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Nurse of all trades

School nurses help kids learn by keeping them healthy

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Almost everyone knows how important teachers are to education, but there are plenty of other people working to make sure our children develop into well-informed citizens.

There are parents and other family members, child-care providers, tutors, and community volunteers. And there are countless other individuals supporting children from behind the scenes at local schools—iuch as administrators, education specialists, and school nurses.

Most people today can search the recesses of their minds and recall that calm, caring woman—let’s face it, they’re mostly women—who bandaged their boo-boos or called home to tell Mom and Dad they weren’t feeling well.

But school nurses do a lot more than just, as one nurse called it, “Boo-Boo Patrol.”

To even hold the title of school nurse, an individual must be a Registered Nurse (RN) with a minimum of a bachelor’s degree and a certificate in school nursing. People without those qualifications can work at schools, but they have to be supervised by a certified RN.

“I’m always on call for every school day. If there’s an emergency, I need to drop everything and go,” said RN Robyn Turner, the nurse administrator for Orcutt Union School District.

Turner’s main office is at Orcutt Academy High School, but she spends her days visiting each of the district’s eight (and soon to be nine) schools.

Like any school nurse, one of Turner’s main duties is administering mandated health screenings, including vision, dental, hearing, and scoliosis screenings, depending on the grade. She then compiles that data and reports it to the government. When not screening students or attending case meetings, she examines kids who get into fights or fall on the playground, and then makes the appropriate decisions on how to proceed.

“I always tell the [kids with broken bones], ‘I left my Superman X-ray glasses at home, so you really need to go to the hospital and get an X-ray,’” she said with a chuckle.

Most of Turner’s nursing background is in public health. Out of her 30-plus years in the profession, she’s only spent about two of them in an actual hospital.

“I always say I waited 24 years to find the perfect job,” she said. “It doesn’t differ a lot from public health. The setting is different and the mandates are different, but you have to be aware of the public resources available to your families.

“It’s nursing, but it’s low-stress nursing,” she said. “But it’s still really gratifying to make connections in the community.”

One thing’s for sure: School nursing is never boring.

Turner recalled a little boy who was planting a vegetable with his Kindergarten class.

“He was planting peas, and he thought it would be a good idea to put one of those up his nose, and he didn’t tell anyone about it,” she said. “Well, at the end of the day, because of the moisture in his nose, it had expanded. And I got a call asking if I could get it out.”

Using narrow tweezers, she was able to “move it just enough to tickle his nose, and he sneezed it out,” she said. “I still see him [at school], and he smiles when he sees me.”

But things can get considerably more serious than that.

Nurse practitioner Michelle Brooks is the school nurse at Nipomo High School and Oceano Elementary School. She said her background in diagnosis and assessment has really helped her in the school setting.

She recalled a case when a teacher asked her to observe a student who was acting strangely in the classroom.

Upon doing a classroom observation, Brooks said, “I could immediately tell that something was wrong and that this kid wasn’t just fooling around.”

Brooks’ first concern was the student’s safety; she had to rule out the possibility of drug use. After further assessment, it turned out the student had a serious neurological disorder and that was the first time anyone had noticed.

Some of Brooks’ more routine duties include providing her students with mental health and sex education.

“The role of the school nurse, especially at the high school level, takes on a huge counseling component,” said Linda Hogoboom, the head nurse for the Lucia Mar Unified School District and Brooks’ supervisor.

Brooks agreed, adding that getting access to mental health care seems to be difficult for a lot of local families. Luckily, the school district has forged partnerships with Community Health Centers and San Luis Obispo County health services.

As students age, Brooks said, a nurse’s focus tends to shift from mandated screening to “how are you going to prepare for the workforce,” and other issues like peer relationships and body image.

Both Brooks and Hogoboom said budget cuts to education have made addressing students needs more of a challenge.

“This year, we took a hard look and didn’t do vision screening at the 10th grade, which we had been doing,” Hogoboom said, adding that until recently the district was short one nursing position.

“With school nursing, it’s not written into ed code law that you have to have so many nurses per student population,” she continued. “It just says you have to make sure that the kids are safe and that you comply with the mandates.”

Lucia Mar currently has 6.34 nurses for a population of 10,500 students throughout 17 schools. That comes out to a ratio of one nurse for every 1,700 students. The recommended ratio from school nursing advocacy groups is one nurse for every 750 students.

Hogoboom said she’s visited schools in states with better nursing ratios, and the impact is apparent.

“The education you’d be able to do [with a ratio like that]—wow,” she said, explaining that she’d be able to work one-on-one with students in educational workshops on various topics.

“I get excited just thinking about it,” she said.

Amy Asman is managing editor of the Sun, New Times’ sister paper to the south. Contact her at aasman@santamariasun.com.

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