What your school nurse needs to know

Parents talking with school nurse

By the time I started kindergarten, every school official, monitor, volunteer — even the principal — knew that I had deadly food allergies to peanuts and legumes (peas and beans).

At my school, all the kindergartners ate at a different lunch hour. They also had recess on a separate, smaller playground from the rest of the school. This made the directive my mother handed down to the staff to institute (or enforce, depending on your point of view) a little easier.

The table I sat at had a big laminated image of a peanut with an even larger red slash going through the middle. A “no peanut” zone. I can still remember being teased, sitting there by myself the first week or two. Maybe this kind of thing marks an informal beginning of the whole millennial entitlement complex….

It gets better.

After lunch and before recess, my classmates had to wash their hands at a station overseen by a parent volunteer. Why? Well, let’s say a classmate brought a peanut butter and jelly sandwich. Or, perhaps they touched something with peanuts. Afterwards, they likely would touch playground equipment. Then, if I touched my face after grabbing the same rung on the monkey bars, I could have gone into anaphylactic shock. This is an extreme allergic reaction that causes swelling in the face and throat, as well as hives.

The more serious reactions to an allergen exposure can produce hours of vomiting and difficulty breathing as the airways and throat close up. This can lead to death, but we helped the school prepare for this. I had two Epi-Pens in the nurse’s office another two at home just for this situation. The four pens would cost around $1,000 these days. These epinephrine-filled pens are used when someone has a severe allergic reaction to keep them from going into anaphylactic shock. To say they are a lifesaver is understatement.

Rosa Rotella, a family nurse practitioner with Banner Children’s Community Clinic that serves the greater Phoenix area, elaborated further.

“At its core, this is simply a precaution,” she said. “No parent wants their child to be unsafe at school, no less feel unsafe. Being upfront with the school nurse about your child’s health risks, whether it’s an allergy or intolerance — even just to go over medication dosages and administration or their immunization record — all go a long way to keeping the whole school healthy, including your child.”

And this speaks to the end result. All those years ago, my elementary school’s nurse worked with my mother to come up with a plan, and I’m still here to talk about it. Some of it might have been overkill, but with the way little kids are, things could have quickly gotten bad.

And being one of the first in my elementary school to have a peanut allergy, the new liability the school nurse and my elementary school as a whole had to face was as much a consideration as was determining a protocol for how to prevent a reaction for future students with deadly allergies. By the time I moved on to middle school there were several other students with a peanut allergy that the nurse was able to successfully utilize the same safety measures with. A 2010 study revealed an increase to a rate of 2.1 percent of school-age children with allergy to peanuts in 2008 from 0.6 percent in 1997, the population tripling over the period of a decade.

Why to Keep the Nurse in the Know on Vaccination and Immunization Records

Not only was I allergic to peanuts, I had skin test reactions to pretty much every form of vaccination that young kids — especially incoming kindergartners — need when they start school. I couldn’t get the flu, measles, mumps, rubella or varicella (that’s chickenpox) vaccines. I couldn’t get these vaccines because I had an egg allergy, and chicken egg albumen is an ingredient in these vaccines.

Looking back, it feels like I avoided a minefield of disease that a modern school system and a modern society shouldn’t usually need to worry about.

Having missed out on the literal growing pains of annual check-up inoculation, I also still haven’t had chickenpox despite the overall decline of vaccination rates during the ’90s. Maybe it was just blind luck that I never caught anything. Nonetheless, my elementary school nurse also made sure to notify parents when a classmate did get the chicken pox. This included fact sheets with symptom guides that ensured parents knew what to look for early on if there was any possibility of exposure.

These few simple steps did the following:

  • Provided peace of mind for parents and helped to establish not only a rapport with the school nurse.
  • Created a dialogue about the importance of immunization for those children able to receive their shots.
  • Informed everyone that vaccinations are important to health and well-being, including those who cannot get vaccinated for health reasons.

In the end, “what your school nurse needs to know” goes beyond degrees and tenure when there is communication with parents. This can lead to lasting takeaways for the sake of the health of the school and its families.

What your school nurse wants you to know

Banner Health’s Children’s Community Clinic nurses, who specialize in pediatric care for the uninsured, offer these additional tips:

  • Staying up on flu shots and other boosters such as tetanus
  • Participating in organized sports, hobbies or other engaging activities that will get your kids moving
  • Packing a balanced and healthy lunch, as well as making time for breakfast each morning
  • Getting enough sleep (that’s at least 10 hours a night for elementary-age kids, according to the National Sleep Foundation)
  • Taking advantage of vision and hearing tests if the school offers them.
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