School Nurse Perspectives     GerriSchoolNurse.com

 

But Is It Really Nursing?

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By Gerri Harvey, RN, M.Ed. NCSN

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Recentl y in an online school nurse group, there was a discussion about Frequent Flyers. Several were bemoaning the fact that these are kids who show up over and over but who are not really sick.They take up nursing time that kids who are really sick might need. The veterans among us said that the FF's may not always be sick, but clearly, if they are coming to the nurse, they need something. That something might be attention, release from a stressful situation, sleep, food, the bathroom, a sympathetic ear, orjust someone who will look them right in the eye, face to face, and ask them non-judgmentally, "How can I help you?" 

 

As someone shared her frustrations regarding the reasons teachers send kids to the nurse and the reasons kids ask to come, one weary school nurse said, "Yes, but is it really nursing? They waste so much of my time. "

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I want to offer a different perspective. If nursing is ONLY about caring for the sick and the injured, then it's easy to sort out the nursing from the not- nursing. I have heard school nurses say that if they do not see blood, vomit or a temp over 101, then the child does not need a nurse and is sent back to class, and some admit to sending a scolding note to the teacher about the child needlessly missing class or not requiring  nursing care This is actually medical model thinking. Health is the absence of sickness. Period.

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In today's complex world, one in which we understand how sadness,hopelessness, stress and loneliness can predispose a person to suppressed immune function, heart disease and even cancer, nursing is so much more than the old medical model.

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Nursing is about caring for not just the body, but also the mind and spirit. 

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Nursing is about having the skills to assess for the unspoken as well as the unspoken pain.

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Nursing is about prevention.

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Nursing is about comfort. Nursing is about teaching our patients how to achieve and maintain physical and emotional comfort themselves.

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Nursing is about empowering patients toward self-care. 

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Nursing is about giving others the understanding and awareness to deal with whatever hurts instead of substituting a "legitimate" illness to get what they need.

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And school nursing is about doing all of these things for little people still in progress, children, who are still learning how to be in this complicated and sometimes painful world and hopefully stay well.

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It is good to have those acute care skills, and be a nurse who knows how to do CPR if a person's heart stops beating, there's no doubt that THAT is really nursing. But it's also good to be a nurse who knows all the ways to protect that heart before it becomes sick.

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So yes, the answer is yes. Getting gum out of hair, sewing up ripped pants, inviting a child to eat lunch with you, opening the door for when they might want to disclose some pain you cannot even imagine, being the one to help figure out where the real pain might be coming from. are all part of nursing in a school.  Call it TLC if you will, it is the school equivalent of  of things you might do in a hospital to save a patient humiliation, embarrassment, or rejection in a vulnerable situation. It is harder to see those internal wounds, harder to measure how your attention might have prevented the development of something big and scary and physical,

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But yes, it is really nursing. 

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