School Clinic

Nurses Notes:

I can be reached by email:

rboothe@ycsd.york.va.us or by phone at

757-220-4583

Please keep the following in mind when making a decision about whether to send your child to school or to keep them home:

Absences: Please report all absences to the attendance office at 757-220-4067 (voice mail available 24 hrs.) This is a safety precaution and we will be calling you at home to verify student absences in compliance with Virginia State law if we don’t hear from you.

Illness: After a child has been sick, please do not send them back until they have gone 24 hours without a fever, vomiting, diarrhea, or muscle fatigue. Remember the following: “If your child is sick today, then tomorrow they shouldn’t return to school or play with other children “. This may be a bad year for colds and flu and we try very hard to keep kids healthy at school.

Medications: If medication is necessary during the school day it must be brought to the clinic by a parent or guardian in the original container with the appropriate label. A signed parental permission form must be completed.

Students may have the following items for personal use.

Parents are encouraged to replenish as needed.

· Snacks

· Water bottle

· Peppermints or throat lozenge

· Anti-microbial wipes

· Chap stick

· Hand sanitizer

· Sunscreen

· Lotion

· Contact lens solution

· Change of clothing

· Personal hygiene products

PE Excuses:

Illness, especially asthma, and injury can result in the need for limited or restricted PE activities. This requires a written note from a parent or guardian and as per the Student Handbook states on page 23 “The only acceptable excuse from physical education for more than three consecutive days is a doctor’s excuse.” This is especially true with sprains and breaks. We need specific instructions from the physician to ensure your child’s safety. If you have any questions, please call me 757-220-4583.

Emergency Information: Please call the office 757-220-4067 or Clinic 757-220-4583 with new phone numbers (Home, Work, and Cell) so if I need to contact you in the event of an Emergency, I have the info I need!

Kindergarten Parents:

A change of clothes in a Ziploc bag in your child’s book bag would be a great idea!

TIPS FROM YOUR SCHOOL NURSE ON FLU PREVENTION AND
SCHOOL POLICY FOR SICK CHILDREN

Here is some helpful information and good health habits from the CDC on “stopping Germs at Home, Work, and School”. As you know the Influenza germ is a virus. It is not treated with antibiotics because it is not a bacteria germ. It is an illness that is spread from person to person in respiratory droplets of coughs and sneezes from an infected person. When infected droplets form a cough or sneezes move through the air they can land on the mouth or nose of someone nearby. These germs can also be spread when a person touches these infected droplets on a surface like a desk, table or doorknob, and then touches their own eyes, mouth or nose before washing their hands.

The best defense or protection from these germs is to:

1. Cover your mouth and nose with a tissue when you cough or sneeze.

2. Clean your hands by washing them often or using an alcohol-based gel or hand sanitizer.

3. Practice health habits such as:

--Avoid close contact with people who are sick and when you are sick keep your distance from others to protect them from getting sick.

--Stay at home when you are sick. You will help prevent others from catching your illness. Keep in mind that if your child has any of the signs and symptoms of the flu keep them home. Signs and symptoms of the flu are a high fever over 100, stuffy nose, headache, extreme tiredness, dry cough, sore throat, and muscle aches. Also, gastro-intestinal symptoms such as nausea, vomiting, and diarrhea are more common among children than adults.

--Avoid touching your eyes, nose, or mouth. Germs often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose or mouth.

Adults may be able to infect others beginning 1 day before getting symptoms and up to 7 days after getting sick. That means you can give someone the flu before you know you are even sick!

Thank you for your cooperation and please call me in the clinic at 757-220-4583 if you have any questions.

~Renita M. Boothe BSN RN

General Clinic Forms

School Physical

Administration of Medicine Form

Allergy and Food Allergy Action Plan

Asthma Action Plan

Epi-Pen Action Plan

Seizure Action Plan

Special Dietary Needs

Clinic Phone Number is 757-220-4583

Illness: If your child is sick, please do not send them to school when they have had any of the following symptoms: fever, vomiting, diarrhea, or muscle fatigue. Your child may return to school after they have gone 24 hours without vomiting, diarrhea, muscle fatigue, fever (greater than 100.0 F without using fever reducing medications). We want to keep our students healthy and this is the best way to keep them from becoming sick. “If your child is sick today, then tomorrow they shouldn’t return to school or play with other children.”

Absences: Please report all absences to the attendance secretary at 757-220-4067(voicemail is always available). You will receive a call from us to verify a student absence if we do not hear from you as a safety precaution and as required by law. For the absence to be excused, a written note or email to the attendance secretary is required.

Medications: If your child requires a medication during the school day and cannot be given at home, it must be brought into the school by parents/guardians. The appropriate paperwork must be completed and signed. Medications cannot be placed in the students backpack for transport to school. There is a form called the Administration of Medication Form that must be completed allowing the nurse to administer medications at school (located on the clinic web page).

PE Excuses: Injuries, illnesses, and asthma can mean your student needs restricted PE or physical activities. If your child must be restricted from PE or physical activities, please send a note stating which activities and how long. If your child is to miss more than 3 days from P.E., a doctor’s note is needed by the school nurse. We need specific instructions from the physician regarding breaks, strains or any other physical limitation so we may keep your child safe while at school. If you have any questions, please call me 757-220-4583.

Emergency Information: Please keep these numbers up to date. If there are any changes, please call the office at 757-220-4067 or Clinic at 757-220-4583 with new phone numbers (Home, Work, and Cell). It is important that we can reach you for illnesses, injuries and emergencies.

Clothes:

A change of clothes in a Ziploc bag (kept in backpack) may prevent you from having to bring a change of clothes to school during the day. I have very few items left in the clinic. If your child slips outside in the mud, spills drinks, or has an accident at school, it helps to have that change of clothes, just in case!

Thank you so much! Nurse Boothe

Immunization Requirements:

https://www.vdh.virginia.gov/immunization/requirements

Lice Information:

https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/pediculosis-head-lice-infestation

General Lice information:

Dear Parent/Guardian:

There have been some cases of head lice in our school. This is not unusual; however, lice have become more difficult to treat over the years. Controlling an outbreak involves early diagnosis and effective treatment. So that we can stay ahead of this issue, I would like to ask that parents/guardians perform weekly checks of students during the school year at home. A good head check can take about 15 minutes, especially in an early infection.

Head Lice are very small, tan or gray, six legged insects that feed only on humans. They cannot fly or jump, but they can crawl quite fast. Lice live for up to 35 days once hatched from an egg (nit). A female will lay about 4-10 eggs per day. That’s a lot of eggs for such a short life! That’s why it’s important to catch it as early as possible with weekly head checks at home. The fewer number of eggs to comb or pick out, the better. When you begin the head check, search for the nits (eggs). They are white/tan/silver colored, and are firmly attached to the hair, close to the scalp because they need to stay warm to hatch. They are shaped like a sesame seed, but smaller, and stick to the hair by “lice glue”. If you suspect that you are seeing the nits, begin the search for a living louse. A louse varies in size. It is very tiny in the early stages of life, and grows to be about the size of a sesame seed before it dies. They are hard to spot because they move fast and don’t like light. Use a bright light and a lice comb to find them (metal combs work best). Toothpicks or the ends of Q tip sticks can be used to rake the hair during your search if you do not have a lice comb. Only treat the head if you actually find an infection.

There are varying reports regarding how long a louse can survive without a human meal. Some say 24- 48 hours and others say up to 10 days (for nits). I am going to settle on 1-10 days to be safe. Lice are spread by direct contact with them or their eggs that will eventually hatch if kept in a warm, moist environment. They cannot jump from one person to another, but if one happens to fall off of your friend and attaches itself to you, your clothing, bedding/pillows, hats, scarves, carpeting, couch or any other place that you touch within that 1 -10-day survival period, then you may become the louse’s new home. Lice do not care if their new home is clean or dirty, only that it has a never-ending supply of food. One telltale sign that you may be infected is frequent head scratching. They do not carry diseases and therefore usually cause no harm to infected persons.

What to do if you find lice:

-Treat the infected head. There are a ton of products available over the counter, by prescription, or naturally. Follow the manufacturer’s instructions if you decide to use a chemical product. Some require a waiting period to retreat, so read all instructions carefully. Treating only one time is not going to end the life cycle. The eggs take 7-10 days to hatch. If they survive the initial treatment, which is very possible due to recent resistance, the life cycle will begin again. So, there is almost always more than one treatment needed.

-Lice check the family.

Only treat those infected.

Continue to check heads every day for several weeks following an infection.

-Wash/Clean the environment daily for at least 2 weeks.

This includes vacuuming flooring (not sweeping) and emptying the bag afterwards to an outside trash container.

Wash coats, scarves, hats, clothing, bedding, pillows, stuffed animals, combs, brushes, towels and toys in very hot water and dry with high heat (over 130 degrees).

Anything that is not washable, such as back packs or toys, place in a plastic bag and seal for 2 weeks.

Dry cleaning is also an option to kill un-washable linens or clothing.

Disinfect combs and brushes by boiling for 10 minutes, soaking in medicated shampoo for 4 minutes or soaking in Lysol (2%) solution for one hour.

Continue to check head’s daily.

(Remember that while treating infected individuals, you must clean the comb between each pass in very hot water. The hotter the better.)

-Report head lice to school nurse at 757-220-4583.

Return to school clinic for re-entrance to school after treatment.

York County currently has a no nit policy. Children should be lice and nit free upon returning to school.

Transmission Whenever people gather together, the possibility of head lice transmission exists. Head-to-head contact is the primary mode of transmission, but contact with infected hair pieces/combs/brushes is a possibility too. Prevention involves encouraging children to maintain their own body space. Not playing with other’s hair, not sharing hair bows, ties, combs, hats and brushes. At sleepovers kids should use their own pillows and not sleep in crowed beds with head-to-head contact.

Health Risk

Lice do not carry or transmit diseases. A potential health risk occurs if they develop a secondary infection. This can happen when they are scratching and the protective skin membranes of the scalp are broken. If they scratch hard enough, break the skin and bacteria enter the skin, then the possibility of scalp infection exists

York County School Division Medication Administration:

York County Public Schools recognizes that it may be necessary for your child to receive medication during the school day. For the health and safety of all students, the school nurse will strictly enforce the following in regards to medication:

1. All prescription and over-the-counter medication (Tylenol, Advil, cold and cough preparations) must be administered by the school nurse (or designated trained school employee) in the school clinic.

2. Students are not allowed to be in possession of any oral medication during the school day.

3. All medication must be in the original, unopened bottle.

4. A parent/guardian must transport medication to school. Medication cannot be sent with the student.

5. Prescription Medication must be in the original container with the child’s name, medication, dosage, time and amount to be given.

6. Non-Prescription Medication must be in the original unopened container with the child’s name on the container.

7. The Medication Permission Form, which can be obtained from the school nurse, or under the Clinic Forms Tab on the MES webpage, must be completed before medication can be administered.

8. The clinic cannot accept phone or verbal permission for medication administration.

9. All medication permission forms must be updated every school year.

10. A parent/guardian must pick up any unused medication by the end of the school year. Any medication not picked up will be destroyed.

Asthma Medication – The Asthma Health Care Action Plan & Authorization for Medication must be completed and on file in the clinic before a student can carry and self-administer asthma medication. Forms are available in the school clinic or on the Clinic webpage.

Epinephrine – The Epinephrine Permission Form must be completed and on file in the clinic before a student can carry and self-administer epinephrine. Forms are available in the school clinic or on the clinic’s webpage.

If you have any questions regarding medication administration, please feel free to call the school clinic at 757-220-4583

Related Links

Religious Exemption:

http://www.vdh.virginia.gov

Childhood Obesity, Nutrition, and Physical Activity

National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) | National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) | CDC

Children Dental Health

http://www.adafoundation.org/give-kids-a-smile

Concussion Signs and Symptoms

https://www.cdc.gov/heads-up/signs-symptoms/index.html

Eating Disorders

Eating Disorders - National Institute of Mental Health (NIMH) (nih.gov)