Just trying to keep kids safe...

When RNs work in hospitals, it's pretty easy to quantify what they do.  They have an assigned patient "load." They perform assessments, administer treatments, medications, interventions.  They have "outcome" expectations related to infection control, discharge, etc.  There are consultants and nurse directors who determine how many patients can safely be handled by one nurse.  These are issues that require understanding and knowledge of safety.  Safety for patients.  Safety.  It's a word that needs to be explored in the school setting.

In it's infinite wisdom, our legislature has decided to cut funding for public schools, to the point that safety of children will be a very important concern.  Legislators think that schools are overfunded.  They believe that there are too many "people" in schools.  Too many administrators, too many support people, too many this, too many that.  How do they know I wonder? Are they education experts?  Do they understand the population of our public schools today?  Have they visited a school lately to see?  Frustrating topic.

I've been really lucky in my professional life as a school nurse.  I've had the opportunity to participate in the Nurse in Washington Internship (NIWI).  I've served as a member of a national school nurse committee affiliated with my union.  I've lobbied on Capitol Hill, and in Topeka.  I've spoken before legislative committees and the Board of Education.  I've presented at a national EPA conference and participated in a CDC study of registered nurses in schools.  All of these opportunities have helped to form my understanding of the importance of registered nurses in schools.  It's also served to further my understanding that the public, the legislators, the board of education members, and even school administrators, really don't understand what a nurse "does" in a school.  The ability to "quantify" what a nurse does in a school is a difficult challenge.

Attend any school board meeting, you will hear about testing results, No Child Left Behind, new initiatives to reach students who aren't learning.  Graduation rates, math/reading proficiencies, all the things that quantify an education.  This is the language of learning.  The quest to produce life long learners.  And unbeknownst to most, health and safety are the integral missing piece.  For if you don't have those two components, life long learning cannot happen.

In Wichita, the BOE is trying to cut $30 million dollars from their budget for next school year.  Because of legislative decisions, public funds for education are being decimated.  And in an effort to keep the most amount of dollars cut, away from the classroom, support people such as Registered Nurses are being considered a luxury.  The inability to quantify the registered nurses role, thier positions are seen as non essential, and employees with less education looks to be a good decision to those making the decisions.  Decisions being made by people with no medical background and little understanding of the health and safety needs of students. 

I talked to a school nurse tonight after the BOE meeting and he said something that highlighted this issue.  He told me that the "tasks" he performs at his school (medications administration, bandaids, vomiting, etc.) take up the least amount of his time.  Dealing with the social and psychological issues facing students consumes the largest amount of his day.  The problems that children bring to school with them are, at times, unsurmountable.  They bring hunger, chaos, violence and abuse with them everyday.  They are just children, and have no defense against such things.  There is much new research about how stress affects young brains, but I'll save that for another day.  Registered nurses have the unique education to address these problems.  There are counselors and social workers in schools too, but none of them have the exact scientific background to help children with these issues.  They require so much more than a bandaid.

Ryan was a kindergartener at my school many years ago.  He was a very bright, articulate little boy with dark curly hair and a smile that matched his enthusiasm for school.  Ryan was what we in the business, call a "frequent flyer."  He was in the health room for a myriad of complaints. Frequent tummy aches, frequent head lice, frequent cleanliness and hunger issues.  One day he came to me complaining of not feeling well and asked that I call his grandma.  He had a fever and needed to be sent home.  I knew he lived with his father, and offered to call his dad, but he cried and begged me to call his Mimi in Oklahoma.  I didn't have this phone number, but did have the number for his other grandma in town.  I made the call and asked grandma to pick him up, but also asked her why Ryan wouldn't want me to call his father.  Grandma told me that Ryan was new to living with his father.  He had been raised by his maternal grandmother in Oklahoma until his father found out about him when he was four.  Evidently, Ryan's mother hadn't told his father about Ryan's existence.  When his father found out, he insisted that Ryan live with him in order to avoid financial support orders.  So, Ryan went to live with a man he didn't know, after being raised in a loving home for four years.  Ryan's grandma told me that she didn't want to "tattle" on her son, but she asked me to please visit Ryan's father's house to see how Ryan had to live.  In the meantime, she picked Ryan up and took him home with her.  Home visits are one of the things that school nurses do frequently, that aren't written down, and therefore aren't a number that can be reported on a report for administrators to interpret.  The social worker at my school and I, went to Ryan's father's house.  It was a very small house that sat way back from the street in our school's neighborhood.  There were broken down cars, batteries and empty propane tanks littering the yard.  The windows were covered with heavy blankets.  His father answered the door and the stench from inside was palpable.  We weren't allowed in the house, and with concerns for Ryan, and evidence of possible drug manufacturing, I called our local police officer to further investigate. Because of the conditions of the house and living situation, Ryan was removed from his father's home.  Police reported that there was no indoor plumbing, so Ryan crawled out the window in his bedroom to defecate and urinate at night.  His father, in an attempt to make money, was raising rats to be sold to laboratories.  Unfortunately, he had allowed the rats to become feral.  Ryan was found to have numerous rat bites on his arms, legs and feet.  I was subpeonaed to court to testify on Ryan's behalf in a custody hearing, but was never called.  Ryan's father relinquished custody to Ryan's Mimi in Oklahoma.  A few months later, Ryan's Mimi from Oklahoma called me.  She wanted me to know that Ryan was doing well and excelling in school.  She also told me that she was a Registered Nurse and that whenever she talked to Ryan on the phone, she told him to tell the nurse at his school what was happening at his father's house.  And Ryan, in his kindergarten way, only knew to come see me and complain of various aches and pains.  He didn't have the words to tell me of the filth and terror that he lived in every night.  His Mimi told me that I saved his life.

I have an almost three year old grandaughter who calls me Mimi.  In honor of Ryan.  I think about him often.  I think about how he endured almost two years of feeling like his world had been torn out from under him and not knowing how to fix it.  And I am grateful that because of my nursing knowledge, my understanding of growth and development, I was able to help him.  Safety.  It's an important word.