Speaking with a female
teacher school, I was shocked to hear that there is no such a thing like
environmental health team in the local elementary and high schools in the BVHP
School district. Rather students are taken to the community health center or to
the San Francisco General Hospital and department of Public health for
assessment and treatment if a student presents with any suspected environmental
health illness, such as acute Upper respiratory symptoms such as bronchitis,
dyspnea, , chest pain, and palpitations, redness of the eyes, irritation,
discharge, or swelling. There is a visiting nurse who is not available to the
school all through the day. My personal knowing is that there is prevalence of
environmental health hazards in the BVHP district, and this should call for a
concern to advocate for a permanent full-time environmental health care team in
this BVHP school district.
Having spent time completing my MSN practica at two different San Francisco Unified School District campuses, it became evident that the scope of a school nurse is much more limited than one might expect. This is probably due to distinctly American litigiousness, liability insurance can be very restrictive.
ReplyDeleteThe extent of most care is either an ice-pack, or cleaning a superficial wound and applying a plastic bandage. For nearly anything else it's either child is picked up/sent home or 911 is activated. RNs can't even dispense APAP or ASA without a provider's direct order specific to that child. The role can be very rewarding with the kids, but very frustrating professionally.
The only thing school RNs can do unless it's a contagious public health threat is refer/recommend the child's parent(s)/caregiver(s) seek care at their medical home, or the nearest thing they have to a medical home, which may well be an ED.
I agree with David Chika, The school nurses' roles are limited and not all proactive in any any issue, particularly in environmental health. Like you, I have never encountered or heard of a team assessing schools and performing an environmental health assessment, at least not in my school district. If there is one, I will be completely shocked and dumbfounded.
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