School nurses don’t just dole out bandages and aspirin anymore. Public schools are seeing more children with special needs, chronic conditions that have been diagnosed and disabilities that require attention from time to time. Moreover, forty million citizens of the United States are without health insurance today and many of those are children. It is common for the school nurse to be the only health care professional with which a child has contact, especially in poorer neighborhoods.
Children that are under a treatment program for a condition that has been diagnosed become the school nurse’s charge during school hours. Today’s school nurse has health care responsibilities that may include doling out medication and monitoring the response; monitoring respiratory patterns and dealing with respiratory emergencies such as asthma attacks; and monitoring blood glucose levels for diabetic children.
Both parents work in a majority of American households today. For that reason, children who in another day might have been kept home with a minor illness are today sent off to school. Responsibility often falls on the school nurse to provide health care for children with influenza, bronchitis and other such minor conditions that were a parent’s responsibility not long ago.
As school budgets have fallen, so have special services. Today a student with special needs that might have been enrolled in a tutoring program is now folded into the main student population. Those children may well end up in the school nurse’s office when they find themselves unable to function in some capacity.
Because school nurses today are often the primary health care provider they are charged with responsibilities that used to fall to the family doctor. School nurses monitor for skin infections, parasites and infectious diseases. A thorough school nurse will always look for signs of physical or sexual abuse. However the fact remains that emergency treatment still remains the primary responsibility of the school nurse.
School nurses are trained to deal with respiratory emergencies and shock. Over ninety percent of the nurses in public schools have had to deal with seizures. Triage and treatment for physical trauma will often include monitoring the student for neurological symptoms if there is a head injury involved. A school nurse must have the basic skills and tools to deal with ear, nose and throat emergencies. One of the most challenging health care issues for a school nurse is assessing and treating abdominal emergencies.
It is important to keep in mind that virtually all health care provided by school nurses is pediatric health care. Diagnosing a crying child is a different and more complex challenge, often, than diagnosing an adult. A good school nurse hopefully never forgets the value of compassion, although a long-standing school tradition is convincing the school nurse that you need to leave school early.
Health care in a school environment is a delicate issue in that it means different things to different students. For some, it is the only medical treatment they get. For others with chronic conditions that need daily monitoring, it’s an unpleasant necessity. For many, it is meaningless until there is a playground trauma that is a major upset. School nursing is a profession that steadily grows more complex.
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Tags: health care, nurse, school nurse
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