At 7:30 a.m., Olga Wright, RN, CPNP, the school nurse is ready for the day to begin at Samuel Tucker Elementary School. I try to be in a little early, said Wright, as sometimes even in the parking lot, students get off the buses not feeling well
or they have been crying on the bus and they will need some immediate attention.
So the day begins.
On an average day, Wright will see 35 students for a variety of issues. She will make calls to doctors to verify medication orders, get a referral from a teacher about a child for a vision check, and hold meetings with parents of children who have health conditions that need to be monitored such as diabetes, asthma, or severe food allergies.
Managing a child with a food allergy is a good example of how the school and family work together for the student. It takes coordination and education of staff, teachers, parents, food servers and other students to provide a safe environment. There are general plans in place and emergency plans. These conferences are crucial to provide a safe environment for these children, and for chronic illness such as diabetes, a lot of planning is required, according to Wright.
School nursing includes copious paperwork. Documentation is a very important part of our daily routine because it guarantees a continuity of care, Wright said.
The documentation within the Alexandria City Public School system gathers information through day to day contacts with the students and through planned screenings required by the health information system. For example, Virginia requires hearing and vision screening for students in kindergarten and third grade and any students new to the school. Wright will screen 300 students at Tucker this year.
One of the exciting aspects of school nursing for Wright is in providing support for the entire family. When children have difficulty in school, we need to evaluate the child to provide the intervention needed. Wright said. We also look at psychosocial health, so when a child complains of a headache or a stomachache we can sometimes uncover something else. There may be something going on at home, or separation anxiety for a new student. Students who complain of a headache when they come to school in the morning might be asked what they had for breakfast. If the answer is nothing, Wright offers a snack to see if that helps.
We do a lot of health education as part of our daily routine and have a lot of resources that Alexandria is committed to provide. Wright said. She talked about the system as being very proactive and that with seven nurse practitioners in the ACPS, such events as the Student Health and Immunization Fair are able to provide physical exams, TB skin tests and immunizations for students.
Wright added that the Tucker Today Show, a program that the students participate in to address current issues, is an effective way of getting information to the students, through the students. They have talked about backpack safety, wearing seat belts, good nutrition, and other healthy behaviors.
By 3 p.m., most of the students have left for home and Olga Wright is getting ready to leave. In her 32nd year as a school nurse, Wright is still excited to come to work. This is fun, she said, We are here for the children and this is an exciting place to be. It is a field where you work with the whole family. It is always changing, and we have to be aware of what the current issues are so they we can confront them and be prepared.