Are School Nurses Real Nurses?
Yes, I have been asked that question. No, we got our license from a Cracker Jack box. Of course, we are real nurses. After all, I’ve been informed by a young child that I must be one since I have RN after my name. I asked the child what RN stood for. He promptly said, “Real Nurse. My mom told me so.”
And that, gentle readers, is one of the reasons I love working with children. They say some of the funniest things in all seriousness. Their words have a grain of truth as they miss the truth by a mile. Working in pediatrics gives you such a wide range of options, and every age group has their blessings and drawbacks. So, how did I end up working in “a germ factory?”
When my hubby and I started talking about having children we looked at the finances. Our biggest question was what changes would we need to make if I worked or if I stayed home. For us, it made more financial sense for me to stay home. I also wanted to be with my babies and young children. The largest drawback was what it would do to my nursing skills to stay home for a large chunk of time. But nursing skills are something that can be regained and continuing to read professional magazines would help me keep abreast of changes occurring.
The biggest curve ball was having a child with special needs and realizing the huge impact that would have on childcare in the future. Despite the ADA (Americans with Disabilities Act) our children were still discriminated against. Toss in some life-threatening disorders into the mix, it made finding care outside the home beyond challenging. I needed a job that would have me home after school and during vacations.
Now, I wonder what kind of job would fit that schedule?
I was already consulting and supervising an LPN at the preschool my two youngest attended. Oh… wait… I wondered if there was a possibility I could work something out there.
I worked part time initially. That meant I could put the girls on the bus and take off for work. I would also be home before their bus dropped them off. As program hours expanded, my job hours expanded, too. When Forrest’s job situations changed from full to part-time, back, and forth for years, my boss increased my hours to full time. She kept me as a 10-month employee; however, there was an expectation I would work the six-week summer program as well.
When I first started this job, there were two sites. I worked at one site and was available for the LPN at the other site, should she need me. Initially, I was embedded in a classroom. There was no spot in the building for a nurse’s office and no one was sure if there would be enough to keep me busy. There was, but I loved my time in the classroom. It gave me a great grounding in how to work with children on the autism spectrum.
One of our special education (SPED) teachers was also a licensed occupational therapist. I learned so much about how to work with children that had auditory processing problems. She also educated her staff about ways to help the child with sensory issues. One of our speech therapists frequently pushed into the classroom to run a snack group. She would model how to help children “wake up their mouths” before snack was handed out to children. We all took turns running snack groups and we all spent the first 5-10 minutes “waking up their mouths.”
Selfishly, all these tricks of the trade would help me with Sheila. Why do mouths need waking up? In Sheila’s case, she had motor planning issues and lack of awareness of where food was in her mouth. The various techniques helped her become more aware of her tongue, moving it from side to side, pushing down on the center of her tongue with a spoon helped her tongue muscle activate and “bowl” around the spoon. Rubbing her cheeks helped activate muscles in her cheeks. Having a child use the tip of their tongue to push against the inner cheek wall may be a silly looking game, but it helps teach a child to move their tongue around in their mouths to clear food that might be “trapped.”
When the speech therapist found out I could play the guitar and was running some music groups, she asked if she could push in. Like the proverbial camel sticking his nose in the tent door, the next thing she asked was, “If I give you this week’s theme words can you work them into songs that use them repetitively?” Suddenly, I found I was running my own group with familiar nursery rhyme on other silly children’s songs and then co-leading a group with the speech therapist. I would use familiar tunes and make up silly songs using the theme words. Why music for language learning? It evokes emotion and engages the brain. When we repeat words over and over again it helps plant them in our memory. Children engage with music and are motivated to learn. Between repetitive exposure to words, engaged emotions, and friends surrounding you engaged in the same activity, confidence builds within the group, spilling out to every individual.
But what does this have to do with nursing?
I used music groups to familiarize kiddos with foods that keep them healthy, hygiene that keeps us healthy, scary tools a doctor or nurse might use, like a stethoscope, thermometer, or syringe. They might not sound scary to us, but I worked with young children, and you would be surprised what they find scary. Because I was embedded in a class, children were not frightened about seeing me if they were not feeling well, or if they got hurt. I was known to them and that is so important in the early years. Nurses are caregivers, but it is hard to feel cared for if you are hurting and you are brought to a stranger.
The first site I worked at had just two classrooms. Although I was embedded in one, I did music groups in both classes, on my own and with the Speech therapist. So, both the 3-year-olds and the 4-year-olds got to know me. I would miss those days later when we grew as an agency. I would eventually be pulled out to do more traveling between sites and attending meetings off sites.
Once a Nurse… Always a Nurse…
Years ago, my Aunt Barb (also a nurse) said to me, “Once a nurse, always a nurse.” Embedded in a classroom, or moved to an office, I still felt like a nurse, thought like a nurse, and performed like a nurse. Are school nurses, real nurses? The nurses are taught the nursing process during their training. It provides a systematic guide for gathering, planning, implementing, and evaluating the care we give. It is a problem-solving method for nurses to use. It is implanted into our very being. Do school nurses use it in their practice? Of course they do. Yes, we are real nurses.