The beginning of a school year can be a busy time at a school nurse’s office.
“There are lots of tummy aches and tears,” said Kristine Pfeifer, a nurse with Wichita public schools for the past 20 years. Usually the conditions aren’t serious, but rather the result of kids being anxious about being back at school.
Pfeifer splits her week between two Wichita schools, McLean Science and Technology Magnet and Black Traditional Magnet elementary schools, where she promotes health; takes care of any illnesses, scrapes or broken bones; and makes calls to parents about having a sick child in her office.
But she doesn’t take making that call lightly.
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“My philosophy is if they’re not running a fever of over 100.4, and if they haven’t vomited in the last 24 hours, they need to be in the classroom,” Pfeifer said.
She advised that parents discuss with children that taking a sick day is a serious matter – for both parents who miss work to care for a sick child and the kids who can fall behind in schoolwork.
“Kids do work their parents, and it’s an issue everyone deals with,” Pfeifer said. “You really need to sit down and visit with your child and explain what times they should stay home – because there are times you should stay home – but don’t call woof because the rest of the time they need to be at school. Their job is to come to school and learn every day. Visit with your kids about being truly, truly sick.”
To help you make the call about whether your kid is too sick for school, Pfeifer and Amy Seery, a pediatrician with Via Christi, provided some guidelines on common conditions.
▪ Fever. Even with a low-grade fever of 100, a child can still go to school, if there are no other symptoms, such as diarrhea, vomiting, a sore throat or cough. USD259 policy uses the threshold of 100.4 to designate a fever, while Seery cited anything over 101 as a fever. A child who has had a fever of more than 100.4 must be fever-free for 24 hours without any medicine to come back to school, Pfeifer said.
▪ Diarrhea and vomiting. If a child has these symptoms, “that’s a person who needs lots of rest and fluid,” Seery said, which is best done at home. “Plus if you have stomach cramping, you can’t concentrate.” Parents need to ensure that the child is getting fluids – something with electrolytes such as Pedialyte. A child should not have vomited in the past 24 hours before being sent back to school, according to USD259 policy.
If it’s been less than 24 hours, but the child has been able to stomach eating bland foods, “looks rested and has color,” Seery said, parents can consider sending the child back to school. Encourage a bland diet in the days following the appearance of these symptoms.
▪ Colds and coughs. “Runny noses are constant with kids and that alone can trigger a cough because of the mucus,” Seery said. Seery and Pfeifer cited the prevalence of allergies contributing to drainage and coughs. Coughs often linger, so it’s not feasible to keep a child home every time he develops a cough. If a child appears exhausted and lethargic, keep him home.
“If they can still play, they are probably well enough to go to school and learn,” Seery said. Encourage frequent handwashing to avoid spreading germs and give the child a spoonful of honey to soothe a sore throat, Seery suggested.
▪ Contagious diseases. The general rule for infectious diseases such as pink eye caused by bacteria (bacterial conjunctivitis) and strep throat is that a child can return to school after 24 hours of being on an antibiotic treatment, Seery said. The skin conditions of ringworm, a fungal infection, and a scabies rash, caused by a mite infestation, need to be treated and the affected skin needs to be covered before returning to school, Pfeifer said.
For head lice, children with live bugs need to go home and be treated before returning to school. Children do not have to stay home if their hair has nits, which are the eggs of the parasitic lice. To help prevent the transfer of lice, discourage children from sharing combs, brushes, hair ties or head gear, Seery said.
If parents are concerned about their child’s health, they should talk to the school nurse and a doctor.
“We’re always available to be a resource,” reminded Seery.
Generally, children are not allowed to have medicine with them or take medication on their own at school.
“Every child who needs medicine at school, even Chapstick and sunscreen – and no, I’m not kidding – has to have an order from the doctor,” said Wichita school nurse Kristine Pfeifer. Lip balms and sunscreens can contain ingredients that are toxic when consumed, which is why schools want the products locked up in cabinets in the nurse’s office, she said. Parents can come to the school themselves to administer the medicine if a doctor’s order isn’t provided.
Schools generally have a sick-day policy for children, too. At USD259 in Wichita, a child who misses three consecutive days of school must have a doctor’s note. A child who has missed 12 days of school because of illness will have to have a doctor’s note for any additional sick day taken.