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A day in the life of a School Nurse!

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We started the day at a secondary school having received a referral for a young person with anxiety. In our role we assess the emotional wellbeing of children and young people and use assessment tools to support with this. We met with Sam who was 13 years old and in year 8. He was anxious about coming to school and this had escalated after a short period of illness. He also worried about getting detentions and being told off. His anxiety had resulted in him struggling to go to lessons and sitting in Matron’s office for long periods of time. After assessing Sam using our emotional assessment tool we established that he was already using some positive strategies to manage his anxiety. Sam was able to talk to a trusted adult about how he was feeling; he regularly participated in sporting activities and was using distraction techniques such as fidget spinners. Sam also demonstrated that he used positive self-talk to encourage himself to take part in activities that he found challenging. Sam was amazed when we told him that he was already managing his anxiety symptoms well and was demonstrating resilience. In our discussions with Sam we noticed him becoming more relaxed and speaking positively about how he could manage his feelings of anxiety. Sam agreed to meeting with us for some further sessions to support him in recognising his signs of anxiety and to set goals and strategies on how to manage them.

We then visited another secondary school and met a vulnerable young teenager, Sarah, aged 13, whose family was being supported by social care. School nurses regularly undertake health assessments on vulnerable children and young people in schools or in the family home. We undertook a health assessment on Sarah and found that she was suffering with symptoms of uncontrolled asthma. She presented with a cough, chest tightness and wheezing which woke her at night 3 times a week and negatively affected her school attendance. During the assessment she told us that her inhaler medication had run out over the weekend and her symptoms were exacerbated by severe mould growth in her family home. We ascertained from the assessment that Sarah had not attended an asthma review at her GP practice in over a year. Sarah agreed that we could speak with her mum and her social worker. From these conversations mum agreed to take Sarah for an asthma review to check her inhaler technique and review her medication. The social worker confirmed that she was arranging for the mould in the family home to be treated which would provide Sarah with a healthier living environment.

After lunch we visited a primary school to see, Victoria, a 9 year old girl with Down syndrome to support her with preparing for puberty. School nurses are able to liaise with our colleagues from the Community Nurses for Children with a Learning Disability team to access tailored resources for children with special needs who attend a mainstream school. School nurses support children in school with Personal Social Health Education (PSHE) on both an individual and group level. We had spoken with Victoria’s mum before the session and she said that Victoria’s learning is better supported through visual resources and practical demonstrations. In the session we used various pictures from babies to older women to demonstrate the physical development from young to old. We highlighted with Victoria that she was approaching the developmental stage from being a girl into a young lady and this meant she would experience various body changes over the next few years. We used visual aids in a picture booklet and a personal hygiene pack. Victoria was really enthusiastic to take objects from the bag which prompted practical learning. To help Victoria with her understanding of how to manage her periods and sanitary hygiene we needed to clearly demonstrate how she could achieve this. So….Victoria decided that both she and the school nurse should practice putting on the pants and sanitary towel so that we both knew what to do. Being only equipped with young girl’s pants….it was a bit of a squeeze! But not being one to disappoint we embraced the challenge and hoped that no one was looking through the window facing the car park! Victoria got really involved and animated with this new learning experience and it was a joy to be part of. Victoria left the room telling us that she will ‘remember the pants’. School nurses need to be adaptable in their role and it’s not often you get the chance to wear your pants outside your trousers when you’re at work!

*All names have been changed to protect the confidentiality of the young people discussed.