- Jane Becker, R.N., is working at her desk in the Caldwell Elementary clinic when there is a tiny knock at the door, and it opens just enough for a child’s face to appear, peeking around the corner.
A young girl steps through the door, and announces in a small voice the age-old complaint of elementary students—a stomachache.
Becker ushers the young patient into the clinic, invites her to sit and listens kindly and attentively to her complaint as Becker asks questions and begins to formulate a course of action.
It’s the type of scene that plays out many times a day in McKinney ISD school clinics—and everywhere else for that matter—and, frankly, it’s what most of us envision when we hear the term “school nurse.” In the old days, that was mostly the sum total of the job.
But, to characterize the job that school nurses like Jane Becker perform today solely with scenes like this is to oversimplify the challenging role they play and the broader impact that they have on our schools.
Earlier this year, Becker—who has been a registered nurse for 30 years and has worked in a school setting for 16 of those—was chosen by her fellow MISD nurses as the district’s 2017-2018 School Nurse of the Year; in April, MISD received word that she had been selected as the Region 10 School Nurse of the Year, as well, making her the fourth MISD nurse in the past seven years to earn that accolade.
The news was no surprise to Caldwell Principal Kelly Flowers, who has a rather lengthy professional history with Becker.
“Personally, I have had the privilege of working with Jane as a teacher, as her assistant principal and most currently as her principal,” says Flowers. “Nurse Becker exemplifies what a school nurse should be in that she is dedicated to providing the students and families we serve with excellent care. She has a passion for nursing and has emerged as a leader not only on our campus but in the district.”
When nurses are nominated for the School Nurse of the Year honor, a panel that includes former MISD Nurses of the Year—two of whom went on to become the Texas School Nurse of the Year—vote on the nurse who will represent the district at the Region 10 level.
Becker said she feels humbled by the recognition and is humble in her response. “It is an honor to have been nominated by one of my fellow nursing colleagues for McKinney ISD Nurse of the Year. That has only been magnified by becoming the Region 10 Nurse of the Year. Without my fellow nurses, the educational staff and students, this would not be possible.”
MISD Health Services Director Julie Blankenship says, “Jane is very dedicated and a morale booster across the district. She goes the extra mile, and she has a special heart for the students at Caldwell.”
Each of MISD’s school nurses is, like Becker, an R.N., and they bring a wealth of experience to the job from a variety of settings. Before she became a school nurse, Becker worked in hospitals as a NICU nurse and in orthopedics, pediatrics and labor and delivery.
To that list, Blankenship adds oncology, surgical, psychiatric, pediatric emergency and pediatric respiratory work to the resumé of medical expertise that the nurses under her supervision have accumulated.
The job is more complicated than it once was; all of the pediatric health issues that children contend with today converge on the school campus in varying degrees, and the nurse is the front line when it comes to dealing with them.
“School nursing is not just band-aids and boo boos,” says Becker. “We are at the forefront of caring for the complexity of increased critical health issues of youth in the school setting.”
It’s not a job for a beginner; while MISD school nurses communicate frequently and make themselves available to each other as resources, the job requires someone who can work autonomously, and each must be able to make medical decisions without the immediate availability of a doctor, physician’s assistant or nurse practitioner.
“School nursing has evolved into what we call 21st century nursing protocols,” explains Blankenship, pointing to a graphic from the National Association of School Nurses on the wall in her office. The chart features five section headings with a lot of bulleted items under each one.
“We do care coordination, we provide leadership, we do quality improvement, we do community public health—which means we have to be clinically competent for the increased medical needs that are coming to our campuses,” she says.
Blankenship and Becker point out that MISD school nurses manage and care for students who regularly take medication during the school day, who have diabetes, asthma or dangerous allergies. There are students who require assistance with a feeding tube or a catheter or a host of other needs.
There are families who struggle to meet the costs of health care, and Becker and her fellow nurses serve to connect them to available medical resources.
“A lot of the nurses are responsible for case management,” says Blankenship. “They’re the liaison between the doctor and the parent or the hospital and the parent. We ask ourselves, ‘What do we need to do to from a health perspective, so that child can be in their seat in class and not spending all of their time in the clinic?’
“We collaborate, we educate teachers on student medical needs because a nurse can’t be everywhere. So, we educate to make sure we have a medical safety net around all those kids,” she says.
They also collaborate with the district’s food service provider, Aramark, to bring healthy food options to MISD students. They complete hearing, vision and scoliosis screenings each year, which seem incredibly mundane but sometimes reveal indications of serious underlying health issues—such as cancer.
Every campus in MISD has a registered nurse on duty. And, if a student goes into anaphylactic shock or a teacher has a health emergency or a student needs help with serious daily medical needs due to a chronic condition—an experienced, registered nurse is just a few doors away.
In addition to all of those additional modern responsibilities, some things haven’t changed. Day in and day out, kids complain of a stomachache or a headache or report flu-like symptoms or say that they just don’t feel good—or whatever the need may be. And, when they poke their head into the clinic looking for help…
They find a school nurse like Becker.
And, that is a very good thing.