Ah, kids.

A student wandered into my office while waiting for her very late aunt to pick her up. She leaned over my shoulder and asked what I was eating. It was strawberries that I was dipping in leftover cake frosting, but I didn't particularly want to admit that the nurse was eating frosting by the spoonful. "It's dip," I explained. She was clearly skeptical, but she bought it. Kids...they are so innocent, it's lovely sometimes.

This is the thing.

This is the thing about school nursing: the kids do not care about the personnel drama of your organization. The secretaries, for the most part, don't know about the personnel drama of the nursing staff. And yet, that personnel drama is what will make or break the job. I love some of the school sites I've been at over the years; they are a joy to go to. Others...not so much. But in the case of school nursing, it's not just whether or not the school site is a pleasant place to be, it's the leadership and camaraderie, or lack thereof, of the nursing staff. Even if I don't see them, or maybe because I don't see them, the worst part of my job is the "team" I work with.

So, it's important I separate the kids and other staff I work with from the other...people...I work with, the ones that are the reason I am leaving. I will trudge to work tomorrow and put on a smile, leaving it out from my daily conversation that the LVN that was supposed to "support" me with my impossible caseload this year has been more work than she's been worth. Critical thinking isn't one of her high points - I will never understand the medication error she made early on* - but attendance hasn't been either. Perhaps I am the only one who grew up thinking you're supposed to go to work, school, whatever, unless there's an emergency, because she's been out approximately once a week for the last few months and seems to think that's the norm. But I am even less impressed when she sends me an email with a "P.S. Also I am taking a sick day tomorrow." Not a question to ask if she should find someone to cover her assigned diabetics or if I will, just, this is what is happening.

These situations create a cloud of frustration for me that I need to check at the door, because not one of my secretaries or students will understand, or should have to try to understand, this kind of thing. <Sigh.> I really do like what I do, just not who I do it with (or who I don't do it with). This is why I only have 16 work days left with this district.

*The infamous med error: This LVN administered an inhaler to the wrong student...and not just any incorrect student, but a student that didn't even use an inhaler. Apparently she was expecting another student - one in the special day class, that isn't easily mistaken for another general education student, mind you - and gave this other kid who wasn't having trouble breathing an inhaler. He was in there because he "didn't feel well" and when the school nurse gives you an inhaler, I guess you're going to take it, right? This one still boggles my mind.

Busted.

Spitfire came to my office around lunchtime saying her blood sugar was 471 and her mom wanted her to go home. This is normal these days: kids bypass me using their cell phones and clue me in once everything is arranged. She said she needed a new pump site (which I showed her we had with her bag of extra supplies) and her mom wanted to take her to the doctor's, so she arranged for (one of) her mom's ex-husband's to come get her. 

When the ex-husband arrived, he had a new pump site in hand. I asked if that's all that needed to happen, because,  clearly, I had been left out of the loop. I explained that I had already told Spitfire we had the supplies to change her pump site, but she was obviously hoping to get picked up from school. He was firm with her in expressing his disappointment, and explained that she would be staying at school. She and I changed her pump site while the ex-husband waited. 

Afterward, she checked her blood sugar. It was 141. I looked directly at the ex-husband and commented that it was quite remarkable for her blood sugar to drop 300 points in half an hour with a malfunctioning insulin pump. We asked her to show us the history in her pump meter to, and, unsurprisingly, found no 471. Ex-husband said to her he would deal with the matter later, and left very politely. 

Spitfire sat quietly eating in my office, unable to make eye contact with me. Finally, I broke the silence and said, "Busted." She looked at me with anger, claiming that it really was 471 and her meter was broken. Um...No. 

I have been working with her since she was in 3rd grade; she's now in 6th grade and never have I seen her as mad today as when I called her out for lying about her blood sugar. Our relationship is coming to an end in a couple of weeks and while I am sad that I know she will hold a grudge about this for some time, perhaps the rest of my time with her, hopefully one day she'll look back and see that she needed some tough love. 

Universal Precautions

This morning I had two students in my office, one waiting to go home with pinkeye and the other one also waiting to be picked up as he was feeling ill. The secretaries placed a third outside the door to my office, also waiting for her ride to pick her up as she wasn't feeling well. A fourth student came in to get something to package a tooth in (a "tooth" necklace, yes, they make such a thing), and while he and I were packing it up the third student in the doorway vomited. And by vomited, I mean vomited. [Stop reading now if graphic descriptions of bodily fluids make you ill.] 

I actually thought chocolate milk had spilled, until I smelled it. There was a thick layer splattered around the girl, right at the entry to my office, and some had dribbled onto her pants, down her leg, and onto her shoes. The largest puddle was so thick a paper towel wouldn't stand a chance. The secretary called for the custodian to clean up, and I kept the students in my office in so they wouldn't step in the vomit, or get sick themselves from smelling it, as one green-looking boy said he might. 

Next thing I know, the principal - who has never been particularly warm toward me - stepped over the vomit, and barged into my office to ask me what was going on. I explained what each of the students were doing in my office, including the one that came in for his tooth but was now stuck due to the vomit at the doorway, and that parents had already been notified for everyone. The principal's response: "You need to prioritize a little better," and an eye roll to boot. She was apparently quite irritated that I had not cleaned up the vomit. 

First of all, I don't need eyes rolled at me. We're adults. But second of all, I'm not going to apologize for waiting for the custodian. I do not have the materials in my office to clean up a vomit puddle that size. (And even if I did, I'd still make the kids in my office wait to step on the floor until the custodian got there.) I do not have access to cleaning solutions, rags, mops, or the stuff that you sprinkle on puddles to help mop them up. So, no lady, I will not get on my hands and knees and wipe up a sea of vomit, exposing myself to who knows what.