Thanks for the responses. The cases I was speaking of were only those that tested positive by an MD. If the swab was initially positive and the culture changed I did not hear back. I have read about the carrier status and maybe we have one. I will have to be more strict about referrals to MDs and not returning to school unless it has been ruled out. I have tried this but they return to school and have not been ruled out. It is true that they don't always take all the antibiotics, the students will tell me that. Still welcome any and all ideas.
We as RN's, can't diagnose, so are you sure it is Strep? Some times I thought it was Strep only to have a parent get snippy and say"I took her to the doctor like you said, and it was negative." Most times it was, positive. We have a policy that states those with a fever are not allowed to return to school unless fever has been gone for 24 hrs without Meds.
Most of the time with repeat cases, I have found that parents did not administer the entire prescription. The child will tell you that if you ask them. If you feel they still have it , the parent doesn't go back to the doctor, and the entire Rx was not given, then call DCYF.
Unless you have tested the student for strep and know they are positive, you won't be able to exclude them unless they are running a fever. We had some cases of strep but more cases of a strep-like pharyngitis this year. Some parents automatically assumed it was strep.
Also, it will be important to do some health teaching about not drinking after each other and keeping enough space between people.
Better luck next year!
My school had a problem this year with students getting repeated cases of strep. Many of the students got it at least once. Although most parents/guardians take their child to the MD on a timely basis and appropriately, there are some that do not take them ordinarily. This is either from religious beliefs or a distrust of conventional medicine or antibiotics. Does anyone enforce a policy that would cover these students to be out until they have an MD note to return? Or some other way to deal with this? I just don't want a repeat of this next year.
New Hampshire School Nurses' Association
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