School nursing isn’t what it used to be. Routine activities like lice screenings and keeping health records updated are still very necessary, yet the role of on-site campus medical professionals has expanded to include a whole host of soft skills and capabilities as schools lean into the growing need for a holistic approach, taking into account mental and social factors, rather than just physical symptoms.
In any given school day, Joffe Health Coordinators will encounter a wide spectrum of student health needs - preventing, detecting, and treating everything from more common occurrences like a scraped knee to more severe health threats such as asthma, allergic reactions, diabetes, seizures, and depression. Each visit is an opportunity to get to know a student, build trust as an ally, and gain insight into the student’s overall well-being.
As we reflect on the past school year and prepare for the start of a new one, we asked Joffe Health Coordinators to share the most common reasons students visit the health office – and share why there could be more than meets the eye.
Headaches are a very common ailment sending students to the Health Office, and can be – but are not always - a sign of something more serious. Simply administering pain relief and sending students on their way is a missed opportunity to get to know the student and discern what may be causing the headache. Prior to doling out meds (if parental consent is given), Joffe Health Coordinators inquire about how and why the headache started. It sometimes takes some digging to discover, but common causes of headaches among high school students are dehydration, lack of sleep, and stress.
Helping students realize possible roots for the headache allows them to recognize ways to prevent them in the future. In addition to pain medicine, offering water, a space to express emotion freely, and a quiet space to rest should help alleviate symptoms.
Headaches are also a COVID-19 symptom. If a possible cause for the headache cannot be identified, or if headaches are not common for a student, a COVID-19 test is a good idea.
In the event of a hit or bump to the head, deciphering between a headache and concussion is extremely important. Concussions often go undiagnosed in general, as most institutions do not have a standardized approach when it comes to students hitting their heads. The CDC offers excellent resources on concussions, such as the Concussion Signs and Symptoms Checklist to observe and evaluate students at different increments over the course of 30 minutes. The form is a method of standardized documentation and can be sent to urgent care or the hospital with the student.
If there are any signs of a concussion, schools should always call the parent to have the child evaluated by a healthcare professional outside of school as well. The healthcare team will be able to create a plan with the family regarding the student’s return to school. This may mean that the student will need to be excluded from certain activities, such as watching a movie or doing activities on iPads, as screens and blue-light emitting devices can worsen the effects of a concussion.
Female students often visit the health office seeking pain relief from menstrual cramps. They are typically seeking ibuprofen/ acetaminophen, a hot compress, or a quiet place to lie down. Changing hormones and changing bodies can be a sensitive topic for many students. Health Coordinators create a judgment-free zone with medical expertise that can assuage fears and provide factual information if a student inquires.
Minor lacerations (cuts)/scrapes
Cuts and abrasions can happen inside and outside of the classroom: from trips and falls to paper cuts and outdoor play. Students may come to school with existing scrapes.
Again, listening and asking the right questions will reveal more than meets the eye. Providing reassurance that everything will be okay can go a long way to calm the student, as well as assistance cleaning the wound and applying a bandage. High school students may not need help applying a bandage, but they often forget that the wound needs to be cleaned before being covered. It can also be helpful to work together to apply a bandage to a cut on a movement-heavy body part. For example, a scrape on the elbow or knee is best secured with athletic stretch tape to ensure full range of motion without the bandage falling off. A few tricks of the trade can ensure a more pleasant experience. For example, using soap and water or non-alcohol antiseptic cleansers such as BZK to clean a wound is less painful than alcohol-based options. Alternative bandages such as Coban come in many different colors and designs and are great for students with sensory challenges.
Jammed fingers / twisted wrists and ankle sprains
Most of the time students jam their fingers playing basketball or volleyball during lunch, or believe it or not, playing ninja! These jams are typically minor enough to only need a buddy tape and some ice, but finger splints are needed for the more severe cases.
The main culprits of ankle sprain (aka rolled ankle) on campus include sport activities on uneven floor surfaces such as grassy fields and the occasional high-impact misstep on a smooth court.
Prompt application of ice packs and elevation of sprained ankles will reduce pain and swelling. Health Coordinators can further advise on which activities must be avoided, and for how long, as well as provide a temporary brace for compression, and crutches to help students get back on their feet.
Having a bad day
Students often come to the office because they are having a rough day. Maybe they are being bullied, felt rushed in the morning, or just needed a quiet place to re-center themselves. The health office is viewed as a safe place by most students. Health Coordinators are skilled in listening, and providing medical aid, in addition to teaching important coping skills such as mindfulness, deep breathing, and coping/affirmation statements to nurture resilience.
If the occasional “bad day” becomes more frequent, regular office visits may be indicative of a more serious underlying matter that warrants additional attention or support. Listening closely to gain insights into a student’s life can inform other areas of a student’s well-being. Health Coordinators watch for reported stomach aches and headaches, as anxiety or stress will often manifest as physical symptoms in the body. As an advocate for student health, Health Coordinators can provide resources for additional care, including providing referrals to counselors and other services if needed.