Overzealous school nurse is killing my budget

[flakypuff]

Okay, I'm going to have to put in my 2 cents...As a middle school teacher, I'm seeing things from another angle. I have had kids over and over again with head lice whose parents didn't do what they needed to do. I had a student with merca (sp?) whose parents sent him to school because they didn't have childcare. I can name these kinds of issues over and over again. A school nurse can see probably 100 or more kids a day. They are constantly bombarded with parents who use them as free healthcare. If your child has an ongoing issue, get a note from your doctor. The nurse is just trying to keep the whole school safe. School nurse's offices aren't a clinic (like some believe the emergency room is) but a place to get relief for kids who get sick when they come to school. If more parents would do their jobs and take care of their own sick kids at home, the nurse would probably have more time to take care of the things she should really be taking care of.

Honestly, I understand your point. HOWEVER, I guess it all depends on the nurse I am sure there are wonderful school nurses. I also am very sure there are parents that send the children to school sick, and do use the school as a healthcare. The point that I would like to make is our nurse is a nosey little asking a parent to bring a child to the doctor or get a doctors note everytime they are sick is way over the top. I agree with others posters here. And as another said...THEY DO NOT HAVE THE RIGHT TO CALL MY DOCTOR TO VERIFY WHAT I HAVE SAID OR THE NOTE I PROVIDE i plan on sending the school a letter stating they
do not have my permession to contact my childs doctor or speak about my childs medical condtion without my consent unless it is a medical emergency and I can not be reached. It upsets me that I even have to do this but I never thought my doctor, or I would be questioned by the school nurse and that is what makes me nuts...ok...deep breath

 

[McKelly]

As an ER nurse, and now an Infectious Disease nurse, I can tell you that Conjuntivitis (pink eye) is HIGHLY contagious. Hospital staff diagnosed with pink eye CANNOT return to work until at least 24 hours of antibiotic treatment has been completed, AND all drainage must be gone. There is NO WAY I believe that a 3rd grader wouldn't rub their eyes and spread it to everyone in the class. I don't know what your Doctor is thinking.
It is also very disturbing to hear all the complaints about school nurses. Please try to keep in mind that they are only trying to protect your children. Don't take it personally! Geez!!

I thought it was contagious too!! But when I told the doc I was going to keep her home anyway, she rolled her eyes at me. I just said, well, for no other reason than she looks really uncomfortable with her eye gooping out stuff!! I know the school would have sent her home anyway!! You can't win!!

 

[IDoDis]

You know, you COULD make the school district pay for that doctor visit! I've read stories about how teachers have insisted or recommended that parents take their kids to the Dr. to be checked for ADHD and the parents sued the district for the doctor bills and all of the medication and they won! We have strict orders from the higher ups not to EVER tell a parent to take their child to the doctor. A teacher can say, "Have you had your child's doctor look at him/her?" But, teachers CANNOT tell parents to do so in order to come back/stay in school or the school district has to foot the bill.

I know it wouldn't be worth the money to take them to court, but a letter to the principal stating that you could or would do this in the future might warrant a policy change at the school.

 

[deltachi8]

Wow, let me take a moment to be thankful we homeschool.


One thing is really bothering me....2 different posters said that the school nurse called the doctor's office to verify the doctor's note???? Correct me if I'm wrong, but wouldn't that be a HUGE infraction to the HIPPA laws? A school nurse has no right to discuss your child's medical condition with anyone else without your express approval, and the doctor's office shouldn't even admit your child is a patient, again without your signed express approval. Personally, I'd be threatening legal action.

It is not a HIPAA violation.

 

[JacobsMommy11002]

When you are the parent who is frequently summoned from work over nothing, how do you not take it personally? Should you just tell your employer not to take your frequent absenses personally? I'm sure that would go over well with lots of employers. The OP had a handle on the situation. She had acted responsibly. The nurse needs to learn to listen to the parent, who is ultimately responsible for the health care of the child.

I would take it to the principal and to the superintendant if need be. Perhaps they won't admit to you that there is a problem, and perhaps they will defend the nurse to you. But if they get complaints frequently enough, someone will talk to the nurse, even if they don't let you know about it.

I am a nurse...and unfortunately, you can't take the word of the parent. I know that sounds awful...but many parents lie. Oh, its just a little cough...then the kid tells you they were up throwing up all night. I agree, parents are in an incredibly difficult situation. You work, you only get so many sick days, you need your kids at school when they are healthy. The downside is a LOT of parents send there kids to school when they should be home. I've been there, I know how hard it is.

I have to say, I would probably do the same things the school nurses you have mentioned were doing (with the exception of whooping cough...I would make sure my kids parents knew that!). But nurses work under a license. You can't work without it. So we have to be extremely careful, and overly vigilant. Our livelihood is on the line. Licenses have been suspended for stupid reasons. Plus, nurses can not diagnosis. We can say, it looks like pinkeye, you need to have it checked out. But only the doctor can make the diagnosis. I have had more parents than I can count say its hay fever....because they don't want to miss work. 98 times out of 100 its pinkeye. Get the note. Help yourself out so you don't have to miss work.

 

[ajk912]

It is not a HIPAA violation.

I keep thinking it should be a HIPAA violation, though. At the beginning of the year, my kids' school nurse had the BIGGEST problem with the fact that my daughter is special needs and incontinent. Kept saying (even the assistant principal, too) that kids had to be toilet trained to come to school, she can't do anything, and dd has to sit in the clinic till whenever I was able to come change her. Since she is incontinent, this would happen several times a week. After a LOT of running around and phone calls (including to the special ed headquarters locally) we were able to come to an agreement that dd was allowed to change her own accidents. It was a HUGEEE battle to get to that point. She has a medical form on file, saying she has brain damage and she is and will be incontinent, and the nurse and assistant principal insist even with the medical form there isn't much they can do. I keep saying..What the heck??? If she had a dang colostomy bag you would have to change it, so why can't you change an accident? They say it's different. Telling me that my dd is in regular education so it's different. They claim they are working with me the best they can. They even insisted on calling my daughter's doc TWICE because they said that we aren't being helpful enough in "fixing the problem". She is incontinent, it's not like we are doing that on purpose!!! Most 7 year olds don't CHOOSE to be incontinent..seriously..get OOFFFF your high horse! They even told me that it was MY fault and I CHOSE to leave my daughter in poopy pants all day in the clinic, since it was MY choice not to get there faster to change her (never mind she always has clothes/wipes/new undies there!)

That could be why the school hates me and calls me for fake diagnoses of pinkeye. I am also the OP of this thread. I hate my elementary school's admin.

 

[trekkie2]

I am a public health nurse and we see parents all the time wanting us to sign something that says their kid is ok to go back to school. Unfortunately, although I can usually look at pink eye, or chicken pox spots or rashes and make a pretty safe guess, as a nurse we legally can not diagnose and because of this most nurses when asked will tell you that you need to see a MD for a diagnosis. When the school system you are in makes policies stating that a child must be send home for a suspected contagious illness and not return without documentation that the child is not contagious, the nurse has to follow that policy. Not to say that there are not totally insane and pita nurses out there!!

 

[Vickie46]

I totally agree with the nurse... she is just protecting all the other students... I had the same issue with a child in my class.. and I wanted him sent home... BUT... I didn't know he had allergies... for one.. I don't want pink eye and 2. I know the other children don't either... so... she is just doing her job... but I do understand your point!

 

[robsmom]

I got the pinkeye call today!! I really thought it was allergies but i respect that the nurse has to do what she has to do to protect the kids. Turns out that she was close, he had a bacterial stye(sp??). I think that the nurse does the best she can with a large group of kids and in this case she was right.

Lisa

 

[dougsmom98]

Omg, I hate to say I hate people.. but... the school nurse at my kids' school REALLY pushes my buttons. I have had her tell me at LEAST 10 times this year that my kid needs to go to the doctor for this and that, and most of the time I ignore her. Well, today she insisted that my daughter could not return to school till she had her eye drainage checked out. I JUST took her to the doctor TWO weeks ago for her allergies, I TOLD her that, and she insisted it was pinkeye and she can't come to school. omg. I KNOWWWW it isn't pinkeye. I am not even experienced in this, and I know. SHE should know, you know? So I took her to the doc. Guess what? It's allergies. I wasted $20 to find out what I ALREADY know to make the overzealous, bored school nurse happy. Why does the parents word mean NOTHING? I hate how they have the authority to say that the child cannot come back to school till they have a doctor's note. Seriously. I even told her, I can't afford to take her to the doctor for every single sneeze, it's crazy. She says it's policy. Anyone wonder why (part of the reason) why health care costs are so high? My kids' doc says she hears it at least once a day..the school says my kid can't come back til ___ is checked out. BTW, if this was an isolated incident that would be fine, but there were 3 other inicidents this year the school nurse wouldn't back down, and I had to take my kids to the doc for no reason. Ugh.

My son got sent home Friday with pink eye and it was just allergies. I couldn't get a doctor's appointment because they were booked. They said if it got work go to the emergency room, like I want to pay that bill. I waited it out, gave him his allergy pills and he was fine the next day. I understand the school nurse needs to protect all children though so I don't really mind, but by the time he got sent home he would have infected half the class anyway. Oh well.

 

[Mkgaapril]

Honestly, I understand your point. HOWEVER, I guess it all depends on the nurse I am sure there are wonderful school nurses. I also am very sure there are parents that send the children to school sick, and do use the school as a healthcare. The point that I would like to make is our nurse is a nosey little asking a parent to bring a child to the doctor or get a doctors note everytime they are sick is way over the top. I agree with others posters here. And as another said...THEY DO NOT HAVE THE RIGHT TO CALL MY DOCTOR TO VERIFY WHAT I HAVE SAID OR THE NOTE I PROVIDE i plan on sending the school a letter stating they
do not have my permession to contact my childs doctor or speak about my childs medical condtion without my consent unless it is a medical emergency and I can not be reached. It upsets me that I even have to do this but I never thought my doctor, or I would be questioned by the school nurse and that is what makes me nuts...ok...deep breath

you may want to send that note to the doctors office...they are the ones who are responsible for keeping medical private since they hold the chart...

 

[Good Ol Gal]

I am the Health Aide at our elementary school. I have made many calls to parents to talk about possible illnesses. Pink eye has come up many times. We actually had four kids come in today with pink, watery, itchy eyes.

What gets to me about all this is who is qualified to say something is "pink eye?"

Only a Dr. can diagnose.

I thought it was contagious too!! But when I told the doc I was going to keep her home anyway, she rolled her eyes at me. I just said, well, for no other reason than she looks really uncomfortable with her eye gooping out stuff!! I know the school would have sent her home anyway!! You can't win!!

You have to be on the eye drops for 24 hours before returning to our school. so if they go home at 11am, Dr. at 1pm, start drops at 3pm, they CAN'T go to school the next day. It is very contagious and kids.. don't care what age group it is.. touch everything!

My son got sent home Friday with pink eye and it was just allergies. I couldn't get a doctor's appointment because they were booked. They said if it got work go to the emergency room, like I want to pay that bill. I waited it out, gave him his allergy pills and he was fine the next day. I understand the school nurse needs to protect all children though so I don't really mind, but by the time he got sent home he would have infected half the class anyway. Oh well.

We have to keep the kids in our clinic, we don't send them back to their classrooms. I always have the kids rinse their eyes, look for lashes, etc, and then put a cool pack on the eyes and see if they will stop itching and if the pink will go away a bit before calling the parents. I would love it if parents would just send notes in from their Dr. if their kid has allergies. It would save me time and worrying and trying to play detective.



Of our four cases today, only one was sent home due to possible pinkeye. Of course, there was a case in his classroom on Friday that the parent argued with me that their kid did NOT have it.. but they did take them to the Dr. and found out they did.

There are many situations that drive me crazy on my end....

like the parent who hung up on me everytime I tried to call her house (her DD was throwing up). Her poor kiddo stayed with me for 4 hours before mom finally answered the phone and then she said she was going to send her new boyfriend to pick the little girl up

The little girl just cried that she didn't want to go with him. I called mom back and asked her again if she would come and pick her up... nope!

 

[LanaJae]

Only a Dr. can diagnose.

LOL, that wasn't a question, what I went on to say is that unless it's cultured, conjunctivitis is based on observation.

If a particular child has allergies that always seem to affect their eyes, chances are it's the allergies.

If I got a call like this about one of my kids, I would immediately suspect a viral or bacterial infection, because they don't have allergies. This nurse is familiar with this child, she's seen what the allergy eye reaction looks like in this child.

I don't know why everyone gets so crazy about eyes, I wish they'd get just as alarmed about noses. I can bet that for every child that gets sent home for rubbing their itchy eyes, 10 kids are left in school with discolored discharge from their noses, which is also "highly" contagious.

 

[SeansMom]

Only a Dr. can diagnose.

You have to be on the eye drops for 24 hours before returning to our school. so if they go home at 11am, Dr. at 1pm, start drops at 3pm, they CAN'T go to school the next day. It is very contagious and kids.. don't care what age group it is.. touch everything!



We have to keep the kids in our clinic, we don't send them back to their classrooms.

Of our four cases today, only one was sent home due to possible pinkeye.

There are many situations that drive me crazy on my end....

Thanks for stepping in and saying this. I worked for seven years as a school nurse, and I almost didn't post because this thread pushed so many buttons. However, Good Ol Gal covered in a sane manner many things that frustrated parents often forget. I'd like to add the following:

1) If you know your child has allergies (seizure disorders, asthma, diabetes, migraines, severe nut or bee reactions) for the sake of saving BOTH our sanities, GET THE INFORMATION to the nurse, and have the doctor verifiy the information if at all possible.

2) PLEASE remember this: We don't have an X-Ray machine. We don't have a slit lamp microscope (to diagnose pink eye). We don't have the abilty to run labs. AND even if we could, nurses, by law, are not able to diagnose. It's beyond our scope of practice. Only a physician, PA, or Advanced Nurse Practitioner (ARNP) can do that.

3) If your child is sent home, it is most likely for a good reason. For example: A) Your child exhibits symptoms of a contagious disease. B) Your child has a fever and/or is throwing up. C) Your child has an injury that can't be diagnosed without said X-Ray machine or similiar equipment.

4) POLICIES are in place at (one would hope) ALL schools. If your school has a policy relating to pink eye, it has to be followed. Ditto for other illness/situations, as mentioned above.

5) Not all nurses are created alike, or educated alike: Are you speaking to an RN, LPN, CNA, or health room assistant? There is a wide variety of education involved for each.

6) How many students is YOUR school nurse responsible for? I just raise this issue for awarness. Teachers fuss about their numbers. When I started as a school nurse I was responsible for SEVEN schools, one offsite Campus, as well as a daycare. That was a total of roughly 3,500 students.

And my personal rant regarding parents (although I'm sure nobody here would be one): You wouldn't believe the things I witnessed in those seven years, ranging from refusal to pick up very ill children of all ages, blatant refusal of cooperation in building health plans for serious illness', including diabetics and kids with multiple health problems, and severe sexual and physical abuse that even made the detectives sick. There wasn't a day that went by that I didn't worry about at least one of those kids, and often more than one. It was a VERY difficult job. So, next time your nurse calls you, try to remember that she has not only your child's best interest at heart, but is also juggling the risk of infection to other children, administrative policies, and a list of things to do that will, even in a good year, never get done.

 

[gabriellyn]

Wow - what a gamut of experiences! I am lucky with my older DD and DS - nothing out of the ordinary with their nurses. My toddler DS though - his daycare is pretty strict. DS has a blocked tear duct. His brother had the same when he was a baby and it was severe enough to have a procedure to unblock it. Toddler DS's eye only bothers him when he has a cold and is very congested. Which is what is going on now. Got the call today. *sigh* He HAS a note on file with the school, but not doing us much good now.

I sympathize with all the parents out there who have to deal with nonsensical calls AND I also sympathize with all the nurses who have to put up with parents who just don't care about their children. I know it is a difficult job.

 

[momof296&02]

I keep thinking it should be a HIPAA violation, though. At the beginning of the year, my kids' school nurse had the BIGGEST problem with the fact that my daughter is special needs and incontinent. Kept saying (even the assistant principal, too) that kids had to be toilet trained to come to school, she can't do anything, and dd has to sit in the clinic till whenever I was able to come change her. Since she is incontinent, this would happen several times a week. After a LOT of running around and phone calls (including to the special ed headquarters locally) we were able to come to an agreement that dd was allowed to change her own accidents. It was a HUGEEE battle to get to that point. She has a medical form on file, saying she has brain damage and she is and will be incontinent, and the nurse and assistant principal insist even with the medical form there isn't much they can do. I keep saying..What the heck??? If she had a dang colostomy bag you would have to change it, so why can't you change an accident? They say it's different. Telling me that my dd is in regular education so it's different. They claim they are working with me the best they can. They even insisted on calling my daughter's doc TWICE because they said that we aren't being helpful enough in "fixing the problem". She is incontinent, it's not like we are doing that on purpose!!! Most 7 year olds don't CHOOSE to be incontinent..seriously..get OOFFFF your high horse! They even told me that it was MY fault and I CHOSE to leave my daughter in poopy pants all day in the clinic, since it was MY choice not to get there faster to change her (never mind she always has clothes/wipes/new undies there!)

That could be why the school hates me and calls me for fake diagnoses of pinkeye. I am also the OP of this thread. I hate my elementary school's admin.

Ok so now we know there is more to the story- Apparently the admin isn't happy w/ your childs situation & this is really not fair. I am very involved at school PTA Board member, committee char etc., & it's my opinion that the admin will sometimes cut slack to those involved, those that appear to be involved & are SAHM. Perhaps i'm in the school too much & over hear too much. Our principal & nurse know better than to mess w/ me. My child has blepharitis (eyelash excema/psoriasis) and after numerous nurse requested dr appt's I had my dr wrie a note & told both of them I would noit be picking up my child or "alleged" pinkeye.


You would be amazed at how many parents I know who load their kids up w/ tylenol, dimetp etc., & send them to school so they can shop, go to the gym etc. I seem to be on everyone's emergency contact list & i pick up their kids only to find out the parent was doing personal stuff & anticipted the call.

P.S BTW my current dr won't even see kids if pink eye or chicken pox is suspected- they diagnose & prescribe on the phone

 

[Mkgaapril]

Thanks for stepping in and saying this. I worked for seven years as a school nurse, and I almost didn't post because this thread pushed so many buttons. However, Good Ol Gal covered in a sane manner many things that frustrated parents often forget. I'd like to add the following:

1) If you know your child has allergies (seizure disorders, asthma, diabetes, migraines, severe nut or bee reactions) for the sake of saving BOTH our sanities, GET THE INFORMATION to the nurse, and have the doctor verifiy the information if at all possible.

2) PLEASE remember this: We don't have an X-Ray machine. We don't have a slit lamp microscope (to diagnose pink eye). We don't have the abilty to run labs. AND even if we could, nurses, by law, are not able to diagnose. It's beyond our scope of practice. Only a physician, PA, or Advanced Nurse Practitioner (ARNP) can do that.

3) If your child is sent home, it is most likely for a good reason. For example: A) Your child exhibits symptoms of a contagious disease. B) Your child has a fever and/or is throwing up. C) Your child has an injury that can't be diagnosed without said X-Ray machine or similiar equipment.

4) POLICIES are in place at (one would hope) ALL schools. If your school has a policy relating to pink eye, it has to be followed. Ditto for other illness/situations, as mentioned above.

5) Not all nurses are created alike, or educated alike: Are you speaking to an RN, LPN, CNA, or health room assistant? There is a wide variety of education involved for each.

6) How many students is YOUR school nurse responsible for? I just raise this issue for awarness. Teachers fuss about their numbers. When I started as a school nurse I was responsible for SEVEN schools, one offsite Campus, as well as a daycare. That was a total of roughly 3,500 students.

And my personal rant regarding parents (although I'm sure nobody here would be one): You wouldn't believe the things I witnessed in those seven years, ranging from refusal to pick up very ill children of all ages, blatant refusal of cooperation in building health plans for serious illness', including diabetics and kids with multiple health problems, and severe sexual and physical abuse that even made the detectives sick. There wasn't a day that went by that I didn't worry about at least one of those kids, and often more than one. It was a VERY difficult job. So, next time your nurse calls you, try to remember that she has not only your child's best interest at heart, but is also juggling the risk of infection to other children, administrative policies, and a list of things to do that will, even in a good year, never get done.

what about the nurse i had that refused to take 5 notes and had to have a huge confrence fight with the doctor..i was sitting there when she told him "aparently you don't know how it works and who I am" and his response that i loved..."aparently you don't know who i am let me tell you who i am "Dr. xxx MD...you are just a nurse and you are not going to tell me what to do or how to treat my patient and if you want a disability problem you just got one.." those are the nurses I think everyone is talking about..not the ones who know you have a sick child or are looking out for the others...

 

[nuts4wdw]

As an ER nurse, and now an Infectious Disease nurse, I can tell you that Conjuntivitis (pink eye) is HIGHLY contagious. Hospital staff diagnosed with pink eye CANNOT return to work until at least 24 hours of antibiotic treatment has been completed, AND all drainage must be gone. There is NO WAY I believe that a 3rd grader wouldn't rub their eyes and spread it to everyone in the class. I don't know what your Doctor is thinking.
It is also very disturbing to hear all the complaints about school nurses. Please try to keep in mind that they are only trying to protect your children. Don't take it personally! Geez!!

Thanks to the pp! Wow, as a "horrible" school nurse I feel very thanked for my hard work . School nurses are just that, nurses. We are not doctors, but we have hundreds of kids that we must be advocates for. If a student looks to have a contagious condition, I think it warrants being looked at. As for pink eye not contagious, hooey! Last week I "looked" at a kid with pink eye, the child was sent home (the horror). The next 7 days I spent with 3 out of 5 people in my family ending up with pink eye!!!! So, let's think of what that cost me as the school nurse, let alone all of the kids at the school who came down with it and their parents that had to miss work. I very seldom call parents, but when I do, it is nice to be treated as a professional. Kids are amazing little people that must be cared for by everyone. I had a parent refuse to take their little one home when I suspected he had chickenpox because it was "spider bites". Guess those spider bites were contagious. We ended up with over 20 kids home sick with chicken pox. Please be kind to everyone. We as professionals need to respect you as parents, and I ask that the parents respect us as the medical professionals we are.

 

[canwegosoon]

1) I love my school nurse-she is great- very helpful...espically if I am on the fence about taking my kids to the DR(sick w/o a fever), and plus with their medical problems(congenital). I live 3 minutes from school and I come when she calls(and I have to say she tries to leave it to fevers or emergencies/sickness). She will call just to let me know one of my kids came to see her, and she updates me on poss. other factors-like there is a sub in so in so's class, or there have been a lot of kids with a similar problem in that class etc. She has even said...I am not 100% sure your child need to go home-I am going to let him rest a little while,and call you back if he does need to go home. I couldn't ask for more--IMO she goes above and beyond.

2) I can symphaize with others because there have been years where I have had my kids on 10+ dr visits each in a year...for what every reason it is stressful and the money does add up(not just the co pays, the medicine, the time, the next day off from school, missed class work etc). Now that my kids are a little older -10yo, the visits have cut way back. But this year alone I have had both of my kids in for 6 bouts of strep, 2 general sick calls that just ended up being sick calls, 2 bouts of fifth's(both negative), oh yeah and the "scabies" that were actually splinters(we laughed hard at that one) etc.... Our school nurse and I agree our school is not cleaned effectively and is the reason so many kids over several grades are constantly sick(and their parents were getting Strep and Fifth's too).


OP hang in there-I would check with other parents to be sure that you are being treated in a similar fashion...and I would have a conference with the principal or perhaps in your case a parent advocate since your child might already be receiving services(I had a parent advocate when my sons had speech therapy) they can point you in the right direction and many times know administrators well.

 

[trekkie2]

I am so lucky, my daughters high school has a school based clinic with PA on staff most of the week. the kids are able to access the clinic as needed for many health concerns and since she has been at that school, they have treated many sprains, strep cultures, weird spots, upset stomachs etc and I have only had to take DD to the doctor twice for things the school could not handle. And truly the very best is that the clinic is grant funded so they don't charge I wish this was the model at every school system, it would keep costs down for all of us get health care for many kids that don't have good access to medical care.