The Carlisle Mosquito Online

Friday, October 15, 2004

Features

An Ace bandage here, a listening ear there
Two school nurses care for the physical, mental and emotional well-being of Carlisle's students


School nurses Lori Desjardin (seated) and Kathy Horan take a moment to relax in their office in the Robbins Building during a typically busy day at the Carlisle School. (Photo by Ellen Huber)
At 7:45 a.m., just as buses begin disgorging streams of middle school students into the Wilkins Building for the start of classes, Kathy Horan and Lori Desjardin usually have their first customers. Someone woke up with a sore throat; another is bothered by a pulled muscle from the previous day's soccer practice. By 9 a.m., a kindergartner might show up with a stomach ache, possibly the first signs of a virus but just as likely a case of mild kindergarten anxiety. Desjardin is left to make the diagnosis while Horan hurries off to the classroom. She is teaching a health class to sixth graders, and peer pressure is at the top of today's lesson plan. From there, she'll head to a first-grade room to talk to the kids about the importance of hand-washing. She's hoping to consult with a guidance counselor about a student showing signs of a possible eating disorder before she does CPR training with a group of seventh graders. Meanwhile, back in the health office, Desjardin has checked a temperature, staunched a nosebleed and offered words of comfort to a child who just seems to be having a bad morning.

Welcome to a day in the lives of Kathy Horan and Lori Desjardin, Carlisle school nurses. And it's not even lunchtime yet. In the 2003 — 2004 school year, the health office logged a total of 6,500 student visits — a number that does not take into account the visits by school employees with medical concerns of their own.

Taking care of kids

Actually, the list of responsibilities the two nurses attend to in a typical day will probably not surprise you if you are the parent of a child in the Carlisle school system. Those who have the opportunity to view the nurses' work firsthand already know just what a demanding job it is. "You really get the sense that these women are there for the kids and their families, whatever they need," says Julia Krapf, parent of a second-grader and a fourth-grader. "They're not just treating illnesses; they are taking care of kids in every aspect of their lives." And the two nurses say that it is just this variety of responsibilities that make "every day a joy," in the sincere words of Desjardin.

"I love my job," echoes Horan, who has worked in Carlisle's health office for the past 12 years. Before that, she was a surgical nurse. Her exposure to small children in the hospital setting convinced her that school nursing would be a good match, and five years ago she enhanced her medical training with a master's in education, the better to qualify her for the many teaching and training responsibilities her job covers.

The general duties of the school nurses include assessing minor illnesses, conducting yearly vision and hearing tests, passing out Tylenol when necessary, and administering short-term courses of prescribed antibiotics. But far more than that happens on a regular basis in the health office, and they need to keep on top of constant changes in the field. One major example is the burgeoning of food allergies among school-aged children that has occurred in the past several years, which places an enormous additional workload on health professionals. Each child in the school system known to have food allergies has an EpiPen stored in the health office, Horan says. "This year we have about 40 EpiPens. When I started here 12 years ago, we had two."

Food allergies

Because reactions caused by food allergies tend to be so severe in nature, it is crucial that the school be well-prepared should a reaction occur. "We've developed a very good program for our staff regarding allergy awareness," Horan says. "Every staff member employed here has to watch a short film about how to spot a child having an allergic reaction." She stresses that this training extends not only to teachers but also to playground aides, cafeteria workers and bus drivers, who also learn basic first aid from the nurses. "I give them all credit for being so willing to undergo our training," she says. "When I tell my colleagues in other school systems that our bus drivers come in willingly to learn about health issues from us, they are amazed. But it's typical of this school system: we all work as a team. Lori and I feel appreciated and respected, which is not the case for nurses in many school systems."

A team approach

The team approach is integral to every aspect of student health care, Horan explains. "Once a week, I attend what we call a NAG meeting. It stands for nurses, administration and guidance. The guidance counselors, principal, superintendent and I talk about any kids we have concerns about. We might be talking about a child who has just had surgery and may need some extra help catching up academically. If I mention a student who has been in our office a lot recently with vague complaints, a counselor can sometimes fill me in on something that's going on in that student's home life. This is not the kind of teamwork you see in many school systems. It has a hugely positive effect on the students, because by collaborating in this way, we can often figure out pretty quickly what a particular situation requires and how we can best help."

Drug education

Horan and Desjardin both believe that developing a strong rapport with students and their parents is vital to their success at treating the school community. "A lot of doing well at this job has to do with simply getting to know the kids. We try to get to know them all in the early grades. If an issue arises in middle school with some kind of risky behavior, it's easy for us to address our concerns when we've known the child for a long time." Much of the middle school health curriculum, a three-year course that Horan team-teaches along with physical education teachers Lynne Carmel and Margaret Heigl, is devoted to social issues such as substance abuse. "We hammer the kids with drug education," Horan admits. "They groan, 'Not this again!' I tell them, 'You heard it last year, you'll hear it this year, you'll get it again next year. And I just hope that when you get to high school and someone offers you a joint, you'll remember me standing here telling you why you should refuse it.'"

One interesting way that Carlisle students' health profiles differ significantly from national norms is on the issue of weight control. "Every day you hear more about childhood obesity, but that's quite rare in our school system," Horan says. "Our kids are very conscientious about nutrition and good eating habits." Smoking is another topic on which Carlisle students do not fit national statistics, she explains. "Most kids here are appalled by smoking. They don't want anything to do with it."

Contact with the parents

Michelle Sobin still remembers the immediate and lasting comfort that Horan and Desjardin offered her when her daughter was diagnosed with diabetes at age five. "It was a very traumatic time for us," Sobin says. "We were reeling as to what it meant to our family. Before I even had a chance to contact the school myself, Kathy and Lori called me and said, 'Is there anything we can do to help? Don't worry about how to manage in terms of the school; we will work that out. We will do everything we can to support your daughter.'" As she does with all Carlisle school families who have a child with a severe allergy or other medical condition, Horan meets with the Sobins every summer to review their daughter's situation and to reassure them that the school is well prepared.

The Sobins reflect the view of many Carlisle School parents that their children are in extremely capable hands when they visit the health office. Desjardin and Horan both augment their existing knowledge with frequent continuing education opportunities, ranging from asthma programs to summer seminars designed particularly for school medical professionals. But they are quick to point out another dimension to their expertise as well. "Both of us are mothers with three children," Horan explains. "We have plenty of medical training, but a lot of the time all it takes is 'mom's intuition' to figure out how we can best help a child."


2004 The Carlisle Mosquito