How I got here...

First of all, THANKS to those who've decided to follow my blog.  I'm feeling very "techhy" these days! 

I started this blog because I wanted to try and get people's attention.  I wanted people to "follow" me and let me tell them about Registered Nurses in schools and the wonderful resource and support they are to kids in Wichita Public Schools.  But now, I'm thinking, maybe it's a little more personal than that.  Maybe, it's my attempt to validate who I am, what I did and what RNs continue to do for children in schools.

When I started my journey into school nursing, I really had no idea what I was getting into.  I was like the rest of the public, and probably like the rest of the "real" nurses in hospitals.  I thought it would be great to have weekends and holidays off.  I kinda thought that it wouldn't be as time consuming as my home health job at the time;  It'd be much easier on my feet than the hospital job I had.  Man, was I ever wrong.

I started out as a substitute registered nurse for WPS.  There were no openings, so I subbed as often as I could.  I'm trying to remember where my first assignment was, and I think it was at Truesdell Middle School in "South City."  It may not have been my first assignment, but it's the most memorable.  Truesdell is a middle school of close to 1000 students.  I think at the time, there were three or four students with Type I diabetes, so many kids with asthma it was hard to count, and tons of psych drugs to give at lunch.  There were also two students who were in a classroom of SMD (severely mentally disabled) children who needed tube feedings.  I remember walking through the hallways of this '60's era, institutional type school, and thinking to myself..."I'm the only one in this school with any medical background.  And I'm in charge of the health and safety of these kids and their teachers."  I wondered what in the world I had gotten myself into.  The kids in the SMD room were very low functioning, with about one adult for every three or four kids.  I was told by the teacher that the children would be taking a field trip to the grocery store that day.  Evidently, they took a field trip most days.  I asked to meet the children with feeding tubes and was introduced to two very sweet, very fragile children, kids I'd only seen in a hospital setting.  They didn't really respond to my interactions, but appeared happy and well cared for.  Their feedings took time, so, while waiting I assessed their breathing and skin, looking for evidence of overfilling their stomachs, or of reflux. Looking and assessing that their skin was not breaking down because of being positioned wrong in their wheelchairs, or because they had been in one spot too long.  This is what is called the "nursing process."  Registered nurses learn this process throughout their education. It's a process of constant assessment of the different functions of the human body and to look for abnormalities.  While performing this vital function, the registered nurse is also taught to begin identifying any areas of concern, to understand and know the physiological process behind the abnormality and planning how to address it and intervene.  This is one of the greatest "unknowns" among non medical people...what is it that nurses "do."

As I walked back to the health room, I heard them before I saw them.  Approximately twenty kids in the hallway outside the health room, waiting for my return.  Some of their needs were trivial, yes, the dreaded boo-boo, even at this age.  But some were overwhelming.  One boy complained of soreness on his foot.  He took off his shoe and revealed a sockless foot that was macerated and peeling with open sores along the bottom of his foot.  It appeared that he had started with a bad case of athlete's foot that hadn't been attended to, and had become infected and needed to visit the doctor.  A call to his parent revealed that they had no insurance and felt they had no other recourse than the local emergency room.  I worked with his parent to find a low income clinic where this student could be seen.  I washed his feet with warm soapy water, wrapped his infected foot with guaze and waited for him to be picked up.  While this was happening, I was working with the diabetic students whose blood sugars were not within normal ranges; calling parents for guidance; listening to lung sounds, and dealing with the non stop health room traffic.  I was by myself, assessing these students, prioritizing their needs, making phone calls, administering medications, making decisions about calling an ambulance for a student with asthma and conferring with the office personnel to make arrangements for students to go home or back to class.  I believe I saw forty to fifty kids that first day.  Of course, many of them had figured out that a "sub" was in the health room, and it was probably an easy ticket home.  And they were probably right.  I was trying to keep my head above water and make sure no one died that day.

Have you ever been to a foreign country?  Or a place where no one speaks your language?  As registered nurses, we are "raised" to speak a new language.  One that includes lots of acronyms based in the Latin language.  These include "PRN, BID, QOD" and many others you've probably heard shouted on those doctor showson TV.  Ours is a language specific to medicine, and when we work in medical situations, everyone there understands us.  Education, however, knows none of this language.  And why should they?  They have their own: FERPA, FAPE, IEP, MTSS, and so on. So, you learn this new language, all the while using the one you grew up with, and trying to figure out how the two can possibly work together.

And then it happens.  One day you're in your car on the way home and you realize, "I made a difference in the life of a child today.  A real difference."  It may have just been that hug you provided to a distraught kindergartener who lost his first tooth.  Or to that sixth grader who started her period for the first time.  But most likely, the greatest difference you made was that you helped a family find a physician who diagnosed a previously unknown, life threatening heart condition/blood disorder/cancer/broken limb/or child abuse.  And you know, just know, that you really did save a life today.