A day in the life of a school nurse

What a beautiful morning to wake up to! There's a definite Autumnal nip in the air but the sun is shining and the sky is very blue. The talk is still about the earth tremor which happened the night before. Lots of references, amongst the adults, about how 'the earth moved for them' !

Having seen my husband and daughter off to school (he's a schoolmaster) I tidied the house, fed the tropical fish and checked the garden before leaving for my office in the hospital.

After dealing with the usual mountainous bureaucracy of paperwork and a 'phone call to see if the student nurse will be joining me today, I completed my preparations for the day and set off to begin the medical screening at one of the larger schools in my town. In order to ensure that the health requirements of all school-age children are met, the children undergo periodical checks on their visual acuity, hearing levels and growth. Before this can be done parents must give consent and are asked to complete a health questionnaire about their child's general health and can raise any concerns they may have. Without this form I cannot carry out these procedures and problems will undoubtedly be missed and go untreated.

There are four of these screenings during the school life of a child in Powys and today I will be doing the first one's for these children in this school. Unfortunately 50% of the forms have not yet been returned and the deadline was a week ago. I bite my lip and prepare 18 reminders, which takes a lot of precious time. The apathy of parents towards their children's well being constantly amazes me. It is the same at the clinics when sometimes a third of the clinic list patients don't bother to show up or let us know that they won't be coming. (Think waiting lists and you will understand my anger.)

When I arrive there is a lively buzz from busy children. Some of them know me from previous visits. I spent some time last term teaching a lot of them how to wash their hands and clean their teeth properly. Several children remind me of this and tell me that they are still using that technique. Good. Lots of them want me to look at their work as I thread my way to the room I will be using for the next few days. They also want to be reminded of my name and look to see whether I am wearing the blue tin dragonfly brooch that I always wear when I'm working in a school. I always ask them what the Welsh for dragonfly is but I'm afraid I never remember. I am wearing it so all is right with the world! While I am setting up my equipment I can hear the slurpy gurgling of milk being sucked through straws - that takes me back! Great to see that milk is back for under 5's.

By the time I'm ready to start work it is playtime! As the weather is so fine everyone is outside and only a few are wearing coats. Lots of noise. Why is having fun so noisy?

I spend the spare time checking which children have left since I was last here and in which class I'll find the one's I want today. It takes a while for them to settle down after play. One of the special educational needs children is being very helpful helping the headteacher find a box she's left somewhere. Somebody else has locked a loo door from the inside and crawled out under the door so no-one else can get in - a big enquiry for the culprit! A neighbour's son who has just started recognizes me but has gone suddenly shy as he didn't expect to see me on his territory.

Amidst the general hubbub I manage to start measuring a few children. After this I get them to stand on one leg for a while and then the other. Then we closed our eyes, spread our arms out and tried to put our fingertips on our noses - without cheating! Then they all skip back to the teacher and tell her what they've been doing. Tomorrow we'll play the pirate game, with one eye covered with a pirate's patch, and also the 'chase the mouse and bang a stick' game. Sooner than it seems it should be it is dinner time. Lots of toiletting and hand washing is done before they all sit down to eat.

I pack up and head back to the office to swap my bits of equipment for my Healthy Eating pack. I'm off down the mountain after lunch to do a bit of Health Promotion in a school I'm covering for a colleague who is on maternity leave. I have spent the last couple of days beside the photocopier preparing for this lesson as well as some more that are booked. This is a subject I love to teach.

While in the office I take a call from a Health Visitor telling me that the student nurse is off with a bad back and won't be able to join me this afternoon "Oh, and by the way. " ..It seems that one of my schools has written to the Health Visitors inquiring why there seem to be so many new children these days with speech problems. Of course there could be many reasons for this but the most likely is the T. V. Mums just don't have the time to play 'one to one' with their toddlers teaching them to say words properly. They also learn how to talk from the cartoons and videos and maybe don't hear the words properly. I promise to speak to the Headteacher and see what can be done to pick these problems up earlier. While I'm there I make a quick 'phone call to a multi-national company to try and order the sanitary samples they usually supply me with when I take the Health and Development (sex-education) lessons with all the Year 6 pupils in the summer term. They are anxious to ensure that I know about their new representative who will come and talk to the children for me. I refuse, politely, as I'm not into product promotion. They are somewhat annoyed. I'm not sure whether I'll get my supplies!

Right. A quick cheese sandwich and an apple on the hoof as I make my way down the mountain. Get stuck behind a group of slow moving vehicles all the way and arrive a little later than I planned. After showing my ID card as I'm new here, I find the years 5 and 6 children are waiting patiently for me and are stuck into their reading books. After greeting the teacher and introducing myself to the children I explain why I'm here and what we're going to talk about. I introduce the subject by telling them a little about my poor eating habits when I was young and how my mother spoiled me by giving me lots of things to eat which had been unavailable during the 2nd World War, after which I'd been born. I had been encouraged to eat plenty of chocolate and tinned peaches in syrup as well as steamed puddings and so on. I developed a sweet tooth very young and I was hoping to dissuade them from doing the same. This is quite a good interpretation of the phrase "do as I say not as I do" as I'm still rather large!

After we've been through the good foods and not so good foods (I never say bad), and why they are good or not so good, I can see that they're starting to get a bit restless. A quiz is what's needed. I have a list of packaged foods and ask the children to guess haw many teaspoons of sugar there are within each item. For instance: a carton of Ribena, a Mars Bar, a can of diet coke and a can of regular coke. There are lots of wild guesses and much hilarity as we try to find the right answers (9,8,0,9). These are really nice kids with lots to say so it's good fun -and they're rather shocked! There is another quiz about their eating habits to find out whether they eat a balanced diet of 5 portions of fruit and vegetables a day - as laid down by the Government - as well as plenty of fibre, proteins, carbohydrates, vitamins and water. Most of them had average to good consumption of the important things. (If this had been one of the schools in the town there would have been more of a lean towards convenient, quick, fatty foods.)

The time flies by and it's afternoon break time. They thank me for coming and rush off out to enjoy more sunshine. Some of them stay behind for a natter and I'm told that their new headteacher has decided to start a new rule of only having fruit to eat at break times. The children seem quite taken aback at this decision but I tell them how pleased I am to hear about it and what a great chance they have to try different fruits - perhaps a different one each day for two weeks. They could swap with each other. This idea seems to go down well.

One of the girls offers to help me hand out all my information sheets. These are along the lines of advice to parents and kids on healthy snacks and lunch-boxes, how to stay fit and well and a few handy hints on preparing quick and interesting foods that the children can learn to prepare. There is one on the different food groups as well as a work sheet I have designed on the computer which is like a poster with lots of fruits and vegetables all around the edge. For homework they've got to write down all the healthy foods they can think of on it - as many as they can. They'll need to write it small to have room for everything. (It took a LOT of colour printer ink but it's a really nice idea and the kids like doing it.)

I find the health promotion teaching is the most enjoyable part of my job as school nurse. I love doing it but it is very tiring. I take the back road along the canal back to my office and I admit I dawdled a bit as it was so lovely. I have got Mozart's Requiem on a tape in the Clio as I'm learning to sing it in Choral Society at my husband's school. I'm afraid I sing the bits I know very loudly all the way back (soprano's have to sing loudly to reach the top notes- that's my excuse anyway), I hope I didn't frighten anybody, or animal! Wish I had time to stop and pick some blackberries. The canal is busy for the time of year -several barges with families enjoying a late 'Indian Summer' holiday.

Back in the office it's quite quiet. I pick up and deal with all my messages and prepare the work for tomorrow. I spare a couple of minutes to think about my number 3 child who has just started University. He's having to buy all his meals, on top of everything else, and I reflect on how ironic it is that he's hardly likely to be eating many of the good foods I've spent the afternoon promoting to children half his age. I must remember to pack some apples from the garden into the goodie box my husband will be taking when he goes up to see him at the end of the week. I'm also keen to hear how my 15 year old daughter got on with her netball league match this afternoon.
Illus. By Rob Davies

And so to Safeways! A bit near the end of the month so I've got to be careful and can't really afford to get the ready planted winter hanging basket, which looks rather nice and will save me doing it myself. Ah, well maybe next week I'll spoil myself.

When I arrive back at home it's warm enough to sit in the garden and read the paper. I set the hose sprinkler to watering a very dry area as we've had no rain for ages and I'm trying to establish a new border. The cat is trying to out-stare the two cats next door who have wandered in between the bars of the gate, placid hatred in their eyes. My husband calls in to say that he has to attend an early lecture so he won't be in for a meal until later. We chat about our different days. I decide to write this diary after he's gone - putting off the ironing.

Daughter comes in at 9.30 and dances about telling us of a fantastic victory over the opposition - 48 goals to 5. Proud parents sit by the fire grinning. (It IS nippy).


Diaries of a staff nurse and a registered general nurse