gods she didn't seem the least bit put off by my absence, but I apologized anyway. I know I can't be everywhere at once, but I do know I was supposed to be there by then. 


Thinking for two...

The school counselor approached me today: an eighth grader confessed she might be pregnant. I called the student into my office to talk; the conversation we had was more serious, intense, and productive than I'd thought I could deliver.



The elephant

California has enacted a law requiring updated Pertussis shots for all students entering 7th-12th grade in the 2011-2012 school year. It’s a monumental ordeal whose impact is difficult to stress enough to those unaffected: in short, best put, it’s HUGE. 

What it entails is first determining which students have the correct and current Tdap shot, and which students need it. For those whose records show they need it (keep in mind students only need to show shot records for when they enter the school, often times kindergarten – in other words, many are very outdated), they will be excluded from school next year until they do. What’s the problem with excluding kids from school, besides detracting from their learning days? Big money. Our school district will lose approximately $33 per student per day they are excluded for missing immunizations. Therefore, it is someone’s job – just whose, yet, hasn’t been defined – to ensure every student both gets the shot and turns in a current shot record before school starts.

To give you an idea of the magnitude of this issue, yesterday I counted and verified students for whom I have a record of a current Tdap shot at my middle school: 17 students, leaving well over 900 that need to be tracked down, many of whom won’t speak English, some of whom won’t speak Spanish, either. It is a large contributor to serious, rising tension among our staff as people get queasy thinking about August. I’ve known about this law for some time now, but it wasn’t until speaking with some employees of the district that have been here for decades (through new Hepatitis B and MMR requirements) that I began to grasp the severity of this law. There have been all sorts of horror stories about lines stretching for blocks on the first day of school when most people show up with their shot record, angry parents needing someone to scream at for their child’s exclusion, etc. The whole thing is a nightmare.


Secure your own mask first

Between class periods during the second day of scoliosis screening, the two other nurses and I, along with our health clerk, were sitting in the nurse's office cracking ourselves up. From the attendance clerk, we heard "Down!" Our coordinator, sitting with her back to the window to the main office, ducked. Having thought I heard "Keep it down!" I apologized to the attendance clerk, who said she had been yelling at a student, "Hood down!" (Hoods aren't allowed to be worn on campus.) It wasn't until the coordinator stopped laughing long enough for the words to escape that she told us she had heard the command and ducked - clearly saving only herself in what she thought was the face of serious danger. That's the kind of quality nurses we have on staff: we save ourselves first.

Today was nothing short of a barrel of laughs, mostly politically incorrect and directed at each other, and it reminded me of what I am missing as a school nurse: camaraderie in colleagues. Our position is so independent that while we become part of our school's staff, we're also on our own and "at the other school" so often that we miss out on a lot of action at every school. An important benefit of this position, though, is one I'm frequently thankful for: in being so independent, drama (at least that I'm aware of, which I try to keep to a minimum) is at a minimum, and certainly no micro-managing is taking place.

Tuesday we screened the 7th grade girls for scoliosis, and today we finished off the school with the 8th grade boys. A few lessons I learned in these two days:
  1. Boys smell bad. 
  2. Girls take a long time to undress and dress. 
  3. My eye is as good as any level. The key to scoliosis screening is in spotting asymmetries, and some nurses do this by running their hands all over the kids' backs. I'm not sure of any middle schooler who enjoys being touched by strangers, and I'm confident that my hands-off screening is just as accurate as those that feel all over the place. 


Ignorance was bliss.

I wish I still didn't know this about my colleagues. 


Overheard in the locker room:

Today was scoliosis screening, and I had a girl clearly anxious about taking her shirt off. Her face showed evidence of vitiligo, and she said she didn't like taking her shirt off. I assured her I was just looking at her bone structure, screened her, and told her to re-dress. As she was putting her shirt back on and moving out of the screening area, she looked back at me: "I told you it was ugly." I turned around too slowly to respond, and out she went. Poor girl, she has no idea how lovely she is, vitiligo and all - but I suppose when you're twelve, that's a concept too difficult to grasp.


Gross gross gross.

This is what your children eat at school. I had a bite, and nearly puked... and I am goat-like in my eating habits. 



Teachers should be able to take care of themselves, and tenure rears its ugly head again. 


The fleecing of your tax dollars

Warning: this is gross. 


I spent the entirety of yesterday trapped in my office with a boy who had received a suspension before school even started but whose parents or guardians would not be answering any calls all day long to come pick him up. He was atrocious: completely disrepectful toward me and tormenting the kids who came to see me. With the way he talked, I was sure he could beat me up, so I had to tread carefully. By the time I left, I was so annoyed I am sure billows of smoke could be seen steaming out of my ears. Just as I was escaping a little girl who had come to me earlier complaining of a tummyache came running to give me a big ol' hug. No reason for it, but it erased the hours of torture in my office. 


Who let the dog out?

Right after recess I went to a kindergarten class to pick up a couple kids for screening. Everyone was standing outside looking at the teacher holding a terrier puppy that could not have been more than 7 or 8 weeks old. I joined the crowd and asked the teacher if it was show and tell time - should I return later? "Oh no, this isn't show and tell. One of my girls brought her dog to school, it's been in her backpack all morning." I was completely unhelpful as I couldn't contain my giggles. 


Thank YOU!

Today I was greeted with a fat stack of thank you notes from the 6th graders I talked to a couple weeks ago. It kind of offsets the lice chaos that is now happening at all three of my schools.


I may never be right again.

The secretary brought a girl to my office saying her teacher said she had been itching her head. The girl mumbled something that sounded like "I don't like socks." I thought it was odd because I could see her wearing a pair, so I asked her to repeat, and she shouted in my face, "I DON'T LIKE BUGS." Okay... I took one peek in her hair: eggs everywhere, and worse, LIVE bugs everywhere. I thought I was going to lose my breakfast, and I'm sure I'll be having nightmares about it tonight. Of course the girl, a kindergartner, didn't  know her name so it took some sleuthing to track down her emergency card. Once that was out, we discovered her home number and parent cell phone numbers on the card were all disconnected. I went down the list of Grandmoms and finally reached one who said she would pass along the message to the parents.

Meanwhile, I was trapped with a kindergartener who could talk anyone's ear off yet didn't know her first name. I called her sister down for a lice check, and she was equally loaded with bugs, but even only a year older knew to not scratch her head in public. Now I was stuck with two lice-loaded girls in my small office, one of whom wanted to take off her coat and fling it around. She kept picking bugs out of her head and would shriek with delight, "I found a bug!" and bring the treasure to show me. It was like playing keep away trying to keep myself at a reasonable distance from the lice potentially flying off the coat swinging around and the girl's arm when she was shoving the bugs in my face. When I got strict and told them to sit still, the looks on their faces told me they've never been disciplined before.

Best was when I asked the two of them if they had told their mom they had bugs in their hair. There was just no mistaking the extent of the problem, even from a distance, and I was wondering how a parent could miss such a thing. I understood when the older girl answered: "My mommy told us not to tell anyone so we could come to school."