School's out for summer!!

I wish I could summarize this year more eloquently than the only word I can come up with: wow. It's been a whirlwind of a year filled with far more excitement than necessary, from heart attacks to asthma attacks to kids stoned out of their mind. Between the bursts of excitement, though, it's also not been dull. There have been days where blood is spattered over my office floor, and days where I just wanted to give up, with too many parents, staff, and kids driving me to the point of insanity. This job may not pay all that well, and I know I am an endangered species as a school nurse; even still, and even if this isn't true for every second, this job is great. I feel pretty darn lucky to have a job where I look forward to going back to school on Mondays, where I regularly collect hugs, and where quite frequently I find myself laughing to the point of tears. When I look back to the beginning of the year, it's amazing how much I've changed; I never thought I would make it through the school year much less want to come back from more. 

That said, I have been, to say the least, very much looking forward to my summer break that begins today. For my growing number of faithful readers, please add me to your RSS feed. I'm taking a sabbatical from this blog as I travel overseas (because as much as I love these kids, I need to get as far away from them as possible in an effort to recharge my draining self), and will return in August. 

Have a great summer and come back soon!

In the mailbox today:


Don't give me lip.

My eighth grader diabetic is everything stereotypical teenager. She knows everything, and everyone older than her is just totally embarrassing. I think I get along with teenagers pretty well usually, I've been told I'm "cool" by plenty of their own and have a fair amount of experience with them after working at a weight loss camp for teenagers this summer. But this girl has been a challenge more than I can deal with. I've mentioned some of this before, but since she was diagnosed six weeks or so ago she has: forgotten her meter, forgotten her insulin, taken 14 units of insulin and then changed her mind about eating, and on a whim decided she was independent and didn't check in with me - I had to go hunt her down. I decided to embarrass the heck out of her that day by waiting for her in her fifth period class after lunch, and after a stern lecture about how I make a trip to that school just to check in on her and my time isn't free, I thought I got the point across. She didn't make that mistake again...until today. Today they had a minimum day, and it was optional for them to stay through lunch. The two days she decided to come to school this week I explained that if she decided she would stay for lunch I would come check in on her - but I was making a special trip for her and she needed to be sure she was eating. She assured me she was staying for lunch, but it wasn't a surprise to me when she didn't show up in the office. I had the attendance clerk do an all-call just to embarrass her one more time and she came down to the office; she had to pick up her insulin anyway. She looked pale - it was a hot day and they were having a field day so she'd been out running around, and it was after her normal lunch time. I asked if she was eating lunch on campus, she said no, I said to check her blood sugar anyway. She said she felt "fine" and, oh yeah, "I need my glucagon." I told her that, as I had told her all week, and in the weeks prior, her mom would sign it out. In response, in the most spiteful teenage tone, "She don't get signal at work." For any other kid I would probably have given them the glucagon to take home, because I'm one of those people that bend the rules on occasion - but not if you're disrespectful and rude toward me, wasting my time. I stood firm, knowing her older sister can come get it at any time, and she glared at me as she strode back to her watching friends.

I'm sure she gave me attitude because her friends were watching - it was the first time she's ever been outrightly rude toward me - but whatever the reason, I will not put up with it. Then again, I'm not sure what kind of nurse I am when I try to exert my "power" by withholding her emergency medication (that really, I don't trust her with anyway). It was her last day today, and I have to say I feel a bit of a failure for not ending that on a better note with her. Afterward, I called the nurse who will have her next year at high school to give her a heads up on the attitude and irresponsibility headed her way. "Tag, you're it!"

Assuming she makes it through the summer, willy-nilly-ing her way through insulin dosing, that is.

Today's screensaver.


My third grader diabetic, if he's good all week, gets to change my iPod touch screensaver at the end of the week. This is one such screensaver.


Out of the mouths of babes:

Eighth grade promotion was tonight, and in preparation more than just a handful of our girls left school early in order to prepare for the 5:30 pm ceremony. The reason, said one girl to the attendance clerk: "Us black girls - our hair takes time!"


Today's feel good story:

Brought to you by the local fire department. What's cuter than watching a fireman totally suited up crawl through an enamored kindergarten audience, letting them fawn over his funny looking suit and mask? Answer: Probably not much.

In other news, I made my 3rd grader diabetic cry today when I told him Thursday would be our last day together. He's been a challenge and apparently he is not looking forward to it as much as I am. It would almost be cute if not for the fact that he's been do difficult since I met him - challenging authority, using his diabetes to get out of class, etc.

Getting attached.

I'm pretty sure I'm getting attached to these kids when I'm happy to take phone calls after hours about their well-being, when I have nightmares about their safety, and when I look forward to Mondays. But this afternoon is why: there's a little kindergartener girl who wears a smile too big for her body and holds her arms wide enough to hug Northern California redwoods, who gleefully comes to visit everyone and anyone in the main office as often as she can. Never mind that she's in trouble, she just wants to give you a hug.



Today I got my first piece of junk mail (school health related). It was addressed to: My Name, School Nurse, Middle School. How exciting! I'm so official I am on a junk mailing list!


I am supposed to leave these kids for 8 weeks?

A boy came in with hives today, and I asked if I could call home:
"Is there anyone at home we can call?"
"Well I don't want to call my dad because he's frustrated."
"Why is he frustrated?"
"Yesterday he found out he can't go to my brother's wedding so he started drinking."
"And he's still drinking, since yesterday?"
"Yeah, I don't want to call him."

I don't blame you, little one. :(

Friday Recap

Yesterday a kid came in with a bee sting - he had stomped on and then picked up the bee. Hard to feel sorry for that kid.

A kid bolted from the emotionally disturbed classroom yesterday. Police picked him up not too far away from campus. I really believe the teachers in that classroom are from another world; I can't imagine working with those kids.

I've taken to amusing myself by messing with the kids. When one comes to ask for an ice pack, I offer to amputate their limb instead or ask for a donation. Some of them find me hysterical, but I'm pretty sure there's a fair number that find me disturbing - I'm waiting to get a call from a parent asking why I tortured their child.

Why do parents not call me back? I know I'm no parent, but I like to imagine that if I were, and I received multiple messages from the school nurse asking to discuss the well-being of my child, I'd call back. Immediately. Especially if she gave me her personal cell phone number. But...no.

One more week. Everyone's already falling apart, and tempers are short. Time for summer.

Dear Parent,

On second thought, good job parent for taking your kid in when I told you to with that 102.5 degree fever. Mono isn't something to mess around with in a first grader.


My review of "Nightmare on Puberty Street"

I give it one big LOL. I went to a presentation entitled this for 8th graders put on by Kaiser, and I need to give them my sincere compliments: the show was awesome. It's a funny way of getting kids to talk about stuff that matters, and they present it with songs, dancing, and skits that get the kids listening - an amazing feat at my middle school. I went to a similar presentation a couple weeks ago at one of my elementary schools, urging kids to "Keep the Peace: Stop. Think. Act." They conveyed the message with a stoplight - red light, yellow light, green light, and I've never seen such a large audience be so captive. Think what you want about the HMO, these presentations Kaiser does (that are totally free to the school) are fantastic. 



The other day at my elementary school I was helping some girls try on donated dresses for their 5th grade promotion (one of those "other duties as assigned"). I asked them if they'd be going to the middle school I work at in August, and one of them replied very hesitantly, "Um...I'm not really sure...My mom said it's pretty rough over there." I didn't have much of a response, and today was a good example of why: first thing this morning the attendance clerk had to go running, literally, after a suspended student, and a policeman came to confiscate a LARGE bag of marijuana and a BB gun that had been brought to campus. In the course of any given day, I patch up at least a few fight related injuries, and watch more Incident Reports be filled out than I thought possible. Still...the elementary school I was at during this conversation is a feeder school into this middle school: if the mom is okay sending her kid to school with the peers she has now, they're going to be the same peers next year...


Shoe Girl Saga, continued

Last night my cell phone rang at dinner time: it was the CPS worker following my Shoe Girl case. She wanted to ask if I've seen Shoe Girl (i.e. has mom beaten her too much to attend school?), and if I've had any contact with the mom. I said no, but that she had an appointment with the assistant principal to complain about "someone trying to get her daughter taken away" last week. The CPS social worker let me in on the fact that mom is claiming an appointment in July to get the girl new shoes - but that's in the summer, when no one can be sure that she'll have gone. She's also being uncooperative and refusing to sign a release of information for us to confirm this appointment with the hospital. Unexpectedly, the social worker gave me an earful about how difficult and frustrating this mom is; I couldn't agree more. (I suppose even social workers need to vent eventually.) The social worker warned me she is expecting this case to go to court, whatever that means, and for me to keep an eye on Shoe Girl's well-being. Mom is furious CPS is involved now with the shoes and it wouldn't be unexpected for her to take the frustration out on Shoe Girl.

<Sigh.> At least there's others involved now. I figure it's a good sign if the social worker is calling me after hours to talk about it; it's clearly weighing on her mind just as much as it does for everyone who meets this little girl. :(

As a way aside, it's quite flattering (I hope) to have the principal come ask if you're going to keep their site next year. My answer, because I'm at the happy and orderly elementary: "I've already asked to be here." :)

Dear Parents,

Please do not send your child to school with a 102.5 degree fever. And if I call you and tell you to come get said child, don't be irritated with either your child or me.


Your School Nurse


Remain. Calm.

I've had my 8th grade diabetic under my care for a month or so now. Under normal circumstances, I'd have expected her to be independent weeks ago; instead I have an unpredictable, rebellious, know-it-all teenager on my hands to whom I'm trying to stress the importance of taking care of her diabetes. It's not an easy task, and she's trying me as though I'm just another obnoxious and embarrassing adult. In the last four weeks she has: taken 14 units of insulin and then didn't eat lunch, decided on a whim that she knew how to check her blood sugar and dose her insulin on her own, left her insulin at home, and the new one today was that she left her glucose meter at home - this time with no current phone number to call for someone to bring it. I was saved by our district LVN, who takes care of diabetics and medically fragile students; she happens to have diabetes herself and we used her meter. As she was dropping it off in my office we made small talk until a few minutes before my girl usually arrives. She left saying, "I'll let you lecture her, I don't want to be here for this." That's right: my ability to lecture kids has become a well known district fact - don't make that nurse mad.

When the girl arrived, we had a good talk and I was not as intimidating as we both know I can be. I want to stay on her good side, partly because I think she's had enough negative reinforcement from me, and partly because I am hoping with positive reinforcement she'll be independent for next year's nurse at the high school she'll be attending. Inside me, however, was a different story: it was more like a stream of expletives. These kids are going to give me gray hairs and I'm going to have to start watching my salt intake if they don't start behaving.


Turns out not all my kids are poor.

My 3rd grader diabetic - the one that goes to the school across the freeway, the school that's not really mine except for this kid - walked in today and announced he is getting an iPhone for his birthday. He looked at the phone I was texting his mom on, as I do every day to tell her his blood sugars so she can track them, with pity. [It's nearly 4 years old, from the Razr era, and certainly no smartphone.]

Tying up loose ends

The diabetic that wanted to go independent last week: arrived ten minutes early on Tuesday, and was clearly humiliated to tell me she had told her mom and her mom said to continue checking in with the nurse. She even understood the difference between carbs and units - terms she, to my worry, has been mixing up since the beginning - when we discussed what she'd have for lunch. Progress? I think so. 

The girl with the shoes waved a friendly hello to me in the hallway yesterday. Her mother, who claims a disability prevents her from taking her to the hospital to get her daughter free shoes, came to an appointment with the assistant principal to complain that someone at the school was trying to get her daughter taken away. When I got to work on Wednesday, the vice principal and her were in my office - except I didn't know it was her. There's a big joke in the office that as soon as I step out of my own office, whether to file papers or talk to the clerks, someone shuts themselves in my office - often the assistant principal with troublemakers, or the school police officer on the phone. I saw the two in my office when I got there, and laughed it off with the attendance clerk that now I shouldn't even bother coming to work. Thank goodness I didn't barge in there to take it over, as I often do, and allowed the mother to know what I look like. I didn't hear until much later in the day that had been the girl's mom in my office; if I'd known, I'm not sure I would have sat right outside of it hoping my stares would hurry them along in their meeting. Also, it turns out it was the school psychologist who reported it, but she was so scared of retribution by mom she didn't want to tell anyone on campus. I can't blame her.

It's my Friday today, and not a moment too soon. I have one kid in my office puking, one with possible pink eye, and one taunting me with an inhaler he won't give up that he has no paperwork for.


My turn

Last week, I'd apparently had enough of rude parents, and became a rude nurse in response.