Opinion: What doesn’t the school nurse do?
To the editor:
“School nursing is ER nursing without the staff and supplies,” said one of the nurses on my first day of shadowing at Dartmouth Middle School. I laughed at this statement in my head. How hard could school nursing be? I would be handing out ice packs, band-aids, and treating headaches… or so I thought.
I am a senior nursing student at the UMass Dartmouth — part of my pediatric clinical is to spend time in a school setting with a nurse. I was assigned to my former school, Dartmouth Middle School. I met both nurses on my first day and wondered why there were two school nurses. Doesn’t a school only need one nurse? How busy was this place? By the end of the day, I was asking myself why there weren't three of them.
As a school nurse, you are not just a nurse. In addition to the standard care nurses provide like assessing, diagnosing, planning, implementing, and evaluating, nurses also provide social support, emotional support, counseling, and education. They communicate with students, faculty, parents, and health care providers. They manage medications for all students and must remain up to date on doctors’ orders. They manage chronic conditions such as diabetes, seizures, asthma, cardiac conditions, ADHD, and those that require G-tube feedings. The middle school currently has four diabetics on continuous monitors that the nurses must watch throughout the school day. They provide constant care for these students and must remain vigilant. When students do not show up when they are supposed to, the nurses must be two steps ahead of the game and be ready to call the student to the office.
In addition to these many tasks, they also deal with piles and piles and PILES of paperwork. They are in charge of filing paperwork in students’ charts such as health forms, physical education notes, doctor’s notes, and absence notes. They must also document every child they see throughout the day. This includes the student, the time they visited the office, what they presented with, and what the treatment was. When there are an average of 50-75 students visiting the health office each day, it can be a daunting task to keep track of who, what, where, when, and why.
With the addition of Covid-19, these tasks become much harder. Students and symptoms, positive cases, potential cases, close contacts, and contact tracing are other things the nurses must manage and monitor.
With all these things in mind, nurses must provide screenings to students. The nurses test all middle school students for scoliosis which takes anywhere between 2-4 weeks due to the logistics. They also screen all 7th grade students for BMI, vision and hearing, and Screening Brief Intervention and Referral to Treatment (SBIRT) — a drug and alcohol screening that typically takes two days to complete.
While being a school nurse, you must keep your certifications and licenses up to date. Registered nurses must complete 15 continuing education units (CEUs) every two years through Massachusetts. School nurses must maintain an educator’s license through the Department of Elementary and Secondary Education which entails completing 75 CEUs. If the nurse has their National School Nurse Certification, they must complete 150 professional development points every five years.
As you can see, school nursing is certainly NOT just Band-Aids, ice packs, and headaches. It entails much more than just those things and requires two very knowledgeable, organized, helpful, and caring individuals.
Many people overlook school nurses, but from what I have seen, these two nurses deserve all the credit in the world. They are extremely hard workers that deal with any problem thrown their way.