coordinated school health

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Bugs and Gaps- what’s the connection?

eva_general[2]

eva_general[2]Achievement gaps.  Those reports, the watch lists, and strategies to help ensure all students are successful.  I wish that we could add “attendance gap” to the list but that’s a topic for another day…

So what do bugs have to do with gaps?  Maybe quite a bit.  When I started in school nursing, I came across lists that a savvy former nurse had kept regarding follow up for students diagnosed with “live lice”.  Her record-keeping was quite telling.  Children were being excluded from school for weeks at a time, the school bus would refuse to pick them up, and there weren’t enough nurses to do all the checks so there were really no guidelines as to who was diagnosing the children. I imagined her frustration as she had to deal with the issue day in and day out.  Why were these practices so telling? At the time, the district had one of the highest dropout rates in the state.  I couldn’t help but believe that had a lot to do with the way kids were made to feel about school early on.

Anyone who has been subjected to standing in a room full of kids having their heads checked, and then later asked to go home from school can understand the dread associated with these practices.

Does it happen this day and age? Absolutely.  Scan the internet for policies related to head lice in school districts and see what practices exist.  The Centers for Disease Control and Prevention, American Academy of Pediatrics and Harvard School of Public Health have been quite clear regarding the harm of no-nit policies and school exclusion for head lice, yet districts continue to send children home.

If you look at the children in your classroom or school struggling academically, often they are the ones with the most obstacles to overcome.  That’s why the identification of “gaps” even exists.  Those families living in poverty often end up living in close quarters with other extended family, sharing rooms and beds and have circumstances where lice is easily transmitted from one child to the next. Sometimes getting treatment is difficult, and since lice are often resistant to the products Medicaid and CHIP insurances are most willing to  cover, the problem is not easily corrected.  Parents are then often accused of neglecting to care for their children.

I had a parent (a local minister) call  one time wanting to know what I was going to do to take care of the “lice problem” at his daughter’s school.  In conversation I found  the “problem” was that his 6 year old daughter was telling him  a girl in the class had head lice and she wasn’t being treated.  His complaint was that the district did not have a “no nit” policy to make sure his child wasn’t exposed.  I explained to him that the school nurse would do follow up with children who have lice and his daughter would not know that he/she had been checked.  I also explained that nits cannot be passed from one person to the next.  His response?  “I don’t want my daughter around THOSE children!” (Also bear in mind he was getting his information on what was and wasn’t being done from the perspective of a 6 year old!!)

In our jobs there are just “children”.  Children who all deserve a chance.  When we set them up to miss school repeatedly, we set them up for failure.  When they fail, they become a burden to local resources in our communities and the cycle is perpetuated.

There is a way to deal with head lice, using national guidelines and science.  It doesn’t mean ignoring the issue altogether- it means following up in a way that helps resolve the problem.  It means taking a look at other practices that might be impacting the gaps in our schools and finding new approaches to intervene. The most basic of which is not looking for ways to keep them out of the classroom.

I find it helpful to use a flow chart to help keep on track with students that have ongoing issues with lice.  The flow chart allows a nurse to document what treatments have been utilized, along with what teaching has occurred for parents.  It won’t cure the issue- anytime children are together in one place (and can put their heads together) we will have head lice.  But it can help ensure proper treatment and support for children to be where they learn best, in school!

A copy of the flow chart mentioned above can be found at:

http://www.teacherspayteachers.com/Product/Headlice-Follow-up-1117152

Lice is often to blame for high emotion and distress.  Hold firm to your mission of advocating and supporting all children. Follow the guidelines and  remove barriers which can help in your work to reduce gaps in the children you serve.

 

 

Diabetes Tips

eva_general[2]

Things have sure changed since I went to school.  Some may say for the good, some may say for the worst but either way life is different than I knew it. I was raised in an era where the lunch ladies made home cooked meals, the president’s wife wasn’t worried about how much sodium we had and it was unusual to see an overweight child.  We never heard of peanut or tree nut allergies, there didn’t need to be laws allowing student to carry their epi pens and (gasp) we really did walk to school no matter what the weather.

I wouldn’t trade those years for anything.

I was also a student with type 1 diabetes. And as I see what children encounter with their diabetes in schools I am thankful I grew up when I did.  I took my insulin at home, in the morning and evenings, watched what I ate and when I did check my blood sugar it was at home.  There were no school staff reviewing numbers making me feel “good” or “bad” based on a reading I often couldn’t control.  My sister and friends looked out for me, and the one time I drank a regular Pepsi in front  of a teacher she called my dad (who also happened to be a principal).

Diabetes care has advanced tremendously since that time, but it’s also made things a bit more challenging for both students and teachers.  For students, it has to feel somewhat like being under a microscope.  Over the years I have had well-meaning staff do things that would make any child hate to come to school.  Checking blood glucose becomes an ordeal as does taking insulin.  Counting carbohydrates is a challenge and well-meaning people question what kids are eating.  With that, I would just like to offer school staff a few thoughts about children with diabetes from the perspective of someone who has been around the block a bit.

1- Diabetes is always there.  Kids do not get a day off.  24/7 children with diabetes are living with this often exasperating condition.  Please do all you can to make their routine “normal”.   Depending on the age and developmental ability of kids some are fine checking blood glucose in the classroom.  Often they know much more about their bodies than anyone else. Give kids as much flexibility as you can in making those decisions.

2- Don’t refer to children as “the diabetic”.  Granted, I hear this more in my nursing peers than I do from other school staff.  As someone with diabetes I am offended when someone tries to define me with that label.  I happened to develop a condition that I didn’t choose but it does not describe who I am.  It’s much less offensive to use language like “the child with diabetes” etc.  Just be aware of the impact of your words.

3- Learn what to do.  The biggest worry in school is low blood sugar (hypoglycemia). Know the signs and be prepared to respond.  I would hope that everyone has nurses in the schools to help provide training (but as we know this is an area sorely lacking in our prosperous country).  If you don’t have someone to train you, talk to parents and access information available for school staff on the American Diabetes Association website.

4- Make sure you have what you need to respond to a low blood sugar reaction.  Parents should supply snacks and supplies but unfortunately not every child has parents who do so on a regular basis.  Rather than spend your time fighting, ask the nurse or principal to get a tube or two of glucose gel.  You can also use cake gel (it must be GEL, not icing, the icing has more fat and takes longer to absorb).  That way you have a cheap and quick way to respond and prevent an emergency situation.

5- Know that if he/she has high blood sugar then there will need to be extra trips to the bathroom.  I’ve heard lots of staff talk about how kids abuse the system to “take advantage”.   There are lots of psychological issues than can come with diabetes that become classroom management issues.  That is a topic for another blog!  But do know that it is very real for a child to need extra trips to the bathroom when blood sugars are running high.

6- Low or high blood sugar levels can interfere with test-taking abilities.  These kind of things should all be addressed in a health plan, and often students with diabetes will also have a 504 plan.

7-Families are taught to count carbohydrates not limit foods.  Children with diabetes have the same nutritional needs as any other child.  They can eat cupcakes and other treats, it just has to be covered with insulin (either via pump or by an injection)- they should have access to the same treats the other students have.

Over my years in school health I have seen the number of students with type 1 diabetes increase.  It’s the rare occasion for schools not to have at least one student with diabetes. Please know they often feel “alone” in their condition.  When I was a child my parents packed me off to “Camp Kno-Koma” for two weeks every summer (I am NOT making the name up- that’s what it was called) where for once I was not the weirdo. We all had to do the same thing and I didn’t feel like everyone was staring.  Be aware of those feelings in your students.  Those thoughts will vary by child but sometimes kids just want to have a “normal” day.

Diabetes care at school is a team effort, and some days are easier than others. The more you know, the more comfortable parents will feel sending their child to school and the more confident you will feel in being able to respond to the needs of the kids in your care!!

 

 

 

 

 

About THE THREE SQUARE PEGS

Pegs with schoolhouse

One School Nurse + One Behavior Specialist + One School Psychologist =

The Untested ESSENTIALS of Learning

A square peg in a round hole is an idiomatic expression which describes the unusual individualist who could not fit into a niche of his or her society.[1] ^ Wallace, Irving. (1957) The Square Pegs: Some Americans Who Dared to be Different, p. 10.

Above found at http://en.wikipedia.org/wiki/Square_peg_in_a_round_hole

 Most employees of school districts are… [insert a drum roll here]…teachers.  And the customers of their expertise are the wonderful students who walk through the doors of their respective schools each day, ready to learn all the fascinating things teachers have prepared to teach.

[Insert the sound of screeching brakes] Hold on a minute!

What happens if a student walks through the doors of the school and is not 100% ready to learn? What if the student is not even 50% ready to learn? What if the student is hungry? Sleep deprived? Scared because yesterday another student threatened to beat him up? Worried because her mother’s boyfriend threw her mother around the kitchen last night? Angry because her family’s electricity was turned off the night before? Sad because his grandfather is dying? What if the student, himself, is sick? Or has a learning disability? Or has attention span issues? Or…well, you get the point.  The list of hypotheticals is endless.

In an average day in a classroom of 25 students, there are probably at least 5-6 students who have some sort of barrier that interferes with his or her ability to learn academics optimally.  That’s where we come in…The 3 Square Pegs. Our jobs are to provide support services to students, their families, and the teaching staff so that teachers are able to teach, and more importantly, students are able to maximize learning.

What can you expect from our blog? Our focus will be on the multitude of untested essentials that are required for learning to occur.  Head lice? Check. Classroom design? Check. Bully Prevention? Check. De-escalation strategies? Check. And on and on the list goes. These essentials will be in the form of a host of practices at the district, school, classroom, and individual student levels.  With our 60+ years of collective experience in helping teachers teach and students learn, we think we have something to offer.

We are blessed to work in a school district that has vision. To be a small, rural school district with approximately 2,600 students, having a Nurse Practitioner designated as the district’s Director of the Coordinated School Health Program, a School Psychologist functioning as a district-wide counselor to support our excellent guidance counselors, and a Behavior Consultant who is currently the Director of our Alternative Education Program, we consider ourselves rather unique.

Per the meaning of “A square peg in a round hole”, we are unusual individualists who do not fit into a niche of our society (aka, schools). Don’t confuse our “not fitting neatly into our educational society” as meaning that we are not wanted there or that we don’t want to be there! We are welcomed and appreciated by the educators with whom we have the privilege of working. We just happen to think differently in some respects. While we all want the best for our students, our focus is on the many foundational essentials required for learning to even be an option.  Teachers teach.  They are under tremendous pressure to improve achievement and adhere to new national standards. The three of us provide support services, direct and indirect, to our district’s excellent teachers and awesome students. The result? Students who, for the most part, come to school happy, healthy, and ready to learn.  Not BECAUSE of us, but with our help, these students achieve more academic, behavioral, and social/emotional success.

What can you expect in the days and weeks to come? The format of our blog, while it has the common thread of addressing barriers to learning, will shift as each of us take on the responsibility of writing one or two blog entries per week.