2018-05-14 / Front Page

Are we meeting our students’ needs?

Health in Our Schools:
Times Record Staff

Today: Introducing Health in Our Schools, 
Tuesday: School Nurses on the Front Lines, 
Wednesday: Midcoast Community Alliance, 
Thursday: Focusing on Mental Health, 
Friday: Handling Substance AbuseToday: Introducing Health in Our Schools, Tuesday: School Nurses on the Front Lines, Wednesday: Midcoast Community Alliance, Thursday: Focusing on Mental Health, Friday: Handling Substance AbuseBRUNSWICK

Are public schools doing enough to take care of students’ health needs, especially as they grow in magnitude and complexity?

Schools’ responsibility for student health goes beyond simply checking temperatures and applying bandages to the occasionally sick students.

“I think that the general public has the perception that the school nurse just sits in her office and hands out Band-Aids all day,” said Kelley Strout, an assistant professor of nursing at the University of Maine with a focus on community health. “I think it’s seen as an easy job.”

That’s not the case.

“In my experience … school nurses have some of the greatest responsibilities of all nurses in health care,” Strout continued. “They are dealing with absolutely an increase of complexity in child health needs.”

School staff are increasingly having to deal with student mental health issues, trauma, hunger and the effects of substance abuse in the home.

Yet as schools are forced to meet more demanding academic standards, some health needs can get pushed to the side.

Strout said that in many Maine schools she sees time dedicated to student health being squeezed out. Something as simple as time for school lunch can be of vital importance to student health needs.

“Some schools have as little as 15 minutes to eat lunch,” said Strout. “That doesn’t even count the amount of time that they need to wait in line.

“I know there are some high schools that you can set your schedule in such a way that you wouldn’t even have a lunch period,” she added. “I don’t even understand how we’ve got to that point where you can just opt out of not eating all day.”

Strout said national recommendations are for 25 minutes seated for lunch daily. For students who get free meals at school, having time to sit down and eat it is even more important because they may be lacking nutrition at home.

“That may be the only meal they get all day,” she said. “And we’re giving them only 10 minutes to eat it.”

Melinda Nadeau, who handles public relations for the Maine Association of School Nurses, confirmed that hunger is an ongoing issue in many Maine schools.

“I see a lot of very hungry children,” said Nadeau. “I give out snacks every day to kids who don’t have snacks.

“I think so many parents just can’t afford things these days, and a lot of grandparents and single people are raising children,” she added. “They just don’t have the source or the means to get enough food for their children.”

Other practices, like putting recess before lunch so that students process food better, are easy to put in place, Strout said, yet many schools haven’t.

But even if academics are the priority, she said it makes no sense to sacrifice health.

“We have plenty of scientific evidence that show if you are healthy — physically, mentally, emotionally — you will perform much better on academic assignments,” said Strout, “whether it’s standardized tests or papers.

“We need to look at what we’re asking schools to do in six hours,” she added. “Maybe we need to lengthen the school day so that we’re not jeopardizing health for standardized testing and standards. I do think it’s unrealistic to cram everything … into a six-hour day.”

Beyond healthy eating practices and fitness, one problem in schools is a lack of resources.

“We could really use more nurses in our districts. Right now, we usually have one nurse for 750 kids, which has become increasingly difficult over the years because, as we all know, there’s a lot more health concerns — a lot more asthma, a lot more mental health, and safety issues,” said Nadeau, who has been a nurse for 11 years and splits her time between two schools. “It’s very difficult for me to be in two schools at the same time.”

The American Academy of Pediatrics recommends one full-time registered school nurse per school.

“The school nurse’s job comprises much more than just health services,” said the group in a statement when the policy was issued in 2016. “School nurses provide surveillance, chronic disease management, emergency preparedness, behavioral assessment, ongoing health education and extensive case management, among other duties.”

The policy statement notes that “school nurses today monitor more children with special needs, and help with medical management in areas such as attention deficit/hyperactivity disorder, diabetes, lifethreatening allergies, asthma and seizures.”

“The biggest challenge I see is mental health, and keeping track of kids on medication,” said Nadeau. “It went from five medications years ago to (now, where) I have 25 kids on medication in one given day.”

While many districts have gotten better with bringing more mental health professionals into the school, it’s still something many districts struggle with.

“Some schools are starting to listen,” said Nadeau. “I see a lot more health concerns for students today than I did 11 years ago.

“There’s a lot more kids with trauma,” she added. “And that is very interesting. Those kids come with so much trauma and so much behind that.”

While some districts have been better at addressing increasingly complex health needs than others, Strout said that statewide standards may be what is needed to get more health professionals in the schools.

“I do think (solutions) have to come at the state level,” said Strout. “I recently did an investigation of our school nurse ratios across the state of Maine, and the national organizations recommend 700-to-1 for a healthy population.

“But they also recommend that every school has a fulltime school nurse in the building,” she added, “which is definitely not the case throughout most of our schools in Maine.”

Strout advocated for a certain level of staffing to be required of schools.

“Until we mandate certain things at the state level, schools will sacrifice hiring another school nurse,” she said, “to making sure they have a curriculum coordinator or making sure that they’re purchasing curriculums that are going to get them the test scores they need to meet the state and federal guidelines.”

For the rest of this week, The Times Record will be running a series of articles focused on the health of our students, asking what our school nurses are seeing in their jobs, and the effects mental health and substance abuse are having in our learning centers.

KELLEY STROUT is no relation to Times Record reporter Nathan Strout.

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