SCHOOL NURSES: THEY GIVE MORE THAN BAND-AIDS

Dylan Andrews, a first grader at Gordonville Elementary School, indicated the direction the letter is pointing during an eye exam.

First-grader Leslie Birk signaled to Jackson school district registered nurse Ruth Lane during a hearing test.

Cape Girardeau Central High School nurse Jeanne Heise checked Robyn Wren's blood pressure. Heise has been a school nurse for 20 years.

On the wall beside Jeanne Heise's desk at Cape Girardeau Central High School is a framed picture of "Dr. Quinn, Medicine Woman," and her co-star. The gift was given to Heise, the school's nurse, from her family.

Heise was a fan of the Dr. Quinn television series and questions why it had to be taken off the air.

More importantly, she has taken the show's positive approach to medicine and incorporated it into her care of the nearly 1,000 students at the school.

Heise, Central's nurse for the past 20 years, said the scope of school nurse has changed over the years and has delved more into social issues.

The school nurse today has to deal with the physical, mental, emotional and social needs of the students and faculty, she said.

The biggest part of the job, she said, is learning to be a good detective. A nurse has to ask a lot of questions. For example, when a student comes into the office complaining of a headache, it might be from child abuse, not eating, an injury while playing or an illness.

Jackson schools' head nurse, Esther Gray, thinks today's school nurse deals with more serious health problems than in the past.

Heise said the school nurse has students with diabetes, kidney problems, eating disorders and allergies. In these cases, the nurse needs to be aware of the problems.

One example is Mitch Sadler, a sophomore at Central. He and his mother met with Heise before school about his Type 1 diabetes. He checks his blood sugar at school before lunch and physical education class. The test lets him adjust his diet for the upcoming classes. Heise found him a place where he could administer his test.

Pam Harper, nurse for Jackson's North and South elementary schools, had a student come to school with a heart monitor around the neck. The doctor was using the monitor to test the student's heart beat.

Allergies are a big problem in area schools, and Harper has a student that must use an inhaler before physical education class. Another student of Harper's is allergic to different kinds of nuts.

Gray said in the past nurses had more time to get involved, but that isn't the case anymore because of the increase in students.

In the Jackson district, there are five nurses to take care of more than 4,000 students. Each nurse oversees the health needs of two schools. Gray's schools are East Lane and Orchard.

In the Cape Girardeau district, each of the nine schools has its own nurse.

Heise has seen changes in the social needs of students, which she attributes to the breakdown of the family and the stress put on students.

In the Cape district, there are people without money to pay their bills, and when one student couldn't pay for an inhaler, Heise used her connections with the community to get the student an inhaler.

The community is great in helping out in these situations, Heise said.

Gray also has found the community helpful in similar situations.

It seems like there is always someone to go to to help the needy children, she said.

The Area Wide United Way and the county health department have helped the schools in emergencies.

At Jackson, high school nurse Ruth Lane has received a grant to tackle another social and health problem: AIDS.

Her grant will allow her to teach the "Get Real About AIDS" program. The material will be geared to each age group and will help dispel the myths of HIV and AIDS, she said.

The program was started because of the national HIV problem and because "we don't want it coming here," she said. It's for prevention.

While much of the nurse's job is still giving out bandages, the beginning of the school year is spent getting the health records of the students in order, making sure students have their immunization shots and on a variety of screenings.

Student health records are on computer in the Jackson and Cape districts.

Lane helped update the records of the immunization program, as generally sophomores and new students needed to update their tetanus shots. Certain immunizations must be completed before students can attend school.

And throughout the district, nurses have conducted student screenings in vision, hearing, tympanograms, height, weight, scoliosis and blood pressures.

Nurses also give tuberculosis tests and flu shots for the staff and faculty.

Still, many people see the school nurse as a triage nurse, said Lane, who during her four years in the district has seen students with heart palpitations, broken bones and cuts that needed emergency room attention.

Heise also makes on-the-spot decisions and then makes referrals when necessary.

Harper told of an instance when a student's finger got caught in a seat buckle, and Harper had to call emergency personnel to free the student from the buckle.

Harper deems any health problem that affects the child's learning at school as part of her job.

That includes medications, which at times, she said, she has to train the student on what to do for his health problem.

Jackson doesn't have a zero tolerance for students taking medications, Lane said. Students at Jackson can bring Tylenol, aspirin and other medications for their own use.

"Until there is a problem, we'll trust the students," she said of the school's policy.

Heise said Cape Girardeau has a similar policy. Students may carry their own prescription medicine, but it must be in the original container and only enough for a day's dosage.

Cape Girardeau treats its high school students differently than the younger students, Heise said, adding that high school students are treated as young adults.

But, beyond the emergencies, the record keeping, the screenings, school nurses add a vital ingredient to students -- TLC.

Gray said some children come to see her every day because they need a friend.

The first few weeks of the year, nurses use to get to know the students, Harper added.

Lane thinks it's the "counseling, the hugs, all the gratification" that makes her "job" a career.

Dr. Quinn would agree.