What I've Done in School Nursing Lately

Spring and nice weather always brings more busyness in the health room, particularly at the elementary school. We see more scraped knees and elbows; more broken blisters from swinging on the monkey bars; more itchy eyes and runny noses because of increased pollen count. There are also more bug bites and bee stings. Those are the typical things. During the last week or so there has also been a bad cut lip because the student crashed on her bike during bike safety class; ironic, I know. There was a sprained wrist from playing fly-up at recess. I have also been busy preparing final immunization notices for 5th grade students who need a Tdap shot before starting 6th grade in the fall. And there is always the end-of-the year paperwork to send to parents with students who take/have medication at school or have an emergency care plan. I will also be presenting human growth and development at the end of May to the 5th grade girls.

The middle school has its share of busyness as well. Last week I sent a girl to the doctor with a suspected broken bone; it was. Yesterday I sent a  boy to the doctor with a suspected ACL injury; not sure of the outcome but I'm sure I will hear something when I go to the middle school this afternoon. The middle school also has the typical "I don't feel well" kiddos who really just need a 10 minute re-set rest and then they are good to go.

All of those types of things I'm pretty well-prepared to deal with. What I'm not always ready for is the "counseling" that sometimes goes into my job, especially at the middle school where their problems seem to be a bit more complicated. Last week I helped a young lady prepare to have a conversation with her guardian about wearing tampons. She said she has attempted this conversation in the past, but it has not gone well and usually ends in door-slamming and frustration on both parts. So we talked about why she wants to wear tampons (comfort, able to participate in more activities, don't have to worry about them showing through clothes) and why her guardian is against it ("tampons are only for girls having sex"). We talked about ways to start the conversation, how to be respectful of each other's views, etc. I asked if there was another female family member who she could turn to for help and she indicated that there was. She left my office feeling confident and ready to have a respectful conversation with her guardian.

I guess the advice was good and the conversation went pretty well. This young woman has decided that I am a pretty safe, non-judgmental person to talk to because the next conversation was a little more intense. She needed information on pregnancy testing, how old did she need to be to make her own decisions, where she could go, etc. So we talked about all of those things. She didn't want her guardian to know. I explained that even though the State of Washington has said that 14 year-olds can make their own decisions regarding reproductive health, 14-years olds need adult guidance on these important, life-changing decisions. I said I was glad that she comfortable enough with me to discuss these things, but my ability to help her was pretty limited. I said multiple times during the course of our conversation she needs to have a conversation with her guardian. She will need a strong support system to help her deal with the consequences of her decision to have sex. I told her there are always consequences, it could be a pregnancy, a STI (they are called infections now, not disease), a broken heart, but there always consequences. She understood the need to talk with her guardian but she wasn't ready to. I told her to come back and we would practice the conversation just like we had for the tampon talk. That was Monday. I'll follow-up with her today.

My job would be so much easier if it was just about band-aids and lice checks.