Another school year has come to an end. It has been a long, sometimes overwhelming, year for all of us. Still, we have much we can take pride in. In lieu of my letter to you, I want to share the thoughts of Donna Johnson, Pasco County Liaison. Enjoy!

“Walk softly and carry a big stick, you shall go far” — Teddy Roosevelt 1900

Seventeen years working as a school nurse have passed by so quickly! Similar to the analogy: “with a blink of an eye and your children are grown.” At the end of every school year, I try to reflect upon what I have accomplished, did not accomplish, and what I would like to “wish” for the next year. However, I must truly admit, this past school year has been one of the most challenging years. Hard economic times, along with the uncertainty of school district budget cuts, have presented the most incredible challenges for many school nurses. It’s no secret that school nurses play a vital role in bridging the gap between academics and medicine. Teddy Roosevelt’s famous quote, “Walk softly and carry, a big stick, you will go far” summarizes the role school nurses play today in bridging and closing the widening gap between education and medicine. These famous words of wisdom could not describe the functions of school nursing any more eloquently or more precisely.

The beginning of this school year in itself was a whirlwind. School nurses in many states encountered the Swine Flu epidemic in full force having to create and become resilient in addressing this worldwide epidemic. Public fears and anxiety created additional tensions and numerous misunderstandings. Immunizations clinics throughout school districts were efficiently conducted with the collaborative partnerships. More importantly, school nurses became more visible as a cohesive group of health care experts seen within our community. Our phones constantly rang in August and September, as we began to coordinate and work closely with each other in teams providing this community heath initiative service at our school sites. Throughout the fall, we balanced our duties along with the added responsibilities of Swine Flu clinics. Other responsibilities were postponed if they could be, as the priority of completing these clinics throughout many school districts took precedence. School nurses became proficient in their triage skills, troubleshooting school health issues that seemed overwhelming, but we persevered!

January seemed as though, for many of us, we were just beginning the school year! What had we done? The urgency of catching up with health care plans, screening referrals, and other school wide meetings seemed endless! Before long, health education classes were being planned and the thought of summer break seemed as though it would never arrive, but here we are… sigh!

Throughout the years, the numbers of children with medically complex needs have increased tremendously. School nurses are not in the clinic placing band-aids. Conversely, school nurses today spend a large amount of their time case managing, assisting struggling families, allocating resources, and delegating safe effective care at each school site. In addition, the lack of health care insurance and the increasingly identified homeless families present areas of focus where we cannot easily measure our time spent in assisting these families. Every school nurse has their own story to share about the special children that were helped along the way. My own personal reflection of this past year highlights assisting a 4th grade student to be placed in free braces, which decreased his drooling and improved his speech. His peers no longer ridicule him,and he smiles ever so sweetly from ear to ear whenever I see him. Another personal reflection this school year involved an 8th grade middle school student who had a brain herniation requiring immediate surgery. I was able to locate a physician who performed surgery within two weeks. Since then, this student has returned to school and is able to complete her final middle school year without severe headaches and dizziness. Again, these are only two of the countless stories told by my professional school nurse colleagues.

A well-rested summer break is always soothing for all of those who work in education. Resting and rejuvenating themselves; gearing up for a new school year in August. If there could be one wish granted, it would be for there to be a better understanding of the role and legal responsibilities school nurses are challenged with each and every day. Often times, they seem to be insurmountable. School nurses are health care professionals who work behind the scenes of education to ensure student health and safety. Every school administrator, faculty, staff and parent should understand and become familiar with the role of school nursing today, which has changed significantly and is by far deeper than what is visible on the surface in the world of education. School districts should encourage everyone to personally get to know their school nurse, understand the depths of their responsibilities, including the challenging legal issues required for safe delegation. By far, school nurses are a dedicated and committed group of health care professionals who work collaboratively as a team providing excellence in the oversight of health to support every child’s ability to learn, regardless of their medical issue.

As we conclude this school year and look forward to the next year ahead, school nurses will continue to work together cohesively and continue to champion one another in creating a team of excellence for every school district. We will walk together, with our sticks, standing tall and speaking ever so softly to ensure the health and safety of our school children. Well spoken, Mr. President!

Reflections of a School Nurse

Donna Johnson

Pasco County Liaison

June 2010

Thank you Donna for being such an eloquent voice for school nursing!

Karen

Florida school nurses are recognized today for their professional commitment in their school nurse roles to advance the well-being, academic success, and life-long achievement of our students. Since children/youth comprise a quarter of our population,
who else but, school nurses, have the opportunity of touching the pulse of our communities’ health? School nurses are the safety net for students through their collaboration with families, schools, and communities to develop and promote comprehensive health care programs and to provide school health services and health education for our youth.

School nurses have a shared responsibility with our families, businesses, communities, and state leaders to secure health prevention and health care for our youth as an investment in our future. Through developing healthy youth, we will grow healthy communities and a healthy state.

Although there are many disparities in the numbers of school nurses statewide, and we are in very difficult economic times, we know that school nurses do make a difference. Therefore, like an eagle that senses a storm coming, school nurses and state leaders must rise above the storm to let the winds carry us to the highest heights. There with an eagle’s eye we must find the vision together that will allow us to secure a school health model with school nurses to provide that safety net that our students must have to grow a healthy future for our nation.

Let us join with NASN to support NASNs ratio bills that are currently in Congress: HR 2730 and S. 2750. NASN President, Sandi Delack reports that these bills “will pave the way for demonstration projects” that will provide the data that we need to prove school nurses improve health and education outcomes for students.

As we celebrate School Nurses Day, I would like to honor each of you for what you do individually for our students on a daily basis to improve their health and to support their success in school.

Celebrating with you,

Karen Thoennes
FASN President

The Board of Health realized school nurses removed the health barriers that kept students out of school.  They did this in three ways.  They treated the problem.  They educated parents and students to prevent illness.  Finally, they took the steps necessary to keep all the students as safe as possible.

Over 100 years later, our goals remain the same, but the complexity of the students has increased dramatically.  March 27, 2009, was School Health Advocacy Day in Florida.  The Proclamation delivered on that day stated:

“It is recognized that the goal of school nursing is:
to remove the barriers to a student’s education,
to improve student safety and
to educate and empower students to live healthier lives.”

One of every five students in Florida has a chronic health condition that can impact his or her education. Health problems which are left untreated or improperly treated results in an inability to get to school for an education.  The school nurse, working with the student and his family, strives to remove the health barriers to a student’s education.

Mary Jackman, a school nurse at Vineland Elementary in Charlotte County, works with many students with chronic health problems.  “School nursing provides me with an opportunity to education children and families about chronic illnesses such as asthma. I can spend time to teach, reteach, give positive feedback and see progress in a child’s understanding of their health. I feel that I impact lives on a one-on-one basis. I am there when a child does not feel well. I am there to speak with a parent on a daily or occasional basis. I make a difference to the children that I care for. I am there for them. I am not nameless or faceless but a presence who has information about health and wellness.”

Education is a vital component of school nursing.  Whether one-on-one or in a group setting, school nurses work to empower students with the information they need to make healthy choices.  Some school nurses do a “Wellness Wednesday” on their in-school TV.  These 2-4 minute broadcasts teach students and staff valuable lessons on health, safety and nutrition and give exposure to the school nurse and her profession.

School nurses work within their schools to promote student safety, whether it is delivering safe care in the clinic to a student with a health problem or administering medications (over 20,000 meds are dispensed daily in Florida schools) or promoting safety throughout the school with food safety or playground safety.  It may also involve epidemiology after a bacterial meningitis outbreak, or preparing a school for a lockdown crisis situation.

Amy Barnes, a school nurse in Lee County and a FNA Clinical Excellence winner, describes her profession as “the hardest job I ever loved.”  She goes on to say, “Who would have thought that as a school nurse I would be involved with more emergency life saving interventions than I was in all my years as a hospital nurse.  I have often said that one day I would write a book entitled, I Couldn’t Make This Up if I Tried!”

On Wednesday, May 6, 2009, school nurses throughout the nation will celebrate National School Nurse Day. This year’s theme is “School Nurses: Meeting Needs of Today’s Students.”  Connie Blackwell of Collier County, Florida’s 2009 School Nurse of the Year, was asked by the Naples Daily News, What’s so special about being a school nurse?  Her answer, “I have learned by trial and error to see past the complaint and if needed care for the whole family.  I respect the saying that ‘every child can learn,’ but feel it would read better ‘every healthy child can learn.’  I have to say, I love what I do.”

Today, we are finding the role of the school nurse is even more valuable than it was 100 years ago.  At my high school, our vision is “To prepare every student for success.”  One of the stake holders intimately involved with student success is the school nurse.  Whether she is treating a cut, making a medical referral, counseling a student, helping a parent find a medical home, working on a nursing care plan, addressing a chronic health condition, doing health education or serving on a school’s Safety or Disaster Preparedness committee, she is actively working to promote student success, not just in school, but in life.

Kathy

Kathleen C. Rose, RN MHA NCSN
President, Florida Association of School Nurses
President@FASN.net

They came back to their districts and shared some of this knowledge with their colleagues. Check under Clinical Updates for the notes from many of the sessions. Many spent their own money to come to the conference. Some came back from the conference to learn their travel approval had been rescinded. Some were told at the last minute that their travel had been denied.

At a time when more and more families will be using the school nurse as their primary health provider, the opportunity for that nurse to increase her competency was denied. Our legislators are looking closely at the budget because state finances may be even worse next year. If they do not understand what we are doing, if they do not realize that school nurses actively work to keep students in school and engaged in learning, then legislators will see school nursing as a line item that can be cut. What Gov. Crist has proposed and what the final budget will actually be are not the same!

With that reality before us, our Legislative Chair, Mary Jackman, has been working with Dianne Mennitt and Laura Brazell to develop a School Nurse Advocacy Day in Tallahassee on March 27th. Called “March Into March,” we are asking as many school nurses as possible to make the trip to Tallahassee to educate our legislators about school nursing. For many of us, myself included, it will mean taking a personal day to do this, but the stakes are too high not to do it!

We need each of you to do join us on March 27th. Check out the Legislative Page for information on finding who your legislator is, how to contact them, talking points for a conversation, and places to stay. If you can go, it is important to email or call for an appointment to see your legislator ASAP. And if your legislator cannot meet with you, but their administrative aide can, go! Never underestimate the power of personal contact.

And if you cannot go with us? Write a letter, send an email, make a phone call. Make sure that our legislators, no matter what part of the state they represent, know that March 27th is School Nurse Advocacy Day! Help us to deliver an accurate picture of what school nurses do, day in and day out for the students of this state.

Kathy

Kathleen C. Rose, RN MHA NCSN
President, Florida Association of School Nurses
President@FASN.net

As you work on all of these, get medications in place, do your first aid and begin your formal and informal health teaching, remember to tell others, “I’m a school nurse and I help students succeed in school.”  Thanks to our work, teachers are able to teach, and students are able to learn.  We can be proud that we are school nurses!

In my last President’s letter, I encouraged you to begin collecting your stories.  Now we need you to use them.  There is a special session of the state legislature extending from September 18th until the beginning of October.  This legislative session is focused on the budget.

One of the areas legislators would like to cut is school health.  School health services (us!) is a major component of school health.  The three major associations involved in school health (FASN, FSHA, & FAPHERD) have written a joint position paper opposing this action.  (Click on the Legislative link for a copy of the statement.)

Now we need you . . . all of you . . . to tell your story.  This is not just a DOH issue.  Where the legislature chooses to spend its money is an indication of its priorities.  If school health is not a priority for the legislature, why should it be a priority for school districts or health care foundations or hospital funded school nurses or taxing districts?

Just as FASN cannot lobby, neither can DOH nor DOE employees in their jobs.  We can, however, speak out as private citizens who are voters.  We can tell our story!  We can write as “a nurse that works with children”.  We can write as “a parent of a child in school.”  We can remind them that as a voter, we voted so they could represent us and this means a great deal to us and to the children in this state.  If we are not a face or a voice, it is easy to cut the anonymous “they”.  If we are going to work to prevent any cuts, we need to remind them that there are people out there who are watching and listening.  We are watching and listening because we care!

As the FASN Board approved the decision to add our name to this position paper, I was reminded of our goal:  to serve school nurses statewide.  What better way to serve than to remind legislators of the need for school nurses and health services across the state.  As nurses and as voters, we can and should be heard.  Will you join us?

 Kathy

Kathleen C. Rose, RN MHA NCSN
President, Florida Association of School Nurses
President@FASN.net