By Amy Beth Miller-The Daily Times
Today’s school nurses are trained medical professionals who also have to be a bit of a detective, a bit of a social worker and a bit of a mom to hundreds of students.
One moment they may be discovering that a student with a headache didn’t eat breakfast — or dinner the night before. The kid with a tummy ache at the same time every day may be trying to a avoid a class or showing early signs of diabetes. A student hit in the head by a ball needs to be checked for a possible concussion, while another student needs a breathing treatment. Some students who go to the school nurse’s office just need a hug and a smile.
“People think it’s Band-Aids and tummy aches,” said Donna Gray, BSN, nurse at Heritage High School since 2008. “It’s way more than that.” “We’re seeing more and more children come to school with special needs,” including catheters and tube feeding, said Robin Cook, health services coordinator for Blount County Schools. “We have a lot of kids with inhalers,” she said.
BCS elementary schools have licensed practical nurses, generally from 9 a.m. to 2 p.m., and the middle and high schools have registered nurses. Plus special needs classrooms at three schools have LPNs. With many students who must take medicine at lunch time, Cook said, 11 a.m. to 1 p.m. usually is the nurses’ busiest time.
HHS High Volume
Heritage High School has one of the busiest clinics in the school district. On an average day the nurses there see 60 students, not counting those who are just taking medications, which can push that number to 80. On one of their busiest days, the nurses saw 120 students.  “I had no idea there would be this many kids,” said Kristin Hartley, BSN, who began working at Heritage in November. “We always have a stomach virus and an upper respiratory virus,” said Gray. One student may come to the office with the early symptoms of a panic attack while another is suffering side effects from an infusion treatment. The high school has called an ambulance five times this school year for various situations. For minor situations, Gray said, “our main thing is to get them well enough to stay in class.”
Each time they treat a child, the nurses update the records. With that documentation, Gray knows when a student comes in with a headache today to ask about whether the student took care of an earlier ear problem and to recheck that ear. The nurses also send some information on blood sugar and blood pressure results to students’ doctors. “I never leave at 4,” Gray said, because there is always paperwork to complete. “I want to make sure my patients are taken care of first.”
School nurses Donna Gray and Kristen Hartley, in the background, photograph by Joy Kimbrough, The Daily Times
Treating the whole child
The school nurses may be the first to hear that a student is cutting herself or may be pregnant. Even at the elementary schools students may reveal problems to the school nurses that go beyond medical issues. “They trust us and tell us things they would not normally tell other people,” Cook said. “I fuss on them when they need it and love on them when they need it,” Gray said.
Filling the need
Working as part of the school team with counselors, teachers and principals, the nurses help to resolve issues. “We’re a very important piece of the puzzle of helping children to succeed,” Cook said. In addition to the small clinic area where ibuprofen comes in bottles of 1,000, down the hall at HHS is another area stocked with items students may need, from clothing and shoes to shampoo and other personal-care items provided through donations.
The cafeteria staff may notice a student not eating lunch, and the nurses may know the student didn’t eat breakfast. The school will try to work with the family on a solution, such as completing a request for free or reduced-price meals at the school. Other students are homeless and may need to shower at school.
“Kelly Roberts is an angel,” Gray said of the Family Resource Center director, who also works with the Blount County schools to identify resources for students and their families. “It’s heartbreaking,” Hartley said of some of the situations the nurses encounter with the students they serve. “I have a new appreciation for the struggles kids go through.” One of the many handmade notes from students hanging in the Heritage High clinic says, “Nurses heal with love and Band-Aids.” “Healthy children learn better, and school nurses make it happen,” Cook said.
Blount County students with a chronic illness or disability
In 2015, Blount County Schools served nearly 2,500 students with a chronic illness or disability diagnosis.
Asthma: 366
ADHD/ADD: 1199
Mental health issues: 220 (cerebral palsy, sickle cell, cystic fibrosis, spinal bifida, etc.)
Diabetes: 52
Seizure disorder: 68
Severe allergies: 176
Intellectual disabilities: 232
Autism: 88
Other: 76 (cerebral palsy, sickle cell, cystic fibrosis, spinal bifida, etc.)
Total: 2,477
Today, May 11, is National School Nurse Day.