Lucky me

I received notice from the public health department that a student had a lab confirmed case of pertussis the day before winter break starts. When we return from break, hopefully there won't be any new cases, or...everyone will be out with pertussis.  

It's winter break!! Barring another round of pneumonia or some other gross illness (not completely unlikely as I get ready to board a traveling germ factory next week, also known as a plane), I will be back next semester with more regular posting. 

The games kids enjoy

My 6th grade redhead diabetic is a bashful little guy, but I have him talking far more now than he did back in August. He is on an insulin pump, and his mom packs his lunch. He enters his blood sugar into his pump, the amount of carbohydrates in his packed lunch, and it pops out a bolus amount. I started estimating how much the bolus would be, and he clearly enjoyed it, hiding his pump for me while I tried to come up with an accurate insulin dose. Finally, yesterday, after a month or so of doing this on a daily basis, I guessed the bolus amount spot on. Mr. Redhead was so excited about this! I was too, thinking we could stop the game, but no...Today, he told me that I had to guess every day and once I got enough right in a row, then it wouldn't be fun for him anymore and we could stop. 

Whatever makes you happy, kiddo...

Setting up shop

At one of my new school sites, there's a confiscated Razor scooter sitting parked against the wall. Months ago, a student came in to see me and asked whose it was. "Mine," I replied. "I live here." She looked at me with awe and explained that the school has everything I need: a bed (the cot) in my office, the teacher's lounge has a microwave where I make my dinner, and I never shower. She must have gone back and told all of her friends that the new nurse lives at the office and rides a scooter, because now it seems every time a younger student comes in my office, he or she asks, "Is that scooter really yours?" 

Cheaters

I feel really smug about the fact that I caught someone cheating on their CPR test this week...Don't think you can pull a fast one on me! I teach Heartsaver CPR courses to staff on occasion, and was teaching a particularly difficult student this week. I thought we had a language barrier, but she sure did a lot (a lot) of talking for someone with a language barrier. She wasn't getting things, so when I went to grade her test, the first red flag I had was that she got several right answers. Then I continued on, she missed a couple, and then she missed numbers 5-15...She got the right pattern on the multiple choice answer sheet, but all off by one, and I recognized the pattern. I handed it off to the veteran instructor, told her I thought she cheated, and the lady admitted it. Needless to say, she did not get a CPR card. It's a little scary to think that people cheat on CPR tests. The point of the class isn't to pass the test (especially in this case, the lady was not taking it for a job requirement). It's to learn CPR.

It's December already.

I was going to write that I'm not really sure how this happened, but that's not the case. I know how it happened: I spent most of November getting sick, being sick, and then recovering from being sick. I was told, among other things, that I looked like "death warmed over" on the days that I did make it into work, which wasn't many. Anyway, I only have some sore ribs leftover now and it's back to the grind! At least for three more weeks until winter break. 

On the school front, the LVN that had been assisting me was reassigned, which means I am again on my own for an unrealistically challenging assignment. I can't be in four places at once, managing 5 diabetics takes up a large portion of my day, and my other schools suffer. C'est la vie, I suppose, as I'm not in charge of my assignment and can only do the best I can. Supposedly they are in the process of hiring another LVN so I can get the one that I poured the sweat into training back. 

On the other school front, I will be starting my credential program next year to become a full-fledged school nurse. When I received the welcome letter full of weekends I'd need to be on campus for and a list of textbooks I'd need to purchase, I wondered if I'd really gone off the deep end signing up to get credentialed in a specialty that is probably going extinct. Then I remembered that it will allow me to continue to do what I am doing right now, which is work with kids while being home at a fairly reasonable hour every day to spend time with my own. 

On the home front, with the exception of my daughter spiking her first ever fever last night, things are awesome. I could write a whole blog on motherhood, and join the ranks of mommy bloggers worldwide, but I'll try to restrain myself for now and keep this short. My daughter turns 8 months old Sunday, 2/3 of the way to 1 year. What? I don't know how that happened. 

Kids these days...

They can call 911 without you asking anyone to do so. I was just getting ready to pack up at my middle school and go teach a CPR class for the evening when the secretary told me that someone had collapsed in the girl's bathroom. Envisioning an unconscious student with a head injury, I said if there was a true collapse, we needed to call 911, but I knew the student I would be looking for and had my doubts. Sure enough, I found her leaning against the breezeway outside of her classroom, feigning illness. She was really sick, she said, from drinking expired milk at the cafeteria. 

Her pulse was steady, and I even got her to forget her acting job with some chatter, and she sat in the wheelchair smiling as I rolled her back to the office. I radioed to the secretary that all was well as soon, and explained to the principal, with only a little bit of eye rolling, that the student felt sick from drinking expired milk. (It even gave her a limp, imagine that!) 

So, imagine our surprise when the police showed up minutes later. Apparently someone - a student - called 911 for us. Lovely. I told the police all was well and wished I had taken a snapshot of their faces as I explained this was all over "expired milk." (I know our cafeteria's aren't great, but I assure you, they throw out expired milk.)

The teacher that had reported that the student collapsed had obviously not taken a step outside her doorway to see the student standing in the breezeway, either. 

Trick or treat!

One of my diabetics this year - of my five - is an intelligent and polite 8th grade girl. She seems to enjoy making small talk with me, and we chit chat a bit while we calculate her insulin dose. She surprised me today by asking a question I have not heard in at least ten years: "Did you go trick-or-treating?"

Um...no...I'm the one handing out candy now. I'll take it as a compliment that she had to ask though. Either that or she thinks I'm that weird that I'd do that at my age...

Whew.

I recently committed myself to being a school nurse at least a little bit longer, and then: the 2014-2015 school year has been continuing to happen. This has been the craziest, most stressful year I've ever had, by far. I have answered work emails from home more often than ever, I have screened nearly 60 students for IEPs in 1/4 of the school year (compared to a typical 100-120 for an entire year), and I just can't seem to please teachers or parents. The first aid aspect of my job used to have slow days; now it seems there is a steady stream all day long of pink eye, sore throats, and vomiting, no matter what school site I am in.  August is always a rough month as an employee in the education system, but that seems to be continuing still and it's almost November.

Some highlights off the top of my head:

1. A gnat flying around in a girl's eye. We flushed it out but I don't think I'd ever seen a live bug in someone's eye. 

2. I missed a broken foot, and if there's one thing that makes you feel crappy as a school nurse, it's letting a child walk out the door of your office with a serious injury. In my defense, the student said he was okay and didn't want to call home - and he actually walked out. This was a Friday, Monday I was called into the principal's office and put on speakerphone with the dad, having to answer to him as to why I let his child walk out of my office with a broken foot. Thankfully, the principal (who has a reputation for not doing this for her nurses) defended me, calmed dad down, and all was okay. But an UGH kind of morning that was, for sure. 

3. Spitfire's blood sugars are out of control: her meter cannot even read them, so over 500, on at least 2-3 days per week. 

4. I have been training an LVN to help cover my schools and diabetics, which is incredibly time consuming and after she made what I believe to be a huge mistake, I'm not sure it's at all been worth my time. (This is an in-progress situation, so I will just leave it at that.) If you want something done right, you have to do it yourself...except that that's impossible when your workload is greater than what one human can accomplish and stay sane. 

5. Screenings and more screenings. We need to screen Kindergarten, 2nd, 5th, and 8th grade students, and now that I have three elementary schools and a middle school, that is a LOT of students in my case. I have done a good portion of these, including the 5th grade screenings at one of my school sites that I have been at since I started this job. I met the 5th graders when they were 1st graders, and I recognized more than just a handful of them. It's a good feeling when you see them light up with happiness because they know you remember them.

6. Today I was called in to stand as a witness while a teacher took photographs of a student to provide evidence of physical abuse for a CPS report she was preparing. He was bruised and clearly beaten, a special education student clutching a Clifford book tightly. My bleeding heart nearly bled out. 

7. I screened a girl with Down's Syndrome that I had met once briefly before, several weeks ago. She burst in my door and shouted my name, and the fact that she remembered it just completely made my day, week, and perhaps I will just hold onto that moment for the year. 

I will try to return to regular posting now; this place is a good outlet for me that I've been forgetting about in the whirlwind of things. 

The grass probably isn't greener

Warning: long post ahead.

Get some Kleenex

A man called me at my elementary school early one morning: he is a single father, he explained, and his daughter had just started menstruating. Could I please check on her and make sure she has everything she needs? He works the night shift and wasn't able to get as many supplies for her as he wanted. 

Sure, I said. Easy. I called the student down: she has Down's Syndrome, as it turned out, and I went over some basics with her and her teacher. Later I found out that the daughter's mother, the man's wife, had passed away recently. As one of my friends said as I relayed this story to her: some people have real problems. 

Exhibit A

Exhibit A: Example of why we need full time health care staff at all school sites. 

Friday was a minimum day at my middle school and I'd told one of my diabetics - Mr. Redhead - that I would see him at lunchtime, which was taking place at 12:30 instead of 11:47 as it normally does. I went to my middle school at lunchtime to meet him as I always do, except he didn't show up. I checked his folder in my office that we keep his logs in and found that he had come to the office and given himself his insulin at 11:42, just like he does every day...Except it was a minimum day, and he would have gone to PE at 11:42 and not lunch. 

I freaked. For all I knew, Mr. Redhead was hypoglycemic and passed out on the steps of the school somewhere. School had just let out, so through the swarms of students, I looked for Mr. Redhead. (It was like reading a Where's Waldo book, but way more pressure to find him.) No luck. I asked the secretary to page him over the loudspeaker while I called his dad, who said he thought Mr. Redhead stayed for lunch and agreed that his blood sugar was likely dropping. I searched the cafeteria, asked the secretary to page him again, and still he did not show. I called his mom, ready to bawl my eyes out and tell her I lost her child. She answered, thankfully, and said Mr. Redhead was sitting across the table from her eating his lunch. Phew! 

The secretary, as I was leaving, said, "Oh yeah, I saw him come in earlier." What?!?! This is the deal with secretaries: they cannot be nurses and secretaries. They are asked to be, but you cannot have a secretary fulfill her duties and meet the health needs of the students at the same time. Mr. Redhead didn't ask for help, and so they let him do his thing on his own, because they don't know the consequences. I do. 

Poor Mr. Redhead got a lecture about it from me today. He said he realized his mistake as soon as he entered it into the pump, and didn't know what to do...so he went outside and went to PE. We talked about the fact that he got lucky - his blood sugar had been high - but that this could have been a really serious matter. I gave him my cell phone number and asked that he call me if I'm ever not in the office when he is again, and also made him promise he'd talk to the secretaries if he needed to reach me. Before Friday's incident, I'd planned on talking to him about going independent like the doctor's orders say that he is capable of. He said before I could that he still wants to be supervised...I suspect his mom may have given him a similar earful about what went wrong on Friday. 

It was a learning experience for many that I hope to not have to repeat anytime soon. 

Busybodies

I received an email from a secretary several weeks ago at one of my elementary schools that a parent had called to report that a student - not her own - had lice. I archived the email immediately, because I cannot believe every parent complaint, particularly concerning lice, where people like to point fingers. 

I received a second email last week that this other parent had called again to complain that the student still had lice, and that she would be calling the district office if no action was taken. This time I replied to the secretary that I would check the student, but it's no business of the other parent's whether or not the child has lice, and she should feel free to call the district office. 

She called again today, and again reported the lice. This time, she spoke with the principal, and informed him she has already made a report to the district office about this. She still wanted to talk to me, though, so with great dread I called her after lunch. She was surprisingly pleasant as I explained that I would not be reporting the results of the lice check to her, but that I had in fact checked the student, and also that the board policy is that students can remain in school with lice. (This was one of those instances where I take no credit for instigating this board policy...) She thanked me at the end of the call, and all was well. 

Here's the craziest part of this whole debacle to me: there was no lice! I did a *thorough* check, assuming if this parent was willing to go so far as to complain to the district office, that there must be a really obvious case of lice, but no. 

Some people are just busybodies. 

Crucial Conversations

If I may toot my own horn, which is essentially what this blog is a platform for doing, I had a really pleasant interaction with a parent this morning. She was upset because I had let her foster daughter call home when she complained to me that she wasn't feeling well. Instead of wussing out, for lack of a better term, I responded, "I get that that's frustrating, you don't want her calling unless she has a fever. The reason I let her is that I have had too many parents complain of their child not being able to call home, so my policy is to let the student work it out with their parents. Now I know that you would only like her to call home in case of a fever, and we will do that in the future. I apologize." She was *so* nice after that, and all it took was some positive communication on my end, instead of being either immediately defensive, or apologizing insincerely. Cheers to me! 

Also, a secretary came to tell me that someone had called and referenced me with, "the pretty blonde nurse" when she couldn't remember my name.
What a nice Monday. 

Chaos, just chaos.

I feel like I've had no time this year, and I just ran the numbers: it might be because I have nearly 3000 students this year across four schools. Usually by the fourth week of school, things are settling down; this year, I see no signs of that happening. 

Today's lunchtime chaos at my middle school was a good sample of how this year is going so far:

I arrived to find a girl in tears in my office. The staff said she hurt her shoulder and bumped her head at PE and mouthed, "Drama" to me behind her back. She wanted to go home; clearly, they didn't think she needed to, but she said the magic "head injury" words to me so I felt like I should let her call even though I couldn't see injury on her head. Her contacts were red-flagged in the computer, which means pay attention to whom we call as there are custodial issues for that student. I got her set up to call while I tended to my first diabetic. 

I think I counted three students that came in and out for ice packs in the next ten minutes before Spitfire arrived to check her blood sugar. Soon after, a teacher stopped by to introduce herself and tell me I need to have hearing and vision assessments done on several of her students by next week. 

Next, Spitfire came back after lunch to count her carbs and administer insulin at the same time three adults came racing in dragging a student. He has a fish allergy and his aide somehow (do not ask me how) missed the fact that he grabbed a tuna sandwich at the cafeteria. We had an Epi-Pen in the office, which I got out while observing him for signs of anaphylactic shock, which, thankfully, never presented. Drama girl stuck the phone in my face saying, "My mom wants to talk to you" while I got out the care plan for Fish Allergy Boy. Drama Mama was none too happy with me as I said that I couldn't see any head injury ("You are the nurse, I don't understand" - to which I responded, "There is nothing visible"). Luckily she was so annoyed she hung up on me, freeing up the phone for me to call Fish Allergy Boy's mom who, rightfully so, asked how he was able to eat tuna for lunch when he is supposed to have an aide watching him. I told her I wasn't sure how it happened, but she needed to come pick him up as soon as possible. Finally, I attended to Spitfire and released her, and sent Drama girl to go get her backpack, so it was just Fish Allergy Boy and his aide in my office. 

I sat on the edge of my seat with the Epi-Pen in front of me, watching Fish Allergy Boy, for the next 35 minutes until his mom arrived. Just as I sent him home, my last diabetic came in. Finally, when I was done with that student, I was able to leave the middle school to return to my first school site. Phew. 

Be careful what you wish for: last year I was wishing I was busier, right now, I'd happily take that assignment over this one. Hopefully things will continue to settle as the school year wears on, and I hope that the middle school aides learned a good lesson today with Fish Allergy Boy (who has many more allergies besides fish). 

Read. The. Bottle.

Everyone makes mistakes. In the medical field, they tend to be less forgivable as we are tinkering with people's health, but still, mistakes happen. Yesterday afternoon I received an email from a secretary stating that the medication bottle and doctor's orders for a student directed her to give 1/2 tablet, but that the other secretary that had been giving her the medication since school started three weeks ago had been giving the student an entire tablet. According to that other secretary, she was doing that because I'd told her to. 

My first reaction: WHAT. That other secretary had previously asked me to confirm that the brand name in the doctor's orders corresponded with the generic name of the drug on the bottle that was dropped off, which I did. I didn't look at the dosage as we'd received the same medication for this student's sister, so I only confirmed the name of the drug on the sister's order, and moved on with my day. I don't dispense the lunchtime medication for students as I am taking care of my diabetics at other sites then, and the secretaries in the district get a stipend for medication administration. 

I'll admit that I should have checked the medication of the sister as well, but I do not check in and review every medication. If I did that, students would have to wait up to a week to receive it after I was able to review it, as some sites I only get to once a week these days. Far more concerning was that the other secretary had been giving an entire pill for three weeks, when it is clearly labeled on the bottle to give only half, and on the doctor's orders as well. An occasional mistake I could understand. But to do it every day for 3 weeks is a much larger mistake. Apparently the secretaries aren't taught the 6 Rights, something I will be discussing with our lead nurse when she returns from vacation. [Yes, the lead nurse took a week vacation the third week of school. Awesome.] If they are getting a stipend for administering medication, shouldn't they have some training too?

Then I had the pleasure of calling the mother about this. I have never been so nervous to make a phone call in four years in this job. It was all for nothing: the mom said she wanted her to be receiving 10 mg, not 5 mg, and was frustrated at my insistence that we get new doctor's orders to reflect a 10 mg dosage instead of a 5 mg dosage. I tried to suggest she be the one to split the pills in half, but that didn't fly, and I was afraid to draw attention to the fact that our school had been over-medicating her child for the last three weeks, so I relented and told her I'd cut the remaining pills. 

<Sigh.> That secretary got off lucky this time, as I think we got one of the few parents who was totally unconcerned her child had been receiving twice the medication she should have. The scariest part is that the secretary thinks *I* am the one who got off lucky. 

Pop pop pop

Sometimes even I forget what kinds of neighborhoods I work in. Today, there was a shooting across the street from one of my sites, 45 minutes before the students were to be released for the day. We first found out not from the police department, but from the principal who heard it herself while she was outside, three distinct pops. The kids were brought in, and the secretary called the police to question why we weren't on lockdown. (Apparently only the police department can decide when a school is on lockdown.) For whatever reason, they didn't put the school on lockdown immediately, so at the secretary's urging, I walked out with the principal and drove away to pick my baby up from daycare before I got stuck in a lockdown for the rest of the day. Just another day in paradise...

Arachnaphobia

I received an email from a teacher requesting me to talk to a fifth grade student of his that was refusing to use the school bathroom. (Not exactly a nursing issue one may argue, but I took it anyway. The teacher was male, the student female; I can't blame him for sending her to me.) A timid little girl came into my office, and looked petrified as I asked her to shut the door behind her for privacy. I assured her everything was okay and told her I just wanted to talk to her real quick:
Me: So...Your teacher mentioned you aren't using the bathroom here at school and I just want to find out why. Is everything okay?
Girl: Yes...
Me: So no one is teasing you or anything, there's not another student doing something that makes you not want to use the bathroom?
Girl [laughing]: No, no, it's not that.
Me: I've never used the bathrooms here, but if they're anything like where I went to school, I bet they're gross. Are they gross?
Girl [laughing]: Yes! They are so gross!

It turned out that what was gross about them to her was that she saw a spider in one once, and, in her words, she's "terrified" of spiders. Poor thing. I told her I'd talk with the janitor, and a secretary came up with a plan for her to get a buddy to scope the bathroom out for spiders before she uses it.

It's a shame this isn't a performance-based gig, because I think I am way better at this thing than some of the other ladies I work with. (I'm thinking of one in particular who turns her desk so that kids cannot walk up behind her or next to her, they can only approach her head on.) Oh well...I'll just give myself a pat on the back for this one.

Late already

I have so much to write, and so little time to write it. In an effort to continue breastfeeding as long as I can, I squeeze in pumping sessions between my diabetic rounds. So, in a typical day, I start at one school, pump, check diabetics at one school, pump, check diabetics at my middle school, pump, and return to my first school. This all takes from about 10:30-1:30, leaving me just a short time period in the morning and afternoon to get everything done at my school sites. (Then I race home to see my baby, hang with her until she goes to bed, then eat/shower/pack for the next day/sleep.) Needless to say, the days are passing by quickly, and I've been neglecting this blog.

Last week was the first full week of school. I could do without the administrative staff at my middle school, but all in all, I have a pretty decent assignment. A sampling of last week's activities:

1) Active lice in a middle school girl's hair. The poor thing was nearly in tears about it in my office, explaining that she got it from a cousin's house in a recent visit to Pakistan. We had a good little chat about it though, and she seemed cool and collected again as she left my office.

2) A hole the size of Texas in a 4th grader's molar. I wanted to strangle his mother for allowing it to develop, but I didn't. Instead, I asked the secretary to call home and tell his parents that the nurse will not be allowing him to come back to school until we have a note from a dentist certifying that he is being treated.

3) My daughter's first week of daycare...She did just fine, but boy, did it suck, to put it plainly, dropping her off that first morning. She's in a perfectly nice home daycare just two blocks away from us, but I still didn't want to leave her with, essentially, strangers.

More to come!

New Assignments

Classes started on Wednesday, and I am back to the usual nuttiness that seems to breed in my school district. I have three new schools this year, in addition to one I've had since I first started in 2010 (2010!), which means this year will certainly be more interesting than last year. An overview:

Wackyworld Elementary School: I actually had this school my very first year of school nursing, and had a couple of memorable experiences there, including this one: Being right never felt so bad. Yup...It's the weed cookie school. That incident pretty much sums up the clientele in the area. Lockdown isn't a rarity here, and I've been told specifically to not buy gas at the gas station across the street; it's too dangerous. Get in, take care of the kids, and get out. I like this kind of school; the kids need me, and I can make a difference. 

Disneyland: I've had this school every year since I started, and it's just a good place to be. Like Wackyworld, the kids need me, and the principal and secretaries make it a good place to work. I rely heavily on the Spanish speaking secretaries to contact the parents here. There are some high maintenance teachers here that I could do without, but again, I like this kind of school. The kids know me now too; kids I met as kindergartners are now in 4th grade and wave at me every chance they get.

Unknown Elementary School: I know nothing about this school. It's another elementary school with grades K-8, and a similar student population to Disneyland and Wackyworld. I have two 8th grade diabetics, one girl totally competent, and the other a boy who I'd heard had compliance issues. Sure enough, on day one, he didn't show up to the nurse's office. I had a lunch lady track him down, introduced myself, and told him in the future that he would need to make it to my office on his own. I think he got the impression; the next day, he had dropped off the doctor's orders I'd asked him to bring, and showed up promptly at lunchtime. He'll be a good kid to work with.  

Middle School: By no coincidence, I have been assigned Spitfire's middle school. I have two other diabetics here, including Mr. High Maintenance. I'm taking over this school from a woman twice my age who had been there for years, and for now, the staff is suspicious. I'll admit to being a little suspicious myself, as rumor has it the principal pulls the race card whenever she can. I hope to focus on the diabetics and other students in need, and forget the moody school staff best I can. 

To sum up: 3 new schools, including a middle school, and five diabetics. Spitfire was SO happy to see me on the first day of class that she ran through the gate past the secretary to give me a hug. It felt good to be back. 

A Waste of My Breath

I've been back all of one day and already have had to listen to an irate parent tell me, "You are a waste of my breath." This was in response to her being turned away when attempting to pick up her child's schedule  because she somehow missed the zillions of phone calls and letters that have been sent out warning future 7th grade parents that their children must have proof of a Tdap shot to start school.

The beginning of the school year always feels like being thrown into a hurricane, and this year particularly so after being essentially off for four months tending to full time motherhood duties. Oof. Here we go for another year! 

Greetings, Earthlings

I've been a bit preoccupied in the last seven weeks, but the publication of a study of school nurses reminded me that I used to have a paying job, and this writing outlet. First, the study: School Nurses Save Money. The study mentions RNs, I suspect the use of LVNs might save even more money. It's nice to see something positive about school nurses in the headlines, though I'm not sure it will change the fact that school nurses seem to be being phased out in my area. 

Second, and far more importantly, I had my baby! It is crazy to recall the time in my life in which I just referred to her as "the baby," before she had a name, a face, and a personality. A few thoughts on motherhood while she finishes her afternoon nap: 
1. Natural birth is without a doubt the coolest thing I have ever done in my life. 12 hours to the greatest surprise ever. The most important thing is that our baby arrived healthy, but I am so, so happy to report that I would not change a thing about her entrance to the world. I just found my admission paperwork for the hospital stay while cleaning the house: I signed my consent forms at 4:45 AM, and our baby girl was born 5:51 AM. 
2. Recovery after childbirth is a bitch. No one told me how much I'd hurt afterward. I recall actually thinking I'd never walk again. A bit dramatic, maybe, but I was in pain and sleep deprived. Thankfully, that time has passed. The pain part, I mean. 
3. Breastfeeding is hard. Again, no one told me how hard it would be. My milk was late coming in, or at least too late according to my baby, and one of the hardest nights of my life came just days after the best night ever. Not being able to feed your child is probably one of the worst feelings in the world. 
4. Labor, recovery, breastfeeding, etc. are all washed aside when your baby smiles at you. Seriously, parents aren't joking about how rewarding it is to make your kid happy. It's the best. 
5. Newborns poop. A LOT. 

In the words of my husband and I: we are obsessed with her. Our trials continue, right now facing a possible cow's milk allergy, an unsteady milk supply from me, and irregular sleeping patterns, but so far, parenthood is awesome (except for the daycare costs we are facing come August). It also puts work in perspective. My district has hired more LVNs in my absence, and reorganizing, supposedly, our nursing staff in August. I have no idea what that means. I have one more school year left before my credential expires, and as for now, don't plan on going back to school to get my permanent credential. What that means: I essentially have one year left to be a school nurse, and after that, I'll need a new job, or be "taking a sabbatical," also known as unemployed. The latter doesn't sound nearly so bad when I take a look at my sleeping baby...Hmm. 

One last thing

I saw Spitfire today for the last time and I could not have asked for a better parting gift from her than these words.

Over and out

As of Thursday afternoon, I will be on maternity leave! I'm not due until the end of the month, but I had some comp time to either use or lose, and I'm choosing to use it. 

Things I will miss:

1. The students

Things I will not miss:

1. Everything else: parents, teachers, the politics of it all, commuting...

Even though my year is being cut short, it's been a doozy of a time that I've mostly been omitting on this blog. The restructuring of our nursing staff - adding on LVNs before figuring out how best to utilize everyone - has taken a toll on everyone. One of our nurses made a very serious error and went on paid administrative leave for three months pending an "investigation" into the matter while we all had to fill in for each other and step up our own game, only for her to return bragging about her 3 month paid vacation. Worse, she's now been rewarded with the lightest assignment of us all because she's proven her lack of integrity and can't be trusted around students. Let's just say this: there's a serious downside to unions sometimes. Frustration and lack of morale has reached an all time high, certainly in my time here, and the more veteran nurses that have been here 15+ years agree. 

In all the mess, it's easy to lose sight of why we're here: to take care of the kids. I'll miss Spitfire and many others, and have been totally amused by Spitfire's ability to make it clear to everyone how she feels about the situation. Kids are just kids, and it's a shame to have watched them become less of a priority to nurses and other staff alike. It's been a real challenge to keep this blog going this year simply because just trying to keep afloat in the drama of everything going on with our health staff has put the kids on the back-burner, unfortunately. 

But for now, it's my turn to focus on my own baby. I may or may not be back here; my world is about to change and I don't really know what to expect. Add me to Feedly or whatever blog subscriber you use if you'd like; but until later, in the words of the kids around here: SEE YA! 

A new one

It's rare that I come across a new problem these days, but I did this morning. The principal called me into his office at one of my elementary schools: rumor had it one of the fifth graders was pregnant, and he thought it best if I address it with her directly. I agreed, and talked with the girl who vehemently denied the possibility. Still: rumors gone wild about a girl being pregnant at an elementary school?? The principal even said that in 29 years of being involved in education, he's never come across a rumor like this at the elementary level...ugh. Let's all just hope it really is just a rumor. 

Spitfire strikes again

Next week is my last week before maternity leave starts, so we decided the LVN that I'd been training would cover Spitfire on her own Monday so that she could get a feel for things. Well, she lived up to her a nickname...

First, she asked the LVN what she was doing there, and the LVN explained that I'd be on leave soon so she wanted to get acquainted with her. Spitfire's retort: "Well, you better not kill me or else my mom will be really mad." Now that's a way to make a new nurse feel welcome. 

Second, she returned after lunch for her insulin, but then left again quickly saying she'd be right back...And of course, she never came back, and the LVN had to go hunt her down. I had to explain to the LVN that she most definitely did not forget, she was just testing the new nurse to see what she could get away with. 

The following day, I had a little chat with Spitfire about her behavior, and hopefully it won't happen again. Still, I couldn't help but laugh at it: the girl has some serious spunk and is making it clear to everyone that she is none too happy about my impending absence. 

Teachers as nurses

Why is it that certain teachers will demand a nurse's opinion on something, only to disregard it immediately? 

Exhibit A: A teacher sent a student down to my office with a note about an "abscess" in her mouth. I had the third grader open wide, and found her pointing to an incoming tooth that, while not growing in straight, looked totally healthy. Pink, not red, nothing oozing, no inflammation. I called her mom to tell her about it, and had a pleasant conversation in which we agreed that she'd make an appointment with the dentist, and I'd keep her at school and send her back to class. Later in the day at lunch, that student's teacher stormed into my office to ask why I wasn't doing anything more about the supposed abscess. I asked her as politely as I could if she had even looked in her student's mouth, as it all looked good in there to me. No, she admitted, but her student had called it an abscess so she figured it was infected. Okay...Pardon me for not accepting self-diagnoses by third graders...Even after I explained why I did not believe anything was terribly wrong with the student, she was still clearly peeved and stormed back out - apparently my opinion was the wrong opinion. 

Hallelujah!

I love when I turn to a news site and there's actually good news. Check it out: Obesity rates drop sharply for 2- to 5-year-olds: Study. Thank goodness.

I haven't had much to report here, because there seems to be little going on besides my bourgeoning belly. It's all anyone can talk about when they see me these days, and everyone is acting like I'm a ticking time bomb with another 4 weeks to go until the baby's expected due date. I'll be on maternity leave starting March 14th; I have this Friday off, a baby shower at the usually awful nurses' meeting tomorrow, and a group baby shower Thursday at one of my school sites for myself and two other pregnant teachers due around the same time as myself. Life is good.  

Training my replacement

This week I've been stuck training my replacement...One of the six LVNs they have hired/are hiring within a span of four weeks. She'll fill in for me while I'm on maternity leave, but we all know that in the end, eventually, LVNs are going to take over the positions of the health clerks and us more expensive RNs. 

It's a very strange thing to be training the person (or kind of nurse, rather) that will be replacing the RNs. While I think it's best for the district, and the students, I can't help but automatically not like the girl I've been assigned to. Particularly when I was introducing her to my diabetics, and she said about them, "So basically you're here to babysit them?" 

Hardly. After that comment, and suggesting that my calculated doses of insulin for Spitfire are "guesses," I sat her down and relayed this old story to her. Hopefully I scared her into taking insulin seriously, because I'm not too eager to turn my diabetics over to someone totally incompetent. 

On a related note, I'm feeling and looking more pregnant by the day and now cannot escape the unbelievable comments that people feel free to make to pregnant women. Example: A noon duty asked me this week, "Are you enjoying getting heavier?" Gee...thanks for pointing that out. At least it wasn't as bad as the man who suggested I must be due "in the next month" a full nine weeks from my due date. 

I can't imagine

This would be SO disappointing if you were one of the scam victims.

Ew.

I finally found something in this job besides head lice that made my stomach churn. I walked in after making my diabetic rounds to find a student waiting for me in my nice comfy office chair. Not just any student though...No, the one that appears to have ringworm of the scalp. It's going around, and while I know it's just a fungus, I'd like to avoid getting it on my head. This also happened just hours after a teacher told me that this same child gave her a hug and - through her shirt - she contracted ringworm requiring two rounds of antibiotics, and a scar remains.

Premature Tears

The principal at the Institution is well known for being able to hand down some serious punishment when she wants. She's very serious, and even makes me squirm when she barges into my office and shuts the door behind her - everything is that serious. When a student came into the office bawling her eyes out, and explained that she was there to see the principal and wasn't sure why, I couldn't blame her too much. Turns out, the principal just wanted the student to show off a project she was working on...

I laughed about it (possibly just due to terror myself) with the principal, but I had to wonder...Even as the school principal, do you really want your reputation to precede you like that? 

Just another day in paradise...

I started Monday morning at my usual spot, the Special Place, an "educational complex," I learned that day. One of the secretaries had won our school site a promotion from a local radio station that at 10 am brought us huge platters of bagels and pastries and coffee - awesome! However, said secretary was a tad embarrassed when the radio host arrived at our site: a student had tried to attack her (a tiny little girl using only her fists), she was restrained, and we had to keep the doors locked until the police arrived; the radio host was locked outside for a few minutes with all of her treats. The men in uniform arrived quickly, and the little girl was picked up by mom in a jiffy, but the secretary apologized profusely to the radio host for having to see that...and then said very honestly, "But that's a typical day for us, nothing unusual."

I had to make a special visit to the same site today for a student I needed to do a hearing/vision assessment on. The student is severely autistic and rarely at school, the secretary described her parents as "tweakers." I arrived at the site for my assessment the same time Child Welfare Services arrived there for an emergency visit following a report they'd received on that student I needed to see. Just another day in paradise at The Special Place...

Out for a stroll

I had to perform some hearing/vision screenings on a couple of students in a class, so I called the teacher in the morning to send the students down. The two that I needed were in other classrooms for reading time, and instead of trying to track them down, I told the teacher I'd call back in the afternoon. 

I called back in the afternoon, and the teacher said, "No problem, I'll send them down." Some time later, they still hadn't arrived, and the secretary hadn't seen them either. I thought maybe the teacher had been in the middle of something with them and forgot to send them down. I took no offense; it happens all the time, and I figured I would get to them later. 

Well, even though it has often been the case where the teacher never sends the students down, this one smelled fishy to me so when I saw the teacher after school, I told her it wasn't a big deal, but I'd need to call the kids down later because I still needed to screen them. She assured me she had sent them down and said they were gone for a "reasonable" amount of time, and then came back to class. Who knows where they went, but they definitely did not make it to my office. Oh, those poor second graders: the teacher stomped off fuming that they had done that and swore she would take care of them it wouldn't happen again. Still, I had to laugh, I am sure the kids enjoyed their break. 

Spitfire again

Spitfire's blood sugar continues to be totally out of control, and so we found ourselves in my office waiting for someone to pick her up due to high ketones yet again. My belly has become the elephant in the room to her, so it wasn't long before conversation turned to my future baby. 
Spitfire: "So are you having a boy or a girl?"
Me: "I don't know, it's going to be a surprise."
Spitfire: "How do you not know?! What kind of parent ARE you?!"

I explained that I like surprises, and wanted to wait to find out until the baby is born...which turned into a conversation about how people find out the sex of their children ahead of time...which started with showing her an ultrasound picture of my own baby's face...and then I realized I was going to have to explain how the baby's anatomy is examined to determine the sex. Yeah, I changed the subject after showing her the ultrasound picture. 

Crossing the threshold

Unrelated to work, I know that my baby belly has officially crossed the threshold from questionably and awkwardly fat to pregnant. A student was getting his medicine, took a look at my stomach, and exclaimed, "Are you pregnant?!" He came back to me the next day to ask how many weeks along I am, and I asked him - a fourth grader - how he knows so much about pregnancy. He wouldn't answer me, but I suspect with the 5 older siblings he has, he may already have a niece or nephew.

A nurse left over winter break, and this week they interviewed LVNs to replace the departed RN. One of them will be filling in for me once I begin maternity leave, and it is a very strange thing to know that the person filling in for me will be much more bang for the school district's buck than I am. It's nothing any of us can argue; in fact, I've often wondered why my district hasn't followed the suit of others sooner and let the RNs go, but it's still a strange thing to watch it evolve as it is.

And in one sad incident of the day, a 5th grader wanted to call home for an inhaler. I looked up his phone number and was going to let him call, but then he immediately backed up and said, "I'm scared, I want you to talk to her." I hung up and went to the secretary to ask what this reaction was about: "Oh...He's been having a lot of accidents, and mom isn't happy having to come get him all the time." Poor kiddo - both on the having accidents end, and being scared of his mom.

Points for honesty

A mopey looking student came in today saying he wanted to rest. I asked if he had a headache and he explained the real reason he was here to see me: "I'm exhausted, I stayed up all night playing video games." He agreed that was probably not the wisest idea, and I told him he could take a quick snooze on the cot. 

Soon enough, he stood up and confessed something else: "I told my teacher I was going to the bathroom, I have to go back to class or I'm going to get in trouble." 

Some poor decision-making there, but the kid was so cutely weighed down with guilt I didn't have the heart to make things worse for him.  

The end is near

Usually when I get back from the holiday break, I look at the calendar and see that we still have a long way left until summer break. This time, I look at the calendar and see I have only a short time until March, when I expect to leave at spring break and not return until after summer. (There's a baby that seems to be practicing escaping right through the walls of my abdomen that constantly reminds me of this as well...So much that at my last appointment they suggested we may want to have our hospital bags packed nice and early...)

As a soon to be new mom, my head is, naturally, essentially filled with baby thoughts all day and night; work is a second priority these days. I've been maintaining blissful happiness and ignorance this year while the mood of my colleagues continues to sink lower and lower as the year progresses. 

So, I chose to not let it irritate too much yesterday when I received a call from Diabetic Land that Spitfire's blood sugar was 400+ and had high ketones. This is not unusual, unfortunately, but then the secretary relayed that they had called mom, who was sending a neighbor to "give her some insulin" - at 11:30, when she has lunch at 12:30. A nurse can see the problem with this; the secretary sees that someone is dealing with Spitfire. I called mom myself from another site, who let loose a whole can of frustration on me, saying that she was at work, etc. etc. I tried to say as nicely as I could, "I understand this isn't a good time for you; we still need to take care of your daughter though." It was a pretty unpleasant phone call as she vented to me, as she is sure that all of Spitfire's problems are caused by the school; mother herself, naturally has nothing to do with the issues. 

<Sigh.> History continues to repeat itself (see here and here, and it happens far more times than I write about here). Must. Not. Get. Too. Annoyed.