Column: What your school nurse really does

(Wicked Local) As we prepare for a new academic year, I want to introduce the school nurse. As a school nurse for 12 years, I have heard comments ranging from, “Oh that must be fun, taking care of boo-boos all day,” to “Oh. you have to deal with lice.”

While we do take care of minor cuts and scrapes, and we do educate about lice, we do much more.

For years, when I told people I was a school nurse, I mentioned also the fact that I had worked at Beth Israel Deaconess Medical Center for years. This I threw in to prove my worth; that I was a “real” nurse. I no longer feel the need to do that. I am now more inclined to mention how much I love my job, how challenged I can be by it, how isolated a job it can be, especially in an emergency when we are alone in making an assessment. Unlike the hospital, there is not a team of experts available for consult or to spring into action.

I want parents to feel comfortable with their school nurses. I want them to understand what we do, because I think it will ease their worries to know that a full-time nurse is at their school. I want them to know when to keep their sick children home, and I want them to know what responsibilities school nurses have. Until parents need the school nurse, they don’t typically think too much about her.

You know the school nurse. You stop into the health office each September and bring updated immunizations or physical exams. You may get a call from her when Johnny is not feeling well, has a fever and needs to go home, or a letter reminding you that scoliosis screening is about to be done, or recall that letter you receive every October about “when to keep your child home from school.”

But you don’t really know the school nurse. What else does she really do anyway?

I’m so glad you asked.

In September, she checks all the new students’ immunization records to be sure they are complete. Compliance with the immunizations is a state mandate, and necessary to keep preventable diseases from impacting our children. She reviews medical records and meets with families if their child has a medical condition. She obtains medication orders and administers those medications when necessary. She discusses with parents the specifics of their child’s illness, and creates an individual health care plan when needed.

Virtually every visit from a student involves an element of health education, as do many conversations with parents: from lice to head bumps, signs of strep, when to consult a physician, and when to keep a child home. She also educates staff about basic first aid for choking, when not to move an injured student, standard precautions, or about using the Epi-Pen.

The daily student visits require assessment and care. She takes care of all of the students at your school. She calls parents when they are sick and need to go home, but she does her best to treat them at school: comfort, console, counsel, feed, listen to, advocate for, or whatever else it takes to help them so that they can return to class and be available to learn.

She performs the state-mandated screenings — vision, hearing, height and weight, scoliosis — and refers students on to their health care provider when necessary.

She maintains up-to-date and accurate medical files.

She is involved in preparation for field trips. This includes gathering medications that may be necessary to have on the trip for particular students.

The school nurse is an integral part of the disaster planning team at school, collaborating in the planning and practicing lockdowns, evacuations and medical drills.

She maintains public health through immunization compliance and doing surveillance as necessary during illness outbreaks — keeping school, families and public health departments aware of issues of concern.

The school nurse is involved in mental health aspects of the student’s lives, often working with the parents, the psychologist or guidance counselors regarding concerns such as anxiety, depression, school stress or bullying.

The school nurse does all of this with a commitment to confidentiality. She works with parents to determine who needs to know certain information and shares information with those who “need to know” and reminds staff about confidentiality.

There are many layers to school nursing. It is a job that is often unpredictable, which makes   planning and preparation so important. The bottom line is the health, safety and wellbeing of every child. Keeping students safe and healthy so that they are available to learn is the goal of every school nurse. The rewards are as numerous as the students themselves.

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