For school nurses, blood, vomit and lice are all in a day's work

2014-05-10T00:00:00Z For school nurses, blood, vomit and lice are all in a day's workBy Aimee Snyder For the Arizona Daily Star Arizona Daily Star

“Nurse Sonya,” as Sonya Vasconcellos calls herself, has 692 patients.

Some are sick or injured. Some are on regular medication that Vasconcellos administers each day. Some come to her hungry or sad, or in need of new clothes.

Her patients are the students at Gallego Basic Elementary School in South Tucson, where Vasconcellos works as a full-time nurse.

With a registered nurse in each of its schools, the Sunnyside Unified School District is bucking a national trend.

Across the nation, a registered nurse is responsible for an average of 2.2 schools, the National Association of School Nurses says. 

Only 37 percent of elementary schools nationwide have a dedicated nurse and only a handful of districts in Arizona have a registered nurse at every school.

Nurses are especially vital in Sunnyside schools because the majority of students in the district live in poverty, which increases their medical needs, said Jody Disney, the district’s health services director.

“For many of our children and their families, we are the only health-care provider in their lives,” Disney said via email. “Our kids have nothing, and we have to find what they need, whether it be things like clothing or health care.”

What follows is a day on the front lines of health care at Gallego Basic Elementary.

OFF TO A GOOD START

It’s 7:30 a.m., and school has not started yet, but Nurse Sonya’s office is abuzz.

A student is returning to school after being hospitalized, and his mother is missing work to detail the treatment plan. His medication is a free sample provided by the doctor. It is the only inhaler this family can afford, so it must be conserved.

Throughout the conversation, Nurse Sonya also administers a rescue inhaler to a kindergartener. She kneels by the 5-year-old, modeling counting and breathing techniques. One moment, she is up to guide the mother through the proper paperwork. The next she is down again to work with her young patient.

Petite and fit, in black nursing scrubs with hot pink pinstripe on this day, Nurse Sonya never stops moving.

“I feel like a big kid at times,” she says. “I’m definitely at a kid level, even though I’m 41.” 

Before things get too crazy, Nurse Sonya follows up on another return from hospitalization and on an ongoing Child Protective Services case. She helps a handful of kids who complain of upset stomachs.

This is supposed to be her quiet hour. But instead of catching up on the paperwork piled on her desk, she picks lice nits — inactive eggs — out of a young girl’s hair. The child’s grandparents are raising five young children and don’t have time do it themselves.

A REVOLVING DOOR

At “lunch rush,” she clutches her torso and doubles over in a heave. She is demonstrating for a Spanish-speaking child what she means by the word “vomit.”

Children are escorted into the health office one after another. Tears. Vomit. Blood.

“And this is an easy day,” Nurse Sonya says as she continues to triage children from the hazards of classwork, lunch and recess.

She is flushing her third set of eyes of the day: this one, not from  blowing sand like the others, but from a stray pencil point.

With her hands securing the rinsing cup to a fifth-grader’s eye socket, she assesses and treats other small patients. In the two beds are the sickest kids, who she  allowed to lie down only after sanitizing the beds following the departure of their previous occupants. The three chairs around the room are also full.

It is now standing room only. Nurse Sonya knows all the children by name and investigates their ailments thoroughly by most urgent.

A new boy has arrived with a case of vomiting “ everywhere,” as described by the monitor.

She smells his breath, points out his rosy cheeks and discusses with him his chest cold from the previous week. She helps him clean up, gives him a new shirt, and tests his stomach with pretzels and water.

Ultimately, he is healthy, despite his stomach’s protest of some post-lunch roughhousing. He returns to class.

ALL IN A DAY’S WORK

During the course of this school day, Nurse Sonya cares for 33 students.

Of those children, only one goes home sick. She treats the rest in the health office and sends them back to continue their learning.

At 2 p.m., the school health office shuts down for the day. Nurse Sonya sits at her desk and tries to update the records of her 33 cases, relying on memory and a few sticky notes she left herself along the way.

“I am usually here until 4 p.m., trying to catch up on paperwork, but I’m feeling rundown,” she says. “I don’t think I’ll make it that long today.”

Often she says she takes home paperwork and enlists help from her husband, a registered nurse at Tucson Medical Center. His salary is nearly double his wife’s.

Even as the day winds down, children keep trickling in with tummy aches and nosebleeds. Technically, her office is closed. But each time a small face appears, Nurse Sonya is instantly ready to see patients.

All 692 of them.

Aimee Snyder, is a doctorate of public health student in maternal and child health at the University of Arizona’s Zuckerman College of Public Health.

Copyright 2014 Arizona Daily Star. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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