School nurses tend to students’ aches, pains
It’s a mistaken impression that Havasu’s school nurses have little more to do than to sit around and count the Band-Aid inventory.
In the Lake Havasu Unified School District, the seven nurses looking after 5,400 students rarely have down time. The daily pace is brisk and requires steady hustle. Lunches are eaten on the fly because school health offices are akin to Grand Central Station around the noon hour.
While more than half of the complaints they hear are medical in nature, four district nurses who were interviewed for this story said they also hand out a fair amount of emotional support to students.
The level of tender loving care varies from school to school. Elementary school nurses said younger children may stop by the office for a simple hug. Middle school students in the throes of puberty need help sorting out their feelings or dealing with anxiety. High school students also suffer from anxiety or wrestle with home life problems.
Tammie Dutton, who has been the school nurse at Thunderbolt Middle School for 22 years, has truly seen it all. Over the years, she’s learned that a large part of her job is social nursing and that dealing with adolescent angst requires a high level of compassion.
“I’ve learned that I need to be kinder than I need to be because I don’t know everything,” she said of the selective bits of information shared by a troubled student. “Middle school kids are at a dramatic age. There’s the friend thing (conflicts) and we have to be on the lookout for bullying. It’s a hard age. I tell students, ‘Ask your parents what years they don’t want to go through again, and they’ll tell you it’s the middle school years,’” she said.
In some cases, Dutton said emotional trouble manifests itself as a legitimate headache or stomach ache.
“Stomach aches are a common complaint. We all know (the stomach) is the place where we divert our stress,” she said. Dutton often has to drill down to figure out a child’s core issue. “I’ll tell a student, ‘It does seem to be in the second hour that you keep coming to see me. Are you having trouble in math?’”
Tammy Knight at Lake Havasu High School agreed that school nursing is a psychosocial job. She intentionally decorated the health office in a soothing beach theme to create a calming environment.
“Sometimes this office is like an oasis,” she said. “It’s a place where students who are upset can come, relax and get themselves collected.”
The nut and bolts of the job
Each school’s health office is just that. It’s the place where a student is sent when they are injured or feel ill.
On Monday morning, Knight had to hop to it when a student hobbled through her office door with a hurt ankle. The student sustained the injury while playing basketball in physical education class. While Dutton applied an ice pack to what she suspected was a sprained ankle, her assistant Cathy Fesher turned to a visitor and sang Knight’s praises.
“It’s a good thing we have an experienced trauma nurse here with the stuff we have going on,” Fesher said.
Knight was previously a surgical trauma nurse at Loma Linda University Medical Center before she moved to Havasu in 2013. She is in her second year as the high school’s nurse. With 1,800 high school students, 36 pre-schoolers at the day care center and 25 profoundly special needs students to look after, she confirmed that no two days are alike. She’s seen a good many broken bones, ankle and wrist injuries, female problems, bug bites, seizures, asthma attacks and allergic reactions.
Unfortunately, Knight also sees students suffering from the effects of vaping.
“I know I’m dealing with vaping when a student is pale – almost green – and nauseated. Some of them are throwing up and their blood pressure is up,” she said.
Vaping is the act of inhaling and exhaling the vapor produced by the heated liquid of an electronic cigarette. It is highly addictive. While most kids vape nicotine, some vape marijuana.
“Parents need to be savvy and know what the devices look like; so many don’t. One version looks very similar to a thumb drive,” she said. If discovered, all vaping devices are confiscated and parents most likely will be informed of the incident.
Knight also helps students with chronic problems.
“We have kids here with serious medical issues that I keep an eye on. For instance, a student with diabetes came in and I tested her sugar. It was 45. We had to get her pumped back up so she could go to class. That’s my ultimate goal – to quickly get the kids fixed up and back in the classroom,” she said.
There are times when the high school’s health office functions as an urgent care clinic. The difference is that Knight doesn’t diagnose issues. Instead, she advises students and their parents to see a doctor. Even with that urging, there are times when a student has unmet medical needs.
“Last week I had a girl who was having back pain. I suspected a UTI (urinary tract infection). She finally saw a doctor and was hospitalized for a couple of days. It was a UTI.
“Another time, a student had terrible dental pain. I called the United Way for help, and the student was sitting in a dentist’s chair within the hour. The community has great resources for us when we need it,” Knight said.
Linda Dux has been the school nurse at Oro Grande Elementary for 20 years and plans to retire March 8. She echoed Knight’s comments about the school health office being a de facto urgent care clinic.
“We’re almost a primary care provider,” Dux said. “Parents rely on us to look after medical issues and use us as the first line. Sometimes we’re looked up to make a determination. Is her ear clear? Is his chest clear? Should they see a doctor?”
Dux finds it frustrating when a sick child is forced to attend school.
“Parents have to work, so they send the child to school even though they are ill and shouldn’t be here,” she said.
Dutton at Thunderbolt has experienced similar issues.
“Once, a mom came in with her daughter, who was in tears. The mom said, ‘She just got her period and I have to go to work.’ The mom walked out and I had to deal with her upset daughter. I couldn’t believe how the mother handled it,” Dutton said.
School nurses review students’ immunization records plus test their vision and hearing. They dispense medications. On occasion, they administer first aid and call for an ambulance.
“I’m super busy just seeing all the kids. The day goes very fast,” said Shannon Ward, the school nurse at Smoketree Elementary. “Working with very young children requires lots of patience and compassion. Sometimes a small paper cut on a little finger needs a Band-Aid. For elementary children, every boo-boo is a big boo-boo.”
Sidebar with nurse roster
District’s school nurses answered a special calling
By Pam Ashley
Of the seven nurses employed by the Lake Havasu Unified School District, four are full time and three are part time.
Principals are the nurses’ direct supervisors at the schools sites. Aggie Wolter oversees the health offices at the district level where she is the director of special services.
Nurses are Tammie Dutton (Thunderbolt Middle School), Paula Struve (Havasupai and Nautilus),
Lynn Burns (Jamaica), Tamara Knight (Lake Havasu High School), Linda Dux (Oro Grande), Shannon Ward (Smoketree) and Bernice Heinrich (Starline).
Shannon Ward said she went into nursing with the intention of working with youngsters. For her, the school setting is a perfect fit.
Ward previously worked at a pediatric doctor’s office. When there was an opening for a school nurse at Smoketree, she pounced on it. This is her first year at the school.
“I’d been watching for an opening with the district. I’m glad I’m at this school. It was my mom’s favorite school to work at when she was a substitute teacher,” Ward said.
The job is also a perfect fit for a working mother. Ward’s two children are students at Smoketree, so they travel to and from school together.
“We have the same breaks and summers off together. It’s the perfect schedule,” she said.
Wolter at the district office said identical family schedules are a perk of the job and may contribute to the low nurse turnover rate. In the next breath, she emphasized that school nurses are a breed apart.
“It’s a calling for them,” she said. “It’s one of those professions with a strong, dedicated force.”
School nurse salaries are slightly below that of a beginning teacher’s earnings, Wolter said. Tammie Dutton, who has been the school nurse at Thunderbolt Middle School for 22 years, shrugged off the difference.
“I accepted the pay a long time ago. It’s a family-friendly arrangement. The lifestyle and the days off will hook you in,” she said. She believes some school nurses quit because they are looking for something more in their careers.
“They don’t stay because of the pay or they find out they really thrive in an environment with high acuity patients. You won’t find that in a school setting.”