As kids' anxiety spikes, school nurses step in to address mental-health needs
Chicago TribuneAug 23, 2018
The school nurse began asking him routine questions to determine the root of his troubles: Can you describe your symptoms? What have you eaten? Are you on any medication?
It's a scene that school nurses are expecting many times over as the new year opens, reflecting both the growing number of mental health issues among school-age children, and how the traditional role of school nurses has evolved from cleaning up playground scrapes and taking temperatures to meet the needs of this growing population.
"There's so much more in the school nursing world today than there ever has been," Traut said. "These are constant conversations that we're having here in this school setting to make sure we're on top of supporting these students."
According to the
School nurses in
To meet the new demands, school nurses are offered extra training in mental health as well as resources from the
"In the past, we used to be kind of hard-nosed. 'Nope, you don't have a fever, you've got to go back to class,'" said
But today, the nurse's office is often the first place students turn for help with mental-health issues, she added. "It's one of those areas where we've tried to create a space that's super-nonjudgmental."
Despite these efforts, local and national school nurse associations worry that they are outnumbered by the number of students in need of their help. Today, there are only 700 school nurses in the
The shortage is exacerbated by the fact that the state does not mandate school nurses in each district, and school nursing positions tend to be less appealing to nursing graduates because the pay falls well below what they could make in a clinical setting, officials at the
Another challenge is that with budget shortfalls, outside state-funded mental health service providers for teens have dwindled, leaving the burden largely on schools.
"I think we need to advocate for more school nurses in our buildings," said Traut, who also serves as a director to the
At
One room holds half a dozen vinyl-covered sick beds to handle students with fevers and stomachaches. Another room offers a comfortable chair and table with a desk lamp for students or staff who are breastfeeding. That room doubles as a quiet sanctuary for students having panic attacks or needing a break from stress.
"It's just a safe place for them to come," said
"It's a huge culture shift," said Vollinger, who is also president of the
While many schools and districts have social workers and psychologists on staff, students tend to think of the nurse's office as the first stop to get the attention they need. In turn, nurses, social workers and psychologists at schools today work closely together to make sure a student gets continued care.
The prevalence of mental-health issues has prompted structural changes at Stagg and other schools. Three years ago, district officials allowed Vollinger and other school staff to create an "intervention" classroom located between the nurse's office and the guidance counselor's office.
The classroom is designed to help both students who have been out of class for disciplinary reasons and those who have had mental-health-related absences transition back to the daily routine in a more nurturing setting than being thrust back into busy hallways and full classrooms.
When the school nurse learns that a student is returning after a prolonged absence, she works with other building specialists -- including intervention room teachers, school social workers and guidance counselors -- to collect the student's coursework. The student is then able to ease back into the school day in a room decorated with sayings such as "Be Happy" and "Be Original." The room also is used for students who experience testing anxiety and need a quieter place for exams.
While such classrooms were unheard of even a decade ago, they are becoming more common across the state as schools recognize the adjustments needed to address students' growing mental health needs.
At Stagg, the intervention classroom hosted 771 students last school year. Of those, 607 had disciplinary issues. An additional 164 students were in transition after missing school for social or emotional problems, said
Elementary school nurses are also encountering students with mental health needs. In standard paperwork turned in to her office at the start of this school year,
Kim used the information to develop helpful lists for the child's teachers on the reasons for the drug, possible side effects that may be noticeable in the classroom, and possible interactions with other medications for which teachers should be mindful. She also called the student's parents to ask for a meeting so that she has a thorough understanding of what the child may need in her care.
"It's becoming somewhat easier to talk about, so that's good," Kim said. "If I see a child with medications for diabetes, I do what we need to do to make sure that diabetic child is safe. If I notice a child coming in with psychotropic meds, I'm going to alert the teachers about what we can do in the same way."
For now, Traut and other school nurses say they work with what they can to meet the needs of their student populations. Through online resources and their own continuing education, they learn about how to talk to students struggling with mental health issues in a way that helps to position them for the best continued care. And as students stop into her office, Traut tries to offer them the care they need, whether it's a look at a cut, or a glass of water and a fidget toy to calm their anxiety.
"There's a whole lot of rewards," Traut said. "I love the challenge of working with teenagers and adolescents and helping them become independent, helping them build skills of independence and self-advocacy."
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