School Nurse

Spending two days shadowing a school nurse was a wonderful experience. I had the pleasure of doing my school nurse rotation at Fox Creek Junior High School. I never realized how difficult and overwhelming it could be to be a school nurse. Ms. Bodauine was the nurse I got to shadow. She spent her day doing paperwork, helping the sick and injured, and doing vision and hearing screenings. There were several kids who came in throughout the day, approximately twenty-one per day that was either sick or injured. Upon each kids visit, I had the opportunity to observe, assess, and communicate with them. I was able to observe behaviors of some children showing Industry vs. Inferiority, according to Erickson. I also observed transitions the kids were experiencing, such as situational, health-illness, developmental, and organizational. Industry versus Inferiority is the fourth stage of Erik Erikson’s theory of psychosocial development. This stage occurs during childhood. During this stage children want to do productive work on their own. “Difficulty with the child’s ability to move between the world at home and the world with peers can lead to feeling of inferiority. It is vital for children at this stage to discover pleasure in being productive and the need to succeed.” (Erik Erikson’s 8 stages of psychsocial development, “n.d.”)

Two examples of industry that I witnessed in two different children that I observed are: The nurse gave a paraplegic girl her physical therapy progress report to give to her parents instead of mailing it out. This showed the student that the nurse trusted her to give the note to her parents, which made the student feel productive by her accomplishment. The second example took place when I was doing a vision screening on a little girl. Before starting the screening she started asking questions. She asked why she had to get the test done, what each line meant on the snellen chart, and what would happen if she failed the test. This student showed her willingness, and desire to learn. Culture played a role in both examples of industry in that each student had their own way of being recognized and feeling accomplished. One by the nurse and her parents by giving her parents her Physical Therapy progress report, and one by showing her willingness and desire to learn about the vision screening.

Two examples of inferiority I witnessed were: a boy came in with a complaint of cat scratches that occurred at his home a couple days ago, he stated his mother refused to provide band-aides because the scratches were minimal. After being in school for day students had made comments about the scratches so he decided to come get a band-aide. This made him feel inferior to his peers. Another example was a kid came in crying with a headache because kids were making fun of him because he was failing P.E. class. This made him feel inferior to his peers. There are different transitions students may go through upon entering a new school. Fox Creek Junior High School is ranged from 6th-8th grade. Becoming a junior high school student has caused a situational transition because of going from one teacher in grades kindergarten-fifth, to five to six different teachers a day in grade sixth-eighth. They are also attending school with other kids from other elementary schools that they have never seen before. Some health-illness transitions I saw were among a paraplegic kid, a diabetic kid, and a severe asthma kid.

Each of these students were going through a health-illness transition because they are learning to cope with a new disease. The paraplegic girl had to get used to getting around in a wheel chair, and self catheterizing herself 3 times a day during school. The diabetic kid had to change her eating habits. She also had to get used to counting carbs, checking glucose levels, and taking insulin throughout the day. The asthma girl had to get used to giving herself a breathing treatment at least once a day during school hours. According to Fraser-Thill (2010), “The developmental transitions that children in middle school are experiencing are, more responsibilities, puberty, and exposure to drugs, alcohol, and sex.” The organizational transitions that these children may experience are joining sports, and clubs. Children that experienced real health care needs were, the ones that came in with swollen tonsils, fevers, bloody noses, visible cuts and scrapes on elbows and knees, and a kid complaining of chest pain that was diaphoretic and dizzy.

A couple kids used manipulative behavior to go home and a couple used it to spend the hour in the nurse’s office to miss class. One student stated that she had a headache and stomach ache and wanted to go home. She stated the pain had been going on for two days. When asking if she wanted Tylenol for the headache and crackers for the stomachache she said no she just wanted to go home. Ms. Boudauine did a very good job at handling this situation. She explained to the girl how important it was to go to class, but if she really weren’t feeling well she would call her mother to come pick her up. Ms. Boudauine was very caring and considerate toward the girl. The girl ended up going home, but while waiting for her mother to arrive she sat in the nurse’s office doing homework and chatting with all the other students that came in. It just didn’t seem as if she was really sick. The next day Ms. Bodauine was informed by the girls’ teacher that she missed class, because she didn’t do her homework.

Ms. Bodauine was very caring toward the kids at Fox Creek Junior High School. She educated the kids as much as possible throughout the day. I listened to her educate a student on how to clean a cut. She explained why it was important to keep the cut clean and dry. She also informed to the student to be careful when using knives in the kitchen. The student stated he would do so. Another teaching experience was when a little girl came in with a complaint of a sore throat. Ms. Bodauine taught her how to gargle salt water, and also told her she could use Cloraseptic spray instead if she didn’t like the gargling. She informed the student that she needs to wash her hands frequently to avoid getting sick, or getting others sick.

The student shook her head and said she would do so. The school nurse rotation was a very interesting experience. The nurse seemed to love her job, she was very caring, nice, and compassionate to the children. She had wonderful communication skills with the students. I found communication to be a bit of a struggle for me, because I am not really used to talking to children. I was unsure of what to say or how to word things so the kids could understand. The way I would improve my professional practice as an a effective communicator and teacher would be to speak to kids more often and ask more questions so that I have a better understanding as of to what they might be struggling with. Being a school nurse in not a job I see myself doing. I found it to be more difficult than I had thought, but still isn’t the type of nurse I see myself becoming.

References
(“n.d.”). Erik Erikson’s 8 stages of psychsocial development. Retrieved from http://web.cortland.edu/andersmd/ERIK/stage4.HTML Fraser-Thill, R. (2010). How do tweens change over the Middle-school transition. Retrieved from http://tweenparenting.about.com/od/educationissues/a/Middle-School-Transition.htm