School nurses are dealing with problems never addressed before

Sara Wojcik, RN, and nurse in the Amherst School District said she is speaking on behalf of school nurses in the communities to share an updated picture of what school nursing involves.

“Gone are the days when a school nurse’s role was limited to maintaining health records, applying band-aids and checking vision,” she said.

Relative to evolving patterns of family dynamics, educational laws, society at large and children’s health issues, the role of the school nurse has become increasingly complex. Children with myriad chronic health and psycho-social problems are now attending school.

Additionally, fewer stay-at-home moms in today’s society often results in children with transient illness and injuries returning to school before they are fully recovered, Wojcik said. Consequently, school nurses frequently need to “pick up the loose ends” and act as liaisons between parents or physicians and school administrators, teachers and social workers.

“The objective of school nursing is to promote the optimum health and well-being of individual students and the overall school population, so that students are prepared to learn,” she said. “Promoting optimum heath for students with physical disabilities may necessitate catheterizations, tube feedings and respiratory treatments at school.”

Students with chronic, potentially fatal conditions such as asthma, diabetes, food and bee sting allergies, metabolic and digestive disorders, cystic fibrosis, cancer, and cardiac anomalies require skilled assessment and management, which can be provided only by a healthcare professional.

Health office medication cupboards are filled with asthma inhalers, epinephrine and Benadryl for allergic reactions, glucose monitors, insulin and glycogen for diabetics, plus the occasional Ritalin for Attention Deficit Hyperactive Disorder, antibiotics, medication for migraine headaches and lactose intolerance, and assorted other medications.

“An important aspect of medication administration is monitoring for effectiveness and side effects, which requires skilled nursing assessment,” she added.

School nurses educate teaching staff and food service workers regarding infection control practices and dietary restrictions of students. Nurses also share information with parents regarding infectious illnesses in the school, and we frequently advise parents concerning medical follow-up care for illnesses and injuries.

Health office screening procedures for vision and hearing deficits and scoliosis (spine curvature) often detect problems that could severely impact a

child’s learning and development. Skilled nursing assessments of children’s complaints sometimes discover health problems of which parents were previously unaware.

“At middle school and high school levels, school nurses deal with eating disorders, teen pregnancy, suicide attempts, anxiety and relationship issues, injuries from fights and sports/physical education-related injuries,” she said. “In elementary schools, where students’ verbal skills are less developed, nurses often need to employ detective talents to decipher the meaning of vague complaints. Students at every grade level benefit from the presence of a school nurse to assess illnesses and injuries and initiate appropriate care.”

Wojcik added, “Every school health office is a first aid station and a safe haven where students and staff seek assistance with an infinite variety of physical and emotional health issues. School nurses must be prepared to respond to problems ranging in severity from loose teeth, hangnails and bruises to major lacerations, bone fractures, appendicitis, head injuries, heart attacks, emotional crises and child abuse.”

She said nurses sometimes feel “lost” in a sea of educators, but their goal is to use our skills to make a positive contribution to every child’s life and school experience.