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Coming into this project, I had the preconceived notion that being a school nurse meant that you would oversee happy children, take care of kids with upset stomachs or runny noses, and work the dream schedule of no weekends or holidays. While the schedule of a school nurse is pretty great, a little time spent in the little room designated as the school nurse’s office can open the minds of others, to another side of the job that they never knew existed.
Who is the nurse responsible for? What is the nurse responsible for? What challenges face a school nurse? The role of a school nurse is complex, and understanding that role, eliminates the misconceptions that many have about that role.
School nurses are key to improving children and young people’s health and well-being by delivering health promotion, providing health advice, signposting to other services, active treatment, education, family support, protection, safeguarding, service coordination and multi-agency work. There are five elementary schools within Riverton.
Nurse Trish, (as she likes to be called) is responsible for three of them. That’s roughly seven hundred kids that she is responsible for daily. Nurse Trish also sees over the faculty that works in these schools. She directs the care and medication administration to the students, does the vision and hearing screenings for all the kids, and gives health promotion education to the staff and students.
Nurse Trish also keeps storage totes of clothing for all weather situations and food bags for those kids that may not have options on the weekends.
She works closely with Special Education, spending 13-16% of her time with these kids. This of course involves impeccable record keeping on stats, 504 plans, and specialized care plans. This is all required in order to receive funding from Special Education grants. There is a computer program that the nurse utilizes for documentation and medication administration, but every student also has a paper chart that is kept up to date in cases of technology failure or emergencies. Trish is certified in trauma triage training, the stop the bleed program, and participates in cultural awareness training.
Nurse Trish had an unusual number of student visits during my time with her. From sore throats, upset stomachs, and a few bloody noses, the kids kept her on her toes. They also required countless reassurances, that there would not be replacing their beloved nurse Trish. Miss Anna was one of the featured artists that adorned the wall of the nurses office. She had a history of multiple visits to the nurse in the past few weeks. Today she complained of abdominal pain. Anna had recently been on vacation with her family, which consisted of her mom, dad, and siblings, and Anna has a great home support system. Brayden, had been seen earlier for a nose bleed and now was brought from his teacher due to his inability to keep focused in class.
Brayden is an autistic student who lives with his dad. He used to live with his mom, but due to bed bugs he moved to his dad’s house. Brayden is focused on wanting contacts because his glasses hurt his nose. During the assessment, it is difficult to get him to focus on questions and not on contacts. The complexity of differences in these students needs, is something the nurse deals with every day. Finding creative ways to gather vital information in these cases, can be a crucial art that any nurse should obtain.
The list of barriers that Trish’s faces are mostly focused on psychosocial aspects. The highest priority would be the kids that attend her school, that don’t have their basic needs met. One of her students is a type one diabetic whose parents are alcoholics so her diabetes isn’t controlled. There is a complication with parents who do too much and those that don’t do enough. Trish has made it her mission to implement school programs that can help to provide these kids with access to hygiene products, clothing, and food. The staff and her have also assisted with contributing to finances for emergency dental care for the children whose families couldn’t afford it.
Doing these things help eliminate the kids worries and lets them focus more on their time in the classroom. Trish is the advocate for all the children, even in times she provides from her own pockets. Trish faces a heavy workload, cultural considerations, an enormous amount of paperwork, health screenings, health promotion education, medication administration, and the overall health and well being of those inside the school and families outside of the school. In conclusion, the roles of nursing vary in specialties and facilities. The school nurse role requires someone that can juggle many hats and tasks while still wearing a smile. The role is not easy to define.
They are the first line of defense in school emergencies and everyone in the building looks to them for their response to situations. The nurse is the leader that coordinates all the health care and training. They address the physical, mental, emotional, and social health needs. Nurse Trish works hard to advocate for her students when they may not be able to advocate for themselves or have someone that will. She copes with the problems caused by cultural disparities, poverty, broken homes, substance abuse, domestic violence, and abuse. The well being and success of the children are her focus even with these barriers.
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