School nurses: More than a Band-Aid

by: Leslie Bek

It’s been called the worst nursing job you could ever love. Imagine having to care for hundreds or thousands of school children. Imagine going to work knowing that today may be nothing like yesterday and tomorrow needs sixteen hours and you have four. Imagine caring for this job so much you’ve stayed with it for twenty-seven years.
If you have a child enrolled in a local public school, you can begin to imagine. You have seen the letters sent home from your school nurse warning you someone in the classroom has strep throat and what precautions to take. Or you may have read the school nurse’s notes in the regular school building newsletter that include prevention tips for communicable diseases or food allergies.nurse
Transparency: it is a word that has been applied to systems and organizations. The public is calling for transparency in government. Perhaps transparency in our school systems would allow you better to see your school nurse at work.
Let’s wipe off the glass.
The Michigan Association for School Nursing (MASN) has set a School Nursing Agenda for Michigan.
“The focus of the school nursing agenda for Michigan’s children is concerned with meeting the health needs of students in the school setting. By setting standards of care for meeting the health needs of children, school nurses can impact educational outcomes.
“The best health and educational outcomes for students can be reached when all students have access to a school nurse. Minimally, Michigan’s school children should have the opportunity to attend school where policies and procedures reflect current legislative initiatives and health/safety standards.”
According to the National Association of School Nurses:
“School nursing is a specialized practice of professional nursing that advances the well being, academic success and life-long achievement of students.
“To that end, school nurses facilitate positive student responses to normal development; promote health and safety; intervene with actual and potential health problems; provide case management services; and actively collaborate with others to build student and family capacity for adaptation, self management, self advocacy, and learning.”
When it comes to application of these duties, each school nurse has to invent her own job. She must address those tasks that are mandated by the Michigan Department of Education and Department of Community Health. These include activities such as serving on the Sex Education Committee, Safe and Drug Free Schools Committee, teaching sex education, HIV/AIDS awareness, sexual abuse prevention education, tracking down and reporting immunization records. Health assessments are conducted at various grade levels, based on outcomes the school nurse develops, implements and monitors individualized health plans.
The potential for the school nurse as a classroom educator is endless; examples can range from dental health education to a home-alone program. Her prevention and education role also extends to the school building, the district and parents.
These school-based Florence Nightingales respond to the direct needs of their students. They pick nits, treat injuries, supervise medication administration, count carbohydrates with diabetic students, administer insulin, make home visits, write Protective Service referrals for potential abuse and neglect, refer kids to Bay Cliff Health Camp and serve as the nurse for the school’s spring camp at Bay Cliff.
In the policy and planning arena, a school nurse plans and implements school health management protocols for the child with special health needs, including the administration of medication and health treatments. Recommendations are made to help implement modification of school programs to meet individual student’s health needs.
Beyond the school environment, a school nurse coordinates school and community health activities and serves as a liaison person between the home, school and community. A school nurse also will assure that school staff is trained in first aid and CPR and provide health counseling as requested.
Most job descriptions contain the all encompassing statement: All other duties as assigned. For the school nurse, this leaves a very large door wide open.
Requirements to become eligible for a school nurse position in Michigan can include a Registered Nurse license, specific education qualifications, skills and experience preferences. It has been my observation over the past thirty years that there is a special character component that perhaps would be written between the lines of the job description and resume.
Only Angels of Mercy need apply. Angel of Mercy has long been used as an affectionate nickname for a nurse. The Angel of Mercy is believed by some to be one of the first of the Caring Angels. Of all the spirits, this one has to be of extreme compassion, gentleness and has to have love radiating from its very being.
I smile when I think of local school nurses past and present such as Joan Erickson, Rosemary Harrington, Diane Garrett, Jean Gannon, Andrea Korpi, June Laakso, Rhonda Mattila, Rose Moratti, Diane O’Boyle, Carol Romback, Paula Ross and Jeannette Wealton. It is easy to place a face to go along with the Angel of Mercy association.
The school nurse and administration determine which school nurse duties may be delegated to whom, and under what circumstances. Local school nurses are aided by Northern Michigan University student nurses. Placements are made much like the more widely known student teacher program.
Hands down, Marquette County school nurses indicate their greatest asset is the building secretaries. It has been said if you really need something at a school building, check with the custodian or the secretary. In this case, the secretary is the first line of communication between the teacher, student or parent.
Secretaries have knowledge and experience with families and are great at triage—knowing when to call the school nurse or take other actions. In many cases, a “sick” child just needs a smile, a hug and a little encouragement to get through the day.
The professional groups such as MASN provide determination of standards, competencies, advocacy and professional development. Approximately thirty Upper Peninsula school nurses meet annually to receive continuing education, program updates and share experiences.
One of the ongoing challenges facing school nurses is making sure they have a job. As school districts struggle to balance budgets, decision making often falls to whether the service, program or curriculum is mandated by the government and what revenue source is available to cover the costs. As a result, the majority of local school nurse positions have been reduced to part-time status or, in some cases, eliminated.
There are many special people assisting in the education of our children, assuring that the learning environment is safe and each child is ready to learn.
Perhaps the transparency of the role of the school nurse is now clearer to the greater community. You just never know whom you will see if you take a clearer look around.
—Leslie Bek

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