Kiddizzy

Today I got to see our little kidney gal. She unfortunately soiled herself and was brought to me to clean up. Little Valerie, or Val Gal as we’ve nick named her, is such a cutie. She tries to play like all the other kindergartens but due to her kidney problems she has some growth and development delays. Because she is so little, she still has baby cheeks; some of the cutest I’ve seen in a while. She has hearing aides but was quite the little talker at me. She has an aide that stays with her and waited patiently outside the bathroom. We both praised Val Gal and she left all smiles.

Val has an older sister, Autumn, who also has some problems and I saw her as well today. Autumn was born with a genetic disorder with her bladder and as a result she will dribble urine. Autumn has clothes at my office to change into when this occurs and we’ve become good friends. It’s tough for Autumn, being a fourth grader that appears to wet herself. Today a friend came in with her but was only teasing. I told the young lady to go to lunch and think about being a better friend and then ushered Autumn to the bathroom before anyone else came into my office. The bathroom is in high use at the lunch periods as my office faces the outside lunch tables.

Silly things occurred today as they do everyday. One first grader explained to another how blisters on her feet are also “d-i-a-Rrhea,” giggle, giggle. I’ve noticed young children like potty talkin’.  She actually sounded sillier since one of her front teeth came out earlier in the day.

Some days, you just can’t help but smile at how cute some kids are . . .  and keep a straight face.  

Names have been changed to protect the innocent.

When she is asked to do other tasks not related to being the nurse.

At the beginning of a school term things stay busy for a while. There are school lunch forms, pesticide notification forms, Parent Handbooks, and a host of other documents that parents should be aware.  Once parents respond, then someone has to organize all of these things.  Since I’ve worked the school system going on 7 years now, I’ve become much faster at the work needed for my office. This opens up spaces of time and I can help the office. But I admit, sometimes I am not up to the pull away from being a nurse. Here are just a few of the tasks I tackled today:

Sat at the front desk and signed in tardy children.

Alphabetize one group of forms.

Alphabetize a second group of forms.

Put the mail away.

Take care of supply orders for teachers.

Take care of an exchange of supplies for first grade teachers.

Start organizing incoming emergency forms.

Do the roll for the after-school program.

Alphabetize a third group of forms.

Do a second round of roll for the after-school program.

And of course, I helped answer incoming phone calls all day.

Pretty nursie huh?  Tonight I will soak in a nice bubble bath, with soft music and candles, taking care of me and then I will be ready to start over in the morning and perhaps find the humor in this pull. After all, between students and pleasing the office staff, I’m sure I must look like one of the three stooges bouncing from one location to another. Now if I could just figure out which stooge I am. 

“I bumped my head” . . . iced it.

I’m itchy” . . . put on Caladryl.

“I got scratched” . . . cleaned and covered.

“I got hurt on my knee” . . . oh dear, it’s scraped, cleaned, covered with bandaid, drew kiss on bandaid.

“My neck hurts” . . . iced it, you can stop walking like Quasimodo.

“My nose is bleeding” . . .  tissue, pressure, all better.

“I think I pulled a muscle in my knee” . . . area iced, walking fine.

“I was reaching for my friends sucker and fell backwards ” . . . hit head, iced, no swelling, whew!

“I got stung by a bee on my hand!” . . . removed stinger,  iced, mom notified. That bee’s gotta be dead now!

Slipped on water in class, hurt ankle, had to use  wheel chair, nothing broken.

Talked to three parents  about their child’s  med alerts. Answered 21 calls coming into regular office. Answered 7 calls coming in to mine.

Getting tired, need coffee – and chocolate.

Traffic issue some where, 48 kids not picked up on time, all waited in school office, helped keep everyone calm.

Never got coffee – or chocolate.

While waiting to be picked up, student used nurse’s bathroom, left evidence of big business.

Kindergarten freaked out over tiny abrasion on arm, used pretend magic wand to make all better.

Student pointed out anomaly on hand, explained it was a blister.

Can’t go home yet, have to stay for after-school program, still need coffee – and

Incoming!

chocolate.

Yes, it was a normal day.

Several times during the school year I will encounter a child who becomes ill and because a parent has not kept the school updated on contact numbers the child will need to camp out at my office for the entire day.  Today, a six-year-old boy vomited and had a fever. We are still trying to obtain updated emergency forms for the new term – the forms that parents can write any changes in contact information. We, the office manager and I, tried all contacts that were listed from last school term and those numbers were also no longer valid. I got the child to color, rest, and reassured him but he continued crying for mom. Luckily, we were able to locate a cousin’s records, at another school, and that cousin had updated information which led to our locating mom.

In the meantime, while taking care of this poor little one I managed to fix the glasses of one of the teachers and a tongue of yet another. The tongue, I mean teacher, bounded into my office in a panicked state with tissue in her mouth stating, “I ite y ongue ad ik o’t  op eeding!”  What? Points at tongue and I figured out she had bitten her tongue and in her world it was bleeding a lot. I gave her some ice to suck on and that seemed to do the trick.  This scene distracted both me and the little boy and we both started to laugh. For a moment he smiled. Whew!

Yippee it's Friday!

Today was our quietest day this first week and I think that is pretty amazing as questions and concerns tend to continue for at least two weeks.  Most states of confusion have been addressed and parents are leaving the office with smiles. Feels good!

Something else that also feels good is learning that we have enrolled the student I had been hoping to see. She is tiny, 5 years old, stinkin’ cute and a kidney transplant survivor. Organ transplant children require special observations and she has a one-to-one aide due to developmental problems. A special health care plan will be written for her by the district nurse as organ transplant kids are immunosuppressed due to the anti-rejection drugs they must take daily.  It will be necessary to monitor her for any signs of illness and keep her protected.

Additionally, we have 3 new students to our Special Ed. Class, all with Down’s syndrome. Down syndrome often brings many different medical problems, any where from hearing deficits to cardiac problems. They can be loud, laugh uncontrollably and lack muscle co-ordination and be prone to falls. It is also not uncommon to have bowel and bladder control issues and when this happens they are brought to me to clean up. I don’t mind though. Down’s children never judge you or try to be mean or disrespectful and I often get into some interesting conversations while working with them.

Yes, this school year shows much promise. I enjoy the medical challenges. I enjoy advocating for children with medical challenges. I actually don’t mind getting peed, pooped, or farted on. It’s SCIENCE! I like science.

If you have a child with special needs and fear their care in a school setting, check out the Family Educational Rights and Privacy Act (FERPA) at http://www2.ed.gov/policy/gen/guid/fpco/ferpa/index.html. Hoping your child too has the supportive care they deserve.

Today was more the normal flow of activity, 19 total children flowed through my office. Abrasions, headaches, a banged nose, crying first grader, and lots of teeth came out today among fourth graders – 6 total. Phones are still ringing but no new change of teacher requests occurred. Tonight is Back-to-School night for the third, fourth, and fifth graders. Hopefully this will help parents feel a bit more settled with their child’s new teacher. Now if we can just get kids picked up on time we’ll be moving along nicely for the new school term. But I understand it is hard to want to get back into the school schedule, and with the weather being so warm right now I don’t blame parents for poking along. Who wants to spend time in a hot school parking lot?

Note: As a follow up regarding my 8/25/10 post of parents requesting a change in teachers, PBS has a website that offers tips on building a parent-teacher relationship, plus links to other parent-teacher concerns. You can take a look at it at http://www.pbs.org/parents/goingtoschool/talking_teachers.html.

The first day of school is always very noisy, hectic, exciting, and goes by very quickly. It was 11:20a.m. before I realized what time it was, and 1:10pm before I had a chance to eat. I usually take my lunch at 11:10a.m. so I am back in my nurse’s office for the start of the kindergarten lunch period at 11:40. The recess periods are always my busy times but today I only saw two students all day (I average at least 20). That’s a record! Additionally, there were only a few kindergarten and first grade tears – we always have criers some where. Last year we had one K student that not only was screaming and crying, but kicking too. Mmmm . . . it has been a full moon. Maybe it is working for us.

Another thing that starts to occur is parent requests for change of teacher. Mind you, today is the first time they are even setting eyes on their child’s teacher. What could they possibly know of this person, yet, to make such a decision? Here are some of the reasons coming in thus far:

Because my child’s cousin had Mrs. So & So.

Because I don’t know this women and I know Mrs. So & So

Our 6 year old twins dreamt of Mrs. So & So and they want her, not Mrs. X.

My child is gifted and Mrs. Z I thought worked with gifted children.

It’s personal; the change just needs to be made.

We always try and accommodate teacher requests, but honestly classroom assignments must be balanced. A balance of genders, English learners, medical alerts, behavioral concerns (ADHD, Bi-polar, Autistic), and really a host of other criteria always play into how classroom assignments get set up. Could a parent not try and at least get through Back-to-School Night and get better acquainted with the teacher, before such a snap decision?

Over the next few weeks we will hear of more requests.  Look forward to those reasons – they are always very unique.

Many kids this time of year get what parents call the Back-to-School Blues.  Children can feel anxious with the thought of meeting a new teacher, feeling separated from home and family, and basically having fears of the unknown. Even high school and college students can experience similar feelings. It can make parents feel terrible as we want our child’s school experiences to be remembered with happy thoughts, not bad dreams. So how does a parent help their child with the back-to-school blues?

I looked for resources by Googling “how to help my child with school stress.”  I came across information under the About.com site: http://childcare.about.com/od/behaviors/bb/backtoschool.htm.  This site put things in simple terms plus offers other links to similar topics. In summary, the site suggested practicing a routine as if already in school. Bedtimes, clothes preparations, etc… can help become re-familiar with rituals that are about to take place for the next ten months. Put a note in your child’s lunch or backpack, or for the very youngest, draw a silly picture. Really listen to your child’s fears and concerns. Try and make suggestions or help them to make a plan to attack the concern and then follow up. Usually, once the school routines are back on track, the concerns will dissipate.

On occasion, things don’t always resolve. How do you tell if your child remains stressed? Moodiness, periods of upset (anger or tears), trouble sleeping, or continued complaints of headache and stomach aches, especially in the a.m., are all behaviors indicating a problem. Try to get your child to talk. If necessary seek advice from the family doctor or talk with the teacher and or principal. It may take time to completely figure out the cause of stress, but if your child sees that you are trying to help, that in itself may reduce continued problems.

School starts for us tomorrow. My youngest will be dropped off at one school while I go to another to be the nurse. I wish I could remain with my daughter, but she’s 13 and I guess that is not so cool. It’s just a little weird sometimes to drop my child off one place and then run to take care of the children of others – but I’ll get through my back-to-school blues too.    

This time of year is actually fun as I get my office reopened to begin a new school year.  I picked out some new office decorations, stars that I wrote what I hope will be inspiring words to students (honesty, respect, honor, etc.)  The stars are all different and bright colors. I took down all posters and picked the ones I remember students making the most comments about. There is one that shows a hamburger being squeezed like a sponge and all the grease is dripping out. The poster was showing how much grease is in the average hamburger. Many kids said it grossed them out.  That poster stays. Another poster is one of a plate of fruits and vegetables with bright colors shooting off to form a rainbow. “I eat a rainbow every day” was the poster caption. Many kids that came to my office would comment they liked eating a rainbow.  I also brought the comforts of home I like having for me, such as my favorite teas, music, family photos, and some stuffed animals, freshly cleaned.  The stuffed animals have made a good comfort source for upset children, especially the kindergarten children who are not ready to leave their mother’s sides those first few days of school.

Sometimes the first days back are humorous. We usually have to deal with the parents who can’t quite get their acts together. This one single mom had her daughter in kindergarten last year, and has a son who is ready for kindergarten this year.  She remarked to one of the campus aides that the aide will want to quit her job after dealing with her son.  Now tell me, are you not embrassassed for this mother? Has she not done her job in teaching the boy right from wrong? The daughter had behavioral issues and the K teacher was successful in teaching the standards as well as mellowing her behavior.  The teacher wanted to talk with mom but mom was always on her cell and in a hurry.  We do have many wonderful parents at the school I work. We just don’t get to talk with them much as they are usually handling the job as parent and never want to bother us in the office. I wish they would bother us.

One more day before school starts. Let see what walks in the office tomorrow.

All the school site nurses and district nurses get together before the start of the new school term. The district nurses provide training and review information on procedures that pertain to the individual school sites.  There were a total of 12 of us: 6 elementary, 2 middle school, 1 high school, and 3 district nurses.  This day is usually the only day we get to see each other and talk about things.  We got to not only review nursing procedures, but we got to discuss any problems we have encountered. One problem is when teachers, office staff, and administrators think you don’t know what you are doing.

Take head lice for instance. Suddenly one case of head lice means you have to check the entire school, or at least the class room.  That’s 500 average student count at the elementary schools, 900 at each of the middle schools, and more than 2,400 at the high school.  Truthfully, one case doesn’t even require a letter home to parents. Consider too that many parents don’t want us touching their child, and lice actually is not as easy to get from another child as you might think.  Unless the critters are crawling, you can’t get lice from a child with just nits. If we explain the rules, everyone gets their panties in a bunch and we don’t know what we are talking about.  It can be a bit lonely being a school site nurse.   Once we started talking about scenarios we easily recognized how silly they all sounded and ended up laughing.

Once through the review process we broke for a pot luck lunch and got on a kick trying to out do each other with the craziest thing we had students sent to us for.  The winner was the nurse who had a 1st grade boy sent to her because he complained “my balls are stuck to my skin. “  First graders are very open and descriptive.  The nurse, knowing she cannot touch the boy, did have some powder in her office and carefully explained to the boy to go into the bathroom and apply. This occurred on a very warm weather day so the nurse was sure more than just his privates were sticking to something.

It was good to discuss our woes, but we also got follow ups on students we had been tracking through each other. Those that knew the diabetic girl in elementary that then went through middle school with another nurse, and now at the high school level with yet one more nurse. Those are truly rewarding moments. We’ve seen some students at their worse and hear how far they’ve come, despite any issues they had to deal with. This kids have inspired all of us to continue on our paths as school nurses.

Next week I will begin the process of reopening my office.  I hope I get to have another student with a medical issue. I know that sounds tacky, but really, that’s why I’m there. And who knows, maybe I’ll get a new child to become attached and watch work their way up through the grades. Aah! Sounds great!

Note: if you fear lice, check out http://www.headlice.org/faq/index.htm. This site has photos and will answer anything you ever wanted to know about lice.