I recently came across your article titled "A Nurse In Every Public School Is a Sick Idea", dated Feb.16, 2009. Being a school nurse at a public school in Tennessee, I just wanted to respond to hopefully give a clear picture of my job as a school nurse.

The article made reference to our "allegedly ADHD kids". While I have a child of my own who was diagnosed with ADHD in second grade, I chose not to medicate her. Unfortunately, when she made it to high school, her years of struggling academically got tougher and she began medication. She went from significant struggles, to straight A's. All that to say, I believe medications are some times necessary to help a child succeed in school. Other medications administered on a daily basis include insulin and asthma medications (sometimes an emergency situation). This however, is only a small part of my job.

The article seemed to say that there is, or would be, an increase in students going home to play video games after claiming to be sick. I can almost guarantee you would find this not to be true. Teachers often send a child who is supposedly sick. The nurse takes the time to question the child carefully and can usually determine if they are indeed sick, or just have "schoolitis". Very few children are sent home from my school each week, but those who are assessed and found to be sick are definitely sent home or to the doctor to avoid spreading the illness to other students.

And yes, there are actually times when children are rushed to the E.R. from school. I have had students experience anaphylactic reactions (one child who had no idea he was allergic to cashews, a very frightening situation if you have never seen how quickly it happens) and significant bone fractures which required an E.R. visit. But also, I have often had parents say they are going to the E.R. to be treated for simple strep throat and I have been able to intervene and guide them toward a more appropriate clinic for treatment, thus ultimately saving healthcare dollars for all of us.

Other duties for the school nurse may include suctioning, tube feedings and other procedures for those students with special needs. In addition, sadly, the nurses are sometimes the first to discover the signs of neglect and abuse of a child and initiate steps to identiy the source so that appropriate interventions can take place.

Many hours are spent arranging appointments and communicating with parents regarding resources available for students who have been screened at school and need glasses or dental care, but cannot afford these services. Poor vision and pain due to tooth decay are very real barriers to a child's learning.

While my main focus is to promote health and prevent the spread of illness at school, I also function as a back-up to the school secretary and bookkeeper on a daily basis and when they are out sick so that a substitute is not necessary. I answer phones, make copies, file and am happy to do whatever else is needed to help out the school when I am not busy with a student. Every other school nurse that I know has multiple duties in addition to her nursing duties, often doing things that were once done by paid teacher assistants. Nurses functioning in this capacity can be a cost-effective way of the school benefiting from having a nurse while not having to utilize another paid teacher assistant.

I agree that having nurses in schools can be costly, but I truly believe that school nurses are of great benefit. I believe that in the future we may see more healthcare be given at the schools with the public health departments working closely to provide healthcare for children by utilizing the school nurses. The children are already at school; if we can promote health and administer some care while they are there, I believe doctor and hospital visits could be greatly reduced and thus save money spent for these services.

I honestly cannot tell you if my view is Republican or Democrat, I just know that my heart is for all children and I am in favor of assuring that each and every child has the best chance possible of receiving quality healthcare and education to help them be successful.

I have to agree that, at first glance, the thought of a nurse in every school sounds ridiculous, but I believe that the benefits outweigh the costs, especially if they are utilized in a cost-effective way.

Sincerely,

Amy Fisher
Tennessee