Pediculosis and The School Nurse

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Hopefully Helpful School Nurse Tip: As a school nurse, it is just a matter of time before you are introduced to head lice. Having the most reliable information will help you offer accurate healthcare advice and educate your students, staff, and parents.

“The school nurse plays an integral role in providing education related to treatment and environmental recommendations for families affected by head lice.” (Bultas & Smith, 2022) Yet school nurses struggle with what their role in this very sensitive issue. As the leader who bridges health care and education, the registered professional school nurse… advocates for evidence-based head lice management strategies that eliminate exclusionary practices and promote positive student outcomes, including reduced absenteeism. (NASN, 2020)

What is Head Lice?

Head lice are parasitic insects found commonly on the head, eyebrows, and eyelashes of people. Head lice have a 3 stage life cycle: egg (nits), nymph, and adult. The adult louse lives off the blood of a human head. This louse cannot survive without blood for more 1-2 days.

Although head lice can be a nuisance, they are not known to spread disease. They also don't discriminate and have nothing to do with the cleanliness of a family, student, or classroom. Lice enjoy clean hair just as much as dirty hair. Lice have been found on the heads of those who live in the out in the country and those who live in the big city.

Though head lice may be a nuisance, they don't cause serious illness or carry any diseases. Head lice can be treated at home, but it's important to check with the doctor first.

What are common signs / symptoms of head lice?

itchy scalp
feeling like something is moving in the hair or on the scalp
trouble sleeping because lice are moving around more when it is dark
occasionally sores occur on the head from scratching

Important head lice facts to remember

Head lice cannot jump
Head lice cannot fly
Head lice cannot hop
Head lice can only crawl

How are lice spread?

Close contact
Leaning into close and/or rubbing heads together
Sharing combs/brushes/picks
Sharing head phones, hats, scarves
Borrowing blankets, pillows, masks (face masks and Halloween masks)
Laying on a surface recently in contact with someone who has lice

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Head Lice Don'ts

Don't screen entire classrooms or grade levels for lice
Don't exclude from school for nits or even live lice
Don't send home school wide or class wide lice notifications

Head Lice Do's

Do provide privacy and head checks as needed
Do notify the student and parent as soon as possible if live lice or nits are found
Do provide accurate treatment options to the parents
Do allow the parents to pick up their student early to begin treatment (but don't require it)

I'd like to end this post by reminding the readers that school nursing tasks like handing out Band-Aids, ice packs, or doing lice checks may look simple on the surface, but they’re grounded in clinical judgment, evidence-based practice, and the full nursing process. In those brief encounters, school nurses are assessing, making nursing diagnoses, planning, implementing, and evaluating—all with the goal of helping students feel safe, supported, and ready to return to learning with minimal time out of class. Just as important, these everyday moments help build trusting relationships with students, showing them they’re cared for, listened to, and safe seeking help. What seems “minor” to some is often deeply meaningful to our students.

If this resonates with you—or you’ve ever felt your work was underestimated—In Defense of Band-Aids and Ice Packs is well worth the read. It captures the depth, purpose, and quiet impact behind the everyday moments of school nursing. https://journals.sagepub.com/doi/10.1177/1942602X251379900