Allergies, asthma and meds...OH MY!

Just a short entry tonight folks.  I plan to have a regular bedtime...emphasis on the word plan!

WPS RNs continue to work hard to educate people about the safety and medical needs of kids in schools.  We opened the dialogue with the BOE members last night with a speaker from Newman University.  Bernadette Fetterolf, RN, PhD, spoke before the board regarding the high needs of pediatric "patients" and the importance of the continuum of care between physicians, hospitals and community settings (like schools).  She also emphasized the vast difference between LPNs and RNs in schools.  A huge thank you to Bernadette, who for those of you not in the know, is THE pediatric go-to RN in the state of Kansas.  And a fantastic teacher!

The title of this blog just barely touches the surface of health issues children deal with in schools.  The tasks associated with these conditions, are the "things" people associate school RNs with.  (That and those damn bandaids!)  Nursing is so much more than a science.  It's an art.  As I sat with Bernadette last night, we talked about her current nursing students and the differences she sees between the students now and when I was her student.  She talked about the loss of passion for the art of nursing.  Maybe, I decided, that's because we've become such a technical world.  And because of the technical aspect, and the science associated with it, nursing has become more of a job, a business to be done.  I'm sad that the passion for the art of nursing is being lost.  Because it is this passion, that I carry so deep in my heart.  A passion for children, and the need to make their world a better place.

Dreamius was a kindergarten student at our school who came on the first day.  He rode the bus by himself.  No excited parent with him to meet his new teacher.  No big sister or brother to show him to his room.  Just his little five year old self, clutching a note in his hand.  Looking lost, he handed the note to an adult, who immediately brought him to the health room.  The note, written in rudimentary hand writing with spelling errors, said "Dreamius can't have no nuts."  Peanut allergy.  One of the school RNs worse nightmares.  Peanuts or peanut products are in everything.  School lunches, treats in the classroom, birthday party treats, after school food fundraisers, and on and on.  And to exacerbate the allergy, most kids have a severe case of asthma to accompany it.  I immediately called Dreamius' dad, who I finally reached after a couple of hours of trying different phone numbers, leaving messages and playing phone tag.  All the while, worrying about Dreamius in his new classroom and having no emergency medication at school for him.  I worried about what he would eat for lunch, would he have a reaction to someone else's lunch, developing a plan of action in the back of my mind for that emergency I feared would happen.

When I finally talked to Dreamius' father, he told me that they had just moved to Wichita from western Kansas.  They hadn't been in town long enough to find a doctor, much less get Dreamius' medical card transferred to this part of the state.  He also confirmed that Dreamius had asthma, but had no asthma medication or emergency allergy medication that could be brought to school.  Besides, they had no car and no money for the bus or cab to bring them.  I kicked into high gear, calling a community case manager from one of the local hospitals.  Within a few hours, Dreamius had a physician appointment, arrangements were made to get his medications, and a cab voucher was received so that Dreamius' dad could take him to the doctor the next day.  We made it through that first day of school without mishap or emergency.  We found some food that Dreamius could eat for lunch.  I followed up with his father to get special lunch paperwork filled out, his medications at school and an appointment with the asthma clinic to be evaluated. (I could hear Dreamius' wheezing through a wall when he arrived at school each day.)  There were many times throughout the first few months that I made home visits to help Dad sign papers, get to doctor appointments and educate him about Dreamius' severe asthma.  At his first visit to the asthma clinic, Dreamius was diagnosed with "status asthmaticus," one step from respiratory failure and possible death.  It was obvious that Dreamius and his allergies/asthma had been neglected for a long time.  

I tell this story to emphasize a point.  The art of being a registered nurse includes having the knowledge of the science behind allergies and asthma.  And it doesn't just include understanding of community resources.  The ability to assess and intervene is part of the art, but passion is at it's core.  Passion to help, no matter what it takes.  Passion for a child to breathe comfortably and safely at school so that they can participate fully in their school day. 

When I first started as a new nurse, I was offered jobs at all three hospitals in Wichita.  I chose one of the Catholic hospitals because of thier motto..."That which you do to the least of my people, you do unto me."  That's my mantra.  Wish I could get others to see that too.

Night all!