Happy Endings

There was a situation just before break that my LVN called me about: a student that gets migraines did not have any medication at school, and “just FYI, you may want to contact the parent about it.” In hindsight, she clearly knew something I didn’t, because when I emailed the parents, the father had already been made aware of the situation and was FURIOUS about it.

There’s good and bad to having this correspondence by email. On the plus side, I didn’t have to have an immediate response and could craft my response to him slowly. On the other hand, it’s in my inbox, and able to be re-read whenever. In a phone call, I may not respond with the exact verbiage I’d want to later, but at least it’d be over as soon as I hung up.

Anyway, craft I did. There was more to it than the student not having medication: supposedly she had turned in a medication form earlier in the year, and supposedly she had asked to call home and the office hadn’t let her. I wasn’t on site when this transaction occurred, but still had to play the messenger: contact the office, get their side of the story, etc. It was enough to give me a headache. To top it off, this dad was sure to leave in his email signature that he has a higher degree in education than me.

He didn’t respond and I dreaded what would happen the next time the student had a headache.

Fast forward to this week, when I reached out to him and asked if there was anything else I could do for his daughter (implying, ahem, that he still had not turned in the proper paperwork and we were still waiting on the medication to be left at the office). I dreaded the “new email” ping on my computer, and instead was relieved to find this from him:

“Dear [Mrs. Nurse]:

Thank you very much for your note, for following up, and for your empathy. I am most touched by your commitment and professionalism. 

I will take care of this as soon as possible. 

Sincerely,

[Dr. Dad]”

It often feels rare that I get an angry parent to come down from his soapbox. I’ll take it where I can get it.

Welcome, 2016!

The first day back from winter break, I was scheduled to cover for an LVN’s assignment – part at my school and part at a school foreign to me. (This was a result of the fact that our work was sponsoring a conference, unrelated to the medical field, for those interested. I didn’t feel like it was worth the cost of what they wouldn’t be covering for the trip, so I passed.) The day was to involve four diabetics of varying independence levels and a G-tube feeding, which I haven’t done alone…um…ever. I tagged along with the LVN on her assignment in December to meet the kiddos while trying to ignore the fact that I had somehow volunteered to do this assignment despite the fact that a) RNs in our district are not supposed to have to cover for LVNs (a breach of contract, I’ve learned!) and b) the middle and high schools were scheduled for a “work day” without students, meaning at least a handful of LVNs had nothing to do the day I would be covering this assignment. But I digress. I met the kiddos, was reminded how to do a G-tube feeding, and then went into winter break with a small cloud over my head reminding me that my first day back I’d be covering in uncharted territory, and our lead nurse, supervisor, and every other veteran RN I knew were on a work trip.

It was a dark and stormy day, literally, and I hoped for many absences to make my day easier. Not my luck: all the students I needed to see made it to school. The day went by in a blur and I loved it. I remembered that I really do enjoy what I do sometimes. I taught a first grader how to change her lancet, and she said, “Thank you! I didn’t know how to do that before.” How much better can a job be? The G-tube feeding was for a second grader who chatted happily with me the entire time about the puppy she is getting next month. I was told if you don’t keep her distracted, she complains she’s full and tries to stop the feeding early; instead, I had to remind her it was over and time to go back to class, and she asked to see me again. And, once more, how much better can a job be?

Unfortunately, that job was covering someone else’s job. She’s an RN herself working as an LVN, and she told me when I met her she didn’t want my job…I know why. I get paid a ridiculous hourly rate for what I do, can work from home sometimes, and have all the holidays off, and I still don’t think that is enough anymore. The longer I’m a school nurse, particularly after finishing the credential program – in which I became convinced every other district has similar problems, the less sure I am that I want to do this any longer. I tossed out a couple of resumes last month to see what the job market was like and was 2 for 2 on interview requests. I declined because I’m not ready to break my contract just yet, but it was good feedback. When I originally became a school nurse, I didn’t feel I had other options and just needed a job; now, I have options and am not sure I’ll be staying here for eternity…or the next school year. (Which I’ve said for five years now, and then summer break comes along and I suddenly have amnesia about any of the problems in this job.)

I'm still here, thank you.

What a nice bunch of comments and emails I've received lately, questioning my whereabouts in the blogosphere.

I'm here, and wanting to get back to writing. I don't think I have enough work stories to feed this blog alone, depending on how many tales of bureaucratic BS anyone wants to read though. I've tried to avoid the magnetic pull I'm feeling into the mommy-blogging category, but I am not sure I can resist a rant on some of the toys I've deemed inappropriate given to my child. If the possibility of reading about another crazy mother's path through parenthood terrifies you, go ahead and unsubscribe now just in case...I feel a post on the subject of pink Lego sets coming up.

On another note, I'm famous today, and I would have tidied up my house a little more had I known my snapshot would have been posted along with my comments. But seriously, P&G, you almost doubled the scoop size. I can't imagine laundry dirtier than what's in my house: toddler cloth diapers. One scoop of it has been sufficient for the last 20 months - what on earth would someone be washing to need almost double the original suggested amount of detergent? And how asthma-inducing would the fragrance be of the clothes washed using the new suggested amount?

Anyway. I'm here all, and open to suggestions on post topics - see the contact information in the sidebar. Happy holidays!

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.

Oops.

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.