A school nurse takes you behind the scenes to learn how to read your child’s symptoms…especially on a school day.

By Shoshie Steinhart

You’re on line at the supermarket and your cell phone rings. It’s your child’s school calling.

“Hi, it’s the school nurse. Everything is ok. Shaindy is running a fever and needs to be picked up.”

When Should You Keep Your Kids Home from School?How we all dread that call! When we send our kids off to school each day, we wish them a great day, give them a kiss, and hope to see them again on the carpool line. But of course there are those days that they wake up in the morning and say, “Mommy, I really don’t feel well, I don’t want to go to school.” Are they pulling shtick or are they in fact sick? And we as parents are faced with the question, should we keep our kids home from school?

The answer may seem obvious to some, but trust me, not to all. I am in the unique position of being a Mommy and a School Nurse, so I see it from both sides. I have three kids and work full-time as a school nurse to over 800 students.  I see the full gamut daily from needing a band-aid, stomach ache, and homesickness, to full on fever and vomiting. I have the kids for whom I know their parents’ numbers by heart from calling so often (affectionately dubbed “my frequent flyers”) and I have the kids that I barely know their names, since they so infrequently visit me.

Since cold and flu season is officially upon us, I figured now would be a good time to put out this PSA [public service announcement] of when to keep the kids home from school, and offer a little peek into the nurses office.

New York State Law and general good practice is to keep students home from school until they are fever free for 24 hours. That means: No fever for 24 hours WITHOUT the use of Tylenol or Advil. (p.s. Tylenol is acetominaphen and Advil is the same as Motrin or ibuprofen). Sometimes a child has fever in the middle of the night and wakes up with no fever and is feeling ok. So, the parents will give them a pain reliever in the morning before leaving to school hoping that their child will feel better and not need to stay home. Well, 9 times out of 10, that child will end up in my office a little later in the day with fever and feeling really sick. It is not fair to the student, classmates, or teacher to send such a kid to school. While I completely understand that parents need to go to work and not everyone has grandparents or other people to babysit, it is not appropriate to send a child with fever to school. Fever is anything over 100 degrees.

On the other hand, sometimes a kid can be feeling perfectly fine in the morning and then starts not feeling well in school. When a student comes into my office complaining that she feels sick, the first question I ask is, “When did you start feeling it?” If a kid tells me they just got a headache two minutes ago, I encourage them to eat, drink, or get some fresh air and they can return to me if it worsens. If a kid tells me that they woke up not feeling well, I first make sure they don’t have a temperature, and then encourage the same things, hydration and some fresh air. But, generally those kids who woke up not feeling well keep coming back to me. So then my options are limited and I need to call home. When the school nurse calls you to let you know that your child has been to their office three times that day complaining of a stomach ache or sore throat (headache, eye hurts, coughing….you get the drift) please understand that there is only so much we can do. I try very hard to only call parents when I truly feel their child needs to be picked up.  I am a working mom too, and totally understand the stress we feel when our kids need to be picked up due to illness.

If your child has a cold or the sniffles and is not running a fever, then it is ok to send them to school with extra tissues and sucking candies. If they develop fever or body aches, then that could be the flu. As mentioned before, they must remain home until they are fever-free for 24 hours. If anyone who has a cold would stay home from school, then nobody would be in school. There is a fine line and hopefully this post will help you determine that line.

On the other hand, there are some students who visit the nurse’s office who don’t really need to go home. Here are some usually avoidable reasons that kids come to my office:

*They didn’t get enough sleep the night before.

*They didn’t eat breakfast, so by the time 9:30 rolls around the kids are in my office with a headache and stomach ache. (Our rule at home is that the kids must eat breakfast before leaving the house. If we are running crazy late, you know, because the 6-year-old princess decides she doesn’t like the tights I put out for her, then she must have a bag of cereal with her for the bus and a big drink.)

*“I didn’t bring a drink with me today,  I don’t want to drink from the water fountain, and my mother told me not to drink from the water fountain.”

Sometimes moms give instructions but often don’t realize the consequence or how their child understands it. For instance, there was a Pre 1-A aged girl who was constantly having accidents. When we looked into it, the girl told us that her mommy told her not to sit on the toilets at school but hadn’t taught the girl to line the toilet seat. The girl didn’t know what her mom meant. Once the student was taught how to properly line the seat, the accidents stopped. On the same note, why don’t you want your child drinking from the water fountain? Do you not want them to touch their mouth to the fountain itself? Do you not want them touching it with their hands or do you simply rather they not drink tap water? Whatever the reason, always make sure to give your child alternatives. Train them how to use a public restroom; send along a water bottle.

*If there is something going on at home that might be bothering your child, please make sure to let the teachers and/or nurse know. Many times a significant event can make a child anxious or homesick. That child will come to the nurse complaining of psychosomatic symptoms. If the nurse and teacher are aware, then we are better equipped to deal with your child. We can validate the student’s feelings while keeping them in school. 

I once had a student who was having some issues at home, but we at school were unaware. She came to my office almost daily for a week saying she had thrown up. For the first three times, I called her mother and her mother refused to pick her up. During the fourth phone call home, the mother admitted to me that they had a sick child at home and the student was feeling anxious and wanted to be with her. The parents do not need to give details if they don’t want to, which is understandable, however a simple note or phone call saying “we have some things going on at home and Shaindy is a little anxious, BH everything is ok, just letting you know, please keep her in school.” I have received notes like this and respect them whenever possible. Of course, if a child is clearly sick or has fever I call the parent anyway.


On a similar note, if a parent knows they are going out of town or will be unavailable for whatever reason, please give your child or teacher the phone number of the person who is taking care of them. I can’t tell you how many time kids come to my office and say “my mommy is away and my throat really hurts.” Sure, I could call the parents cell phone in hope that they are in the country.  Having a phone number of someone local would be super helpful.

Wishing us all a happy and healthy winter!


About Shoshie Steinhart
When not menu planning or grocery shopping, Shoshie is a wife , Mommy to 3 and works full time as a nurse. When she is not busy with all that, she works on her blog KosherMoms where she shares her passion for family, food and fun! Follow her on instagram @koshermoms and website koshermoms.com



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