This afternoon's meeting has to be rescheduled because our nurse is out sick and I prefer to wait for her return. She and I had chatted about the approach for this meeting and she mentioned that she had already spoken to DD's teacher and the student teacher, but she thought it would be helpful for all of us be in the same room, confirm that we are all on the same page, and reassure DD as well. Our nurse is open to whatever signal DD wants to use -- her main concern is that DD be safe -- so she wants it to be something that differentiates DD from other kids raising their hand, etc. The suggestions here have been really helpful. DD has waffled back and forth a bit. Right now she wants to have a card that says "nurse" at her desk, but use the "L" signal in gym class, on the playground, or when she might be in a different classroom, and not have the card with her. I'd just as soon forget about the card -- but I also don't see why she can't do both. I'm planning on her having that "L" be something she can signal to me for other times, as well. Thanks all!