Street roots., January 19, 2018, Page 10, Image 10

Street Roots • Jan. 19-25, 2018
News
NURSES, fro m page 10
children develop acute and chronic health
conditions at increased rates over children
that have stable housing. The stress of their
living situation definitely negatively impacts
their ability to learn. It keeps triggering that
trauma brain. So we have a part in our brain
that is really our fight/flight thing, which is
from way back when we were hunter
gatherers, and you had to be aware of your
surroundings or a saber tooth tiger would
eat you, that kind of thing.
And so children living in homelessness
experience chronic stress at-such higher
levels that that part of their brains is
constantly triggered, and that prevents you
from higher-level thinking. And learning is
one of those higher-level-thmking
experiences. So it takes a long time once a
child enters a school to be able to develop
enough trust in their environment for that
part of their brain to be able to calm down
enough that they’re able to learn.
I think homelessness is huge as far as
impacting our children’s graduation rates; If
you track attendance, if a child’s not at
school, then obviously they’re not going to
be able to learn. And the more a child
misses school, the more anxiety they’ll have
about coming back to school, because all of
a sudden they’re sitting in a classroom and
they don’t, know what’s going on. And they
feel ridiculed by others. They can feel like
they’re less smart because they don’t know
what’s going on. And it’s, not necessarily a
matter of their intelligence; it’s just that
they weren’t there. All those impacts can
dramatically decrease a ch-iRks: chance-at- ¿4.
graduation, a chance at higher education, a
chance at a higher paying job, a chance to
get housing security.
It’s kind of this vicious cycle that we’re in.
If we’re able to educate those children,
provide the emotional support that they
need, provide for their basic needs of trust
and security, food, clothing, those kinds of
needs: Give them the ability to start feeling
more self confident, have some self
motivation - because that’s the other thing
that really gets damaged quickly, is a child’s
ability to be motivated to learn, to continue
to fight, to continue to strive. That gets
damaged early.
S.H.: The housing crisis is especially felt in
rural communities. Do we see more of these
cases and their impacts in rural communities?
N.F.: I think the impact is definitely
there. I think it’s difficult to see the impact
because there are fewer eyes out there,
there are less service providers. Rural
districts in Oregon, those are the districts
that don’t have any school nurses. They also
probably don’t have school counselors.
There are fewer health care providers out
there. In a few counties in Oregon, it’s over
100 miles to get to a dentist. So with fewer
eyes out there seeing and uncovering the
problem, I think it can go unnoticed.
I have a nurse down in southern Oregon,
and the school district goes across the
mountains, so part of the district is in the
east side, part is on the west side. The main
office is on the west side, close to the
valley, and she had a student with diabetes
that lived across the mountain. She said
especially in the winter, there is no way for
a schooLnurse-to get there — because there
was one school nurse for the district — or
for the child to get to a health care provider.
So her charge, and what she felt she had to
do, was to teach everybody in that
community - the school community
especially, but she also had meetings with
the volunteer emergency firefighters who
were there - all about diabetes: how to care
for the child, what signs and symptoms to
watch out for, if the child was unable to
check their own blood sugar. So really kind
of developing that support, realizing that if
there were an emergency, they were going
to have to rely on themselves. She made
sure that everyone, understood how to take
care of that condition.
■;i£5Yp’re uncovering.more and more stories
like that. (Many rural youth) don’t have
access to .dentists ^routinely, so many of
them have never had dental screenings.
They don’t have access to eye care, eye
visits, eyeglasses. It’s kind of shocking the
number of children who were referred for
special education services for learning
disabled because they’re unable to read and
it’s because they can’t see, their vision is
bad. Those are the kind of things; it’s -
primary preventive health care that we’ve
kind of gone away from, because we expect
every child to have a pediatrician. The.
concept is, every baby that’s born has a
pediatrician, so they have pediatrician visits.
And then they get their wellness visits once
a year. Well, that’s not a reality for a huge
percentage of our families and our children.
I think were seeing the effects of that with
high dropout and poor graduation rates. It’s
time for us to start picking that back up.
That’s what I love about school nursing, to
make sure that every child has that equal
access for their education. We’re really
trying to provide that health equity for
them.
S.H.: What other effects is poverty having
on students, their education, their health, in
rural communities? You've already covered
some of those and I ’m wondering if there's
anything else that comes to mind.
N.F.: I think, in a way, our rural
communities are more disadvantaged than
our urban communities because of
homelessness and poverty, because they
lack many of the social service agencies that
the metro area has. Rarely will there be
homeless shelters in rural communities.
Page 11
building, to be able to address those health
needs. I would really like to see big
concentrations at the elementary level
“ I do believe that
because that’s where We pick up a lot of
schools have sone
stuff. Nurses with more behavioral and
responsibility in
mental health training in the middle and
high schools, because that’s where we see a
p ro vidin g fo r our
lot of that going on.
ru ra l communities.
Washington State has done this model for
a
while
— they identify regions in more rural
Because oftentimes,
areas, and they have regional health teams.
in ru ra l communities, 4
- So it includes a nurse, it includes a
counselor, sometimes it includes a social
the school re a lly can
worker, and those regional health teams
be the hub of
then go visit those schools and do
assessments. The school nurse would go
com m unity support."
into a rural district, do a needs assessment,
find out how many children have whatever
I n in a fekaris
kind of chronic diseases, they would look at
attendance, they would look at all that stiiff,
put those plans in place. And then identify
There’s a dramatic lack of health care,
how frequently they felt they needed to go
health care providers, school nurses, school
back to follow up on some of those things,
counselors, schbol social workers, those
provide routine vision and hearing
that can help connect families to services.
screening, those kind of sendees for those
That’s what I think is sad, and I do believe
rural areas, andoperate that regionally.
that schools have some responsibility in
What must happen, however, is health
providing for our rural communities.
care must start to contribute to school
Because oftentimes, in rural communities,
nurse and school health team pay. This can’t
the school really can be the hub of
just fall on education dollars, which is what
community support.
it is now in Oregon. It is primarily education
. Definitely we are seeing the impact of
dollars that provide school nurses. So there
poverty, homelessness, food insecurity,
are, I think, 13 nurses in Beaverton (school
hunger, lack of health care. And that’s the
district) right now for our 60-some buildings.
thing that has us all worried. We wërë
But you go to our administration and they
thrilled the last couple years to be able to
say, “Well, we can add another one or two
say every single one of our students had
nurses, or we can add another one or two
health care. We could get any child in to see
teaoher>s.4’jAi§sho|4 should never have to
a doctor that needed it. And now the option * "make that chorc^ft-'shouldmever conre
that families have-to opt out of insurance,
down to a nurse, versus a teacher. Health
our fear is we’re going to go back to what
care and public health have got to start
we were five years ago where, sorry, we
identifying that a school nurse, while part of
don’t have any insurance, so we’re
the education team, is. an integral part of
scrambling trying to find a free clinic
the health care for our community and our
somewhere but they’ve all closed up. I’m
school community. Because really, we have
worried about the near future and what that
children five days a week, six to seven hours
means for health care coverage for our kids.
a day. Children are with us oftentimes more
than they’re at home. We see them for
longer periods of time. Health care has got
S.H.: Do you think improving health care
services in schools, having a healthy proportion to start stepping up. They’ve got to
recognize the importance of providing these
of school nurses to students, would impact,
services to children at school because that’s
graduation rates?
their point of access.
N.F.: Absolutely. There are primarily two
reasons why kids miss school: It’s either
health related or it’s mental health
behavioral related. If school nurses
intervene early in those absences, and we
get kids back to school, then wé break that
chronic absentée cycle, which is a huge
impact as far as kids being able to graduate.
Some of the recent studies coming up now
about absenteeism say if a child misses, I
think it’s more than three days of school in
the first month of school, then they’re more
likely to drop out
S.H.: What do you think it would take for
school nurses all over Oregon to have the
capacity to provide those sorts of services that
would be needed to have an impact on
students’ success?
N.F.: Of course my ideal would be you
have a school nurse in every building.
Especially with bigger school districts. Now,
I understand we have some schools that
have 50 children, you’re not going to have a
nurse for those. You need a nurse in every