Recently, school nurses have been given a lot of recognition from the media, including AJN (here’s the most recent post, which contains links to several others). I was really happy to see them finally getting the credit they deserve. I was a school nurse for a while and I know firsthand how often they are taken for granted.
The first year, I worked for the New York City Department of Health as a per diem nurse, going to a different school almost every day to fill in for nurses that were out for the day. The following year I worked full-time at a school for the NYC Department of Education. (Department of Health nurses take care of mainstream students and Department of Education nurses are placed in schools to care for children with special needs.) I couldn’t believe how poorly I was treated by administration, students, and teaching staff. I quickly realized that school nurses were considered to be either glorified Band-Aid distributors or the place where children went to avoid classes they didn’t enjoy.
One time I was sent to a school for the Department of Education and their full-time Department of Health nurse was also there. She informed me that the principal of the school insisted that the nurse ask for permission to call 911 if a student had a medical emergency.
Children often quipped that all nurses can do is apply ice to injuries. I understand why they said this, because it was a common occurrence, as were warm compresses and cups of tea.
But there was also a lot more. My regulars included a gastric tube feed, straight catheterization, multiple asthma treatments, glucose monitoring, and psychotropic medication administration.
Then there was the case finding. One severely depressed student began psychotherapy based on my recommendation. Another student with a long history of truancy was moved from an intolerable home environment with one parent to a more stable environment with the other parent based on a consultation I had with the attendance monitor. I also had to call 911 numerous times for various head injuries, asthma exacerbations of children who didn’t keep albuterol inhalers at the school, and one time for a teacher who collapsed on the floor.
I’m sure there are many other stories out there just like this. School nurses are an incredibly valuable resource for promoting the health of both children and staff through case finding, ensuring environmental safety, infection control—anybody in the education system who is unwilling to take advantage of this resource is doing a major injustice to the students, parents, and community.
–Christine Moffa, MS, RN, AJN clinical editor