School is back in session, so that means school nurses are again seeing students and their various afflictions and medical needs. But life as a school nurse is much more than tending to scraped knees and tummyaches and passing out medication.
Pam McCarthy’s son is living proof that the role of school nurse is more than sitting around all day passing out medicine.
Having registered nurse Teresa Elmore at Glenwood High School saved the life of McCarthy’s now 16-year-old son, she said.
“My son wasn’t feeling good and went to see the nurse near the end of the day. She asked all the right questions and immediately took his blood pressure,” McCarthy said.
“His blood pressure was so high for a child his age that she immediately called 9-1-1. They transported him to the hospital by ambulance. It really scares me to think about that day if she hadn’t been there for my son.”
Elmore, who is starting her second year as a school nurse at Glenwood, sees 100 to 120 students daily at the high school of more than 1,000 students. While she must be on the outlook for acute emergencies, she’s also busy with routine duties.
Students with chronic medical conditions need to have medications administered. Diabetics have their blood sugar levels checked throughout the day. Students with emergency conditions have sought Elmore for help with dislocated knees, broken bones and lacerations that needed stitches.
“Most people don’t understand how many kids you really see. A lot of kids will come to you first,” said Elmore, who worked at the Springfield Diabetes & Endocrine Center for four years.
“Parents, instead of going to a doctor, they’ll say, ‘Go see the nurse and see what she says.’ You kind of have to triage and see what’s really wrong. Is it something that they need to go to the doctor for? A lot of parents will send students to us first.”
Throughout the more than 100 years since school nursing began in New York City, nurses such as Elmore have worked the health front lines with a common goal: to help children stay healthy so they can learn at school.
“It is interesting to note how little school nursing has changed over the years,” stated the National School Nurse Partnership,
A firm foundation
The school-nursing practice launched on Oct. 1, 1902, when nurse Lina Rogers Struthers was assigned to serve four schools with 10,000 students in lower Manhattan as an experiment to see if school nurses could improve school attendance and children’s health, according to the National School Nurse Partnership.
Struthers wrote about that first year in her book “The School Nurse,” published in 1917:
“An hour was devoted daily in each school to treatment of minor contagious diseases, such as ringworm, scabies, impetigo, and such conditions as inflamed eyes and discharging ears, to dressing sores, cuts and infected wounds, and to the inculcation of the oft-repeated lesson of personal cleanliness in the constant fight against pediculosis (lice infestation).”
There was a 90 percent drop in the absentee rate in the first year of the trial, according to “All Your Scrubs,” a Web site about medical apparel and the medical profession.
“The experiment was so successful, however, that the school board several months later began to supply funds and assigned nurses to more schools, totaling 27 nurses within six months,” stated the National School Nurse Partnership.
Struthers’ work in reducing school absenteeism due to communicable diseases led to
the employment of school nurses in New York City and across the United States.
Today, there are 66,171 school nurses in the country in public and private schools and other school health services, according to “The Condition of Education (2009),” a publication of the U.S. Department of Education, National Center for Education Statistics.
According to the Illinois State Board of Education, schools in the Land of Lincoln
employ 989 nurses (although some may not be working full-time). In 1999, there were 926 school nurses in the state.
Nursing in central Illinois
Nursing supervision and education of staff are keys to maintaining a good educational “health atmosphere” so that students can get the best education, said Pam Powell, RN, school nurse for 17 years for Auburn Community Unit District 10.
Powell said several of the district’s roughly 1,560 students require supervision for ailments including asthma, diabetes and allergies (such as those to peanuts, latex or bee stings).
For example, 11 district students have allergies requiring the use of EpiPen, a prescribed emergency treatment for life-threatening allergic reactions. Six students have diabetes.
“They come and get their blood sugar checked. Depending on what the situation is with the doctor’s orders, some get insulin, some don’t get insulin,” said Powell, who serves Auburn Elementary School in the morning and Auburn’s middle and high schools in the afternoon. Glenda Grider, RN, the district’s other nurse, serves Auburn Junior High at Divernon/Divernon Elementary School in the morning and Auburn Elementary in the afternoon.
Powell says she trains the staff how to administer the EpiPen because “they’re the ones that have the students in the classrooms. They see how they are acting and may be the first ones to see or identify any problems.”
Powell also keeps the staff informed of students’ medical issues and trains them in CPR (cardiopulmonary resuscitation) and an AED (automated external defibrillator that has a built-in heart rhythm analyzer). There are also preventative measures to conduct, including screenings for lice, hearing and vision.
Powell also helps students with stomachaches, vomiting, headaches, rashes, pink eye, fever, earaches, bloody noses, dental infections, fractures, lacerations, knocked-out teeth and concussions.
“As far as the students go, I think a big plus is helping educate them in a lot of their medical (care). I always explain to kids what we’re doing and why. I always encourage the strength in kids. Don’t enable them. Don’t baby them,” said Powell, who has been a nurse for 29 years.
“Somebody comes in covered with blood and hysterical, I feel good knowing that they’re leaving calmed down and understanding what we did and why.”
Plus, students have to understand that their job is to be in school to learn. Faking illness to get out of class doesn’t get students very far with Powell.
“They very rarely come down and fake throwing up anymore because I make them blow in my face (to check for vomiting aroma.). They know that. There’s no way you can hide that,” Powell said.
As a school nurse, Powell must report anything suspicious that threatens a student’s safety. There have been calls to the state Department of Children & Family Services.
“One little girl who was a confirmed DCFS situation ended up getting taken out of the home. She laid down here a lot with me when she was sick and we couldn’t locate parents to come get (her),” Powell recalled.
“She always remembers those times. She was like, ‘Remember, Mrs. Powell? I laid down here with the fever?’ I thought, ‘Boy, if this is the high point of her life, how sad.’ ”
Keeping track of work
School nursing involves a lot of record keeping and paperwork, Powell and Elmore said — everything from recording when students have physical exams to keeping up with immunizations and whether students have had eye or dental exams.
Elmore began work two weeks before school started at Glenwood, making sure required physical exams and immunizations were filed.
People wondered about that.
“Most people will go, ‘Two weeks before school starts? Do you have enough to do?’ My gosh, yes,” Elmore said.
The paperwork ensures that school nurses are always busy, Powell said, even if there’s not a line of students at the door waiting to be seen.
“Somebody will walk in, and if there isn’t a student in here, they’ll say, ‘Oh, gee, you don’t have anything to do.’ They get the impression if the room’s empty, there’s nothing to do,” Powell said. “There is tons of paperwork. Everything I do is dictated by parent consent and doctor standing orders.
“You’re always busy.”
Tamara Browning can be reached at (217) 788-1534 or firstname.lastname@example.org.