Shot records? Check! Physical forms? Yep! Band-Aid? You bet!
Donna Pierson, RN, Effingham's School Nurse, wants you to know that her work does include all three — and much more. Donna addresses the needs of 2,500 Unit 40 students every year, ranging from pre-K to high school senior, and spread across five attendance centers.
Pierson's work is holistic nursing practice. The focus changes as the student transitions from pre-K to high school. The needs of the smallest ones are often as much emotional as physical, and a hug with the Band-Aid goes a long way. High schoolers are more complex, and teaching them to get healthy and stay healthy is a big part of her work there.
Every day is different, with new challenges. Pierson visits each of the five schools once a week on a rotating basis, but is available to all of them. She uses email, text and telephone to keep in contact with parents and school personnel. The work space at each facility varies, but a laptop and the internet permit her to connect to the district's database at every point of contact. In any given week, she has face-to-face time with around 150 students, in addition to telephone conversations with many parents.
The school nurse collects the state-mandated physical exams, shot records, vision and hearing screens, and dental exams. Pierson is physically present at the end-of-summer school registration days to meet with parents and to let them know about Effingham County resources. The nursing role includes keeping track of forms, reviewing their contents, and following up with the family if there is an unmet need. If a student has a problem with vision, for example, the nurse works with the parent or guardian to see that the child gets corrective lenses. All students have a paper file that follows them through the system, and that can be copied and transferred if they move away from Unit 40.
There is more to school nursing than thousands of paper records. Pierson develops a specific nursing plan of care for students with acute and chronic medical conditions. In acute cases, she does a physical assessment on the spot and decides what should happen next. If a temperature check, node palpation, and throat inspection indicate a student has an probable strep infection, that means arranging with the parent to see the child's primary care provider.
Once in a while, there are signs and symptoms of injury like a fracture, or a unique problem like an acute abdominal malfunction. Then a trip to the ER is advised. Pierson serves as an adviser and buffer zone between the school system and the outside health care system.
Some students come to school with chronic medical conditions that need day-to-day supervision. There are students with asthma who benefit from an asthma management plan and continuous access to an inhaler. Allergies of varying degrees of severity are a common problem. Student with allergies must recognize their triggers — what not to eat or come in contact with, as well as what to do if an allergic reaction occurs anyway.
Students with diabetes are strongly encouraged to self-manage their condition, including blood sugar testing, carbohydrate counting and insulin administration. Everyone in contact with that student is part of the plan, including the parent, a consulting dietician, the classroom teacher, paraprofessionals and even the bus driver.
In a district with over 2,500 students, there are quite a number with IEPs (Individualized Educational Plans). IEPs level the playing field for students with special needs so they can be successful. If a child has medical needs that impact learning, Pierson is part of the team, which also includes the special education coordinator, psychologist, social worker and the classroom teacher. The team members collaboratively set goals with the parent and the student and track the student's progress.
Pierson has been a school nurse for seven years. She is an ADN graduate of Lake Land College and earned a BSN from SIUE. Currently, she is working toward a master's in nursing at the University of Southern Indiana, with a nurse practitioner focus. She loves school nursing, and her dream is to use her advanced training in that setting.
Linda Ruhol, effinghamdailynews
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