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Cornell: School nurses perform vital roles
Part one of a four part series on school nurses
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The proposed state budget eliminates funds for school nurses. But what are all the responsibilities of the school nurse?

“First of all our scope of duties are very broad,” said Marsha Cornell, Effingham County school nursing coordinator. “We are the only licensed health care provider on any campus, so in a sense that makes us the health care expert, and so we get a wide variety of anything and everything.”

She said nurses will often monitor staff members blood pressure issues, diet issues and disease issues.

“Of course, we’re here to support the staff as well as the students,” Cornell said. “The typical things that most people are obviously aware of are giving medications to any student who requires medication on campus and monitoring those medicines, and evaluating are they working.

“That’s where some people question, ‘well, anybody, can give a pill.’ Well, anybody can hand a pill, but not anybody can understand what the medicine’s for, is it doing what it’s supposed to do, are we showing side effects? The evaluation component is where the professional comes in, but giving medication is something that everybody understands.”

Cornell said school nurses handle all first aid and injury care issues. They determine if it’s an illness, something the child should go home for, or if it’s something that the school needs to monitor and let the parent know while the child remains in class.

“If a child is not feeling well at school, we assess the child and try to evaluate what’s going on,” she said.

She said it’s the evaluation component where the nurse is important.

“A lot of times it’s just a phone call home to parents that they have to come get the child,” Cornell said, “because that step of being able to determine ‘can this child stay at school with this,’ and there are a lot of those.”

Along with the evaluation process when a student doesn’t feel well a nurse educates students on various health and nutritional issues.

“They often might just be hungry,” Cornell said. “This is at all ages, little kids in pre-k all the way to the high school level, many of the kids don’t eat breakfast before they come to school. The little ones usually will eat breakfast at school, but the older ones are just going to eat junk. Well then, about 9 o’clock or so their tummy’s hurting, they’re tired, they’ve got a headache, they don’t feel good. It’s often as simple as nutrition they haven’t eaten. That’s a health education thing.

“We can talk to them about the need to eat breakfast or just eat food. Part of that is also evaluating is this something that isn’t really a sickness. Is it sickness? Is it sickness that can stay? Is it sickness that has to go home?”

She said nurses work to educate students in two ways. They work with them one on one, and they go into classrooms to talk about health-related issues.

“Many times we’ll go into the classroom and do a topic for a class, whatever the teacher’s asked us to address related to health,” Cornell said. “Sometimes it’s part of their health lesson. Sometimes they want us to come in and talk about hand washing and infection control. Sometimes with the older schools, the nurses help with our family living, puberty-type education — the nurses will help with that because often times the teachers don’t feel comfortable.

“There’s a lot of education that goes on, whether it’s one on one or group education.”

She said nurses also work to educate the staff.

“Our school system has been very pro-wellness for the last several years. We’ve really tried to focus on that to have a staff stay well and healthy and the children, too,” Cornell said. “We’ve been working on a lot of nutrition teaching with kids and with staff on nutrition topics and being healthy.

“We have lots of weight loss challenges through the schools that the nurses head up, but it’s often just about nutrition choices and about living healthier and being active. It’s general health education for staff as well as students.”

Nurses also perform wellness screenings that typically involve vision, dental, hearing and scoliosis screenings.

“Those are state mandated, but they’re also a way to detect problems early hopefully before it becomes a serious problem and hopefully before it interferes with the child’s ability to learn,” Cornell said.

“We can find a child who’s having vision or hearing problems in the classroom and get them referred for correction before it becomes a serious learning problem. Then hopefully we’ve made a difference in their education as well as in their health.”

Cornell said nurses also work with counseling issues for students who need someone to talk to.

“They see the nurse as an objective, helping person that they can talk to,” she said. “Many times we’re going to refer them back to parents or the school counselor, but sometimes they use us as a sounding board to kind of sound out their problems before they’re able to go to the counselor or their parent.”

School nurses also help with management of chronic health problems students have. They also develop health care plans to help faculty and staff members understand how to deal with the issues specific to a student’s health needs.

The nurse will work with anyone who will be supervising the child from teachers to bus drivers so all the adults know how to handle situations that may arise.

School nurses also work closely with special needs students in the schools and take part in the student’s individualized education plan when that plan involves special medical needs.

Cornell said this includes students with seizure disorders as part of their condition and students who may need to be tube fed. Nurses become a consultant with the special education department and help monitor care. Nurses will not only administer care for the child but also educate the teachers on how to perform the same tasks.

“Even though I might be going in and tube feeding that child every day, or they’re coming to me or what ever I want that staff to know how to do that to, so that if I’m ever not there, or there’s an emergency that’s pulled me away that child’s care is not going to suffer, and we know they’re safely able to do that,” she said.

She said nurses also are heavily involved in crisis plans.

“Our system has a crisis plan, each school has a plan, and the nurse often becomes either a chair of that committee, or a co-chair with the principal of that committee in the school building, and kind of monitors those meetings, and certainly helps to do first aid training for our staff, and for our crisis team.”

Nurses also work with crisis training and practice drills.

“After we have practice drills we have some debriefing with our staff in each school building.”

Pam Cox, communications specialist, said Cornell was highly involved in the grant application process for the drug-testing grant the school system received. Cornell said the school system is focusing on wellness issues.

“As our budgets get tighter the more we’re looking at grants to help,” she said. “One of our schools just had a grant to help with a walking trail and playground equipment, more for fitness for staff as well as the kids. More and more we are looking at helping to obtain some grant monies.

“We’re trying to be involved with that not only on the teaching end, but in helping to find monies that would be good for our community and our school that are health related.”