Go See The Nurse

Vision tests, puberty class, checking immunizations records and a place to hide when it's your turn to read aloud by claiming a stomachache.

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A Short Tale of How I Have Begun to Understand the Children

About this time during my first year as a school nurse, I had just finished working 78 days in a row without a day off. I thought being a school nurse would be great! But you know the old saying, “If it’s so great, why isn’t everyone doing it?” For people who aren’t school nurses, that “why” is usually income-related. For me to make ends meet, I worked another full-time job on the weekends as an on-call hospice nurse. I counted down those 78 days to the Wednesday before Thanksgiving, all the while thinking, “This is just not for me.” Those kids drove me crazy…and the teachers…sending some of those kids down for the smallest things. Shame, shame, shame. And so by Thanksgiving, I was planning my job-interviewing strategy for May.

What changed, then? Why am I still a school nurse?

My principal sends out a daily bulletin. No, I don’t read them all (she knows this), but I do try to read the majority. One daily bulletin had an attachment that got my stinkin’ thinkin’ back on the right track. With eyes wide-opened, I started to actually “see” what many of the children come to see me for and why many of the teachers send them.

“Cause I Ain’t Got a Pencil”

I woke myself up

Because we ain’t got an alarm clock

Dug in the dirty-clothes basket,

Cause ain’t nobody washed my uniform

Brushed my hair and teeth in the dark,

Cause the lights ain’t on

Even got my baby sister ready,

Cause my mama wasn’t home.

Got us both to school on time,

To eat us a good breakfast.

Then when I got to class the teacher fussed

Cause I ain’t got no pencil.

— Joshua T. Dickerson

Read More at: http://goseethenurse.com/2017/11/22/cause-i-aint-got-a-pencil/

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Concussion Symptoms Assessment for the School Nurse

“Whoa, man! What happened to you? Did you get in a fight with a ninja?” A little kindergartner enters the health office with a huge goose egg on his right forehead. “I bet you licked him, didn’t you?” Of course, without a frame of reference, the kinder looks at me sideways, kinda like a puppy who just heard a funny, squeaky sound.

“What’s that sound? You hear it? It’s a funny, squeaky sound.” – Aunt Bethany

It’s obvious that this child has hit or been hit in the head by something. And figuring out what “that” is takes a quick (yet temporary) backseat to performing the assessment to identify what the actual injury is and its severity. Let’s step back and review what that goose egg is telling us.

The goose egg is secondary. What I mean is: it’s on the outside of the skull. Swelling and bruising there, though a concern, is less of a concern than what may be going on within the skull itself. Swelling on the outside has room to move around and show off. A big ol’ goose egg is usually what makes the bump to the head “look” bad. Swelling on the inside is what makes a bump on the head…bad. A “goose egg” inside the skull is difficult to determine, given the short period of time and limited assessment tools for the school nurse. Rule number one when a child reports they have “bonked my head” is to assume there may be a concussion. That goose egg is telling us to do two things: that we need to treat the outside stuff (what we can see) and assess for the inside stuff (the stuff we can’t see and that may show up hours later).

What is a concussion?

A concussion is a brain injury that causing the brain to behave somewhat abnormally. It’s like dropping your laptop, and the screen freezes until you reboot it. The brain has just been “jolted” inside a closed cavity: the skull. And a concussion doesn’t always have to result from a bump to the head. Even falling and landing on your bottom or back can result in a concussion. After all, the fall is not what is causing the problems; it’s the sudden stop. This sudden stop causes to brain to move toward the direction of fall and then “bounce” back from that side of the skull and slam into the other side, kinda like a rubber ball. Often if you hit the back of your head on the ground, the front of the brain is injured.

Interesting:

In a year, traumatic brain injuries complications will cause the deaths of 3,000, hospitalize 29,000 and result in 400,000 ER visits. Get this: these numbers are for children younger than 15 years old.

Boys are twice as likely to suffer a traumatic brain injury than girls.

In our public schools, 13,000 children will end up needing health services beyond what we school nurses can offer (Youse, Le, Cannizzro and Coelho, 2002).

Individuals with Disabilities Education Act defines a traumatic brain injury as “…an acquired injury to the brain caused by an external physical force resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child’s educational performance…”

Bumps to the Head vs. Head Injuries

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Read more at: http://goseethenurse.com/2017/11/04/concussion-symptoms-school-setting/

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School Teachers vs. School Nurses – 3 Reasons to Listen

Two teachers came to visit me today. They were polite as they approached me with a few questions. At first I didn’t know what to think; I didn’t feel like they were teaming up on me, the school nurse. But I did feel they were attempting to “tread on thin ice.” Funny thing is: My ice is pretty thick.

“We wanted to see if anything had changed as far as policies go,” one asked. “Sometimes the students come down to see the nurse and then come back to class, lay their head down, and try to rest. When I ask what’s wrong, the child says, ‘The nurse said I wasn’t sick’.”

They were not being coy or rude; they were genuinely looking for information and understanding. “We’re not trying to tell you how to do your job, but…”

I quickly realized that the intention of the two teachers was to ask, though in too many words, “When we send the kids down sick, why do you send them right back to class still sick?”

Teachers teach, and nurses nurse, right? Na… No way, Jose’! It hasn’t been as often as I’d like, but I have gotten in front of the classroom and taught multiple times. Teachers have put Band-Aids on children before. The line between the roles of school nurses and teachers should be gray and somewhat fuzzy and more like a “shared responsibility” rather than a fine, red line that dichotomizes (that’s a fun word) the two roles.

“We sent a child down earlier because she said she was going to throw up, and you sent her back to class. She ended up throwing up, and I called her mother to pick her up.”

Sometimes We Just Call It Wrong

Read more over at:http://goseethenurse.com/2017/11/12/school-nurses-school-teachers/

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State Of Emergency Over Deadly Hepatitis A Outbreak

October 19, 2017

“California declared a state of emergency Friday (October 13th, 2017) after a deadly Hepatitis A outbreak has spread faster than the state’s ability to supply the vaccine that can ward off the disease.” says Jack Davis over at westernjournalism.com. A “state of emergency” says it all; in the entire year of 2015 there were 1390 cases reported nation-wide (the latest statistics available by the CDC as of this writing). This outbreak has already claimed 17 lives from the 569 people who have been infected and just in the in Southern California area and just over the past 11 months.

What is Hepatitis A and How Did I Get Infected?

Hepatitis A communicable disease of the liver caused by a virus (Virus vs Bacteria Article Coming Soon). That “communicable” word is a pretty fancy way of saying that it’s, “able to be communicated to others” or can spread from person to person. It’s not really something that you “get” from your dog, cat or mosquitoes. No, you’re not going to get Hepatitis A by just talking to someone with Hepatitis A either. Hepatitis A is spread through the fecal-oral route. Yep, you get Hepatitis A by getting someone else’s poo-poo in your mouth. How gross is that?!

If you are asking how in the world does someone get poop in their mouth, this possible scenario may help explain:

Read More At: http://goseethenurse.com/2017/10/19/hepatitis-a-outbreak-immunize-immunize/

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We’re Going to Be Friends - BACK TO SCHOOL

Being a school nurse is great. This is my third year and I am excited about to go back to school. Well, let’s be completely honest; I could use one more day. And, if you ask me tomorrow, I’ll say the same thing, “I am excited but I could use one more day.” This year we are suppose to start back on Wednesday, August 16, 2017 but I am going back on the 15th to help with registration. Today is the official last day of summer for me.

The school year has to start. If there was no school year, I’d have to find another job. But, for me, there is no other nursing job. This is the only nursing job I will ever have again and I have made preparations for that to be a life-long fact. They implied a “Florence Nightingale” work place when I was in nursing school (1994-1998). After my first job, I realized that it was more like Office Space (movie).

“Hello Peter what’s happening. I’m gonna need you to go ahead and come in tomorrow. So if you could be here at around….nine that’d be great.” – Bill Lumbergh

I had been working hospice and had been for years and years. But, I got worn out over helping folks die from diseases that many were caused from a chosen life-style. What I needed in my career was a chance to help people know what they were getting into before they…well…got into it.

Brownfield Station (or Mötley Crüe for my generation) knows better:

“Smokin’ in the boys’ room

Smokin’ in the boys’ room

Now, teacher, don’t you fill me up with your rules

But everybody knows that smokin’ ain’t allowed in school”

Speaking of Mötley Crüe … I was at a record store back in the 80’s and picked up a Mötley Crüe LP. My younger buddy says, “Woa! Those girls are hot!” I had to correct him, “Those ‘girls” are dudes.” Needless to say, when we got home, he washed his mouth out with soap. If you’re from the 80’s, you’ll get that.

Ahhh… I digress…

Read More Over At: http://goseethenurse.com/2017/08/15/back-to-school/

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The Richest School Nurse in the Whole-Wide World

As a nurse, hearing the word “stat” seeds an emotion of urgency. Kinda like hearing someone shout “fire” or “They got a late delivery of Turbo Man at Toy Works!” “Stat” is used as a directive to medical personnel during in an emergency situation. “Stat” means NOW! Not after you take another sip of your diet soda either. It’s like the ring of a doorbell to your Labrador. “Stat” is from the Latin word statim, which means “instantly” or “immediately.”

“Office! We need Nurse Kevin on the playground stat. Tell him to run.” That’s what I heard over the walkies. And run I did. My 47-year-old legs moving 190 pounds (less an AED and a first aid bag) down the hall toward the playground doors. I get to the door and realize that there are 260 (give or take) children and teachers shouting out, “Nurse Kevin! Nurse Kevin! Nurse Kevin!”

Read More over at: http://goseethenurse.com/2017/06/02/richest-school-nurse-whole-wide-world/

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21 Reasons NOT to Wear Shoes in the House!

Poop (bird poop is still poop and so is the poop that a guy stepped in somewhere else and is now trekking all over the parking lot and into the business).

Urine (don’t think for one second someone somewhere has not peed in a parking lot…or maybe a dog just happened by the buggy carriage you just pushed your shopping cart back into).

Spit (Usually the phlegmy, thick and sticky kind too).

Diaper residue from a dirty kid that was changed before (or after) entering the building.

Leftover drinks that were poured out (that some stranger’s mouth was drinking from).

Dead (or live) bugs.

Toxins leaching from the black top.

Particles of food partially eaten and dumped out.

Butts of cigarettes (that someone’s mouth has been on).

Gum.

Melted (or not) candy or other treats (usually spat out of someone’s mouth).

Blood from nose bleeds, oral issues that are bleeding and then spat out, old band-aids and the like.

Pesticides.

Herbicides.

Fertilizers (those business parking lot trees don’t get that pretty from the nutrients that the asphalt provides).

Oil from cars.

Antifreeze from cars.

Gasoline

Paint from the parking lot markings.

Dirty

And 1000’s of other particles from 1000’s of other shoes and whatever they were tracked through from 1000’s of different places.

Read more over at: http://goseethenurse.com/2017/03/01/shoes-in-the-house/

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Peppermints Makes The Kids Smarter and Calmer

http://goseethenurse.com/2017/01/19/peppermints/

Mints. Just about every child that comes into my office gets a peppermint before leaving. I think that passing along a bit of sweetness helps the day go by better. They see it as a treat; I see it as a little bit of extra health care that will help them in so many different ways.

Can peppermint make you smarter? That’s a tricky question. Do you know what the hippocampus is? That’s a fun word, “hippocampus.” It makes me think of a hippopotamus with a backpack trekking across a college campus trying to get to his next calculus class. Anyway…the hippocampus is a pretty cool little part of the brain that is responsible for so much. It is the organ that is responsible for learning and memory. Additionally, it is reasonable for mood regulation (something we all need “regulated” once in a while).

hippocampus peppermint Peppermints Makes The Kids Smarter and Calmer hippocampus 96

Do you know what the olfactory system is? Yes…the “Old Factory” system is the part of the sensory system that is responsible for smelling. The olfactory sensory system is directly plugged into the brain. It does not travel to the brain via the spinal cord. When olfaction (smelling) occurs, interaction occurs between the olfactory system and the hippocampus. Again, the hippocampus is responsible for the formation of new memories and mood regulation. “No other senses have this kind of deep access,” says Rachel Herz, Ph.D. of Brown University in her book The Scent of Desire – Discovering Our Enigmatic Sense of Smell.

The peppermint oil in peppermint candy, primarily the menthol component, stimulates the hippocampus. As the candy is consumed, the menthol is released and stimulates the olfactory nerves thereby stimulating the hippocampus and enhances learning and promotes a state of calmness. This “calmness” is not a state of restfulness. It’s a calmness that promotes an alert and attentive state.

You can read move over at: http://goseethenurse.com/2017/01/19/peppermints/