Bay City Tribune

Bay City ISD has a full-time nurse at every campus, which seems to be more of a rarity in today's world of budget-cuts. Lynette Cooper, Cherry Elementary nurse, says it makes a huge difference to have a full-time nurse at each school.

"The illnesses we see today in kids are so much more acute. We have some kids with serious medical issues going to school. It would be dangerous not to have a full-time nurse at each campus. I'm so glad our school board recognizes this and continues to budget for a nurse for each school."

Some of the medical issues facing nurses around the district include students with diabetes, asthma, trach tubes, catheters, staph infections, prosthetics, severe hearing and/or vision problems and other chronic problems.

School nurses also deal with fractures, colds and coughs, flu, allergies, various infections, STD's, mental illnesses, alcohol and drug abuse, pregnancy and many other health issues.

BCHS nurse Kelli Hunt said the school nurse is often the first line of defense for students.

"We're the first medical professionals these kids come to. Kids will come to school sick and some make it to their first class and some don't. We have to think on our feet, and our assessment skills have to be strong. Two of our students who have cancer were assessed here first, and we referred them on."

McAllister Intermediate nurse Tammy McMahon said one of the standard things nurses do every year is get students through vision and hearing testing in BCISD, and that the nurses travel together from campus to campus to work together on the screening.

McMahon said something relatively new the nurses are seeing is acanthosis, which is an indicator that someone is diabetic or pre-diabetic. A sign of acanthosis is a dark, velvety patch of skin, which the nurses typically observe on the backs of students' necks. Acanthosis is associated with obesity. "The rise in diabetes in our students is alarming. It's probably the major health risk our students are facing," she said.

Bobbie Oncken, Bay City Intermediate nurse, says her goal as a nurse is to keep her students in good shape so that they can be in the classroom and learn.

"School nursing really has changed since I first began. I think one reason we see so many more sick children is because of the change in the typical family structure, the family condition. So many homes aren't the traditional mother/father/siblings. The homelife really affects the children's physical and mental health. Some children are so tired when they get to school because for various reasons they aren't getting enough sleep at night."

Holmes Elementary nurse Ann Bond said that she enjoys interacting and teaching the children.

"So many of them just need a safe place to be. The hardest part is looking at some of these children whom you know are going to have a tough life. It's so sad."

Bond said there are usually four kids waiting at her clinic every morning when she arrives because they are sent to school sick.

"Sometimes the parents just don't have many options. They have to go to work, maybe they don't have sick days, no sitter, maybe they don't get paid if they don't go to work. And some send their children to school sick because they know their children will get two meals," Bond added.

No day is the same, Bond added.

"Once I had a student come in here with his prosthetic for his eye in his hand. We washed it, wrapped gauze around it, put it in a plastic bag, and I sent him home. I hadn't even known he had this for his eye."

Over at Roberts Elementary, nurse Michelle DElisiis says the school nurse must be good at multi-tasking.

"I fill in at the office if someone has to take a break, run an errand, etc. I've got my defibrillator, but I've also got a tool set, because I'm sort of the school handyman. I even make posters for the school," she said.

In the course of a short conversation with D'Elisiis, a young boy came in with a bloody nose he'd sustained during P.E. when a ball hit him in the nose, a small girl came in for a lice check, and one child came in who'd had an "accident."

D'Elisiis tries to meet the kids needs, no matter what they are, which is typical for the school nurse.

When kids come in late to school and they've missed breakfast, she has some snacks stashed in her office for them.

All the nurses have a clothes closet or area where they keep extra clothes they've bought and collected, as students regularly need clothes. Sometimes they only have a few changes of clothes and they come to school in dirty clothes, there might be an incident at school which requires a change of clothes, there are students who've lost their clothes in fires, students who have had to move and left their belongings behinds, and on and on.

The nurses also try to meet parents' needs with the clothes closet, as many have a difficult time leaving work to bring a child a change of clothing.

D'Elisiis added that she gets students in her clinic who just need to "chill." She said sometimes there's turmoil in the students' lives and they just need to come to a quiet place for 15 minutes or so. "I have some kids who if they get the tiniest scratch, bruise, whatever, they come in here. Sometimes just giving a child an icebag cures it all," D'Elisiis said.

Every student has his or her own story, and goes home to a variety of situations, said Cooper.

"Nurses must maintain empathy. We must help the students and their parents. Bay City has a lot of resources for families that we try to help our parents access. We've got the health department, MEHOP, the Crisis Center. The Lions Club helps with eyeglasses, and Red Cross helps when families lose their homes to fires. We live in a very giving community."

Cornelia Normann-Peterson is the nurse at Bay City Junior High, and said keeping up with each child's immunization records is another important part of the school nurse's job.

"I send home lots of notes to parents about missing records and so forth. It's really important that parents respond to these notes," she said.

She also added that nurses spend a substantial amount of time contacting parents regarding their children, but that it's difficult to make contact with the parents. "Cell phone numbers have changed, are no longer in service, work numbers are incorrect, addresses have changed, and even emergency contact information seems to get quickly outdated. We really need parents to let us know any and all changes of their contact information," she said.

"Many of these kids call me 'Mama.' And in many ways nurses are a mama to the students," said BCHS nurse Kim Dudley.

"Many students don't want to tell anyone of their illnesses. They're embarrassed or scared. The school clinic really is a safety zone for many students."

Hunt also cited the rise of mental illness.

"We have what I call are 'frequent fliers' "kids who constantly come in with minor complaints. That sends up red flags, and I ask the kids what really is going on with them. They'll open up to me," she said.

She explained that the high school takes a team approach to student mental crisis with its student safety plan that involves the parents, counselors, campus police, principals and teachers.

Hunt noted that suicide is the third leading cause of death in people ages 15-19. BCHS refers students to primary care physicians, private medical health facilitites and Texana Mental Health for those students who don't have medical insurance.

Hunt also serves as coordinator of the Life Skills for Teen Parents Program, which is designed to keep teen parents in school through graduation.

The program's goal is to help these students become productive, self-sufficient citizens.

Hunt summed it up by saying, "We approach each day asking ourselves what are we going to do to change our students' lives for the better. Not just for today, but for tomorrow."