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Penny Warner, RN, handled crises as a critical care nurse at Memorial Hermann Memorial City Hospital. She took charge of the Fort Bend, Texas, hospital’s Hurricane Rita evacuation, scrutinized policies and practices with a fine-toothed and got the bugs out of systems as Joint Commission coordinator and patient safety officer.

Today, as the founder of the Missouri City-based Texas Lice Squad, Warner is literally nit-picking – scouring clients’ hair with a fine-tooth comb, administering non-toxic treatments and delivering a solid dose of patient education. Missouri City is a Houston suburb.

“It sounds strange, but this is the most rewarding thing I’ve ever done,” she says. “People are so glad I’m there, I see their stress go down. An infestation is a family crisis that’s emotionally devastating, but you don’t understand until you go through it.”

Her first personal experience was when her elder daughter got head lice at a slumber party. Four years later, both daughters were infested at summer camp.

“For two months, we thought the itchiness was from pool chemicals,” she says. “It was a nightmare come true, and my husband and I both got it.”

Although one in four children get head lice, people don’t discuss it, fearing they’ll be stigmatized as dirty, lazy or bad parents. That silence and failure to alert others perpetuates the problem.

“Fifty percent of what I do is patient education. As a nurse I’m more credible with everything evidenced-based on research articles, so I get better compliance,” she says. “You can’t get lice from pets. Ninety-nine point nine percent is from direct contact, usually children. Lice die within 24 hours of dropping off. It’s a misconception that they live in your house, school or car.”

Getting lice is easy; getting rid of them is not. “They’re more prevalent now because 80 percent of adult lice have become resistant to everything on the market and in drugstores,” says Warner. Worse, most treatments are neurotoxins that are harmless to lice eggs.

“You’re directed to leave them on for eight to 12 hours, although they’re very flammable, and some families end up in the ED with malathion poisoning,” she says.

The first key to her treatment protocol is a non-toxic enzyme solution that softens the “glue” that anchors eggs, followed by use of a micro-grooved comb designed to catch lice. Families are advised to follow-up with weekly inspections to catch new infestations and to use a deterrent mint spray daily.

Diligence is essential since one female can lay 300 eggs. Warner has combed out clients after they’ve tried other treatments, removing hundreds of lice and nits they left behind.
“One non-compliant client was a physician who didn’t follow through on a five-minute maintenance program or use the spray,” she says. “She was busy and thought the crisis was past, but it’s never past while kids are in school. When they returned two months later, it took five hours to comb out her daughter.”

In 2006, Warner asked her daughters if they’d be embarrassed if she started the business, discussed family experiences, and put magnetic signs on the family car.
“They think it’s really cool,” she says.

So do clients, who come from across Texas. One family flew her to Alabama, another called from abroad to book her six months before their U.S. visit. “Most are word-of mouth,” she says, “and when word got out, business exploded.”

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Wendy L. Bonifazi, RN, CLS, APR, is a senior staff writer for NurseWeek magazine. To comment on this article e-mail editorSC@nurseweek.com.

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