Get Healthy: Public school nurses: What don't they do?

This column addresses topics related to the health of our community.

Q: What is the role of nurses in the public schools?

A: The primary role of a school nurse is to support student learning. This is accomplished through a number of strategies and duties, including:

• Health Services: Provide nursing care

• Health Education: For students, staff and parents

• Healthy Environment: Identify health and safety concerns on campus

• Nutrition: Support healthy food programs

• Physical Education (PE): Promote healthy PE and sports policies and practices

• Counseling: Provide health counseling and assess mental health needs, interventions and referrals

• Parent/Community Involvement: Promote community involvement in assuring a healthy school

• Staff Wellness: Provide health education and counseling

SPECIALTY

School nursing is recognized as a specialty nursing area. The National Association of School Nurses recommends that all school nurses have a minimum of a baccalaureate degree and School Nurse Certification. In Carson City, the majority of the schools have a nurse and they have experience in pediatric, public health and mental health nursing.

HISTORY

The idea of school nurses may seem odd to some who are not-so-young. Many of us never benefited from having a school nurse at our elementary, middle or high school. But the passing of P.L. 94-192 in 1975 began a new era for school nursing. This is the law that required the mainstreaming of physically and mentally challenged students into the general student population.

In 1999, the Supreme Court ruled on the Individuals with Disabilities Act (IDEA), which affirmed that nursing services must be provided by school districts for students needing nursing care. This meant a lot more than applying Band-Aids and taking temperatures. It meant that school nurses were to provide nursing assessments for special education students as well as deliver procedures such as gastronomy tube feedings, clean intermittent catheterizations, tracheostomy care and more to students in need.

TYPICAL DAY OF A CARSON CITY SCHOOL NURSE

School nurses' days are "packed," according to Sheila Story, RN, chief nurse of Carson City School District. Any or all of the following activities are part of a school nurse's typical day.

Often, even before the first bell rings, students start filing into the Student Health Center. School nurses see a minimum of 30 students a day to handle various complaints, such as stomach aches, ear aches, sore throats, headaches or injuries.

Each day, students requiring prescribed medications during school hours must go through the school nurse, who is required to have a signed medical order from the student's physician. School nurses dispense three kinds of medications:

• Scheduled, to be taken at the same time each day

• PRN, to be taken as needed, e.g., for asthma or seizures

• Short Term, such as antibiotics needed for a week or so

Injuries occur daily and they range from minor scrapes to broken bones. Fractures are taken seriously and the student is often treated for shock until the parent arrives to transport them to a medical facility. That means the nurse elevates their legs, covers them with a blanket and monitors their vital signs (pulse, respirations, blood/pressure, temperature, oxygen saturation).

Often, students are mentally or emotionally exhausted and need reassurance and support. At the high school, it is not unusual for students to come into the health office with questions and concerns regarding risky behaviors, growth and development, along with women's health issues. School nurses help students get through the day, one day at a time, and often refer them to other professionals.

Each school has medically fragile students who require daily medical procedures, such as tube feeding, tracheostomy care, or catheterization. Students with diabetes need insulin; students with asthma need inhalers, and there is also a good deal of emergency seizure medication dispensed. All medically fragile students require close daily monitoring, which could include assessing vital signs, checking blood sugars for diabetics, checking lung sounds for an asthma attack or implementing seizure precautionary measures, just to name a few.

Throughout the course of the school year, school nurses are also required by law to oversee immunization compliance, perform health screenings, and collect body mass index (BMI) data. The Carson City School District offers immunizations to certain children who are eligible to keep them compliant with their vaccinations. Health screenings are conducted yearly for two grade levels in elementary school, one grade level for middle and one for high school.

"Our goal is to make sure the students feel safe and healthy while at school so that they can be academically successful, according to their ability," says Story. "We try to provide whatever they need to stay in school. Yes, our days are packed."

The services offered through the school district are well supported by Dr. Susan Pintar, the County Health Officer; Dr. David Johnson with Job's Peak Primary Care and Dr. Stuart Stoloff Family Medicine. Sheila Story adds, "We greatly appreciate their help, knowledge and support."

CLINICS

WHERE: Carson City Health and Human Services, 900 East Long St., Carson City

CALL: 775-887-2190

WHAT: Clinics by appointment

WHEN: 9 a.m. to 4 p.m. Monday-Wednesday and Friday.

WHAT: Immunization Day

WHEN: 8:30 a.m. to 11:30 a.m.; 1 p.m. to 4:30 p.m. Thursdays. No appointment needed

On the Web:

www.gethealthycarsoncity.org.

Visit us on Facebook.

WHOOPING COUGH EPIDEMIC IN CALIFORNIA

In neighboring California, confirmed cases of whooping cough, or pertussis, is now four times that of last year. Local health officials encourage Tdap boosters for any adult up to 64 years of age that is in close contact with an infant. Whooping cough boosters for adults and vaccine for infants is available at Carson City Health and Human Services.

• Pam Graber is the public information officer, Carson City Health and Human Services 775-283-7906 pgraber@carson.org.