• E-mail
• Print
• Comment
• Font Size
• Digg
• del.icio.us
• Discuss article

Role of School Nurse Changes Over Time: Aberdeen School District Has One Nurse Per 1,044 Students

Posted on: Thursday, 9 March 2006, 18:00 CST

By Russ Keen, American News, Aberdeen, S.D.

Mar. 9--Gone are the days when a school nurse could grab an aspirin from a medicine cabinet and give it to a kid with a headache.

Well, at least the days are gone when the school provided the aspirin. Today, nurses and other officials at Aberdeen public schools cannot hand out any kind of medication except for that which students bring from home.

"Not even a Tylenol or a cough drop," said Sheila Rahja, the nurse stationed full time at Central High School. Times have changed, to protect school districts from liability.

Also gone are the days when a student could reach into his or her pocket for an aspirin brought from home. Students are supposed to hand over all medications brought to school -- prescription and nonprescription -- to officials, who administer dosages as needed or as specified by a doctor.

The medicine-giver might or might not be one of the district's four nurses, who obviously can't be at all eight school buildings all the time. Sometimes principals, secretaries or others give pills to students. Any school employee who does so must first complete what's called medication administration training.

Usually three or four people in each school building have completed the training, said nurse Becky Luecke, the district's health coordinator. Even so, some procedures are conducted only by nurses, such as use of a nebulizer for a student with allergies.

While Rahja works full time at Central, Luecke and nurse Kathy Wagenaar cover most of the rest of the schools. Lincoln Elementary School, however, has its own half-time nurse, Elaine Nold. Lincoln has a higher concentration of children with special health needs than other schools.

So the district has the equivalent of 3.5 full-time nurses, or one per 1,044 students. Rahja alone serves about 1,150 Central students plus the 130 or so adults who work there. The National Association of School Nurses recommends one nurse per 750 students.

The ratio in Aberdeen is nearer the recommendation than it used to be, mainly because enrollment has been declining for several decades while the number of nurses has remained fairly constant. For years the district operated with three nurses and a health secretary. The secretary position was eliminated a few years ago, and the half-time nursing slot at Lincoln was created at the same time.

Like all states except Delaware, South Dakota does not require nurses in K-12 schools.

Allergies, obesity: The nurses' work varies from day to day. Even so, a general picture of a typical day can be painted.

Rahja said she sees 30 to 40 students each day for illnesses or first-aid. She deals with injuries sustained in physical education classes. She administers medicines students bring to school.

She and the other nurses handle such things as eye drops for pinkeye, antibiotics for infections, liquid medications given via nebulizers, injections for diabetes, medicines for attention deficit disorder and seizures, and even tube-feeding for students who do not eat the usual way.

Both Luecke and Wagenaar have been nurses for the district for 18 years. They deal with many more allergies than years ago, they said. That's probably because more are diagnosed, Wagenaar said.

Obesity is a problem in the district, as it is among youth nationwide. Students in general are less physically active than years ago because of computer games and other factors, Luecke said. And there appears to be fewer balanced meals prepared at home because families are busier, she said.

"Statistics show that Aberdeen does have an obesity problem," Wagenaar said.

When a student says he or she is sick and wants to go home, the nurses check things out to make sure the student isn't feigning illness. Nurses are also charged with recording students' weights and heights and curvature of the spine at selected age levels and forwarding the data to the state without names. They conduct vision and hearing assessments as needed.

The state requires the district to maintain health records on each student, which is time consuming, Wagenaar said. She and Luecke estimated they spend more than half their time in schools and the rest keeping up with record-keeping at their office in the District Service Center, 314 S. Main St.

The nurses verify that children have received various immunizations required by the state, which allows exceptions for medical or religious reasons. The nurses do not give vaccine shots.

Physicals: The school system also contracts with doctors and other health professionals to schedule en masse sports physicals at Central. Rahja, coaches and other school officials assist with the behind-the-scenes work involved. Starting at sixth grade, student athletes are required to get sports physicals every three years.

Rahja gets letters out to families reminding them of the requirement, which can be met by getting a physical at a doctor's office or at the events Central hosts.

She also makes presentations in health classes and works with Central employees. Currently 27 Central staff members are enrolled in a wellness program Rahja oversees.

The nurses said they love their jobs because of the variety of work. "No day is ever the same," Wagenaar said. Staff at all the schools are very supportive of what nurses do, which also makes the job enjoyable, Luecke said.

About the only downside is having too little time for preventative activities, especially wellness programs, she said. "There's always more you could do," Wagenaar said.

By Russ Keen

American News Writer

While the Aberdeen school district employs nurses to help take care of the illnesses and injuries of students and staff, it also provides a service for those who attend school events.

About a year ago, two defibrillators were installed at Central for the benefit of anyone who has a heart attack, including spectators at a school event. Last fall, one defibrillator was installed at each of the two middle schools for the same reason.

So far, none of the four automatic external defibrillators have been used, said Kathy Wagenaar, a school nurse. All four are gifts from the Division of Emergency Services of the state's Department of Public Safety.

Four alarm-fitted cabinets housing the defibrillators cost the district $400 each. The district also will bear the cost of replacing supplies, such as pads, that come with the units. The supplies have expiration dates, and must be replaced regardless of whether they are used, Luecke said.

The plan is to rely on volunteers to operate the defibrillators if and when they are needed at a public event. Chances are excellent that someone in the crowd will know how to use one and volunteer to do so, Wagenaar said. The presence of a school nurse is not required at sporting events. But an ambulance is always present at football games.

The cabinets are not locked, and an alarm sounds when they are opened, she said.

-----

Copyright (c) 2006, American News, Aberdeen, S.D.

Distributed by Knight Ridder/Tribune Business News.

For information on republishing this content, contact us at (800) 661-2511 (U.S.), (213) 237-4914 (worldwide), fax (213) 237-6515, or e-mail reprints@krtinfo.com.

Source: American News (Aberdeen, S.D.)

More News in this Category