Keeping kids healthy at a distance

Registered nurses Jill Roaldson (left), Missy Jacobson and Natasha Brunell focus on Moorhead students’ health needs in school and, now, during the challenges of distance learning. (Photos/Russ Hanson)

Nancy Edmonds Hanson
nancy.edmonds.hanson@gmail.com

From bloody noses and asthma to life-threatening bee stings, diabetes and seizures, the three registered nurses who care for Moorhead students are prepared to take care of health problems large and small among the city’s 7,000-plus students. But nothing in their training prepared them and the district’s 10 health techs for the challenges that 2020 has delivered.
“None of us has ever seen anything like this before,” Missy Jacobson acknowledges. Along with Jill Roaldson and Natasha Brunell, she normally divides her days among 10 school buildings – for her, Horizon East and West, as well as St. Joseph’s Elementary and Park Christian Schools. But when Minnesota schools were closed by order of the governor in mid-March, the routine outreach and education that she, Jill Roaldson and Natasha Brunell usually carry out in the last months of the school year abruptly disappeared, leaving the nurses concerned about staff members they train and students with medical needs that now must be met in their homes.
Jill covers Dorothy Dodds Elementary, Moorhead High and the Alternative Learning Center. Natasha circulates between Ellen Hopkins, S.E. Reinertson and Robert Asp Elementary Schools, as well as Probstfield, where early childhood education takes place. With Probstfield now hosting day care for the children of front-line essential workers, the three nurses now take turns there.
In a more normal year, these would be busy times. One harbinger of spring is the annual Growing Up Healthy program, providing 4th grade girls and boys with information on puberty, hygiene and other answers to other questions that loom large for preteens. This year, it has been eliminated.
Another is the spring immunization clinic, generally focused on 7th graders and high school seniors, who require booster shots for various maladies at those ages. The nurses coordinate the clinic – scheduled for April 2 but canceled this year — and follow up with those who need updates, including D-T-P (diphtheria, tetanus and pertussis) and meningitis shots. It’s part of Minnesota’s requirement to monitor all students’ vaccination status and provide it to the state registry.
“At a time like this, I think everyone realizes how important vaccinations are,” Jill observes. Compliance is notably high in Moorhead; according to her and Missy, fewer than 1% are not vaccinated or lack records; only about 3% of the total have obtained conscientious exemptions from the requirements.
Missy says, “Part of our role is to talk to parents about the importance of vaccination and how to get them, usually during well-child visits with a physician. A lot of times, the parents are just not aware or don’t know what to do.”
A large part of the registered nurses’ responsibilities is staff education and training to handle emergencies. Working with special education paraprofessionals, transportation, food service staff and others who have regular contact with youngsters, their goal this year was to certify everyone in first aid and CPR.
They also provide extensive training to the health techs who are assigned full-time to the district’s 10 buildings. Two of the 10 are licensed practical nurses; the rest have a variety of education degrees. They provide the day-to-day care for students with health needs, calling in the nurses for guidance and help with major occurrences. “We make sure that orders are written and followed correctly,” Natasha explains. “We communicate with physicians and parents to make sure that everyone is on the same page.
Dispensing medication is an important part of their responsibilities. According to Missy, records show 32,095 medications were handed out in the past year. She adds that the nurses and techs logged 40,684 visits to their offices during the same period. Now, the women and each school’s staff have tackled the complex job of getting the prescriptions back to the children’s parents.
All three of Moorhead’s school nurses have extensive backgrounds in their profession. Missy, who has been with the district for 12 years, worked with in- and outpatients at Prairie St. John’s and Hospice of the Red River Valley before joining the district. Natasha, completing her fifth year, provided one-on-one nursing with students and worked at Sanford Children’s Hospital. Jill, now in her fourth year, spent 10 years with Sanford and two at Prairie St. John’s.
The three agree that the sudden switch to distance learning has been upsetting to some of Moorhead’s youth. Jill says she sees it in her own three children in 6th, 4th and 2nd grade. “The 6th grader is old enough to understand what’s going on, and the 2nd grader just thinks it’s fun to be on the computer and have lots of time to play,” she observes.
“My 4th grader is having a harder time processing it. The tween age group seems to struggle most. They’re really missing their friends, their teachers, the structure they count on in their lives.”
The nurses agree that missing the students they have come to know well is their own biggest challenge. “I miss walking down the halls surrounded by all that energy,” Missy reflects.
“For some kids, stopping in to say ‘hi’ to a caring adult is the high point of their day. They just like to check in,” Jill adds. “Our offices are a safe place where someone listens.”
“I’m concerned about some gaps,” Missy says. “Are our high-risk kids getting their medical needs met at home? Are they in a safe place? Some kids have significant mental health issues. Are they getting the support they need?”
Jill shares her concern. “At the high school level, my biggest worry is mental health. Teens are not meant to be isolated … stuck in a house with only their parents. They need to socialize and develop relationships. Without that, I’m afraid they’re spending far too much time on social media, and I worry about the unhealthy relationships that may come from that.”
Coming back next fall – something they all expect to see – will be a challenge. “We’re already in discussions about how to make it safe, how to screen staff and students to make sure it’s a healthy environment,” Missy says. “The Centers for Disease Control has developed a process for us to follow, but it changes regularly. By August, their recommendations may be altogether different.”
Though day-to-day practices will certainly change, the nurses agree that the heart of their job is guaranteed to stay the same. “We all really love what we do,” Natasha says.
And Missy takes it a step farther: “I’ve gotten to see a couple of my students during this time, and it’s been great to see how much they miss me … just as much as I’m missing them.”

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