Your tax dollars at work

Sixteen million children (21%) live without consistent access to food.  That is a staggering number. And yet...there's this: the state's vision screening requirements in California changed recently, requiring both near and far vision screening for Kindergarten, 2nd, 5th, and 8th grades. Once you screen near vision, it is either a problem or not, and it is ineffective and a waste of resources to continue to screen for it years down the road. Then why are we asking school nurses to screen for it in the later years? Because lobbyists. Seriously. Eye care specialists made sure this requirement passed, which results in increased referrals (i.e. money) for themselves, and more (unnecessary) work for school nurses. Where are our priorities?


Dear Teacher,

I know you really don’t want to have your student with hemophilia come on the field trip to the pumpkin patch with you but, guess what, he is. You won’t find support from me for your idea to exclude the kiddo because of his condition, no matter how many emails you send me. And yes, I have contacted his parents, and no, they can’t go with him on this field trip. Deal with it. Love,
Your School Nurse

It’s been a busy week. The best part was confirming a thought I had about this position: I can work from home on occasion. There is an enormous amount of case management and report writing in this position, and I’ve been wondering why I even drive in sometimes when all I really need is a quiet place to work. Hello, home office! 


Dear Parent,

Just because you are an MD - which somehow you managed to point out to me despite not being able to return your child's emergency care plan until two months later - does not mean I will sign off on the heavily edited care plan you returned to me.

Perhaps your expertise does not include allergy management, because the new recommendation is that if someone has two or more systems involved in an allergy reaction - in the example you gave, an itchy throat and vomiting - an Epipen should be administered. I am not into the "wait and see" method when it comes to potential anaphylaxis. I also can't say I like the idea of administering PO Benadryl for your vomiting student in case of ingestion. The fact that you seem to know his pattern of reaction so well is a concern too, but not something I can base future reactions on. Just because you have been so fortunate as to have his symptoms stop at an itchy throat and vomiting doesn't mean they won't progress further, quickly, the next time.

We are discussing a severe food allergy, and this is the first I've ever come across a parent suggesting less of a response than the standard, recommended treatment plan. Weird...and my gut says no, I just haven't figured out how I will phrase my response to Mr. Pretentious Parent, MD.



It's been almost a month since I've written and it's not for a lack of material, it's a time problem. This district is nuts. And I say that coming from a district that I also thought was nuts.

We (the district) are being swamped with refugees from the Middle East. During a screening, I asked what the name "FNU" is that I was seeing all over the place on rosters..."Family Name Unknown." Families are arriving without any documentation, so kids enroll in school with no last name or birthdate, no English, and scared out of their minds. They come to school and are behind a fence from their parents surrounded by strangers, and they cry and cry as they feel they are being taken away from their family. I read health histories and find stories of kids watching family members being killed in front of them, of escaping their home country on horseback, and arriving here with no one to ease them into their new world. Now when I see Middle East turmoil in the news, I no longer click to the next headline, I read through the article and try to get a little closer to understanding what some of these kids have been through. It's heavy stuff.

The heavy stuff, then, makes it that much more special when something a little more light comes my way. A secretary brought a student to me yesterday with "possible ringworm" that his teacher had sent him up for. He had a red ring on his hand, but it wasn't raised, and just didn't look like ringworm to me. "That's not a hand stamp, is it?" I asked. "Yes, it is, it won't wash off!" Ahh...yes, that's why they pay me the big bucks. To identify hand stamps.