:) x a million

I came to my elementary school to check my two diabetics at lunchtime, just as I do every day. My spitfire diabetic came in and plopped on my desk a "Large Print Crossword Puzzles" book. She told me it was my (only slightly) belated birthday present, and recalled I liked crossword puzzles from a conversation ages ago. It was before Christmas break, where she saw me working on a crossword puzzle and solved a couple of clues with me. I told her how much I love crossword puzzles, and she told me she was going to get me a book for Christmas, and then, when that passed, for my birthday. I gave her a big hug and told her how thoughtful that was, and she replied, "Well, just don't tell the other nurses, because I don't normally get my nurses presents." It proves what I tell anyone who listens: this girl has a bigger heart than most people think. I rest my case.

Scoliosis Season

I scheduled four days of scoliosis screening over the next two weeks, covering 8th grade boys and 7th grade girls with another nurse I teamed up with to screen two of our middle schools in the district.

Tuesday's 8th grade boys screening, by the numbers:
Boys screened: approximately 150
Boys referred for possible scoliosis: 6
Screenings I conducted before changing my verbal directions for the students from "bend over" to "reach for the floor": 3

Weighing In

As part of 5th grade physical fitness testing, I weighed all the fifth graders at one of my elementary schools today. Doing so confirmed two things for me. One, I cannot guess weights. Two, childhood obesity is a real issue. (Though I know this part better than most, as I spent a summer working for a weight loss camp for teenagers.) Kids weighed in ranging from 52 lbs to a staggering 194.4 lbs, a weight that did not correlate with her height in a healthy manner.

Today I also received a link to this in my inbox: http://theweightofthenation.hbo.com/films from the CSPI mailing list. I hope it does the issue justice.

Meanwhile, an anti-obesity drug is moving forward. Drugs: the solution to all things in America.

Unrelated to unhealthiness, I came into work today to find a lovely gift on my desk of stationery and a candle, as well as a thank you card wishing me a Happy Nurse's Week. Belated or not, it was a good way to start a Monday.

National School Nurse Day

That's today! For you non-nurses wondering when we'll stop showering ourselves with appreciation, Nurses Week ends on Saturday, Florence Nightengale's birthday (look her up if that name doesn't ring a bell). In the school environment, today and this week is hugely overshadowed by Teacher Appreciation Week, but I don't mind: the PTO takes good care of our teachers, and I consider myself entitled to every breakfast and luncheon and "thanks" they're providing to the teachers. I did get one thank-you note from our dedicated noon duty at my middle school, and I'll happily take that one recognition.

Other random musings:
I had the usual conversation with my diabetic today:
Me: Okay, you ready to wash your hands? [After a very long 15 minutes waiting for her blood sugar to go up after I found her shaky and a BG of 64 at lunchtime.]
Her: No.
Me: I don't care, go wash your hands.
Her: "You sound like my MOM!"

I've also concluded the best way to get some kids out of my office is to make it miserable:
Not-really-injured kid: What's she doing in here? [Pointing at a not-really-sick kid.]
Me, the nurse tired of an over-crowded office: We do not talk about other people when we're in here. We can talk about you though, should we do that?
She narrowed her eyes at me and pouted. Suddenly, I heard, "I'm feeling better" and she ran away from me as fast as she could.

Last, it's link time:
Electronic health records in schools. If my district was this organized and awesome...well, that would just be too great for words.
First grader saves friend. Yay for learning life-saving techniques on the Disney channel!
Obesity continues. And we have decided pizza sauce is a vegetable.

Happy Nurses Week!

(And many other things we are never thanked for!)

Happy Nurses Week! Yay us! 

Timeline of a school nurse:

August-September: Crazy mad chaos as the school year begins. Health alerts, unhappy teachers, demanding parents, medication issues, and the always embarrassing moment when you discover two months into the school year you didn't realize you had an epileptic student on board...that sort of thing.
October-November: Hearing and vision screenings all over the place. Mail out referrals that will either be ignored or returned to sender. IEPs and other paperwork.
December-January: Christmas break! Listen to teacher's complain about so-and-so who still can't see the board.
February-March: Morale sinks as the budget proposals and kinks are worked out.
April: No one in education is happy as next year's changes are finalized (e.g. school closings) and state testing approaches. Spring break is a brief, but only brief, respite from the unhappiness.
May-June: Coast into summer. Clean up the medication cabinets, realize with some embarrassment that you've let some expire, or never actually got the right medication authorization paperwork, and breathe a sigh of relief at the epi-pens that went unused. Testing is over, teachers are nicer, parents trust you, and you have two months vacation approaching. The insanity that has happened over the last  9 months is forgotten, and life is good.

It's been a long year, but we're coasting into break now (particularly with that lice policy off my plate). Happy Friday!

Judgement Day:

The short version: an agreement was reached!

 

The long version: My proposed updated policy was passed around to all the nurses at our monthly nurse's meeting yesterday, along with position statements that I used to write the policy, including the one by the Public Health Department. There were uneasy glances exchanged as I described the major change from a no-nit to no-lice policy, but eventually, grumbling agreement. The coordinator, who had previously agreed with me about when to send kids home (taken directly from Public Health, my stance was the unpopular one, that they would be allowed to remain in class with lice; after immediate notification of the parents, they will be excluded by the end of the day at the latest) became a stellar politician and before my very eyes, flip-flopped on that agreement to the more popular one, which is to send them home (thereby humiliating the student) immediately. To say I was upset about this change of heart would be an understatement: she was my sole supporter of this whole project, and if I didn't have hers, I didn't have anybody's.

 

I knew I wouldn't rest at night unless I did all that I could, so I spoke up and provided my reasoning (again, reading directly from the official statements that we base all of our other practices on), only to be met with disgusted looks. But...stubborn people make change! I calmed my nerves and approached another nurse after the meeting, one I have had very little contact with ever, but knows her stuff. She is extremely "by the book," which I certainly can't claim to be, and I knew if I didn't win over her support, I wasn't going to get this approved. Conversely, I knew if I had her support, this would get approved: she can argue a point as well as I can, and if we aren't arguing the same position, we're at a stalemate forever.

 

Turns out I work well with people I don't think I get along with. She is actively involved in the union, school nurse organization, etc., and she commended my enthusiasm and perserverance on something so mundane to most people in education, as well as the fact that I was even involving myself in policy-writing. We worked together to re-write the sentence I was stuck on, adding in the phrase that she suggested: "or at the discretion of the school nurse or designee." Power to the nurses! It didn't take long for us to both be happy with it and given we are the two loudest nurses (who aren't flip-floppers) in regards to policies, I feel good that I've done what I can on this issue. There's no saying anything will become of it, because it still needs to be sent to the board, etc., which will take eons, but I can sleep well at night knowing I've done what I can to save my kids from unnecessary humiliation and needless absences. Phew.