School nurses in Va do more than distribute bandages | Health, medicine and fitness
By PAMELA GOULD The freelance star
FREDERICKSBURG, Virginia – The job of a school nurse seems simple enough.
Be there for scraped knees, sniffles, and sore throats. Distribute the prescribed medications to the students. Monitor children who need to check their blood sugar.
Most of the time, it’s pretty routine. But when an emergency occurs on school grounds, the life of a child or an adult can be at stake.
This is when the training, experience and presence of a nurse is essential.
“Most of the time we don’t use a lot of skills,” said Jenny Gautreaux, a nurse at Ni River Middle School in Spotsylvania County. “But we have to know how to do it all and know how to do it right.”
As a school nurse in Ni River for the past eight years, Gautreaux has had to call on her nursing experience for several emergencies.
One day last month was one of those times.
An eighth-grade girl came to the clinic after lunch complaining of nausea and stomach pain. The girl, who told Gautreaux she was lactose intolerant, thought she must have eaten something with dairy products.
The symptoms were consistent with this, so Gautreaux called the girl’s father to tell him she was sick and then kept an eye on her.
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But soon the symptoms changed.
The girl’s throat started to swell, she had difficulty swallowing, and she felt a tightness in her chest.
“When that happens, you literally have seconds to minutes to administer epinephrine,” Gautreaux said.
“I prepared the epinephrine and called 911 at the same time,” she said. “I told him what we were doing.
Although schools keep a list of children with allergies and keep epinephrine pens with the prescribed dose for each child, this girl was not on the list and did not have a pen because she did not have an allergy. known.
But school nurses have standing orders that allow them to dispense a handful of medications in emergencies, including epinephrine, Benadryl, and asthma treatments.
Gautreaux gave the girl an epinephrine injection and then monitored her while they waited for medics to arrive.
In the meantime, a school administrator called the girl’s parents again to let them know what was going on.
“It was actually the grace of God that the parent was out of the area and the child was there when she went into anaphylaxis,” Gautreaux said.
Within minutes of the epinephrine injection, the swelling in the girl’s throat subsided and she was able to breathe again, the nurse said.
When the doctors arrived, they took over and transported the girl and her mother to the hospital.
This emergency ended well, but Gautreaux also saw the other side.
In September 2005, a boy with known heart disease went into cardiac arrest during a gym class. Gautreaux was prepared and did everything medically appropriate, but the child died that day in hospital.
It was hard on her and on the school community.
“It is always the school nurse’s intention to take good care of someone else’s baby,” she said.
Janet Ervin, the nurse at Courtland High School, was in his clinic in October when a teenager arrived from his physical education class thinking he might be having a panic attack.
The second said he had had one a few years earlier and thought it would pass.
Ervin took his pulse, which was normal. She then asked him to rest for a few minutes at the clinic and kept an eye on him.
About 30 seconds later, he said his heart was beating fast.
“I checked. It was beating so fast I couldn’t even count it,” Ervin said. “I called 911.”
She then checked her heart rate with a pulse oximeter. Her oxygen was good, but her pulse was 281. The normal rate for a child is between 60 and 100.
“I was so glad we had the AED at my doorstep,” Ervin said.
An AED, or Automatic External Defibrillator, is used to restore a heartbeat when a person goes into cardiac arrest.
Ervin kept a close eye on the boy as they waited for the medics to arrive.
Ervin has been a school nurse for 17 years and in schools in Spotsylvania for eight years. She, like Gautreaux, who has two decades of experience, tried to distract from herself, claiming the boy’s life was saved through a team effort.
Ervin noted the physical education teacher’s vigilance in sending him to the clinic, the boy’s own admission that something was wrong, and the prompt arrival of the doctors.
The boy was taken from school to the emergency room on October 20 and then underwent medical intervention to treat what was diagnosed as supraventricular tachycardia, Ervin said.
In this condition, the heart’s electrical system malfunctions and causes the heart rate to accelerate.
Ervin said this was the cause of the sudden cardiac death cases seen in athletes.
“You cannot live with your heart beating so fast,” she said.
The Spotsylvania School Division employs 30 full-time nurses, one in each school.
The school divisions of Stafford County and the City of Fredericksburg are doing the same.
This was one of the first questions Superintendent Shelley K. Redinger asked when she visited the buildings in Spotsylvania last spring after accepting her position with the division.
She had worked with school nurses during her tenure as a school administrator in South Carolina, then no longer had them when she supervised the Oregon Trail School District near Portland.
After observing both situations, she said she was a “big supporter” of nurses because they play a role in preventive care and diagnosis of the disease.
The recent experiences of Spotsylvania staff underscore the importance of the position.
“These situations show how important school nurses are in saving lives,” Redinger said.
The incidents of Gautreaux and Ervin are among the examples of this school year.
Last year, Debra Willis, a retired nurse from Battlefield Middle School, had to administer cardiopulmonary resuscitation to a parent in the school parking lot.
And with today’s tough economy, the roles of nurses have expanded to include the “front line of health care” for many families, Gautreaux said.
Parents without health insurance are now asking nurses for advice on the severity of their children’s illnesses so they can decide whether to see a doctor or just go for over-the-counter remedies.
But the potential for emergencies exists every day in every classroom in every school.
Often they have to deal with a range of illnesses that students and staff have in their medical histories.
“We don’t expect life to be in danger at school, but we still need to prepare for it,” Gautreaux said.
Information from: The Free Lance-Star, http://www.fredericksburg.com/