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.