It’s before the lunch bell rings when sick students who have held it together fall apart at school.

Around 10 a.m., the first round of cold medicine wears off, trash cans are placed near the beds in the nurse’s office, and parents are called at work to pick up their child.

“A child won

‘t learn if they’re not feeling 100 percent,” said Nancy Sutherland, head nurse for the Edmonds School District.

District officials are asking parents to keep their students home from school if they are sick. This way, sick students can recover and avoid spreading colds and the flu to the school community.

Symptoms such as vomiting, diarrhea or a fever are legitimate reasons to have a student stay home.

It sounds obvious.

But with more families feeling the pressure to work and, in some cases, being financially hard-pressed to pay doctor’s visit fees, more kids are going to school sick.

School officials are sympathetic, Sutherland said. “Parents are in between a rock and a hard place.”

The recession has added a new wrinkle. For example, Sutherland recalled a child who missed 10 days of school last year due to an allergic reaction to antibiotics prescribed by phone for what they thought was chicken pox. The cash-strapped family told Sutherland they couldn’t afford to send their child to the doctor for a full diagnosis, which could have meant a quicker recovery.

There are other reasons school officials would have families err on the side of a sick day. Despite having records with contact information, parents aren’t always easy to reach.

For some, phone service has been cut. For others, work obligations and pressure are an issue.

Sutherland recalls a parent who said she was instructed to turn off her cell phone before a work meeting. Meanwhile, Sutherland and district staff tried to reach her because her child was taken to the hospital.

“Imagine walking out of a meeting and finding a voice mail saying your child is in the emergency room,” Sutherland said.

She recommends parents add relatives or other trusted adults as emergency contacts and keep the school updated on changes.

“We don’t want to cast blame. We want to work together,” Sutherland said.

Too sick for school?

Edmonds School District and the Snohomish Health District advise keeping children home if they show any of these symptoms.

Appearance, behavior: Unusually tired, pale, lack of appetite, difficult to wake, confused or irritable. This is sufficient reason to keep a student home.

Eyes: Red, thick mucus or pus draining from the eye or pink eye. Itching with a crust on the eyelids after sleep — this condition may be “pink eye” and need medical evaluation.

Fever: Temperature of 100 degrees or higher. Keep students home at least 24 hours following an elevated temperature of 100 degrees or higher.

Persistent nasal drainage or chronic cough: Should be seen by a health care provider. These conditions may be contagious and require treatment.

Sore throat: Especially with fever or swollen glands in the neck. A student with a confirmed diagnosis of strep throat can return to school after 24 hours of appropriate treatment.

Diarrhea: Three or more liquid stools in a 24-hour period, especially if the student acts or looks ill.

Vomiting: Vomiting two or more times within the past 24 hours.

Rash: Body rash, especially with fever or itching.

Chicken pox: Students are infectious one to two days before the rash appears until the last blisters (sores) are dry and crusted. This is usually five to six days after the rash appears. Students are to remain home while infectious.

Ear pain with fever: This should be evaluated by a health care provider. Untreated ear infections can cause permanent hearing loss.

Lice: Students with suspected infestations will be screened. Parents will be notified of treatment needs. Please notify the school if you find head lice on your student.

Scabies: Students with scabies can return to school 24 hours after treatment has begun.

Source: Edmonds School District