Liaison program supports school nurses

When there are medical emergencies or health questions at schools, teachers and administrators turn to school nurses, who usually have the answers. When they don't, there's a back-up: the Children's Healthcare of Atlanta Kohl's School Nurse Liaison Program.

"We're a doorway to resources, the clinical backbone for school nurses who are functioning as independent practitioners in school settings," said Joyce Allers, RN, clinical manager of Children's school-health programs. "We have the library, the nurse practitioners and the specialists we can ask for very specific information or a referral."

School nurses today deal with a lot more than scrapes and flu. Common challenges include diabetes, asthma, cancer, epilepsy, cardiac issues, bleeding disorders, dermatology infections, mental health conditions, strains, sprains and broken bones.

Children's started the liaison program eight years ago, with a goal to help educate school nurses — especially when children with medical problems are transitioning from the hospital to the school and need specific care plans. Funded by a grant from Kohl's Department Stores, the program publishes a biannual school-health newsletter and a school-health manual.

Four regional liaison nurses serve school nurses in 40 counties in and around metro Atlanta and are available by phone to nurses outside that area.

Angela Bryant-Curry, RN, liaison for the city of Atlanta and the Carroll, Cobb, Douglas, DeKalb and Paulding county school systems, is a child advocate and an educator. She recently wrote care-management plans for 21 children transitioning back into school, and also conducted in-service classes on diabetes and asthma for 500 bus drivers.

"A lot of my role is educating people about health issues and alleviating their fears of working with a child who has had a tracheotomy or is on a ventilator, for instance," Bryant-Curry said.

A couple of years ago, a child who was dying from cancer wanted to go to school and be around his friends as long as he could. Teachers were worried what would happen if he died at school.

"I was able to explain to them that the chances weren't likely, and share information about his symptoms that made them more comfortable," Bryant-Curry said. "A child's last wish was fulfilled, and that was a great feeling for me. I absolutely love my job, and all of the school nurses appreciate what we do."

Bryant-Curry is a member of the National Association of School Nurses and the Georgia Association of School Nurses. Both groups were formed to promote school nursing.

"We need a nurse in every building," Bryant-Curry said. "A school nurse can actually pick up on signs of hypoglycemia or symptoms that could lead to a seizure. They know when to send a child home or to a doctor, and they also know when it's OK for a child to stay in school. They help [students] stay healthy so they can learn."

School nurses also save lives. Allers remembers a child who had been kicked by a horse over the weekend. The girl complained about a stomachache on Monday and wanted to go home.

"The secretary thought it was probably the flu going around, but the nurse assessed her and told her father to take her to the hospital immediately," Allers said. "She had a ruptured spleen."

There are more nurses in Georgia schools since 2000, when the state allotted $30 million a year for 20 years to fund school nurses. The money, which came from a $4.8 billion settlement from the tobacco industry in 1999, funds about one-third of a nurse for each school, but some of the 189 school districts in Georgia kick in money to pay for more hours and nurses.

The American Academy of Pediatrics recommends a ratio of one nurse for every 750 students, but many counties struggle to meet that standard. In Georgia, the average ratio is one nurse to about every 1,300 students.

"School nurses are seeing more children than ever before, but they're also seeing more serious health issues in the schools," Allers said.

School nurses are key to improving attendance rates and educating students about health, Allers said.

"A school nurse is a trusted ally to parents and sometimes the only access they have to health care," she said. "We know many examples of school-nurse heroes, and all of them make a difference."