A Time To Honor School Nurses

By Laurie Borst

Newtown Middle School nurse Barbara Reilly reported late last month that there had been 9,737 visits from the 892 students at the middle school so far in the school year. This can be broken down to 7,200 visits for injuries and health issues, 400 hearing screenings, 600 scoliosis screenings, and 1,537 for medications or treatments.

“Each visit is an opportunity to make contact with the students,” said Mrs Reilly. “An opportunity for kindness.

“Today’s middle school nurse has incredible opportunity to make a difference in an adolescent’s life,” she continued. “The Health Office is no longer just a ‘band-aid bank.’”

Issues ranging from common illness, minor injuries, orthopedic issues, dermatology, increasing sexuality, complex medical disorders (diabetes, cerebral palsy, seizure disorders, severe allergic reactions, cardiac), asthma, psychological issues (including but not limited to depression, anxiety, school phobia, ADD, ADHD, family issues, eating disorders) and more are all part of a school nurse’s responsibilities today.

Mrs Reilly has been a nurse since 1970, and a school nurse for 23 years. She started as a substitute nurse. She has been at the middle school for 15 years, full-time since 1996.

One change she has seen in the field is the increase in paperwork. “If you could just take care of the kids…” her voice trailed off as she started to wrap the bruised toe.

With computers, records are safer and better records are kept. Patterns can be identified easily. Teachers can refer to the records, also, and better know and understand their students. Technology helps with communication, also, through emails. Cellphones make it easier to reach parents.

She also spoke of the increase in the complexity of medical needs. As children are mainstreamed as much as possible, there has been an increase in the needs of students. Catheterizations and tube feeding are two specialized procedures routinely done by school nurses that used to only be done in hospitals.

Better diagnosis and identification of conditions, improved technology for diabetics, and better asthma and allergy medications have changed over the years, too.

April 26 was a slow day in the health office as the eighth grade was away on a field trip. Two students were resting in the office, and four more showed up with complaints, including a bruised toe, a temperature and scratchy throat, scraped knees, and a headache, in a 20-minute period.

Mrs Reilly asked the student with the headache, “Did you have lunch yet?” The student said yes, hunger wasn’t the issue, and the nurse provided her with Tylenol.

“There are almost 40 million students age 10–19 in the United States,” Mrs Reilly said. “They are a unique population — not just giant kids or mini adults. They have different needs which require specialized treatment and awareness. Often, they are not respected for acting exactly the way they should for their age and physiology.

“Society tends to be wary of the teenager — they’re not cute and cuddly. It’s hard to warm up to the piercings and pimples at a time when they need the most understanding and respect.”

There are things kids are exposed to today, new situations, pictures, videos, that their bodies and brains are not ready to handle, she added.

“Today’s adolescent school nurse can make a huge difference in the health and well-being of this age group. The nurse will listen. She will teach them to recognize potential problems and where to go for help — how to be responsible for their complex and sometimes scary health needs,” she explained. “You have to recognize the age as one of extreme body-consciousness and learn to speak their language so they can share issues without feeling ashamed or embarrassed.”

Her philosophy is win trust with compassion, humor, boundaries. Be an advocate. “The leading cause of death for teens is accident, suicides, and homicides. A teen who trusts an adult will have a sounding board, someone to share their feelings and issues with.”

Mrs Reilly acknowledged that she could make twice as much in a hospital, but she would not have the opportunity to teach and impact so many young lives.

‘Never Worry Alone’

“It all starts with an environment of caring and fun. Set the scene first with kindness. Give them a place to go that is nonjudgmental or threatening and especially confidential,” she said. “And maintain open communication with parents without breaking that confidentiality.”

The Middle School Health Office motto is, “Never Worry Alone!”

Pat Philipp, Reed Intermediate School’s nurse, echoed many of Mrs Reilly sentiments. Mrs Philipp has spent 35 years in the nursing field. For 15 of those years, she was a surgical nurse in an orthopedic practice. She also worked for regional hospice, then subbed for five years. She has worked at St Rose School and the high school. She has been at Reed as the school nurse since it opened four years ago.

“It’s more than I thought it’d be to begin with,” she explained. “There’s been an increase in the amount of special needs for students who are mainstreamed.”

She likes the Newtown School District’s team approach to care. The nurse, social worker, and guidance offices are situated close together. This helps facilitate communicate between these three groups to take good care of children. Nurses are now considered part of the support staff, which was not so in past. Nurses help students maintain their school day by providing support outside of the “3 R’s.”

Mrs Philipp began her nursing career with a three-year diploma program. After starting as a school nurse, she went back for the bachelor of science degree.

“There are so many different facets of nursing and medicine,” she said. “I learned a lot that I put to use in this job. The job is an opportunity to teach.”

She said she finds this a great age of kids and is very glad she moved into school nursing.

Reed School has about 900 fifth and sixth graders, but their issues are a bit different than at the middle school. At this age, there is very little of the cutting or anorexia issues seen with older students. Some of the youngsters she sees are dealing with divorce or ill parents. She said, sometimes, parents are not aware of the kids’ reactions. “Kids are very sensitive to their parents needs,” she added.

She sees a lot of parents concerned about food allergies. She reports more and more students affected every year. She works with teachers to set up safe clusters for students where known allergens are kept out of the classroom. By this age, the children are old enough to know what they can and cannot eat, she reported.

Mrs Philipp spends a lot of time planning, doing paperwork, and training teachers to use EpiPens. She said there is a lot time spent on background for some of the health problems she handles.

As of April 26, Mrs Philipp had 4,605 total visits. Seventeen hundred of those were state-required screenings. All fifth graders receive vision, hearing, and scoliosis screenings. Sixth graders must have a physical performed by their physician. If the screenings were not done during the physical, the school nurse will do them.

A few years back, Newtown Middle School created a brochure, “101 Things a Newtown School Nurse Does.” Some of the 101 things students listed that the school nurse does for them include: gives you a Band-Aid when your binder bites you, has a sense of humor, talks with you, explains about all that teenage stuff, teaches about healthy foods and exercise, is a friend, helps you when you want to jump off a roof, helps get stuck rings off fingers, helps you with your blood sugar, respects us, always learning new things, keeps your confidence, doesn’t make a face if you throw up, is the one who cares for you like a mom at school. They are school nurses…They can do anything!