Tag Archives: school health

The Stomach Ache

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Image courtesy of arztsamui
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The vaguest symptom in the history of symptoms.  The classic.  The stomach ache.

Any day of the week, any month of the year, the most popular complaint that lands kids in the nurse’s office is the stomach ache.  This symptom can be caused by a vast assortment of reasons, and the school nurse has to gets to play detective to discover the cause of the tummy trouble on a case-by-case basis.  I’ve found that asking this one question can shed a lot of light on the subject:  “Why do you think your stomach hurts?”

  • “Because I didn’t eat breakfast.” (Break out the Saltines)
  • “Because I ate Taki’s for snack.”  (Heartburn City)
  • “Because I ate too much at lunch.” (Try to use the restroom, and that’s an order!)
  • “Because the soccer ball hit me in the stomach at recess.”  (Oh, ok then let’s see that stomach – injury assessment time)
  • “Because I’m nervous about my test.” (Give TLC – they just need a little “brain break”)
  • “Because I saw Johnny eating ketchup and oranges together at lunch.” (This kid is a “gagger” who is sensitive to unpleasant stimuli – I give him ice chips to crunch on and we talk about other things to distract him from the revolting sight they just witnessed)
  • “Because my sister coughed on me – she’s home sick today.” (Faker Alert! This kid thinks he’s going home to join the party.)
  • “Because…I…you know…I started…” (Allow me to show you my selection of feminine hygiene products – and let’s call mom – my students are elementary age so it’s a BIG deal to have these symptoms.  Moms usually want to hear about it.)
Image courtesy of Ohmega1982 FreeDigitalPhotos.net

Image courtesy of Ohmega1982
FreeDigitalPhotos.net

Equally as important as what my students say, is their body language.  Signs of a legitimate stomach ache include:

  • Holding belly
  • Walking hunched over
  • Pale/yellowish/greenish skin
  • Unbuttoning the pants (these students are usually bloated and genuinely uncomfortable)
  • Pain that is localized (lower right side could be appendix, etc) as opposed to generalized “my whole stomach hurts” type pain
  • Can’t get comfortable on the cot, restless (sometimes this means they’re about to throw up – trust me on this one)
  • Much quieter than usual, teacher says he’s “not himself today”
  • Grimacing with ACTUAL tears – and school nurses can spot the Oscar contenders from a mile away
Image courtesy of Ambro FreeDigitalPhotos.net

Image courtesy of Ambro
FreeDigitalPhotos.net

Signs of a fake stomach ache include:

  • Smiling
  • Chatting with other kids in the clinic (“OMG Joe what are you doing in here?!” giggle, giggle)
  • Student says “I threw up in the bathroom.” (If they threw up in front of a reliable witness – not their BFF – I’m more apt to believe them.  True vomiting is hard to control.  It doesn’t just happen conveniently in the bathroom – it’s difficult to contain.
  • A “frequent flyer” who doesn’t ask his teacher for permission to come, but waits until he is at lunch, PE, Art, etc to ask that unsuspecting teacher (who doesn’t know his habits as well as his homeroom teacher) to send him to the clinic.  We talk to these students about the “Boy Who Cried Wolf” phenomenon – “One day you’re really going to be sick and no one will believe you!”

It’s funny how kids think they’re the first ones in history to come up with their brilliant tactics.  So in the spirit of the hilarity of children and their bag of tricks, I’ll leave you with the this scene from the biggest faker of them all, Ferris Bueller.

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Raise Your Hand When You Hear The Beep!

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This student happens to be my son 🙂

Today was a big day.  Mass vision and hearing screenings for hundreds of students at our school.  The State of Texas mandates that all Kindergarten, 1st, 3rd, and 5th grade students be screened for vision and hearing each Fall.  Pulling this off takes planning and lots of help.  The “Vision and Hearing Team” in our school district consists of TWO nurses.  That’s right, two – for over 100 schools.  This “team” comes on their scheduled day to help the school nurse (me) screen hundreds of children.  I enlisted two additional helpers who volunteered their time out of the kindness of their hearts:  first my mother, a retired school nurse in our school district, and second her good friend, also a retired school nurse!  In the photo above, my mom is screening my son aka her grandson – how awesome is that!?  I also had the help of two amazing parents at our incredible school.  They volunteered their day to call classrooms, wrangle and shush kids, transcribe results, and direct traffic in the library.

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400 Slips for Test Results

I went through the planning phase several days before, with all that prep culminating in a workable schedule for today.  Students aren’t just sitting in their homeroom class all day long – they are going places!  When I planned screening times for each grade level, I had to look at various schedules and AVOID screening during:  Recess, Lunch, PE, Art, Music, Computers, and nap time (for the little ones).  Whew!

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A class filing in

Class by class, students were herded in and given instructions.

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The Snellen “Tumbling E” eye chart

Many of us probably remember having our vision tested as kids.  This chart has been around for over 150 years.  The kids are instructed to point in the direction the “legs” of the E are pointing.  They don’t have to know left from right, E from M or W, and it doesn’t require any talking – only pointing.  Even 4-year-olds can do it.

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My audiometer (a relic).

You also probably all remember the hearing test.  This audiometer is a dinosaur.  There are updated versions – digital ones also that the team brought with them, but this is my district-issued machine.  I am actually quite fond of it.  The students are instructed to “Raise your hand when you hear the beep” and it’s a very simple test.  Some obstacles to this test are:  any noise in the room (hmmm it’s not challenging at all to keep dozens of children quiet when they’re standing in line with nothing to do…); cold symptoms like a stuffy nose – this causes fluid to back up into the ears and they have temporary hearing loss; girls with hairbands, bows, earrings, and glasses (I had a few students wearing all of these things at once) – the headphones won’t fit snug on their heads or will actually hurt.

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Me!

I’m happy to say that this massive undertaking was a success – thanks to all the help I had.  Speaking of help, the office staff had to “play nurse” all day because I was unavailable.  They rose to the challenge of taking care of 48 students who were sent to the clinic today for things like possible pinkeye, a punch to the nose, breathing trouble, groin pain among many other.  They told me they don’t know how I do it every day.  I know they already appreciate me so much, but it’s days like these that it becomes clear what a “team effort” really is.

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