A day in the life of a ... school nurse

1 October 2014

Heather Laxon's job as a school nurse at Mangere College is a lot more complicated than the stereotype of patching scraped knees. Read on to discover the complexities the modern school nurses faces.

NAME | Heather Laxon JOB TITLE | School Nurse (funded by Ministry of Health) LOCATION | Mangere College

Heather Laxon6.30am WAKE: Woken by the alarm, I head straight to the shower to wake up properly while my husband empties the dishwasher. I wake the three kids at 7am (usually involves more than one attempt) then have a quick breakfast. I make sure the kids have everything they need for school, then I head out the door at 7.30am, leaving my husband to deal with the chaos of getting the kids out the door.

7.45am START WORK: I have been a school nurse for six years; I enjoy working in an autonomous role and am energised by the young people I work with. The role is a great fit for the skills I gained from my emergency department and public health background.
I work as part of a multi-disciplinary team made up of a social worker, counsellor, two nurses, and a receptionist in the Student Services Centre (SSC). It is quiet at this time of day, so I restock the clinic.

8.00am BREAKFAST CLUB: Today the student health council runs a club providing free breakfasts for students. I have a quick chat with the two students on duty and make sure that they have everything they need.

8.30am STAFF BRIEFING: The SSC team head to the staffroom for morning briefing. It is a good chance to catch up about students that staff have concerns about and hear what is happening around school. Back to SSC, and we decide that today my nurse colleague Fiona is going to do the comprehensive HEEADSS (home, education, eating, activities, drugs & alcohol, suicide & depression, sexuality, and safety) assessments that we carry out for all Year 9 students. I’m running the walk-in clinic.

9.00am STUDENT WALK-IN CLINIC: Over the next few hours, I see 14 students who self-present. There are the usual headaches and stomach aches. Often, students present with one thing, but there are other issues that also need attention. It is nearly the end of the rugby season, so a few rugby players present with injuries – some I refer on to the onsite physio who comes in weekly.

11.30am TEA & TEAM CONSULT: Time for a quick cup of tea, then I catch up with the rest of the team. I meet with the social worker and counsellor to consult about a student we have all been involved with. She has arrived at school today refusing to go home this evening. The young person has previously been under CYF (Child, Youth and Family) care, and she now discloses abuse at the place she is currently staying. We talk with her about a course of action and agree for our social worker to go ahead with another notification.

12.00am CLINIC: CUTTING: The next student I see requests a bandage for her arm. I ask her what is wrong, and after a slight hesitation, she rolls up her sleeve. She has about 30 superficial cut marks up her arm; I ask her if she has been cutting, at which she starts crying. As I tend to her cuts we talk. It is the first time she has cut herself; there have been problems at home and also with friends and it has all got too much. I have a quick word with the counsellor, who sees the girl. After talking with the counsellor, the girl emerges smiling. I am often astounded by the resiliency of young people in the face of huge adversity.

1.30pm EMERGENCY CALL: Emergency call-out to rugby field.
Five minutes before lunch, I get a call-out, so I grab my emergency bag and phone and head to the rugby field. A student has taken a knee to the back of his neck during a rugby game and is complaining of a lot of pain. The PE teacher has not moved him, and he is lying on his back where he fell. I carry out an assessment; he is very tender over his cervical spine but has no neurological symptoms. I make a 111 call for an ambulance as he is going to need further assessment*.

2.20pm AMBULANCE DEPARTS: I grab a quick bite of lunch. I catch up with our whānau support worker, who runs the afternoon sore throat clinic as part of the rheumatic heart disease prevention programme. There is one student with a positive GAS throat swab. I call the student in to explain the result and then try – successfully – to phone the parent. I give the parent information about the need for treatment, check allergy status and medical history, and then obtain verbal consent to give the student antibiotics (under standing orders). I then go over instructions with the student and give her the antibiotics to take home.

3.20pm SCHOOL BELL: It has been a busy but not untypical day – I love that each day is unpredictable and never boring. Fiona pops in to say goodbye, and I catch up on some notes and check that the list is ready for tomorrow’s visiting GP clinic.

4.00pm LEAVE WORK: I arrive home just in time to pick up the kids and head to their tennis coaching. While waiting for them, I go for a much-needed walk up Mt Eden and clear my head. Back home, I make dinner and find out what has happened in the kids’ day. My husband walks in at 6.30pm just in time for dinner. Then it’s time to clear up, fold washing, make lunches, and tonight, I manage a bit of time to relax reading a book.

10.30pm TIME TO SLEEP

* The boy was discharged later that day after having an X-ray of his cervical-spine, which showed no bone injury.