Health: Back-to-school Tips From A School Nurse

By: Alan Pollock

Topics: Health , Education

School nurses know: flip-flops are a key culprit for playground injuries. CDC/AMANDA MILLS

The new backpacks are packed, pencils are sharpened, and most kids will soon be back at school. But there are steps parents can take now to help make the school year injury- and illness-free for their kids.

Kathy Riley, the Harwich Elementary School Nurse and the nurse leader for the district, said the start of school is always a busy time in her office.

“A lot of kids have trouble with transitions,” she said. The change in routine and work regimen associated with the start of classes can be tough for youngsters in all grades. “Even if they've been in school, it's that nervousness – the new teacher, where to hang their coat, what day is gym?” she said. “It's a lot.” Older kids have additional worries, like wearing the “right” clothes or making friends. Helping students with this transition is a matter of common sense.

“I think it's just reassuring kids,” Riley said. It's helpful for parents to let their children know that back-to-school stress is something to be expected, but that everything will work out. Most high schools, including Monomoy, have identified upperclassmen who are willing to help incoming students feel more comfortable, she noted.

Parents are familiar with the seemingly endless health forms that schools can require, but ensuring that emergency contacts, prescriptions and allergy lists are up to date can help school officials respond more effectively to medical emergencies. In Massachusetts, certain immunizations are required for students to start kindergarten, and a few more vaccines are required for middle school students. The state only provides exceptions for families who have a religious objection to vaccines, not to those who oppose the shots on moral grounds, Riley said. The vast majority of students are properly immunized, but when that doesn't happen, it can mean problems for other youngsters as well.

Last year, a parent made the decision not to immunize a student who later came down with chicken pox. A handful of other students who had close contact with the sick child were forced to stay home from school for 11 days, Riley said. The health benefits of immunizations have been proven “in study after study after study,” she said, and the purported link between the measles-mumps-rubella vaccine and autism has been thoroughly debunked. “But people still believe it,” she said.

“We have a lot of kids with life-threatening allergies,” Riley said. Those children usually carry EpiPens, which deliver a dose of epinephrine using an automated syringe. In the past decade, the manufacturer of the drug, Mylan, raised the price of a two-pack of EpiPens from around $100 to more than $600. This week, Mylan announced that it would produce a generic version of the device for about $300, but the price is still steep.

Riley said that school nurses will gladly train parents and students how to administer a dose of epinephrine using a vial and a syringe, which costs less than $5 per use. But doing so takes a little practice, and isn't as easy as using the EpiPen, particularly “if you're panicked,” she said.

Another tip for reducing trips to the nurse's office? Making sure youngsters arrive at school rested and well-fed.

“Adequate sleep is really good, and eating breakfast is huge,” Riley said. Students who show up in the nurse's office – particularly around 10 a.m. – are always asked if they've had breakfast. Even a small breakfast can give kids the energy and focus they need to make it to lunch.

“Cars run on gas, kids run on food,” she said.

When it comes to heading off injuries on the playground or in the hallways, proper footwear is key.

“Sneakers are best. You can run at recess, and you don't have to worry about changing for gym,” Riley said. “No flip-flops. There are so many injuries. They break, the kids fall, they hurt their toes. It's just dangerous.” It's easier to enforce the no flip-flop rule for elementary kids than for high schoolers, who tend to focus more on fashion than function.

It's also important to remember that warm weather can last through September, and school buildings can be very stuffy.

“We're not air conditioned, and kids want to wear their new fall outfits right away,” she said. Kids can overheat if they're wearing new sweaters or wool leggings in summer-like weather. When it comes to cold-weather clothes, “wait another month or two,” Riley said with a chuckle.