See you next year

I'm officially on three weeks of winter break now, and I was going to write a wrap-up post, complaining of how exhausting and overwhelming this semester has been. Then I read the Connecticut news, and I don't think any of it is worth writing. Take care of your kids. :( 

The VP's Office

The office of my middle school is across the hall from the vice principal's office. The VP at the desk in there is a loud, animated, character who provides day-long entertainment for me. There's a continuous stream of kids in trouble in his office; I don't know the statistics on suspensions here, but it can't be pretty from what I overhear. 

A sampling: 

"THE NEXT TIME YOU'RE TARDY, YOU'RE GOING HOME! DO YOU KNOW HOW MANY CAMERAS ARE ON THIS CAMPUS? DO YOU KNOW I SEE YOU WALKING AROUND THE SCHOOL, NOT GOING TO CLASS?!

AND KEEP YOUR PANTS UP! THAT'S ANOTHER REASON I'LL SEND YOU HOME, IF YOUR PANTS KEEP FALLING DOWN! NOW GO!"

It's really actually very refreshing to hear someone talk to the kids like this, as well as entertaining - and alarming - to listen to the drama of middle school students. I only hear what makes it into that office, but their activities include, but are not limited to: stealing bikes, cutting class, smoking anything out of anything (just about anything can be modified into a pipe), spreading rumors on Facebook or at school, fistfights, and more. Needless to say, the school resource officer is a frequent visitor here.  

On a different note, remember those kids that were unhappy about the changes to their school lunch? Their voices have been heard.

Stroking the ego

Anyone who works with kids knows they speak their mind. Sometime's it's not exactly flattering; I still remember the morning that I was having a reaction to something and a kindergartener asked, "What happened to your face?" Turns out these things can go the other way too. I was picking up a class of kindergarteners to herd toward hearing and vision screenings, and the teacher had them line up at the door. As they were getting organized, a couple of girls at the front started tugging on my sweater. "Hey," they said, "You're preeeeetty!" Apparently they were fans of the outfit I'd chosen when I rolled out of bed that morning, and I gladly took their compliments. 

Watch your back

I had been in the staff lounge heating up my lunch, and returned to my office to find a boy laying on the cot. He nodded his head as I asked if he wasn't feeling well, and was about to tell him to rest for a few when I was summoned by the secretary. Her phone had just rang, with the sickly boy's teacher on the other end of the line. She was laughing as she told me what the teacher said: the boy had been in class, complained he wasn't feeling well and asked to see the nurse. The teacher relented only to watch the boy out her window happily skip his way down to my office, and after seeing that, she wanted him back in class. I broke the news to the actor: "Buddy, I'm sorry but you're going to have to go back to class. Your teacher saw you skip down here." He was crushed, and as he hung his head in disappointment, I recommended next time he stick with his act a bit longer.

Keeping up with the times

Remember the American Girl dolls? Me too! Turns out you can now buy them allergy free lunches. Thank goodness!

Food for thought

A noble cause of course, but I'm not sure what the best way to go about it is: "How to ensure no schoolchild dies of an allergy attack."

Student of the Month

In Diabetic Land, when a student is chosen as "Student of the Month" in their class, they have a lunch BBQ with the principal - or so I'd been told. Somehow both of my diabetics were chosen as student of the month (emphasis on "somehow" given Spitfire's grades) this month, and today was the luncheon. Just to tease Spitfire, who is 9 going on 17, I told her I'd crash her luncheon to embarrass her. I did, and here's what I saw for lunch: a "double dog" (an internet search for an image proved futile; it's a prepackaged thing of two halves of a hot dog served side by side - don't ask how they heated them up), Goldfish brand cookies, chocolate milk, and carrots. This took place in a classroom with a few of the select students and principal, with an iPod docked onto tinny speakers playing Taylor Swift and the like breaking up and otherwise completely silent classroom while the kids munched. Granted, it's a cold and wet day, so there certainly wasn't going to be an actual BBQ, but still. The kids seem to think it's a treat to eat with the principal, it looked more like punishment to me, particularly with the awkward silence. Apparently 4th and 5th graders don't have much to say to the school principal.

No problemo

I was out to eat last week during our break, sitting on the sidewalk patio of a restaurant. A family with two young kids was walking by, and just as they did, the young girl vomited all over the sidewalk. The poor mother was horrified, apologizing profusely while trying to rinse it off. "Not to worry," I assured her, "I'm a school nurse. I see it all the time." Sure enough, on my first day back yesterday, I was overloaded with kids who had vomited in class: four or five all came in within an hour or so, perhaps a bit sick that they had to be back in school, or still recovering from Thanksgiving. 

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Totally unrelated, a substitute teacher needed something out of his car today, and I volunteered to watch the second grade class for a few minutes. The class was watching some puppet version of The Lion King, but when they saw me, the chairs turned around to talk to me in the back of the class. Pretty soon, everyone was raising their hands to tell me their "This one time..." stories of being hurt and seeing a doctor. "This one time, my cousin Flea, he flipped his car..." 

No one saw any part of the movie while I was in there, but I couldn't help myself: second graders are a fantastic age of cuteness, old enough (usually) to know their name, young enough to still be (sort of) innocent. Aww! 

No news is good news

It's been a quietly busy week, the best kind there is in this job. The elementary schools have had minimum days all week for parent-teacher conferences, and without recess and lunch, the chaos of a day is considerably reduced through the lack of ice pack requests and the fact that my diabetics go home before their insulin is due. On top of that, today was a rainy day, and rainy day recess slashes the first aid work to nearly nothing. Though Time Bomb diabetic has been passed off to another nurse, I was at the school anyway on Wednesday, and said I'd take care of her. She checked her blood sugar before breakfast, ate breakfast, and then came to my office afterward to do her insulin and...wait for it...check her blood sugar again. There are only so many times I can explain the concept of diabetes to someone, and despite my best efforts, she didn't understand why I was basing her insulin dose off of her pre-breakfast blood sugar instead of the one she was showing me in my office. This incident is why she essentially has her own nurse these days, leaving me to thank my lucky stars that I'm normally too busy with my two elementary diabetics, including one that steals bananas for me from the cafeteria, to have Time Bomb.

'Tis the season to be off: after a four day week this week, we have all next week off, and then winter break is rapidly approaching after that. Happy Thanksgiving!

Say what?

Several weeks ago I had a parent in my office yelling at me because her daughter's had lice. (Because it's totally my fault, I go around planting lice in children's hair.) She threatened lawsuits, reporting my supposed negligence to the district office, etc. I didn't even write about it in this blog because such incidents have become commonplace over the last two years, and in comparison to Time Bomb diabetic...well, it's just lice.

Fast forward to today. Said parent stopped by my office to tell me her daughters have been lice-free for a few weeks now and "I'm sorry if I was rude to you." I refrained from saying, "Yes, in fact you were very rude" and instead told her, as I had several weeks ago, that I understand lice is frustrating and stressful to deal with. I don't think a parent has ever apologized for being rude, and this parent continued on to say she had been pretty stressed out (lice and a divorce at the same time) and was sorry for taking that out on me. I'm pretty sure my mouth dropped open and stayed so during this conversation, but at least I managed to stay on the chair.

It was a pleasant thing to happen on a Friday heading into Veteran's Day weekend, which will be followed by minimum days next week, which will be followed by a week off for Thanksgiving. Time Bomb diabetic is officially not my responsibility, she's another nurse's now, and screening season is winding down. Hallelujah, the tides may finally be turning.

Why why why... II

A kid came to me complaining a spider bit him at recess. I see a lot of spider bites, but they all have happened the night before, so I asked where he was that he was bit by a spider at school:
Bitten kid: "Well, I saw a spider web, so I stuck my hand in it..."
Me: "How about I get you some ice for it and in the future we don't go sticking our hands in the homes of animals?"
Bitten kid: "Yeah, I'm not going to do that again."

Again...what makes a child think that it would be a good idea to stick their hand in a spider web? I don't understand them.

Happy Election Day! My school is a polling place, and it's been lovely to see the teachers bring the students into the hallway to show them what a polling station is and explain what it means.

Why why why...

I had to re-check a couple of kindergarten boys who had failed my initial hearing screening. It's not unusual at that point: I do my screenings in the hallway, and sometimes the excitement makes the little ones unable to focus long enough to pass the screening exam. I met the teacher at the hallway entrance as they were returning after recess, and she pointed one of the boys out to me and said the other was still in the bathroom. The kindergarten bathroom is left propped open so as to minimize funny business, and I could see the little boy's feet dancing around the stall. He finally finished up and I saw his feet near the stall door, seemingly poised to leave. Next thing...he lays down on his stomach, and crawls out of the stall underneath the door. Imagine his surprise when he stood and dusted  himself off and saw me at the doorway, hands on my hips, eyebrows raised, and trying very, very hard not to laugh.

Sadly, I didn't feel I should let the kid get away with it. I told his teacher, who had him turn his card from green to yellow (I think there are consequences when it gets to red). I was as much amused by this exit as I was disgusted by the germs that must be all over the front of himself, and received no explanation as to why he went that route. I don't understand the logic of a five year old, obviously.

Justified

The most terrifying part about my job is that when it comes to medical decisions, I'm it. I have friends that are teachers that envy the schedule and flexibility; for example, I don't have 30 kids knocking at my door when I get to school after the first bell rings. My response is always that they wouldn't want to be the one everyone's looking at in an emergency, and I usually win with that. Twice last week I had heavily wheezing kids in my office; for both, I took a listen to their lungs with my trusty stethoscope and was pretty alarmed at what I heard. Neither said they had ever had asthma before or used an inhaler, and in both cases I was able to reach the parents and they were taken to the doctor. The result of both: inhalers prescribed. It is totally satisfying when you're right in this job, because even though I've heard plenty of wheezing in my short time here, there's no one right there that you can ask for a second opinion.  (Not to mention the parents appreciation when a trip to the E.R. wasn't for naught.)

On a completely different note, I helped a nurse screen at a different site this morning. As I pulled up, the paramedics and fire department were in the parking lot. A student had fainted, everything was fine, but all I could think was, "Really?" I have seen the fire department and local ambulance company way more than necessary, and I can't even get away from them when I go somewhere totally new.

It's Still Red Ribbon Week

After hearing a student was offering drugs to his classmates, the fifth grade student (yes, that's 5th grade), was summoned to the principal's office. A search of his backpack turned up a makeshift pipe with marijuana residue, and the student confessed both that he does smoke and was wanting to distribute. The cops were called, the parents called, and the student was picked up. All any of us in the office could think was: that poor kid. He apparently brought Hustler magazine to school as a kindergartener, at that time saying that his dad didn't want to bring it to work so he stuck it in the kid's backpack. It's not the kid's fault that his parent(s?) are inept; and this incident reaffirms my believe there should be a license required to have a child. Oh, and it's Red Ribbon Week: this all took place under a zillion red ribbons and decorations suggesting we're too cool for drugs at this school.

As part of Red Ribbon Week, each day has a theme. Today's was pajama day, the first spirit day I've ever "dressed up" for. Naturally, while in my pajamas, I forgot my wallet and needed gas to get home, so I had to a) borrow money from a secretary and b) actually go in to pay and be seen at the gas station, in my pajamas, in the middle of the afternoon. It was also one of the first days I didn't bring enough to eat and had to go to the cafeteria and ask for spare food for the hungry nurse, trudging through the cafeteria in my pajamas.

World Series 2012, Game One

I work close enough to the San Francisco Bay Area to be feeling the effects of the baseball fever that has spread among residents. (Where were all these fans a month ago? Suddenly I have company.) Nowhere was it more apparent than at my elementary school, where it's Red Ribbon/Spirit Week, and today's theme was Sports Day. Everyone was dressed up in sports gear, much of it in support of the SF Giants. A tiny first grader was in my office, saying her stomach hurt, and I've been doing this job long enough to know that if I can keep them talking and distracted, most stomachaches will soon be cured. She was wearing a Buster Posey shirt, and I asked if she liked Buster Posey:

Tummyache Girl: He's my boyyyyyyfriend. 

Me: Oh really? Does he know that?

Tummyache Girl: Well, no, but every time I see him on TV, I go like this [demonstrates fainting]. 

Me: Well, he's playing tonight and if you have a date to see him on TV, your tummy better start feeling better. 

Tummyache Girl: You're right! I have a date! I'll see you later!

And out she skipped. Those are the moments I love my job, much better than the hours I am continuing to spend trying to work with Time Bomb diabetic. 

Vision charting

After two years of begging, I finally got my hands on a near vision chart. It's pretty straightforward, like every vision chart, you have the student read the symbols. Unfortunately though, there's a symbol I can't explain in this one. Is it an apple without the stem? A deformed heart? Or, the kids' favorite, a butt? I don't know, but I wish whoever (whomever?) invented this chart thought about the children that would be looking at them.

TGIF

I can't pretend Time Bomb diabetic isn't sucking the life out of me; I feel like this entire week has been phone calls and emails in relation to her. It's made me particularly thankful for my younger kids that are always good for a laugh. I asked Spitfire diabetic, who is 9 going on 29, if she was dressing up for Halloween. She scoffed, and when I asked why, she said, "That's what stores are for." Because what silly kid goes door to door asking for candy when you can just buy it yourself at a store?

Talking to a wall.

After I checked my kiddos in Diabetic Land, I returned to my middle school to find Time Bomb diabetic about to eat lunch in my office. Another nurse is in charge of her now, but I happened to get back early and beat the other nurse. Imagine how fast the blood drained in me when I asked her to check her blood sugar and she showed me the number: 39. 

The woes of teenagers

A 7th grader came in for an ice pack while I was having a meeting with our coordinator - approximately 20 years my senior. I told her I'd get her one if she tied her shoes, and she said she couldn't bend over. The coordinator looked at her cross-eyed, as the student was perfectly able-bodied, but I could see the problem immediately: "Ahh...Your pants are too low and tight, right?" 
"Yep." 
She sat on the couch to tie her shoes with her rear end facing the wall, saving the coordinator and I from viewing any unnecessary plumber's crack.

Hitting the ground running

A parent asked me to check her daughter's eyes because her first grader had complained she was having trouble seeing. Her vision was fine, so I asked why she had told her mom she couldn't see well:

"Are you having trouble seeing in class?" 

"No, it's not in class. I just can't see very well when I watch TV." 

"Then don't watch TV." 

This has been another solution brought to you by the school nurse. 

On a very different note, I missed a bucket-load at Teenage Wasteland while I was out. The Great Big Learning Experience has apparently only been a learning opportunity for the school staff; mom and Time Bomb diabetic are completely oblivious to the seriousness of it all. In the past week while I was out, her blood sugars have reportedly included numbers in the 40s, and she has been caught lying about her blood sugars and glucose testing. On the plus side, we're going to be holding a little in-service for staff about diabetes, signs of hyper- and hypo-glycemia, and what to do for each. Time Bomb diabetic's lunch and insulin dosing overlap with my other diabetics, so, very thankfully, I have passed on covering her permanently to another nurse in the district, as I can't be in two places at once. And the other issue in Teenage Wasteland that came to light while I was out: an eighth grade student is pregnant for a second time, by rape, by her uncle. 

Thank goodness for vacations. 

Adios, amigos!

I'm taking off for a one week vacation tonight, because you can do things like that when you start the school year way too early in August (and you're tenured). After the Great Big Learning Experience on Monday, I am so ready for a little break. Back soon!

The Aftermath

Well, that was a big ol' day yesterday. There's nothing quite like receiving an email from the higher-ups at the district office asking you to call the parent of a student you called 9-1-1 for to make you quiver in your boots. I called the mom, left a message, and then had to sit and worry for a half hour before she called me back. She had questioned my decision yesterday to call the paramedics, and I really didn't want to hear her grief. However, her complaint wasn't that I called 9-1-1, but that I didn't call it soon enough. While I'm sure it looked different on her end, I explained to her that I walked in only moments before she did, and when I did, I took her daughter's blood sugar and called 9-1-1 in one swift motion. Out of habit now, I always look at a clock when I enter those sort of situations, and knew the few minutes that passed between my arrival and the arrival of the paramedics seemed like hours to all of us in the room. It seemed to placate her well enough, and she told me what she was more concerned about was the fact that it had taken people so long to recognize her symptoms. (Apparently the student fell in P.E., and has no memory of sitting through fifth period science, just before lunch when she became unresponsive.) I tried to walk the fine line of agreeing with her without admitting fault on anyone's behalf for anything, and in the end, had a surprisingly decent phone call with her. We both agreed it's a learning opportunity for all parties involved, that the student should be carrying snacks and logging her blood sugars as I've been nagging her to do, and that the staff need to be better educated on what to look for. The student is back at school today, and I'm just very thankful this wake-up call ended positively. Phew. 

Not it (I wish)

I did hearing and vision screenings all morning, which are never my favorite days. While kids are my favorite part of the job, they're not as fun when I have to keep masses of them in line. From there, I thought I'd get a step ahead and swing by my middle school to fill out some paperwork that was waiting on my John Hancock. I left my phone at a friend's house and hadn't yet retrieved it, and I'd been thinking how nice it was to be sans cell phone: my schools hardly call me anyway, and when they do, it always seems to be about lice. 

Other duties as assigned

I was typing furiously at my desk in Teenage Wasteland this week when someone I didn't recognize stopped in the doorway. She asked if I had a moment to talk to a student, and when I asked what about, she said she had a student who had been disrespectful to a teacher. The student had said there was an issue she was having that she didn't feel comfortable talking about, and the stranger at the doorway said she couldn't find anyone else when I suggested the principal or psychologist. I told the stranger I'd try, and in came a very shy looking 6th grader.

Nearly an hour later, I escorted the girl out of my office. She didn't want to talk to me at first either, she said she didn't feel comfortable, and I said I wasn't going to pry. I kept her talking though, about safe topics, and at some point when she clammed up as we got close to her issue, I told her she could either keep talking or go back to class. She kept talking: her dad passed away a few years ago, her mom has re-married, there's a new younger brother in the class, she feels like no one cares about her, etc. In other words, more than I'm equipped to deal with. I asked her to talk to the school psychologist, and she finally relented, hesitant to have to share her story with another stranger. I have to toot my own horn with this girl: we had a good chat, one that surprised even her. She said when she came in she had already decided she wasn't going to tell me the problem, and on her way out she said it was "cool" the way I had just a normal conversation with her about it. I am pretty sure being cool in the eyes of a 6th grader is a compliment.

Later in the same day, the principal asked me to follow-up with a girl with reported thoughts of suicide that she had talked to the day prior. When I called her into my office, I found another tiny 6th grader looking at me, expecting me to have the answers for her. Her story was different: she feels fat, she said. (From a clinical standpoint: she's totally wrong, she looks like a normal, healthy girl.) We spent some time together, and I didn't think it was productive until as she was walking out of my office, she looked back and asked, "You're here Wednesdays you said?"

A co-worker said on Monday I have a bleeding heart, and maybe I do. But I think even if I were an ice queen, yesterday would have still worn me down a bit.

Feed me!

I am so disgusted by the school lunches. They rolled out some new guidelines for meals this year, and the implications for the school kids mean stricter calorie requirements, as well as more veggies. You'd think that's a good thing, right? Wrong. I have been accompanying my diabetic to the cafeteria on occasion, and each time, I'm shocked by the tiny portions (as well as the poor quality). I know there's an obesity problem in this country, but I am also a firm believer that not everyone's nutritional requirements are the same. The lunches being served would have left me hungry as a child. Blech.

(Read this for more information on the video.)

Oh, children

I walked into my office at lunchtime to check on my diabetics, and found another kid in there already:
"Why are you in here today?"
"Well, I tried to go to the bathroom but I looked in every toilet and they all had pee in them already!"
"So...you went in your pants?"
"Yep, I peed my pants."

Teenage Wasteland

I was going to write something here about the middle school I'm at this year, how overcrowded it is, and how sad it is that students from my former middle school now have to travel through some major intersections (many of them on foot) to get to their new school. I was distracted by my thoughts toward the end of the day, exhausted by the drama and issues that 6th-8th graders face in the community, when someone came bursting into my office and gave me one giant bear hug before I was able to really recognize her: Shoe Girl. (If you're new here, you'll have to read about Shoe Girl for some background on her. Suffice to say, she's important to me.)

I first dealt with her when I started this job over two years ago, when she was a tiny little 6th grader. She's in 8th grade now, and at the risk of sounding like a parent, she has grown up so much...She's a young lady now! When she finally let me out of the hug, she started talking quickly, "I'm so glad you're the nurse here, I've been looking for you but I keep coming on Thursdays and you're never here." She told me how things are going at home (pretty good), and at school (kind of okay, except for the kids picking on her because of her shoes). She invited me to hang out at her house after school one day, or maybe the park, and suggested that when she's done being an 8th grader, I could be her nurse at the high school, too. She told me how glad she was when I stopped by to see her last year, but how much more glad she was that I'm there every week now. With the interpersonal conflict that's been clouding my work lately, Shoe Girl was a breath of fresh air*. Thank goodness, my job has a purpose for at least one kid. As I walked her out, I reminded her I'm there on Wednesdays, and I have a feeling I will be seeing plenty of her this year.



*Not really. She still smells like stale cigarettes and unwashed clothes and hair.

Disneyland

I've been at one of my schools since I first started my job two years ago. It was a wild first day at that school, one we still reminisce about to this day; the secretaries like to say with relief that I wasn't scared away by Day One. It's the district's lowest performing school and is in one of the poorest sections of town; there was a stretch last year where bodies were found within blocks so regularly we had to have extra lock-down practices, and when two of our kids were orphaned by a domestic violence incident last year, no one was surprised. It's at that school that I feel lucky when I can call a parent myself rather than have to find a translator, and I'm surprised if a parent answers the phone or brings in emergency medication, and it's where kids know I'm there on Tuesdays and have parents telling them to save their maladies for that day to come talk to me about. I have that school because none of the other nurses want it; it's too "high maintenance" with its needy population.

I arrived there two years ago, the same year the school got a new principal. Since then, test scores have increased dramatically and attendance has improved. My favorite part about that school, though, isn't a number: it's the attitude. The teachers there are the happiest and most welcoming bunch I have ever met, and they like to tell me about the dark days, before the new principal. The kids are well-behaved and respectful toward me, grateful for any attention they get, and I swear cuter than at other schools. I like being there because I feel needed and appreciated, by kids and staff alike. Most impressively, there's not a single person at that school who doesn't credit it's joyousness and productivity to the new principal. A man who frequently comes to work in a T-shirt and jeans is responsible for saving this place from total hell, which is what it's been described to me as before, and the lesson here is this: one person actually can make a difference. To that man, I say thank you for making that school the "happy place" of my job. 

TGIF for me

I was summoned to the tetherball courts at lunchtime for a first grader who reportedly couldn't walk. Suspicious, as I've grown to be, I left the wheelchair in my office as I went out to check on her. As I broke free of the kids hugging me (my popularity has soared since the hearing/vision screenings), her friend told me the severity of her injury: "It's my best friend. She can't walk." I found Twisted Ankle girl on the ground, tearless and smiling as soon as I asked if we could work on our tans together out in the sun. After a brief check of her ankle, I asked her to get up and come with me to my office for ice. Twisted Ankle girl's friend, ever protective, questioned my decision: "Are you sure she doesn't need a wheelchair?" I explained my decision was based on the fact that there was no swelling, no discoloration, and she could move her ankle just fine. Stunned, her friend looked at me and in all seriousness said, "Wow. I guess you really are a nurse!" 

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I gave my Spitfire diabetic some nail polish she had complimented me on last week, and my other diabetic, ten year old Mr. High Maintenance, noticed.
Mr. High Maintenance: "What? What about me?!"
Me: "I'm sorry, did you want nail polish?"
Mr. High Maintenance: "Ew, no! What I do want is that stuff rock stars wear around their eyes!"
Me: "Eyeliner? You're going to have to ask your mom for that."
Mr. High Maintenance: "I already did. She said I might get an infection."

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I called Mr. High Maintenance's mom to report his blood sugar, as I do every day, and she wouldn't let me off the phone without telling me this: "I really appreciate the way you take care of my son. You work really hard for him and he likes you a lot, and I just really appreciate it." 

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The icing on the cake today was actual cake in the teacher's lounge. I take my lunch after everyone else, and usually get shortchanged on the goodies, but not today. That, and the fact that it is my Friday, and I have no plans tomorrow but to hang out with my dog.  (I told Spitfire that I would be off tomorrow, and she asked if the nail polish was because I was going to be gone. That's right, a nine year old caught me trying to buy her out.)

Still.

I have a lot I could write about: the sweetest lice-ridden girls I know, how Spitfire diabetic has me so wrapped around her finger that I am typing with ten painted fingernails for the first time in years, how I drove past my old shuttered middle school and thought of all the kids that used to go there and now are having trouble getting to their new middle school, or how this morning when I came in and found a girl crying in my middle school office it was because a friend had just told her she'd seen that girl's mom and sister get hit by a car while crossing a busy street (later verified). But when I sit down at my computer to write, I can't think of much other than the continuing interpersonal conflicts happening among my co-workers, and I don't want that to overshadow the rest of my job any more than it already is. I'm nostalgic for the days when parents were my biggest problems; for my faithful readers, thank you for your patience and hold on tight. I will resume my regular writing just as soon as my brain can handle it. 

Teacher's Notes:

"Amanda needs ice. Brian punched her in the face 3 times."

"Clothing malfunction." [Torn tights.]

This week, besides some entertaining teacher's notes, included a broken front tooth after the student's face met the pavement in a raucous basketball game, fingernails falling off, and blood sugars between 51 and so high that the meter couldn't read it. I like this kind of busy.

Quoting.

At 10:30 this morning, a cute-as-a-button 5th grader came in for an ice pack. I asked what he was doing hurting himself so early in the morning, and he replied cheerily, "The girls are always hitting me." 

The quote of the day, though, goes to a different cute-as-a-button 4th grader. He was waiting in my office to go home (due to "too many sneezes pushing out [his] boogers") and he asked how old I was:

Me: "How old do you think I am?"

Sneezy: "Forty." 

Me: "Close, I'm 27."

Sneezy: "What?! You're too young to be doing this!"

So Dang Cute

Contrary to what it may seem like on this blog, I do have coworkers other than the principals and teachers at each of my school sites. There are other nurses in the district, as well as health clerks that manage student health records. I don't mention them much here in part because I rarely see them, but also because, frankly, most aren't worth mentioning. I'll spare everyone the details here, but I liken the group to a gaggle of middle school clique-y girls - except they're not. They're middle aged women that for whatever reason (and it's more than just an age thing), I don't fit in with. I've successfully stayed out of most of the drama among them for the past two years, but this year is different: I'm their target. There are emails going around, and the whispering being done behind my back isn't exactly inaudible. While it's a consolation that the nursing coordinator and my boss are both in total support of everything I do, and I know I'm getting my job done, it's hard not to have it wear on me just a wee bit that I'm so blatantly the odd one out. 

The reason I bring this up is that this mess has made me appreciate my time with the kids that much more. I performed hearing and vision screenings this week on the "Special Day Class" which are the autistic, CP, Down's Syndrome, and other similarly abled kindergarteners. Personally, I think the SDC classes should be renamed the So Dang Cute classes, because that's what they are. Those kids are without a doubt my favorite kids out of all 2000+ that I take care of, even though for about half of them I have to mark "Could Not Test" as their screening results. Those kids - like most 5 year olds - know what really matters in life: whose fly is unzipped, who farted, and when snack time is. 

Happy Labor Day! Don't drink and drive. 

Names are with you almost forever

I used to be pretty stunned by some of the names I come across in this job, but now that I'm an old hag in my third year, I have come to expect the worst. Still, I was surprised to find a new one today. I'm not at liberty to say the full name, but here's a hint: his first and middle names are a single letter. Yes, a letter. No, they don't stand for anything. Naturally, this was the one kid in the class that turned out to be color vision deficient (CVD is the more accurate description of colorblindness), and I had to address an envelope: "To the parents of" - of a letter. A single letter, no period signaling an abbreviation. 

Parents, when you name your kids, it's going to be with them for awhile. Do them a favor and give them a real name, not just a letter. (On that note, thanks Mom and Dad for giving me a short, easily pronounceable, and easily spelled name!) 

Unrelated, I'd like to take a moment and say thanks for the overwhelmingly positive comments and emails I continue to receive. While I can't respond to every one, I do read them, and always appreciate them. Thank you!! 

I will never understand.

The parent of a student with myasthenia gravis said some unkind words about me to the secretary on the first day of school. I attended a 7:30 a.m. meeting with her the next day to calm her fears and realized I was this mother was the quintessential helicopter parent. (She wanted to come to school with her fifth grade daughter for the first month just to make sure she was being properly watched. Note, this kiddo has no need for an aide or anyone like that. She can administer her own nebulizer if need be, and has a pretty clear hand signal in case of a respiratory crisis.)

Fast forward to the second week of the school. Myasthenia gravis mom was in the main office complaining about her daughter's $80 backpack being scuffed up, and mentioned casually that her daughter has Hand, Foot, and Mouth disease...and she'd been at school all week with it.

For the life of me, I cannot wrap my head around the thinking of some parents. I beg of all parents: do not send your child to school with an infectious disease.

Just the usual

I had been nagging Spitfire Diabetic to bring a binder with her doctor's orders and logs since school began. I spoke with her mom myself on the first day of school who said she'd bring one in, but wasn't surprised that almost a week later, there was still nothing. Tired of sending home little sticky notes with her blood sugar and insulin, I had Spitfire explain the holdup: "Well, after school, I do my homework, and then I play with my brother, and then my mom goes to her A.A. meeting." 

That child knows way too much. I ended up getting her a binder myself. 

Seriously

I am not making this up. I was out sick on Friday, and my nursing coordinator called me Friday night to let me know how my diabetics did for the day. (She knows me well, I won't sleep unless I know they were taken care of.) She also relayed to me the shocking story of the mental breakdown of a high school teacher. Apparently a teacher whose mental health was already questionable caved under the stress of the first week of school, and did something I still can't believe as I type it out. She divided the class in half, and threw trash on one half of the classroom. She explained: half of you (the students) will make something with your lives, the other half of you are garbage and are going to waste your life away. I can't imagine being the principal at that school and having to explain that one to parents.

Totally unrelated, I finally made it to my elementary school today (from here on out, referred to as Disneyland). The kids are just the cutest, and a couple of kindergarteners came to see me after a playground accident. While I cleaned up the scraped knees, one of them told me a very long, drawn out story. I didn't follow most of it, but I did catch the end. "And then I left my UNDERWEAR in the BATHROOM!!!"

And that is why I have learned to love kindergarteners. You might be feeling pretty crappy after a rough first week and unwillingly having to take a three day weekend that included strep throat followed by an amoxicillin reaction, but those kids can put a smile on your face like no one else.

Day 1

7:53 Missed call from Elementary School 1. Just left home, on the road, miss the call.
8:19 Almost to Middle School, pull over, and call Elementary School 1. Secretary answers, says they are swamped and will talk to me later. Never hear from them again the rest of the day.
8:22 Middle School chaos. Talk to parents and kids dropping off medicine, enter in shot records, reject shot records missing the Tdap shot.
9:19 Breakfast. Scarf down oatmeal while answering emails.
10:22 Introduce myself to an unfamiliar face saying hello at my office door. Become bug-eyed when I hear in response, "Oh, we've met before. I'm the superintendent." [Oops...]
11:55 Drive to Elementary School 2. Discover High Maintenance Diabetic Mom didn't send along any doctor's orders. Turns out she wanted me to call the doctor's orders and take care of that myself. Other diabetic, Spitfire, came with no orders either. Luckily I had stashed last year's away just in case. Hear about a parent that was "flipping out" and in tears all morning because her teacher didn't know how to care for her myasthenia gravis daughter. Discover a care plan for M.G. girl I'd requested from her previous school had just arrived in the mail, temporarily calming principal and secretary who had been victim to this parent's anger.
13:05 Back to Middle School. Work on Health Alert list and emergency care plans.
14:00 Lunch while answering emails.
15:15 Try to deliver care plan to teacher of student with a pacemaker, but door is locked. Teacher has no mailbox because they are a substitute; the school is still short three science teachers.
15:30 Call parent of one of the independent diabetics at the school who had left her one glucose meter in my office.
15:35 Leave, at last.

This all happened with a tonsil the size of a golf ball in my throat, and tomorrow I have a record three meetings scheduled in one day: one with myasthenia gravis parent at 7:30 a.m. sharp, a 10 am meeting to pull a severely asthmatic student out of P.E. permanently, and a 1 p.m. meeting with a teacher to discuss an epileptic student of hers. In between, I will try to finish care plans and get all emergency plans to teachers that I need to, as well as take care of my diabetics and all the phantom and real stomaches. It is pure chaos for everyone in the beginning of the year, nurses included, but overall, it is such a relief to have the kids back.

The fun begins...

Yesterday the contract days began for everyone else, so while I've already put in seven days of work, everyone else was jolted into reality yesterday. Things are as hectic as they always are in the beginning of the year, and last night I helped pass out schedules for the students at my middle school. I was there to enforce the Tdap law, refusing a schedule to anyone without the shot (and, possibly, off the record, I might have been sliding them a waiver if they didn't have proof or told a good story about why they didn't have the shot). I'm at a new middle school this year, and many of my students from the last two years - the ones previously at my middle school that closed - were there last night. It was great to see them, for them to see me, and for them to see we have some common ground in that we're all in a new place now, with new people.

The real highlight of the kids' anticipated return, though, happened today. I called the mother of one of my diabetics, one I like to call "High Maintenance Boy." High Maintenance Mom took a long time to trust me last year, but she finally did, and her little boy is one I can only describe as darling. He's a naive sweetheart of a kid, one who last year in fourth grade didn't know how to tie his shoes. Anyway, I decided to be proactive and call them rather than have them try to hunt me down in the chaos of the first day of school tomorrow to find out if anything major had changed. H.M. Mom answered, and when I identified myself, she said, "Oh! H.M. Boy was just talking about you, he was asking me if you were going to be his nurse. Here, he wants to talk to you." She put him on the phone, and I just want to let you know, there isn't anything much sweeter than having a high-pitched, squeaky fifth grader ask you if you're going to be his nurse again this year. We talked a little bit about his summer (it turned out he didn't have much to say after expressing his relief that I'm his nurse again), and then I talked with the mom again before hanging up.

Holy crap, I realized, when I hung up: I am so ready for the kids to come back. I know it's a statement I'll regret soon - perhaps tomorrow, even - and I'll be just as "so" ready for the breaks. But working almost two weeks without the children has been a long two weeks.

Welcome back to the kiddos, tomorrow! Let the fun begin!

Assignments

I'm headed into my third year in my district now, which is kind of a big deal for two reasons:

1. I'm tenured. Yes, you read that right. There's a two year probation period immediately after hiring, and, having passed that, I'm safe. This isn't too say I'll never be laid off, they can pink slip me just like anyone else, but firing me would be difficult given I have the California Teacher's Association (no small union) backing me up. This is particularly comforting knowing my boss has made it crystal clear that given a reason, he has no trouble letting people go. We lost a health care specialist last year who was just a week shy of finishing her probation, and apparently in the past, he let a nurse go just before she finished her two year probation period. (I was involved in the first incident, and totally supported his move, and while I wasn't involved in the second incident, it sounded justified.) I'm not perfect, nor is this any reason to slack off, but knowing my job is secure for the next year is no small potato in this economy.

2. Not to brag, but I have some clout. I've made a name for myself, and have stayed on the good side of the nursing coordinator and my boss, which means when it comes time for decision-making, I often get what I want, or at least a say in what I want. This year, I got what I asked for in my school assignments. I'll be keeping my same two elementary schools, which means one in the poorest section of town that I've been at for the past two years, and one in the nicer section, the one with my two diabetics. The two schools are across town from each other, but I decided I'd rather keep my diabetics - and my other elementary school - than have to train someone else on my diabetics and be worried about their care. At least when they're in my hands, I'll know how they're doing every day. The middle school I had for the past two years closed, so I'm taking on the one nearby. It, too, is in the "ghetto" of town, and prior to the other middle school's closing, the two schools were rivals. There was a lot of fuss, understandably, when the one school closed last year, with comments in the local online newspaper giving threats such as, "Bring your Kevlar," referring to the expected fights this year as two schools try to share one roof. It should be an interesting year at the middle school, with many unhappy people and staff trying to merge, and I'm hoping I won't regret my choice of schools.

The kids return on the 15th, and though I'm sure I'll miss these days soon, right now it feels like they can't get here soon enough. I am ready to see my babies again, and I'm tired of doing paperwork all day long without interruption.

I'm baaaaaaack!

I resumed work on Thursday, getting an early start on my contract this year to work on enforcing the Tdap law for 7th graders. It feels like I'm just shuffling a bunch of papers and I'm looking forward to the return of students next week. As I was entering in shot records, I came across this gem written in on a child's emergency contact in the "Mother's Occupation" section: "Cool Mom."

Oh the joy some parents might bring me this year. In the words of the Joker: And here...we....go!

Camp Recap

One week: three lice treatments, one visit from law enforcement, one scabies case, one case of cussing directed at me. It was an emotionally intense week for many of the young men, and exhausting for the rest of us. Two things helped me get through the week. One, when the CEO came to visit, she sat down and listened to me yak for an hour about how I saw the camp, and how I think it could be improved. I've never had someone in power actually sit down and ask for my opinion on how the place should be run, and it felt fantastic. If only I could get that kind of undivided attention from the school district. Second, the boys were at me nonstop all week long, making excuses to see the nurse for splinters I couldn't see, floss, bandages for injuries that weren't bleeding, etc. It was enough to make me start going crazy, and one morning I told my boss I needed to shut down the health center for a few hours while the boys listened to a guest speaker. He was in full support, and two and a half hours later, I returned dirty, scratched up, sweaty, and with aching calves, rejuvenated enough to finish out the week without going crazy. 

I have two weeks before returning to the school district. Time for some dog and beach time - see you in two weeks for round three in the school system!

A few bad apples

The vast majority of young men at camp appear to truly want to turn their lives around. The bad apples, though, put a blemish on an otherwise successful week. There were the guys that started the fight that turned into a small melee requiring law enforcement attention early in the week. Then there were the guys that on the last full day of camp decided to steal some items while the rest of us were at lunch. After a long search, confessions were made, and the guilty parties went home early. One of them was a camper who had made an especially positive impression me: always kind, yes ma'am or no ma'am answers to me, engaging me in conversation, etc. I was sad to hear he left on the bus of thieves that went home, but it was as I said to my boss: these guys, individually, are polite gentlemen. It's when they get together that the trouble starts. :( 

That said, the rest of the guys really did their best. I just about fell off my chair when I woke a camper sleeping off his nausea in the health center and he asked if he could get me coffee or tea in thanks for letting him rest. 

Crossing the Line

On Monday night, almost all of the campers participated in an activity called "Crossing the Line." I suggest reading about it here, but I'll try to summarize it. Basically, everyone stands on one side of the room while someone reads out statements such as, "Cross the line if you are male." If you're male, you walk to the other side of the room. The statements become progressively more personal, for example, "Cross the line if you've ever been lonely."

Surprisingly, the guys got really into it and almost every one of them took it seriously. I missed some of it, but I was able to re-join it for the debrief session afterward. The guys were able to talk about why they crossed the line for some reasons, and some of the explanations they gave were disturbing. A sampling of what I learned about some of the young men here:

• One has a 7 year old sister in therapy after trying to commit suicide, and he thinks it's his fault
• One had a best friend take a bullet aimed for him 
• One was supposed to go to somewhere with three of his friends but didn't; the three were killed in a drive-by and a fourth bullet was shot in the air, presumably for him
• One was raped by a woman at age 7 and a man at age 10

There wasn't a dry eye in the house by the time the activity finished, and it was really impressive the way some of these guys opened up to a room full of 100+ people, mostly strangers. As one young black man summed it up after saying he felt closer to everyone in the room, "Tonight was hella dope, I feel like I can go eat breakfast with my Hispanic brothers now!" 

Goodnight

I'm going to bed having still not converted my notes from last night into something sensical, and it's because I didn't exactly have time for it today. This morning I went to breakfast feeling under the weather, and told my boss I was going back to bed after breakfast. Long story short, I was in bed for about a half hour, and then out of it for the rest of the day due to a couple of major incidents. One: a brawl involving at least 40 or so of the young men requiring the police. Two: scabies. Yes, scabies.

We're all in one piece still, at least.

Overheard at the pool:

"Look at us playing water polo, a bunch of us fucking kids from the hood!"

I was cheerleading an exciting game of water polo for guys that have rarely been able to even swim in their lives. In fact, a young man about 19 or 20, did not know how to swim and was getting lessons from a fellow camper. There's a heck of a lot of colorful language being thrown around these parts, but frankly, I feel right at home. These are the grown up versions of the kids at my elementary and middle schools, and they're so inclusive and welcoming I feel like an insider, despite being the whitest, blondest thing in these parts. Though there continue to be issues with them in groups (think gang references, fights brewing), and they've only been here 24 hours, I am certain this week will have a great impact for some of them.

I combed out a camper's hair to check for any remaining nits, and while making conversation with him, I asked if he'd gone on the night hike with his brother. "No," he replied, "I did some freestyle rap with some of the other guys." As though that's a totally normal thing to do, and for me to hear.

Tonight's activity was "Crossing the Line." If you don't know what it is, I'll explain it a bit next time. For now, I'm going to bed, digesting the night's activity. Hint: it reduced most of a room of over 100 young men to tears. Incredibly moving.

One more week

I have one more week of camp, which, after last week's insanity, is probably a good thing: the pace here, at least that of last week, is not sustainable.

This week is very different: it's a select group of disadvantaged urban youth and young men, ages 15-23. They're here to do leadership type camp activities and experience life out of camp. It's off to an anticipated interesting start: three brothers arrived after a 9 hour bus ride with active lice. Taking care of that nightmare - we couldn't exactly just send them home - took most of the evening and some of this morning. (With the aide of hair clippers, it went much faster than it may have otherwise, and the boys got a free haircut!)

I stopped by my boss's office at 10 p.m. last night to update him on the status of the lice-carriers, and he gave me a short talk about staying safe this week. "Just a head's up, we have a fair amount of gang symbols and such brewing already. Be aware of yourself in large groups, lock yourself in your cabin when you're in there, and call me at any hour of the day or night if you feel even remotely unsafe." Gulp. (In case you're new here, I'm 27 years old - barely older than some of the campers here - and not exactly from an urban background.) I told him some guys had already tried to barge in the health center under the guise of getting directions for a night hike, and had I not been with company already, I may have been a bit uncomfortable with that encounter. The same guys that wanted directions found my bedroom window and were making cat calls to me as I was trying to help some other guests here. That said, the other guys I have had contact with have been nothing but totally polite ("ma'am this and that, please and thank you) gentlemen. It's a good group overall, and so far it's been totally enjoyable to watch the guys learn about being outside. I'm just crossing my fingers there won't be too many fights to patch up.

Dear Parent,

Please do not take it out on the nurse when your child develops a 102.6 degree fever. I'm just the messenger.

Sincerely,

Camp Nurse

P.S. When, after you finally agreed to come get your daughter and I asked if I could give her some Tylenol, I was not asking if I should give her the fever-reducing medication. I was simply confirming your permission to give it, knowing you would be arriving shortly anyway. Please do not insult my intelligence by complaining to my supervisor that the nurse doesn't know what to do in case of a fever.

Text of the day:

"Ive got a little man from day camp coming to u. He did not make it to the bathroom... he will need new pants."

And such is life for the camp nurse...

Oh, the drama.

Happenings in the past couple of days: 

1) A staff member working in the kitchen asking me if he had pink eye. I used my trusty reference I brought with me, Telephone Triage Protocols for Nurses, and questioned him on his symptoms. His answers were so useless that if it weren't for the fact that it were only one eye that was red, I'd have been sure he was stoned. Based on the answers he gave me, and the fact that his eye had been like that when I met him two weeks ago (at which point he said it was due to allergies), I said it probably wasn't pink eye. Fast forward to that afternoon: he'd been to the doctor, who had confirmed a case of pink eye. Everything at camp is ten times more dramatic than it needs to be, and if I hadn't heard the screams myself, I wouldn't have believed the chaos that ensued: "We're all going to get pink eye! I can't believe the nurse told him he could work in the kitchen!" Yeah, that was in front of me. No one listened to my rebuttal, my explanation of why I'd said he probably didn't (his idiotic answers), nor the fact that it is spread by direct contact and as a kitchen staff member, shouldn't be touching anything but the food when he's in the kitchen. And yes, in hindsight, I should have told him to err on the side of caution and take the day off, but still. In any case, it's been over two days and no one has another case of pink eye. So there. 

2) Bloody noses, bumped heads, scraped knees, tears over lost hiking sticks, and more. I haven't had a good rest in days, because every time I try for that, someone needs the nurse. And yet, the comments continue to come in that the nurse doesn't do anything. Still no one listens to my rebuttal, that they could have gone to nursing school and had my job if they wanted, or that I earn my day-time book reading by having to be available 24/7. 

3) Finally getting over the lice cases I sent home at check-in. Both kids made it back to camp with clean hair less than 48 hours later. In the meantime, I was subjected to complaints of itchy heads and claims that lice can jump 7 feet - does the nurse have lice now? Does the entire camp need to be disinfected? Again, no one listens to the nurse's assurances that lice is harder to get than most people think, and that they in fact cannot jump 7 feet. Trust me people, I've done more research on this than I care to admit. 

4) I found an adorable baby snake, above, that I might have kept a little longer had I not been so hungry for dinner. And, speaking of camp food, the menu here is apparently one week long. I'm on week three, and over all of it. Thank goodness for bringing my hot sauce, which has at least livened it up a bit, and for a roommate that's part chef and sent me here this week with a few extra dinners. 

Counselors are as much work as the kids

I had the following conversation with a girl I'll call Airhead Counselor (AC):
AC: So, I'm, like, breaking out in hives. Can I get some medicine for it?
Me: Sure. How long have you had the hives?
AC: Um...Like, two years?
Me: Okay...Have you seen a doctor at all? I can give you some allergy medicine, but it's probably not going to go away overnight.
AC: Well, yeah, but they didn't tell me anything. What can you give me?
Me: [Explains Benadryl and it's possible side effects, and Zyrtec.]
AC: So, Benadryl is stronger, right?
Me: Where did you get that idea?
AC: Well you said it might make me fall asleep. And it's 25 mg, and Zyrtec is 10.
Me: Okay, they're two different antihistamines. You can't compare the milligrams, because it's two different compounds.
AC: But Benadryl is stronger, because it's 25 mg, so can I have that one?
Me: No. If you've never taken it, I don't want to give it to you now and in the middle of the day, because you're working and you might get pretty drowsy. I'll give you the Zyrtec.
AC: Can you give me more than one?
Me: No. I'll give you one, they're 24 hour pills.
AC: When can I come back for another?
Me: How about in 24 hours?

AGHHHH!!!

Bugs

My assistant/lice-checker was out unexpectedly today, so I had to fill in during check-in. Not to fear, I thought; I'd been told by everyone around me that since this camp began 3-4 years ago, lice has never been found at check-in. So, leave it to the Lice Nazi, myself, to find the first case. I hate sending kids home from school with lice, but it's even worse when they're on summer vacation and staring at you with puppy dog eyes as you tell them they need to take their overstuffed suitcase, sleeping bag, and pillow, and go home. It was an unpleasant experience, and the parent was about as unhappy and indignant as you would expect, but I got back to business as the line had increased to a mob during this ground-breaking lice find. 

I was about to check another kid, and when he asked what for, I told him "bugs." It's easier than explaining what lice is when you don't have the time to do that. His dad started teasing him about bugs and monsters in his hair, and as he sat down, I could see from a distance that he was covered in nits. I told the dad that his child did in fact have lice, and the dad, thinking I'm going in on his joke with his kid said, "See, even the nurse says you have bugs in your hair!" It's one thing to send a child home with it, but it's just pouring salt into the wounds when they make a joke about it first, and then you have to explain that no, it is not in fact a joke. He was as irate as ever (with reason: the child had just had a haircut yesterday, and they're supposed to do lice checks before a haircut), the kid as sad as ever, and home they went. 

To clarify, the total number of children who have ever been turned away from camp for lice in the past 3 or 4 seasons: zero. Today: two, out of an intended 37 campers this week. Not awesome. 

Yes.

Extreme parents, helicopter parents, same thing.

There was a parent last week that called twice a day: once in the morning, once in the evening, to check on her perfectly healthy, active 10-year old. Worse, she sent him pictures of herself and her sister, and if there's a faux pas at a children's summer camp, it's parents sending pictures of themselves. The poor kid got a lot of ribbing for that piece of mail. It's only five nights, people! Take a vacation from being a parent, and let your kid take some time off from your worrying.

Overheard at camp:

"So, why do you like the 4th of July?"

"Because this is the day we declared our independence from Great Britain, and if we hadn't done that we wouldn't be free and we'd be paying really high taxes!"

A camp instructor: "Yep, all of us instructors have degrees from college."

Camper, looking at me: "Even you?!"

Me: "Yes, even the nurse has a college degree..."

The excitement of the day:

When I sat down to lunch and heard over the radio, "Did anyone call 9-1-1?" A fire truck and ambulance had pulled into camp, flashing lights and sirens on; after several minutes of confusion, we realized that none of us had called them. Yes, that's right: they had the wrong camp. We're 1.1 miles from the main road, and several miles away from another too similarly named camp. I felt bad for the person who called 9-1-1, because the detour to our camp was a solid five-minute delay at the latest. 

Check In

I take in medication while the director and another do a lice check. They always start by asking the kids questions like, "How are you feeling? Are you healthy?" An especially honest girl told us that her mom wears a headband to cover her thinning hair, and, about herself and how she's feeling: "I'm thick. I mean, some girls are skinny and everything, but I have some more meat on me." We all stared at her in awkward silence (really, I've seen children a lot larger than she!) before we started blubbering about how she's healthy. Kids are awkward. 

I asked another kid if he had medication with him. "Nope," he replied, "Just an EpiPen and an inhaler." When I asked what he's allergic to, he said, "I don't know, ask my mom."

And about that same EpiPen, I had the following conversation with the kid's mom:

"What's he allergic to?"

"Everything."

"Okay...What was the EpiPen prescribed for?"

"I don't know, the doctor just wanted him to have it."

"So he doesn't have any severe allergies that you know of?"

"Well, he's allergic to basically everything, dogs, nuts, you name it."

"Okay...What kind of reaction does he have when exposed to dogs, nuts, etc.?"

And so on the conversation went. Parents, if your child has an EpiPen, PLEASE educate them on when/how to use it. 

Another family told me they packed two inhalers, so I asked them to pull one out for me to keep in the health center and another for the kid to carry around. They pulled out an Advair inhaler and an albuterol inhaler, and when I asked for one, they handed me the albuterol, saying he uses Advair "when he needs it." Again, please educate yourself and your child when it comes to medicine, particularly emergency medicine. 

And, something super sad: A girl was visibly distressed after check in, and the director said she's been coming for four years and he knows her well, so it certainly wasn't early homesickness setting in. No...Turned out she made some friends last year and they had all told her they were all coming back to camp this week. Apparently, in a cruel joke they played on her, they all came last week, leaving her to be stranded with a bunch of newbies this week. Girls can be evil. 

This week I'm down from 91 to 28 campers, no special needs, and medication is only distributed to a total of four kids after breakfast and after dinner. 

Highlights

1. A visitor at 11 p.m. asking for cold medicine. It was just after I'd fallen asleep, and for some reason the boy and his counselor didn't get the hint to take the medicine and leave. No, they stayed for twenty minutes munching on chips and talking to me about video games while I tried not to nod off right in front of them. I could barely stay awake while they were yakking at me, but then of course couldn't fall asleep afterward. 

2. One of my autistic group kids decided not to cooperate in taking his morning medication. Thirty minutes later, thirty minutes of crying and screaming and throwing his cup at me, we got word from his mom that the medication had sat too long in the cup and I just needed to rinse it out and start over. Sure enough, it was fine, but not until breakfast time was over. 

3. A 12 year old so nervous about being on her period, and so homesick and anti-social, that we spent the morning walking until I couldn't walk anymore, and hashing and re-hashing a plan to deal with said period for the next 24 hours of camp. The hike started out in tears, and ended with her asking if we could do it again after lunch. I must have calmed her fears successfully - phew. 

4. Answering a question so gross I won't even repeat it. Kids are gross...and awesome...and you really just don't know what's going to come out of their mouths. 

5. The weather is beautiful, I'm surrounded by pine trees, and am treated to a spectacular star show each night.

The chaos begins

Yesterday I spent the morning working on crossword puzzles, the afternoon surfing the internet and lounging by the pool. I met one of the other staff members and he asked how things were going on my first day and I replied the worst way possible: it's been quiet. If you're a nurse, you know this will jinx you, and it did. 

Camp, Day 1

I started today working for summer camp - wahoo! It's four weeks of varying groups, and I even get to go home on the weekends. It got off to a good start this morning on the drive up to the mountains during which I increased my previous roadkill score of 3 animals over 11 years of driving to 5: I killed two birds in the last ten minutes of the 2.5 hour drive. I met my boss a few minutes later and as he was showing me around, he asked how the drive was:
Me: Pretty good, but I did manage to kill two birds.
Boss: Wow, weird.
Me: Yeah...one of them is in your driveway.
Boss: Yep, I saw that one. 

Then, during check-in a typical kid conversation happened:
Kid: "There's something you should know about me. I burp a lot."
Me: Okay, cool.
Kid: [BELLLLLLLCH!]
Kid's Mom: I don't know this child. 

Other than the mosquitos and getting shorted on a good bunk (but who really cares when I could probably sleep through a heavy metal concert these days), I am quite sure I'm in for a good four weeks: funny kids of all types and lots of them (special needs and traditional camp is happening at the same time here), a boss trying to make me work as little as possible, unlimited food that I neither cook nor clean up after, and a gorgeous setting and some staff to match it. Heck yes. 

Summer school

I'm working summer school this week, which is relatively quiet: the kids that are here need to be here, so no one's coming to complain about being sick, and the days are too short to have recess on the playground, so no tetherball accidents are possible. You're probably wondering why I am working at all, and the answer is that there needs to be a registered nurse in the district in case something does pop up, and I volunteered to work a week of it. It's nice to be able to get paperwork done in peace, and I closed my middle school office in such a hurry (more on that later) that I have plenty to sort through still.

The principal was wheeling a cart past my office today, and then backed up as soon as he saw I was in. "Check out why we have an obesity problem," he said. I went out to see what he was wheeling: brown bags of carrots and bananas. Confused, I said those look better than the average school lunch I see, and then he clarified. "These are the leftovers." The kids - all here during summer school are recipients of free lunch - had already eaten, leaving all the fruits and veggies to go to waste.

Summer already?

Usually I am counting down the days until each break, and yet somehow, summer managed to sneak up on me. Perhaps that has something to do with the fact that I will not be taking much of a break, at least not the two months off that many are: I have next week off, and then will be back at school the following week for summer school. I also just accepted a last minute position at a summer camp, so I'm working the four weeks following summer school. I'll have another week off at the end of July, but have volunteered to come back to the school district as early as July 31 in order to flex my schedule next year and take some time off when the rest of the world is not also on a school break. Goodbye summer, before it even arrived!

I was ready to quit this job a couple weeks into it, which seems eons ago, and I've now finished my second school year - what? Just as how I feel about summer break arriving today... How did this happen already?

At the moment, I'm too tired to speculate. Thanks for reading, add me to your blog feed or whatever you use, and there may or may not be periodic updates during the summer.

Also, congratulations to Melody for winning the Drug Handbook App. Yay!

Sarcasm.

Dear mother of my diabetic,
Thank you for having little to no contact with me throughout the year. Thank you for changing your phone number three times, never telling me when you did so. Thank you for not once including a carb count on those handful of times that you sent your daughter to school with a packed lunch  Thank you for when it was her birthday, not warning me that you would be surprising her with a McDonald's lunch, and not thinking to let me know what she had. I really enjoy trying to identify food items from their greasy packaging, and tracking down an estimated carb count online. Thank you for having a daughter that is so desperate for attention she recently said that she was going to "accidentally" deliver 60 units of insulin via her new insulin pen so that she could go to the emergency room. But most of all, thank you for complaining about me when you took her to her semi-annual check-up at the diabetic clinic. I really appreciate having to defend myself and the nursing care I've been faithfully delivering to your daughter with more careful attention than you seem to do at home.
Love,
Your daughter's clearly incompetent school nurse.

Ugh. Parents can really be the bane of my existence sometimes. Thank goodness the diabetic nurse listened to my end of the story, and ended our phone call with, "You're doing a good job. Keep it up."

Free Drug Handbook App

I've never won something free in my life, but being able to host a giveaway so someone else can be a winner is almost as exciting. I was given a code to download this Nursing2013 Drug Handbook (Nursing Drug Handbook) as a mobile app, which you can find here. I've written about the paper version of this handy reference book before, so I'm going to limit my comments on the content of the app; it is just what's in the paper version, but in a more up-to-date version. I have to admit when I had my hands on the paper version, it was nice and all, but isn't everything going paperless these days? Lo and behold, the same thing, but mobile version is now available. Finally!

The app is pretty much what you expect: drug information in a readable format that you can carry with you on your iPhone, iPad, iPod Touch (make sure you can run iOs 5), or Android. Below is a screenshot of what you find when you search Ritalin, so you can see for yourself that the thing is convenient and easy to read:

Frankly, I much prefer the mobile app version over the paper. Who wants to spend time flipping through pages? Unless you're a hunt-and-peck kind of typer, you're going to find the information you want faster with a mobile version of a drug handbook than a paper one, not to mention the fact that this one won't weigh your pockets down. That said, this is a pretty new app, which means kinks are still being worked out. For one, while I don't consider myself the least bit technologically challenged, I had a small bit of trouble downloading the full version of the app. Second, I found a couple of minor bugs, but they've already been fixed - great response time by the publisher! Others' reviews of this app were similar: a great app if you can get it working properly, which some people were able to easily, some were not. There is a free version as well, but you won't get too far with it: that would be like buying a drug handbook with pages missing. Get the full version if you really want to be able to utilize this as a mobile drug handbook. (If you're concerned about glitches, I have to put in a good word for the publisher: they responded and fixed an issue I found within 36 hours.)

Now for the best part: I have a code you can win, so you can play around with it yourself! Enter your information below for your chance to win.

Disclaimer: I received a free copy of the Nursing Drug Handbook for review; however this review is entirely my own. You can make friends with them yourself here or find them here.

Judgement Day, round 2

We have a monthly meeting where all the nurses come together to discuss our nurse business. Yesterday was the last dreaded meeting of the year, and our head boss even made an appearance. The new lice policy was on the agenda, and I was, yet again, disheartened by the fact that with the exception of the nurse who stayed after last month's meeting to help me edit it, no one had seemed to look at it prior to the meeting (they had an entire month to do so). My boss, who I rarely see, looked at me and asked what the differences are between my proposed policy and the current one. Gulp. I hadn't expected to be in the hotseat as he hemmed over it, gave a couple of suggestions regarding legal jargon in it, and then finally said, "okay." He asked me to send it to him with the edits, and after apologizing for the snail pace of goverment work and board policy changes, said he would try to get it passed over the summer. There have been rumors swirling about some...let's say extracurricular activities...that my boss has been doing and I was worried the gossip would cloud the potential importance of this policy change. Turns out I had nothing to fear as he assured me he will do his best - but makes no promises - to have a new policy for the next school year. I made the edits this morning and sent it off to him. It is officially out of my hands and pushing the send button has never felt so good. I have been working on and off for this lice policy change for a fair portion of the school year, and if it does get passed, I think I'm going to blow it up and laminate it for a certain teacher that inspired me to advocate for a policy change. For now, hallelujah: it's really out of my hands now, and on someone else's plate. Have I mentioned how good that feels?

Moving on - because I can do that now! - check out a student keeping a diary of her school lunches: http://neverseconds.blogspot.com.es/. (Thank you Kristin for the tip!)

Also, stay tuned for next week: it's the last one of the school year, and there will be a sweepstakes! 

Run in with Shoe Girl

Also known as the moments that make things like toileting His Majesty and Ritalingate totally worth it. I was at another middle school helping out with scoliosis screening when Shoe Girl came into the nurse's office to use the bathroom. (If you're new, find some history on Shoe Girl here, here, and here.) She had sprouted since last year and I barely recognized her. She came and gave me a hug and told me how she remembers me, how much better things are at the house than last year ("but my brothers still fight with each other!"), and how much better her feet feel. I thought I was over the moon with happiness for her, until as she was leaving she asked, "Are you the nurse at this school now?" I told her that I was just visiting to help out with screening, and got a typical 7th grade response: "That sucks."

 

"That sucks" in response to me not being her nurse is probably the best compliment I've ever received on this job.

I was back at the school a couple days later for more screening, including Shoe Girl's class. She was all over me again, and normally I can't say I enjoy bear hugs from people reeking of cigarette smoke, as she still sadly does. But, I'll let this girl hug me all day long if she wants - she needs to know someone cares about her. As we parted, she told me I should come by her house sometime. I didn't tell her I don't have the appropriate bullet-proof wear that I am sure I'd need if I ever met her mom face-to-face.  

Ritalingate

I generally try to keep the personnel politics out of this blog, just as I try to ignore them in real life, but, here they come. I was off one day last week, and made the mistake of looking at my phone after lunch. I had a missed call from one of my elementary schools, and I couldn't help but feel the need to check my voicemail. It was from Spitfire Diabetic's school, and her teacher had called me that morning (and apologized profusely for doing so when she discovered I was off) to let me know she'd been at the hospital the day prior. Concerned, I started listening to the voicemail only to discover it was another nurse covering for me: "Um...'ADD kid's' Ritalin is missing and I'm just wondering where you put it. The log says that you had it last and it's not in the cupboard..." and on and on it went. Annoyed, I called her back and was going to let her know that I put it back in the cupboard where it belongs, and instead was met with a long spiel about how she'd talked to our coordinator already, who said we'd have to re-examine our medication administration procedures, among other things. It was clear, by the tone of her voice, and what she was saying, that she didn't believe I put the medication back in the cabinet. I was frustrated and angry that someone - a co-worker - would have the audacity to seemingly accuse me of stealing Ritalin. I went home that afternoon to find two emails from the same co-worker, again repeating that she couldn't find the Ritalin, and that I was the last one to touch it.

 

I woke up early and went to search the medication cabinet to no avail. The coordinator made a call to the district office on my behalf letting them know a bottle of Ritalin was missing, and they told me I would need to inform the principal and assist her in reporting a "theft" to the police. I was still insulted by the whole ordeal, but moving on with my day when I pulled out another kid's medication at lunch time only to find the missing Ritalin bottle behind his in the same cubby. Eureka! Luckily this happened prior to any police report, and luckily for the co-worker, she was nowhere near me when I made the discovery. To say I was perturbed that she had a) basically accused me of stealing Ritalin, b) didn't see it herself when she had been giving the other kid his medicine, and c) blown it so out of proportion on my day off when it was something that could have waiting until the next day would be an understatement.

 

Like toileting His Majesty, there were some good take-home lessons from this nightmare. 1) Trust thyself. Of course I put the medication back in the cabinet. Granted, I put it in the wrong cubby, but that's a pretty honest and easy mistake to make. But I NEVER leave it out on the counter for someone to grab, the bottle is only ever in two places: my hands or the medicine cabinet. I would have saved myself a day of stress had I trusted myself a bit more. 2) It was very interesting to hear the reactions of others. The principal, my trusty health clerk, and the coordinator were along the lines of, "I have no doubt you put it back, and it's either lost in the medicine cabinet or someone stole it. You did nothing wrong, I believe you." The co-worker and site secretary's words went something more like this: "You signed off on it on Tuesday. It's missing Wednesday. What did you do with it?" Ouch - but at least I had the satisfaction of showing it was in fact in the medicine cabinet the entire time, just as I'd been insisting on.

Toileting His Majesty

Something I do very rarely in my position is the "dirty" work of nursing. I give insulin every day, but I'm nearly done with my second year of school nursing, and last week was the first time I found myself responsible for changing a student, a 6th grader with muscular dystrophy. I teamed up with another nurse and we got to work, having run over to the school during a break in scoliosis screening halfway across town. The student's aide was out on bereavement, the back-up aides out sick, and our own LVN, who would have been third in line, was off that day. I don't think anyone can pretend it's rocket science to change a diaper, whether for a baby or a 6th grader, and we finished our work quickly so we could get back to the other school in time. The student wasn't happy, missing his usual aide who has been with him since kindergarten, and let that fact be known to his mother when he got home. It was hardly a surprise, then, when I opened my email a couple days later to find something from one of the "higher-ups" in the district office letting me know a complaint about my work had been received regarding that day's toileting experience. I have grown accustomed to parent complaints about everything I do wrong, but about toileting? How incompetent have I become?

You can't please everyone, and there were a couple take-home lessons from this experience. One, do a job badly enough and you won't be asked to do it again. Mom specifically asked that the other nurse and I do not touch her son again, even if all aides are out, and I was happy to oblige that request. Second, I do not miss changing people, no matter what size. Cheers to the CNAs and people of other titles that do this work for us. Third, it may never cease to amaze me how parents can take their kid's complaint to heart over. The mother does not want two registered nurses taking care of her son, because he said so. Never mind that we did a completely safe and thorough job all while he was complaining about us right to our faces and being totally disrepectful. Awesome - beaten by a 12 year old, again.