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Nurse-1-1, population health, & health influencers

This morning I got an alert from Google that Nurse-1-1 was mentioned in the news. This one was different than the other alerts I usually get if Nurse-1-1 is in the news. It wasn’t an article I knew about ahead of time, and it wasn’t from a tech publication. It was from “The Link”, a small publication that targets students at Concordia University. The article, titled Sex Ed(itorial): Is My Birth Control Ruining My Life?, focuses on women’s health and references Nurse-1-1 as an expert source of health information. This is big news for anyone focused on population health.

From a population health standpoint, reaching influencers in communities is key. The CDC is always engaging PR firms to help them reach local influencers who can help educate a community about vaccinations, flu prevention, outbreaks of preventable illnesses and other health information that they need help educating communities about. The goal of this article is to reach women on a college campus.

It is no wonder to us that Nurse-1-1 is used to help spread the word on campus. In a recent study by Nurse-1-1’s Chief Medical Officer, Dr. Igor Shumskiy, he found that people are 5 times more likely to discuss their sexual health concerns on Nurse-1-1 than even with their own doctor’s office advice line. This morning’s article from The Link goes one step further. Not only are nurses on Nurse-1-1 influencing patients, they are helping publications spread important health information to their targeted communities. 

We are now looking at ways to expand this use of Nurse-1-1 for other organizations focused on population health. As any well functioning startup does, once you see something working, and working well, you need to look for ways to scale. We are mission driven here at Nurse-1-1. Enabling nurse influencers to educate their local communities about important healthcare topics makes us happy. This outcome is just one of many ways Nurse-1-1’s network of over 500 Nurse Practitioners across all 50 states can positively impact the health and wellness of Americans. Nurse-1-1 eliminates the uncertainty of the internet search and puts an expert nurse in your living room. 

—Michael Sheeley, CoFounder/CEO Nurse-1-1

Flu vaccine

Let’s talk flu vaccine. As a mom I understand the worries that you might have. Is this safe? Is this necessary? Am I doing the right thing? It’s not only OK to ask these questions, but necessary. Now, the key to asking the questions is… Who is answering them?  

As a pediatric nurse practitioner 👩‍⚕️I must put my foot down.  A medical professional or a trusted, reputable, science based resource MUST be the one answering your questions about the flu vaccine. Please do not ask on a mom group, a celebrity blog, or a random website🤦🏽‍♀️. Check your source. I don’t make money from vaccine companies when giving my advice, but celebrities do make money from talk shows and magazines. That’s a fact 🤷🏾‍♀️. Always consider the incentives your information source might have. 🤑

Here is an example of a great article about common flu myths from a trusted Children’s Hospital.   

Vaccinate for other people

I worry about the safety of my children and those around us. If my healthy son gets the flu will he be ok? 🤧 The fact is, since he is vaccinated, he likely will be just fine. 💉 Studies show that vaccinated children are less likely to die from the flu than those that are unvaccinated. You can find one of the studies supporting this here from the American Academy of Pediatrics. Just be aware it has lots of science speak🤣🤣🤣! Will Susie down the street be ok when she gets the flu? She just had a heart transplant and her immune system is subpar (what we in the healthcare world call “immunocompromised”). She might not be ok. 

Think about Susie. Patients like Susie who have a suppressed immune system need to be vaccinated to be protected. 🤧 Sometimes, however, patients like Susie can’t get the flu vaccine due to their disease or severe allergies. So, instead, they rely on healthy people getting the vaccine and decreasing the chances that the flu virus is passed around. 👾 Healthy people should be vaccinated to protect themselves and so they don’t give the flu to those who are immunocompromised.  🤧 Not all people can get all vaccines due to allergies and medical issues. 

If you don’t get vaccinated, you are more likely to get the illness and spread it to others. Help protect those who can’t get the flu vaccine for medical reasons. What if Susie were your child. You would protect her right? It takes a village to raise kids. Be the village❤️. Vaccinate your child. 

The flu vaccine is safe

Please, for the safety of your family and families around you, don’t listen to celebrities, mom groups, or untrusted sources that are NOT backed by science. Listen to the facts. The Centers for Disease Control and Prevention (CDC) reports that children are less likely to DIE from the flu if they are vaccinated.  This is a very important statement.  

The flu vaccine is found to be very safe. 💉 Sometimes the flu vaccine can cause pain at the site or localized redness around where you were given the shot.  As your body develops antibodies, you may feel achy, have a headache or nausea 🤢, but the flu shot does NOT actually cause the flu! These milder symptoms should not last long.  Here is a great read on flu shot safety.  😷

The flu vaccine helps protect those who are unable to be vaccinated. 🤧  Help a mama out. Protect Susie. Protect your family. We are all in this together. Read the facts. The flu vaccine is going to reduce YOUR child’s risk. Let’s vaccinate. Don’t let non-medical professionals teach you about vaccines. If your child had the flu you wouldn’t take them to the mechanic, right? Then don’t take them to a Facebook group made up of people who are not medical professionals. 💊 Take them to your local pediatrician’s office and have a conversation. Shoot, have a few conversations! Or chat with us at We are medical professionals, and we can help you figure out what’s best. 👩‍⚕️👨‍⚕️

Our recommended resources for flu vaccine information

Some additional resources we believe are trustworthy and worth a read:


Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like, I have been suffering from headache and fatigue for a while. Should I be worried? Why is my child’s poop yellow? Is fever in kids bad? Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help. 

Foul smelling urine

Foul smelling urine, cloudy urine and odd colored urine— what to do!

Let’s face it, everybody goes to the bathroom, everyone pees. Let’s talk about your body and the urine it produces. 😀 Color and smell of your urine is the topic here! We will talk about infection too, but for now let’s talk appearance.

Urine is produced by your kidneys as it breaks down and excretes waste from your body. From the kidneys, that waste flows into your bladder through a tube (ureter) and then from your bladder, out your urethra through your penis or vagina and into the toilet 🚽…or diaper or floor. 😨

The best urine is clear or light yellow. Dark yellow urine means that you aren’t drinking enough water 💦. It’s important to drink enough water to flush out all the toxins from your body and to keep you hydrated. Take a look at your urine the next time you go to the bathroom 🚽and make sure it’s not dark yellow. If it is, you should make an effort to drink more water. If your urine is dark brown like soda or red, like wine, then head right into your primary care or urgent care office. Your kidneys may be struggling to break down waste. Unless of course you had LOTS of beets the day before as this can make your urine a wine color (certain foods and medications can change your urine color!) 

Foul smelling urine without pain

If you start to notice urine that smells very gross then you might need to worry. Now, if you have asparagus for dinner 😂😆😆 your urine may smell nasty for a day or so. Some people, not all, produce a funny odor when their body breaks down the acid in asparagus. Weird! If there was no asparagus in sight, then foul smelling urine should be checked. Stinky pee can indicate an infection in your bladder. Infection often smells 😔which is why your urine may smell. Same goes for your child. If you notice a stinky smell in their diaper 👶that isn’t typical of good old diaper pee, then it’s cause for some extra attention. 

Holding your urine for a long time can make the smell of your urine very strong. Also if you aren’t drinking a lot of water and your urine is very concentrated, it can have a stronger smell. Both of these issues should resolve once you start drinking more and using the restroom more often. Now if it doesn’t resolve, then it’s time to get checked out.

Cloudy urine

Cloudy urine is another common complaint. Usually the first morning urine can seem a little dark yellow and cloudy. But it could also be that your toilet needs a scrub 🤣🤣🤣. If you feel like your urine is cloudy, it’s best to look at it in a clear, clean container. It’s hard to tell in a white or colored toilet how clear or cloudy your urine is. Cloudy urine can be from holding it a long time and then having a large amount come out quickly. This is common in the morning. The turbulence can cause bubbles and make it seem cloudy in the toilet. Just like if you shook up a bottle of water. Bubbles will form on the top of the water of the toilet making it all look funny.

Let’s make sure you really have cloudy pee— go into a cup! Don’t panic when your teenager leaves you a bowl full of pee in the morning and it looks nasty, have them pee into a clear plastic cup to see the real deal! You can see if your urine is really cloudy or not through the clear container and if those bubbles are clouding your judgement– see what I did there! If you truly have cloudy urine, it could be from infection, so cloudy urine may need to get checked out. Cloudy urine with other urinary symptoms is more concerning. 

Causes of frequent urination

Frequent urination can be caused by a multitude of reasons. Most that need to be checked out. Some can be an easier fix. Here are a few causes of frequent urination.

  • Urinary frequency due to constipation

 If you or your child is constipated, it can cause pressure on the bladder and make you feel an urgency to go. It’s an easy fix usually (unless you have a toddler!) Soften up those poops!💩 Constipation can be a difficult cycle to deal with. It’s ok! Everybody poops! Check out our constipation article with more tips and tricks to help you solve your constipation (will write this week) . If you don’t want to read it you can try increasing water intake, fruits and veggies and exercise. These things can help get your bowels moving! Your frequent urination can be caused by your hard, extra large or pebble like stools. 

  • Urinary frequency because of irritation of the vagina or penis

Irritation to the urethra can cause urinary frequency. This irritation can be non infectious or infections. Let’s first talk about easy fixes and easily overlooked causes that are non infectious. 

  • Urinary frequency due to non-infectious irritation of the vagina

This situation can cause the feeling of urinary urgency. This is especially common in children. Bubble baths and hot tubs can cause irritation of the urethra. Irritation from poor wiping can cause similar symptoms. Younger children often don’t wipe well in the early years after potty training and leave bits of debris AKA toilet paper and poop smears in their vaginal area. This can cause irritation and the feeling of urgency. Doing warm soaks or baths in clean warm water will help the irritation. 

Avoid bubble baths and fragranced soaps as soap can cause more irritation. Also avoid scrubbing that sensitive area hard. Using vaseline or Aquaphor externally for comfort around the irritated labia can also help. Remind those kiddos to wipe front to back! Wearing loose cotton clothes and allowing air to get to the vagina is going to allow the skin to heal and keep the moisture away. Let those vaginas “air out,” sleep with a nightgown and no undies! But be prepared for a bare bum in the air when you peek in to check on your kiddo at night! Ha!

  • Urinary frequency due to non-infectious irritation of the penis

Let’s talk about the boys. Irritation can be common in boys as they wash their penis and soap gets into the urethra through the hole at the tip of their penis. This can happen if soap gets in during bubble baths or hot tub use. This can also happen with a little extra friction and washing (if you know what I mean), especially as they get older and they start to explore more. This will start sooner than you think! Get ready! Even toddlers love washing their penis! Washing with soap is fine, but on occasion the soap can get pushed up into the tube causing irritation and the feeling of urgency. Giving baths in clean warm water without bubbles and avoiding fragranced soaps can help reduce symptoms. 

Urinary symptoms due to infection 

Pain with urination can be caused from irritation to the penis or vagina as a result of infection. See our article on urinary tract infection for more.

Infection can be from bacteria, usually e.Coli that gets pushed into the urethra and then climbs up into the bladder. The infection is called a urinary tract infection or a bladder infection. This infection causes pain with urination. It can cause blood in your urine, cause urine to look a different color, your urine to look cloudy, your urine to smell, pain with urination, fever and abdominal pain, back pain and even vomiting. 

To help avoid urinary tract infections, it’s important to have good hygiene, drink lots of water and pay attention when you have any other urinary symptoms. Once you make sure your smelly urine isn’t just from your asparagus dinner last night, then you can read all about infections to help plan your next move here. Urinary tract infections need medical attention right away as they can make you very sick. Make sure to call your provider or chat with one of our nurses anonymously if you have more than one urinary symptoms, or your symptoms seem like more than just too much asparagus for dinner!


Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like, I have been suffering from headache and fatigue for a while. Should I be worried? Why is my child’s poop yellow? Is fever in kids bad? Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help. 

Treating Transgender Patients

So your patient’s name is Samantha and goes by Sam. They “appear” male but are here for vaginal discharge. There is nothing in the chart about how your patient identifies. There is an elephant in the room… where do you go from here?

Now many of us providers have lots of experience treating transgender, genderqueer and non-binary patients, but many of us have absolutely NONE. The reality is that in many areas of the country these patients have to hide from getting medical care. Patients are scared to be treated badly, and therefore their health suffers.

Fortunately, in many areas of the community, it’s becoming more accepted and more common for transgender/non-binary patients to come to urgent care and their primary care offices for care. BE the provider that keeps those numbers increasing. Don’t prevent healthcare from happening. 

In the recent past and still in many communities, some of these patients would not seek medical help when needed and would become very ill to avoid having to deal with medical professionals that they did not know. They would only see known, “safe” providers who are not always available for urgent care/sick visits. It can be too risky to be seen by someone who may make them feel worse or who may refuse to see them altogether. Not everyone will accept these patients and treat them humanely as they deserve. The health care disparity for transgender patients is real. 

Here at Nurse-1-1 we realized that having only a male and female option was not inclusive enough. We saw the need for care for all humans and realized that we were unintentionally excluding a cohort of patients. After realizing our oversight, we made sure our service included non-binary patients. We added “non-binary” as an option for gender so that all patients would feel welcome to chat with us. We wanted to be sure we were creating a safe space for all patients. 

We want patients to feel comfortable with sharing their health concerns. And we strive to provide the best environment for our nurses to help as many patients as they can.

If you are feeling uncomfortable as the provider, imagine how your patient feels. It’s time to pull your big kid pants on and put aside opinions and biases. Don’t be afraid to ask questions. I mean, you aren’t afraid of blood and guts, so this shouldn’t be that much more difficult. Don’t forget we are all human. You may feel strongly that you are a female or male, but your patient may be struggling with that label, especially if they feel like they don’t belong.

Now when I say struggling, I don’t mean they are confused. I mean that they might not fit into the typical label they appear to be and that they were given at birth. Your patient may have a penis but identify and appear to be a female. Don’t assume, ask. Let your patient tell YOU how they identify. 

Don’t guess. Guessing is ignorant. ASK your patient! How would they like to be called? He? She? They? Ask what name they would like to go by. Put it in the chart, make it clear. It doesn’t have to be permanent, these things change. But make it easy. Help out your colleagues, spare your patient from having to explain to each person who enters the room. 

Respect your patient. You don’t have to understand or agree with your patient’s label and identity. You aren’t there for that. You are there to address the issue at hand. This issue is their current illness and symptoms. They are unlikely at the urgent care center today because they want you to help them choose how to dress and act and who they should have sex with. They are here because they have acute symptoms and need your help. 

Your patient in your office is brave and strong. Some patients just can’t bring themselves to come into the office in person, but need medical help. Nurse-1-1’s text based triage service will allow your patients to connect with a health care provider. One of our goals is to be part of the health care solution and decrease disparities. If you feel like we can help you be a part of this, let us know, there are options to help make your clinic one that is accepting of all patients. Make the changes necessary to be that change! 

Next let’s not assume that Sam isn’t sexually active with men. In fact don’t assume anything. Sam’s vaginal discharge and abdominal pain could be due to pregnancy. Don’t assume that Sam, who identifies as male, is only sexually active with women. Gender identity doesn’t specify sexual orientation. Asking questions politely and respectfully will help you give the best care to your patients. 

Your patients who are hesitant to get medical care are at very high risk for health problems and complications. The health disparity they face must be improved. Offer care, encourage well visits and preventative care, be kind, support your fellow human. YOU might make the difference in their life. Offer them a safe place to come for health issues and concerns. Read up on how you can help these patients feel respected and cared for. Come out of your comfort zone. Keep them coming back to your clinic. Keep making improvements in healthcare and in the lives of others. We owe this to humanity. Be a provider who directly but respectfully addresses gender identify, and help improve health care disparities. 

Constipation– causes, treatment and prevention

Everybody poops! Well apparently not everybody…sometimes people have a really hard time pooping and we call that constipation. What goes in, must come out! Here we will talk hard poop! We love poop so much we have a whole article on all things poop! Check that out if your child has odd colored poop or if you are panicking about poop! 

Your poop is hard

Constipation is best treated as soon as poops get hard. Let’s talk hard poop. Pebble like stools, big log poops and giant hard to push out poops are all considered constipation. Poop should be soft and easy to push out (like toothpaste). Straining, pain, and suffering during pooping can be caused by constipation. 

Hard poop and abdominal pain

When you have a belly full of poo, it’s going to start to hurt. The Poop has to go somewhere. You may start to feel full and eat less, your belly may become distended (look like it’s sticking out), and you might have pain. Some people stool every day and some less often. The key is to have soft, bulky, easy to push out poops! If you try all our suggestions and you don’t poop after a week, take a trip to your primary care for and exam and evaluation! Any belly pain that keeps getting worse without relief, or that prevents you from getting up and walking should be seen right away. Abdominal pain that continues to worsen, or doesn’t improve with a poo or that is accompanied by high fever or vomiting could be serious. Chat with us so we can help you decide if a visit to your primary care or urgent care is the right choice, or if it’s time to head to the emergency room.

Hard poop, how to help resolve the pain

Once you poop, the pain should improve. A nice warm bath to help things relax can help. A gentle massage to your belly is another great technique to get things moving. Going for a stroll is another way to move things along. An active lifestyle can help with getting your poop moving, believe it or not! Sometimes the pain will come and go as the hard ball of poop moves through your intestines. The pain should not be constant, worsen or prevent you from your daily routine. If the pain is that bad, then a medical provider should feel and listen to that belly to be sure nothing serious is going on.

Leaky poop and constipation

When there is a giant ball of poop blocking the exit, the body tries to figure out how to make a little room for the next round of poo. What sometimes happens is that some poop leaks around the hard ball and your child or yourself will start having small accidents. Some think this is diarrhea before they realize it’s just poop leakage. Once the hard ball finally comes out, the leakage should stop. This can be especially traumatizing to school aged kids with constipation. Tell them what’s happening and how to fix it.

Constipation in toddlers

Toddlers hate to poop! It’s scary and gross and they love the control they have when holding in their poop. They have total control over when and where they poo. It’s probably the only thing they can completely control. This is why it’s common for toddlers to hold their poop in and become constipated. It’s easy to hold it in, but once it gets backed up, it becomes really hard to get the poop out! Once it’s painful, forget it! The poo is going to hide for as long as possible. Toddlers are stubborn and strong. That poop is going to take some coaxing to come out! It’s important to try and keep that poop soft and moving along!

Bathroom regimen

Taking a bathroom break and having a poop routine is a great way to regulate poop. Give yourself or your child a toilet break, 30 min after meals. Relax, read a book and take a seat. It’s time to train that body to poop after meals. Have your child head to the school nurse for a more private poop break if privacy is preventing poop at school. Now is the time to offer a new book to your child, an incentive, soothing music or a straight up bribe! Let’s face it, desperate times call for desperate measures. 

Diet and constipation 

A diet full of fiber will help make your poop easier to push out. The bulkier the poop the easier it is to come out. Bulky poop holds water and is usually softer. You don’t want a hard packed poop, you want a nice full soft poo!

Increase your fruit and veggie intake

 Lots of fruit can help soften that poop. Avoid bananas! Increase all of the “p” fruits, peaches, pears, plums, prunes, to name a few. Veggie roughage will help you to poo too! Fill that kiddo with melon and cut up grapes and lots of veggies and you will have a giant poo in no time! Sadly, juicing the veggies/fruits will not work as the pulp that is lost contains all the fiber! 

Nuts and beans are really high in fiber too! So have those kids snack on almonds and make it taco night with lots of beans and veggies…YUM! Check out this great list of high fiber foods. 

Drinking lots of water will help too. You want there to be extra water so that it absorbs into your poop. Lots of water is great for the body. Push water on your child all day long and especially during warm weather and when they are active. 

For infants and toddlers, prune juice can be a great option for a high fiber fluid. If your child is taking bottles, try mixing breastmilk/formula 50:50 with prune juice (example: 1 ounce breastmilk mixed with 1 ounce prune juice) and give them the bottle one time or two times per day. This usually is a great first step! If that doesn’t help, ask your pediatrician. 

Cut back on cow’s milk and dairy products. One serving of dairy a day is the most you or your kiddo should have if you are having hard stools! Limit cow’s milk to 6-8 oz per day. Your dairy loving constipated kiddo will need to cut back on Mac and cheese, cheese sticks and all that milk! 

The poop struggle is real

Don’t panic. The poop must come out! The best way to tackle poop problems is from the top down. Change that diet, increase that water and get that poop out!

If you are having more pain, fever or vomiting or you are worried about your poop, get checked out. Poop can be treated from the bottom up but it’s a good idea to get checked out if you can’t seem to get things moving with good old diet changes. It’s important to know what is going on before starting medications such as a laxative, especially in kids. Chat with us and our nurses can help you!


Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like, I have been suffering from headache and fatigue for a while. Should I be worried? Why is my child’s poop yellow? Is fever in kids bad? Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help. 

Sports Injuries

Sports injuries– who to call

Not only is school back in session, but so are sports. The urgent care hours are filling up with sports injuries. You are one of two types of parents… The run into the office an hour after the injury kind of parent, or the wait until your child’s leg is falling off before making an appointment kind of parent. Of course there is a small, almost extinct group of parents that will wait a few days with proper rest and treatment of symptoms with pain control before making the appointment.

Resting a sports injury 

The best advice I can give is bump into that almost extinct group. Give your child’s injury a few days. REST that injury. Do not let Susie play 5 more games of soccer on her hurt ankle. Make her rest. Johnny can’t be a pro football player if he tears his ACL because he was playing on a hurt body part. The fact is that a minor injury needs to be rested to PREVENT a worse injury from occurring. When you continue using a hurt body part, your otherwise strong stable body becomes unstable and your risk of re-injury or injuring another part of the body goes up dramatically. You have FIVE to SEVEN whole days to have a fracture casted before your healing is affected in most cases.

Sports injuries– decrease the swelling 

The next reason for resting for a day or so is to decrease swelling. An  x-ray done the same day as an injury may be unclear because of all the swelling. Give your child’s injury some time to settle down. Ice the injury to help with pain and swelling (15 minutes at a time, 4-5 times a day). Elevate it to help decrease swelling and allow the body to heal. A minor injury that is rested and cared for, will self resolve. Any major issue or fracture will have persistent pain that will not improve with a few days rest. 

Compression with an ace bandage combined with ice and elevation will allow the swelling to come down. If you walk around all day on a hurt foot, its likely to be very swollen as all the fluid pools near the ground where your foot spends most of the day. If you elevate, you will allow proper drainage and flow and decrease swelling (lift high enough to counter-balance gravity, so preferably above the level of your heart). Motrin will help with pain and inflammation as well. 

When to get that sports injury checked

Let’s talk dramatic child. If your 15 year old claims his hand is broken, but can play video games for 5 hours, then you can worry less. You can’t play video games for hours with a broken hand. If your sports fanatic daughter who never misses a practice says she needs to get her foot checked because she can’t walk, it might be time to get looked at. Don’t ignore them! Pay attention to your child. It’s amazing what you will learn when you observe your child. 

What does my x-ray mean?

Once you come into the office, either urgent care or your pediatrician, your child will have an exam. Based on this, the provider may decide to  x-ray the injured body part. The x-ray will let us see if there is a clear break. You will need to see orthopedics if the x-ray shows a fracture, as well as if there is a high clinical suspicion of a fracture but the  x-ray appears normal. Some fractures are radiopaque which means they don’t show up on the x-ray film. If your x-ray is normal but your pain is getting worse or lasts longer than 5-7 days, then an orthopedic visit is in order. 

If your  x-ray is normal, and the pain improves with rest, ice, Motrin and elevation, then WHOHOO. This is what we hoped would happen. Once you are pain free, head back to that field! Game’s on!

Rest that injury

The key to injury, like I said, is to REST. A rested injury should improve. If it doesn’t, then it’s time for a visit in urgent care, your pediatrician and potentially a specialist. 

We shouldn’t have to say this, BUT if there is a bone sticking out, your child appears clammy or ill appearing after an injury, there are color changes to the area, skin is cold to touch, or you have an immediate concern, take them in. Parent’s intuition is often right. You know your child best! Don’t let a coach, relative or friend push your child to play while injured. Take care of those little bodies! Nothing is more important than a healthy body. 

If you have questions about a sports injury, for your child or yourself, feel free to reach out to the nurses at Nurse-1-1!

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like, I have been suffering from headache and fatigue for a while. Should I be worried? Why is my child’s poop yellow? Is fever in kids bad? Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help. 

Sore throat in kids

It’s Friday afternoon and the school calls. It’s the nurse. Your 10 year old child is complaining of a sore throat. You rush your kid from school to the pediatrician’s office and the rapid strep test is negative. They diagnose her with a virus. Ugh. Happy weekend. 

Let’s chat about what you could have done differently. First. Don’t panic about a sore throat. Yes it could be strep. But it could also be a dry throat, a virus, or seasonal allergies. Or maybe just a crusty piece of bread gone down too fast. 

What is the cause of sore throat in kids?

The rapid test was negative, could it still be strep? It’s best to give your child more than a day or two of a sore throat before you rush them into the office. If your child has strep, it may take a day or so for it to fully present itself. A rapid strep test too early may not pick up the strep and you will end up waiting for the culture results anyways. The rapid test needs to have enough strep bacteria to trigger the test positive. The culture takes a few days because the tiny amount of bacteria needs time to grow large enough to be identifiable as strep. You might as well give the sore throat a day or so at home so you get a quick, accurate result. Don’t rush in too fast! Take a few days to rest and monitor symptoms. Over those 2 days, more symptoms may emerge. This can help you to figure out what is going on with your child. 

Strep throat in kids

Classic strep throat, or strep throat caused by Group A streptococcus is usually accompanied by fever. The strep toxin can also cause other symptoms such as headaches, belly aches and a rash. Scarlet fever, aka strep rash, can be very subtle. It can be more of a sandpaper like rash that is flesh colored, or it can be more pronounced with red spots all over, or in some patients, appear more hive-like. Not all kids with strep will have this rash. The rash will clear with the antibiotics that you get for your strep treatment. Also, note that a virus can cause a rash too. Talk about confusing! Again, don’t panic! This can be sorted out. 

Strep throat can be treated with antibiotics. Lots of fluids will help soothe the throat. Motrin or Tylenol will help with pain and fever. Fever in kids can be rough, so be sure to treat it. Avoid crusty and acidic foods that may cause discomfort to swallow. 

Strep likes to hang around and set up shop in your kid’s belongings, like her toothbrush. Get a new one or sterilize your child’s toothbrush 48 hours after starting antibiotics. No kissing or sharing drinks! Strep is nasty. It spreads easily. 

Treatment should start to work pretty quickly and your child should feel better in a few days. Make sure to complete your antibiotics so that strep doesn’t come back. Stopping the antibiotics early can cause the “super bacteria” to survive and then come back with a vengeance. So, if you started them, do everyone a favor and finish them! 

Non group A strep

What is this? If you get a call that your child’s throat culture grew non group A strep WHAT does that even mean?! Well Non group A strep refers to some bacteria that is commonly found in your throat and other areas of the body. It MAY be a coincidence that your child had a sore throat and then this grew in the culture. Talk to your provider about the plan. Usually treatment is only given for non Group A strep if your child is STILL having symptoms or fevers. If the little babe is all better, and no longer complaining, skip those antibiotics, they aren’t necessary. We often see teens with non group A strep and prolonged symptoms. If this happens to your children, then don’t hesitate to treat them. Teens are whiney enough when they are well!

Viral sore throat in kids

What if your child’s rapid strep test is negative and you are sent home with a diagnosis of a virus? You should take the same care of your child with a sore throat virus as you would a strep infection. Antibiotics won’t help this one. Don’t feel defeated. The time it takes for antibiotics to kick in and treat a strep infection is about the same as it takes a virus to clear on its own. It just SEEMS like strep is a better diagnosis because there is a treatment at the pharmacy. In reality, both treated strep, and a viral sore throat have symptoms that last about the same length of time. A viral sore throat is better, we promise. With a virus, there is no need for antibiotics, which helps with a healthy gut and less risk for antibiotic resistance. 

Lots of fluids will help soothe the throat. Motrin or Tylenol will help with pain and fever. As with strep, avoid crusty and acidic foods that may cause discomfort to swallow. Your virus should last about a week. If your symptoms persist more than that, it’s time to get rechecked. 

Viral sore throat— hand foot and mouth

A sore throat accompanied by sores in the mouth, on the hands and feet, is usually from something called coxsackie virus, aka Hand, Foot and Mouth. Check out our article on Hand Foot and mouth if your child has sores around his mouth or blisters on her hands or feet. 

Dry throat in kids

A sore throat can sometimes be a simple fix. Did you just turn on your heat? Does your child have a stuffy nose? They could be mouth breathing and inhaling dry air all night. The sore throat in the morning will resolve as the day goes on and the throat becomes less irritated. A humidifier can help with this. Cool mist is best! Hot humidifiers are a thing of the past, germy, and a burn risk. If you still have one, toss it out! 

Using nasal saline to help loosen up nasal congestion can open things up and allow your child to breathe through their nose instead of the mouth. A warm bath and a good nose blow helps too. If they are too young to blow their nose, the nosefrida is AMAZING. Get one! It sounds grosser than it actually is! 

Seasonal allergies in babies, toddlers, and older kids

Seasonal allergies can cause a sore throat in kids (adults too, obvi). They can make you miserable, itchy, and a drippy, runny mess. Babies and toddlers can get seasonal allergies too. If it’s springtime and the trees are blooming, or the fall ragweed is blowing in the breeze, think about seasonal allergies as the culprit for your symptoms. Nasal saline is going to be a good friend. Clear up that mucous that is dripping down the back of your child’s throat with some saline. You want it to spray up and then wash back down the back of the throat. This will break up the stream of mucous and help make that sore throat feel better. Now grab a blanket, it’s time to wrap that kiddo up like a burrito and squirt that saline. We promise, it’s worth it! Don’t try and spray saline with a flailing child, it won’t work! Grab a helper or a giant bath towel. 

You can also talk to your pediatrician or urgent care provider about over-the-counter allergy meds like claritin or Zyrtec as well as Flonase nasal spray. These medications can help alleviate your symptoms as well. If your child has a fever, it’s likely not seasonal allergies, these won’t cause fever.

When your child should be seen by a provider for sore throat 

In general, for any fevers that last more than 4 days, symptoms that are prolonged more than 5-7 days, or worsening symptoms, you should always be seen. Call right away and be seen immediately with difficulty swallowing, drooling, difficulty breathing, barking croup-like cough, or if your child is ill appearing. If you aren’t sure, chat with us at Nurse-1-1 and our nurses can help sort out your child’s symptoms. You are not alone. We can help!

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like, I have been suffering from headache and fatigue for a while. Should I be worried? Why is my child’s poop yellow? Is fever in kids bad? Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help. 


Croup in kids and babies

It’s the middle of the night and you wake up to the sound of a strange noise… what IS that. You realize it is coming from your kid’s room. It’s a barky sound, almost seal-like… it’s croup. Croup in babies and young kids can be frightening.  But what is it?

Croup is a virus. It hits kids and babies in the middle of the night. It’s scary. We panic. The kids panic. It’s natural to feel this way. 

Croup is an infection and causes inflammation of the larynx and trachea (aka the “voicebox” and “windpipe”). It can feel and seem like your child can’t breathe. Take a deep breath mama or papa, you can often treat the symptoms to make your baby feel more comfortable right at home. 

What to do when your kid has croup

First take a look at your child. Are they blue or lips look an off color? Do they struggle to breathe and make a weird sound like they are breathing in through a tiny straw? Are they limp in your arms? If your kid is drooling and unable to swallow, or seems to be reaching their head up for air or suddenly looks very ill, call 911 immediately. 

If your child is coughing, and it sounds like a seal or a barky sound, two things can help:

  1. Steam from running a hot shower
  2. Cold air vapors from outside (if it’s cold out) or from the freezer

First, head to the shower. Turn the shower on and let the bathroom fill with steam. Don’t turn that fan on. We need the steam to stay put! If you prefer to get into the shower with your little one, just keep the temp comfortable. We wouldn’t want to add burn to the list of problems! If you prefer to sit on the bathroom floor then turn that water up and let the steam work its magic. 

Your child’s cry and voice are likely hoarse sounding. Try to keep them calm. Offer them a drink and comfort. Your kid is scared and panicked as they don’t understand why they are so uncomfortable. Try as hard as you can to limit crying as the more upset they are, the worse the cough and breathing gets. 

Next you will need to wrap your baby or young child up in a blanket. Once they are all wrapped up… take them out into the cold night air. It must be chilly out for this to work. If it’s warm out, head to your freezer and let your little one breathe in the blast of cold freezer air for 5 min or so. This may all sound crazy, but the combination of cold air and steam will help resolve the symptoms of croup! 

On top of the cough, your kid more often than not will also have a fever. Motrin works best as long as the child is over 6 months old. Follow the instructions on dosing, call your doctor’s nurse line, or log into nurse-1-1 and we can advise you on weight- based appropriate dosing for your baby or young child. Motrin will help reduce fever, and will decrease inflammation, and help calm your kiddo down. To learn more about fever in kids, check out some of our other articles.

You should soon start to have a calmer child who can breathe easier and have less of that constant barking cough. They should calm down and become less panicked. Hopefully you will all get a few hours of sleep now!

When to go to the ER for croup in babies and kids

If you have done the cold air blast and steamed up the bathroom and your child is still appearing to be having the barky cough combined with a squeaking noise when breathing in, then it’s time to get checked out. That squeak when breathing in is called stridor and means they are having difficulty getting air into their lungs. It’s likely the middle of the night and you will need to go to the ER. Here is a great video of stridor. This type of breathing needs to be seen right away! 

If your local urgent care is open (and your pediatrician isn’t), that is also a great option. Your child may need a steroid to help calm things down and open up their airways.

How long will croup last in children

Croup is a virus and will go away on its own. Usually nights 2-3 are the worst so get some rest while you can! Your little one may be up again tomorrow. Following the 3-4 nights of waking with the hoarse cough, your child will likely develop a runny nose and cold symptoms. These should resolve after 7 days or so. If your child develops a fever at the end of the illness or fever comes and goes, get them checked out by your pediatrician. 

If the cough lingers more than 5 days or your kid exhibits increased work with breathing or difficulty breathing, then get them checked right away. Any time your child looks like they are working hard to breathe, it’s important to get them checked out. Signs they are having trouble are heavy breathing, fast shallow breathing, ribs popping out with each breath (retractions), grunting, nose flaring, or any color changes are all concerning symptoms. 

Is croup contagious for babies and young kids?

 Croup is contagious, and is most contagious when your child has a fever and first has the cough. The viral load will decrease over time but it’s a good idea to avoid sharing drinks, kissing and make sure to continue with good hand washing. The younger the child, usually the more severe the symptoms, as their airways (“windpipes”) are smaller. 

As children get older, they may have a hoarse voice and mild cough, same goes for adults. It’s always a good idea to keep other kids away. Keep babies and young kids home from daycare, and keep older kids home from school until they are fever free for 24 hours. 

As always feel free to check in with our nurses at Nurse-1-1 who can help guide you through croup as it is a very common illness in childhood. Now go take a nap and get ready for night two!

Feel free to message us with any concerns!

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like, I have been suffering from headache and fatigue for a while. Should I be worried? Why is my child’s poop yellow? Is fever in kids bad? Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help. 

Nurse-1-1 is Creating a Safe Space & Breaking Down Health Disparities

Author: Igor Shumskiy, MD

Why are patients 5 times more likely to discuss their sexual and gender-related health concerns on Nurse-1-1 than on a typical telephone triage call with their doctor’s office? Read on to get my analysis, but more importantly, the reasoning behind why providers, payers, and public health departments should care about this stat. 

First off, what is Nurse-1-1? Nurse-1-1 is the digital doorway to healthcare for the billions of worried patients searching online for information about their health concerns every day. Through personalized, live, text-based nurse chats, patients receive trusted health information so they can make better decisions about their health. 

Sensitive health concerns are common

We often hear, “this is fascinating… what types of health questions do people have???” Turns out that 22% of all health concerns on Nurse-1-1 are related to women’s health, men’s health, teen health, or sexual health. Seems like a reasonable percentage for such common issues, right? 

According to the American College of Physicians – American Society of Internal Medicine report on Telephone Triage, the highest women’s health, men’s health, or sexual health related concern was difficult urination for women, at 2.3%. The next highest was vaginal discharge, at 1.4%. The report doesn’t share further topic breakdowns below 1.4%, however, I’m going to safely assume that the total sum of these types of questions is around 5% of all calls. 

A combined 22% vs 5%. Umm, huh? This means that more than 1 out of every 5 patients on Nurse-1-1 are asking about women’s health, men’s health, or sexual health. While 1 out of every 25 are doing the same with traditional phone triage at their provider’s office. That’s 5 times more on Nurse-1-1 than a typical nurse triage line.😳😳😳

Why this huge difference? And, does it matter?

Well, in my opinion, this matters a whole heck of a lot. Just because traditional primary care nurse hotlines are not getting called about sexual health concerns doesn’t mean these concerns don’t exist. There are many reasons why patients may not want to call and talk to a nurse over the phone about these types of questions. For starters, it can be embarrassing! Usually these are the types of questions that patients feel they must first lie about to the phone scheduler, saying “it’s just a cold” rather than what it truly is, and then having to whisper about it shyly in front of the nurse or doctor.🙈

Furthermore, a lot of people may not even have a trusted provider they feel comfortable enough discussing these types of topics with. This leaves a huge unmet health need with problematic downstream consequences. Miscommunicating the real concern over the phone may lead to delays in care or recommendations for the wrong level of care, potentially leading to higher costs and missed PCP office visits when needed. 

Advantages of text chat for triage

So why is it that people more readily come to Nurse-1-1 with these types of concerns? First, you can safely and privately message our nurses from anywhere! No need to wait until you get home, walk into your bathroom, lock the door, close the window, and make sure that no one is listening before you even think about making the call.🤣😂 Hey, we’ve all been there! Unlike phone calls, no one will know what you are typing even in the most crowded of places (re: 🚃🚎🏢). Also, patients have a sense of anonymity on Nurse-1-1 — we only ask for a first name, an email, an age range, and a gender. As the patient becomes more comfortable with the nurse in the chat, they feel empowered and in control, allowing them to provide more information. 

Probably the biggest reason that breaks down barriers… the way Nurse-1-1 has implemented text messaging. A 2012 study out of the Institute for Social Research at the University of Michigan suggested people are more likely to disclose sensitive information via text than they are over the phone. This is right in line with our experience on Nurse-1-1, texting a trusted nurse, on your terms, creates a safe space unlike any other. It doesn’t hurt that our national network of nurses are highly experienced and carefully selected based on their ability to communicate compassionately through live text chat. 

Why should providers and health plans like you care if patients share sensitive concerns associated with sexual and gender-related health on Nurse-1-1? 

How text chat triage benefits population health

If you are a provider, payer, or a mix of the two, chances are your patients’ sexual health concerns are not being met. As a payer, you are risking your patients postponing care and creating higher healthcare costs down the road (think unnecessary ED visits 😕 for difficulty urinating, pregnancy tests, or erectile dysfunction). As a provider, you may be missing crucial patient traffic that is instead visiting your competing locations since they didn’t have the right outlet to ask you about their personal concern. When is the last time you considered the way your patients step into your virtual doors? It might be time to innovate your offering and reach your patients on a more 21st century level. 

If you’re part of a population health management team, whether as a payer, provider, or public health department, then we need to talk! This discrepancy above clearly shows Nurse-1-1 can have large scale impact on a public health level potentially never seen before. We are already serving thousands of patients across the country who are turning to us for their sensitive questions! Let’s find a way to work together and narrow crucial health disparities by building a network patients never have to feel embarrassed about contacting! 

Learn more at and reach out to us below!

CirrusMD vs. Nurse-1-1 | Product Comparison


Choosing a virtual care solution is a critical decision for health plans. While there are many options out there, in this article we’ll help you understand the difference between CirrusMD and Nurse-1-1.  A quick summary—you probably can’t go wrong with either option. Both CirrusMD and Nurse-1-1 are focused on offering health plan members a seamless virtual care solution that empowers them to make better healthcare decisions. Let’s first focus on what they both offer.

Chat-first approach

Both CirrusMD and Nurse-1-1 offer virtual care experiences with easy, chat-first services. Texting allows your members to access care wherever they are, without having to find a private place to make a call or to be presentable enough to have a video chat on camera. Text also allows members to send photos that can’t be sent over the phone or may be hard to share on a video chat. 

Chat is asynchronous in its form of communication. It allows both your members and the provider to share information after thinking about it longer than one would while in a phone call or video call. Pauses in text-based chat are expected, while pausing and thinking about an answer on a phone or video call can create an awkward silence that leaves your members questioning the information they are being given.  

Personal touch with live healthcare professionals

Both CirrusMD and Nurse-1-1 connect people to a healthcare provider in seconds with secure and HIPAA-compliant websites and apps. 

Allowing people to live chat with a healthcare professional creates a real conversation that influences proper decision making. While bots typically end with a few recommendations for your members, both CirrusMD and Nurse-1-1 will continue the conversation until there is reassurance and an understanding in the recommendation that is given. This requires empathy, compassion, trust, and influence that only a live experienced healthcare professional can bring. 

Built-in Provider Networks

Both CirrusMD and Nurse-1-1 offer their own networks of expert providers who can chat with your members if you do not have the capacity or the providers available to support your virtual care solution. Both CirusMD and Nurse-1-1 are also both flexible to also allow you to integrate with your own provider network or call center if that is preferred. 

ED Diversions

Studies have shown that up to 71% of ED visits are unnecessary, avoidable. One study showed that nurses at telephone triage call centers prevented 2 out of every 3 ER visits or 1 ER visit out of 7 calls. Another study reported a cost reduction of £4,520,000 (USD $5,571,962) from reduced ambulance dispatch. And yet another study reported a 38% reduction in primary care appointments and a 23% reduction in home visits

Furthermore, another study reported a reduction in workload of 54% compared with the previous 3 months and that nurses were able to handle 26% of requests for GP appointments by telephone, whereas another study reported a 39% reduction in demand 

The data strongly supports the use of nurses and advice lines to help patients make proper use of a healthcare service that ultimately reduces costs drastically. 

Improved access to care

Both CirrusMD and Nurse-1-1 allow your members to chat without making appointments. Your members are connected 24/7 whenever they have a question or are making an important healthcare decision. 

With no appointments necessary and no need to find a private place to talk, care can truly happen from anywhere. When conversation isn’t time bound, your members share information and providers ask questions more completely, delivering more confident diagnoses and care guidance.

With both CirrusMD and Nurse-1-1, your members do not pay for the service. CirrusMD and Nurse-1-1 are cost-free solutions for your members. The cost is handled by the entity offering the solution (like an employer group, health plan, university, community health program, etc.) And these groups find it to be cost effective vs. the alternatives. Compared to other telemedicine solutions, this approach is almost completely unheard of in this industry. 

A few ways CirrusMD and Nurse-1-1 may differ in their approach

Integration with existing Urgent Care, Primary Care, and Hospital Systems

Nurse-1-1 has partnerships with urgent care clinics and primary care, and is working with hospital systems to leverage its platform. The industry trend is for payers and providers to work together to offer the proper value to members and patients. Nurse-1-1 recognizes this strategy and has created a platform that works with both types of entities. Providers use Nurse-1-1 to provide patients with an improved experience and keep patients in-network and out of emergency rooms when it isn’t necessary.  

By offering its service to both providers and payers, Nurse-1-1 ensures all parties who share the cost burden to offer care to members and work together in an integrated solution. 

Starting with a Google Search

Patients start their journey with a Google search. Google receives more than 1 billion health questions every day. Yeah, ONE BILLION with a “B”.  That is 70,000 each minute! These are your members who turn first to Google and sites like WebMD. These searches that increase anxiety. Nurse-1-1 offers a solution to intervene at this stage, and influence patients away from making irrational and expensive healthcare decisions.   

You need to be where your patients are as they start their illness journeys. Being present as early as possible in this journey allows you to foster these relationships and exert the most influence in their decision-making process. Nurse-1-1 actively conducts local outreach campaigns to target nearby patients as they search for answers. The offer to simply “chat with a nurse” for free, is a low-friction no brainer for them. We frequently engage your members at the moment they need you the most. Our smart routing can then filter and route the appropriate patients and concerns to nurses who can help. 


Text-based approaches allow this level of care to scale, as it fits perfectly into most providers’ workflows. Nurse-1-1’s approach of providing health information without the overhead of telemedicine services allows its service to operate at a fraction of the price of other platforms. Nurse-1-1 is FREE to your members. The cost to your organization is only $12.50 per member chat session. Many third party call centers charge $20 to $30, and most telemedicine services charge $40 to $100 for a video consultation, while still charging the patient an additional fee. Nurse-1-1’s $12.50 price point is a much better deal, while offering the exact service your organization and members need.

We are always interested in talking to progressive organizations about how we can help improve member experience while also cutting costs.  If this sounds interesting, please reach out.  We’d love to tell you more!