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PROFILE: Care at school

Beau Brownstead needs his insulin level monitored and Chase Rowe needs his vision checked.

Glucose meter ready? Check! Alcohol swabs ready? Check! Have a seat in front of this vision chart young man. The nurses are in and ready for you.

The nurses’ offices in Ironton’s city schools are busy places.

School nurses are charged with monitoring acute illnesses, educating students to be proactive in their own health care, and often, being a surrogate mom-away-from-home.

Swine flu? Playground accidents? No problem. Toni Barnett and Annette Scott have been there, done that — and probably put a Band-Aid on it.

A few years ago

When veteran school nurse Annette Scott started 20 years ago, there were fewer kids needing her help and fewer tasks on her to-do list. Since then, things have changed.

School nurses help set district policy concerning the health and welfare of students and staff, work with the city health department in the control of communicable diseases (swine flu is the most recent example of this), maintain health records for students, enforce state laws pertaining to health within the schools and screen students for any number of potential problems, including growth and development, vision, hearing, dental care and even emotional health. Nurses even teach CPR classes for teachers.

Scott began volunteering when her daughter, Shalonda, started kindergarten. After a few years of volunteering, she worked part- time and then eventually full-time. In one form or another, she’s been on the job more than 20 years.

Barnett started full-time this year after spending several years at Our Lady of Bellefonte Hospital. Is the job what she thought it would be?

“It’s probably a lot busier than I thought it would be,” Barnett replied.

A day in the life

“When I first started I had, maybe one or two with seizures, not that many with ADHD,” Scott recalled.

These day at Ironton Elementary, several children have long-term illnesses that require daily attention. One has chronic stomach problems, another has cancer.

Children with Attention Deficit Disorder/Hyperactive Disorder (ADHD) need regular doses of medicine.

Kids with asthma need to be monitored. One child has medications for seizures. Diabetic children present their own set of issues: insulin levels have to be checked throughout the day.

“The goal is for the kids to be able to take care of themselves,” Barnett said. “Some kids come in before lunch and take care of themselves; others come in after lunch or before they go home. We give medication to students throughout the day.”

Then there are the things that pop up throughout the day that aren’t planned for, such as playground accidents.

“If the weather is nice and they play outside we get all the boo-boos,” Barnett said.

And head lice. And kids who just don’t feel good right in the middle of the day.

The H1N1, or so-called swine flu, created more work. The nurses had to send out notices about the flu vaccination clinics and then administer the vaccinations.

For some kids, that trip to the school nurse’s office is that child’s very necessary substitute for a family doctor’s office.

“Sometimes the school nurse is only the first line of healthcare that most students receive,” Scott said. “Some parents have limited resources (no thermometers at home or even Tylenol), unable to leave their job to take students to the doctor or unable to get an appointment to get their child into the doctors.”

If Ironton school nurses are busy, the students are fortunate to have them. Scott said school nursing is not mandatory in the state of Ohio.  Nursing is regulated by legislation.  

As the southeast representative for the state school nurse’s association (Ohio Association of School Nurses), Scott and others are in constant contact with legislators and Gov. Strickland.  

“We have met with him on several occasions to push the need for more school nurses in Ohio,” Scott said.  

Crackers, hugs and chips of ice

Not every child who comes to the nurse’s office has a life-threatening illness that requires a dose of medicine.

Scott has found over the years that with the smaller children, a lot of “problems” can be stymied with simple stuff: crackers, ice and motherly hugs.

Is the child complaining of a stomachache an hour before lunch? If a bona fide ailment can be ruled out (the kid isn’t really sick) they may find themselves getting a cracker and a knowing smile from Scott or Barnett.

“Often hunger is the issue,” Scott explained.

Teen years

While the older students may be able to manage their own insulin injections without the nurse’s help, they present a whole new set of challenges that nurses don’t typically see at grade school level, problems that can’t be solved with a cracker and chip of ice.

“Several students frequent the nurse’s office and say they don’t feel well when they just need to talk to someone,” Scott said.

The problems run the gamut: Troubles at home, peer pressure, pregnancy, fighting, sexually transmitted diseases. These frequently fall into the nurses’ laps.

At times nurses are even dispatched for home visits. Scott and Barnett are adamant that good nursing depends on good communication between school staff and the child’s family.

Gal o’ my dreams

If most students at the elementary/middle school look up to the school nurses as role models and stellar caregivers, the fondness of a few surpass that point.

They look at Scott and Barnett, with their expert care and feminine smiles and boy, it is love. Seven-year-old Dustin Galloway approached Scott one day with a rather surprising proposal.

“He asked me to marry him,” Scott mused. “First he said he liked me. Then he proposed. I said ‘I can’t marry you, I’m already married’ and he said you gotta get rid of him.’”

But later he had changed his mind, as only those in the throes of puppy love can do.

“He came down the hall and said, ‘I can’t marry you,’” Scott recalled. “He said, ‘I got a fourth grader.’”