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School nurse enjoys putting smiles back on students' faces

February 06 2007;  The Huron Daily Tribune

CASS CITY — Rachel Malone’s office is one of the most popular places at Campbell Elementary School — even though many students are initially unhappy when they go in.

Within a 10-minute span, about 10 students stop in her office, each with a different issue. One student has a headache while another has a hurting ear. One girl has a hurt ankle while a boy has a hurt finger. One girl comes in with something broken, but it’s not any bones — it’s her glasses.

With a smile and plenty of reassurance, Malone swiftly handles each case with ease. While many students come in with a frown, they often leave with a smile.

Malone is Cass City Public School’s new K-12 nurse. A 1994 Cass City High School graduate, she started in her position in November, and she’s already very much a part of the Cass City school family.

“Everyone is so nice. It makes it feel like I’ve been here forever,” she said. “I know (the staff) appreciates having a nurse here.”

Malone replaced Jeanne Nicol, who left last year for another position.

Malone, who is getting married in the fall, said her inspiration for becoming a nurse is her dad, Curt, who is a nurse. She received her degree from the University of Michigan.

Malone said she’d thought about being a nurse at the school she grew up with, and years ago a position opened up. She knew, though, that Nicol was applying for the position, so she didn’t. She got a job with United Hospice, where she worked for several years. She continues to work with United Hospice in the evenings.

When she heard Nicol was leaving, Malone knew this was her chance.

“I’ve always liked kids, so it seemed to be a perfect fit,” she said.

Malone has been a perfect fit for the school district. Even in a time of major budget cuts and reducing staff in many areas, school administration knew the school needed to have a nurse on campus.

“We have a lot of kids in the elementary who have medical issues,” said Aaron Fernald, elementary principal/athletic director. “As educators, we’re not equipped to deal with these medical issues. (Having a nurse here) is a huge service we can provide our students. She’s done a tremendous job for us.”

Malone feels very much at home in her new position.

“It’s fun. I know a lot of the teachers. Some of them were teachers when I went to school, and some of the teachers were students with me,” she said. “I feel very comfortable. The whole community is like a family.”

While she has her office in the elementary school, Malone serves all grades. She said some students need to stop by her office every day for medication/treatment. She said these children have diabetes, epilepsy, various forms of cancer, asthma, or other medical needs. “A number of students need routine medical care, but many just need some extra TLC,” she said. “They like the extra attention. They like having some extra love in their lives.”

She said she sees middle and high school students on more of an emergency basis. She also keeps up on immunizations and works with the health department to ensure students who need immunizations receive them in a timely fashion.

When a child comes in with a problem, Malone uses her assessment skills to figure out the real story.

“I ask a lot of questions,” she said. “Some things are obvious.”

She said she has to ascertain whether or not there’s really a problem to take care of.

“You quickly learn what kids are trying to just get out of class and which actually have a problem,” she said. “Some of them just need a hug. The more I get to know the kids, the easier it is to figure out what’s going on.”

She said while she tries not to, she does end up sending students home who are not sick.

“I can’t be right all of the time,” she said, noting that she’d rather err on the side of caution.

She said for those who say there’s something wrong when there isn’t, she’s told the story of “The Boy Who Cried Wolf” to try to make them understand the importance of not lying about being sick.

Malone said she sees about 35 students a day on average. Out of these, about 11 need some type of medication every day. She said there are about 470 students in the elementary alone.

She said for all medications, including aspirin or pain medication, she needs written permission from parents in order to give anything to students. She has a list of students and what medications they can receive. If a child is not on this list, Malone can’t give him or her anything. If the condition is bad enough, she sends them home and recommends parents send in permission for the student to be able to receive medication in the future.

Malone said she calls parents and writes notes to keep them posted on what’s going on with their children’s health.

“I can’t diagnose a child, but I can give suggestions,” she said. “We catch a lot of things here, like chicken pox. We have strep throat going around now.”

Malone also does educational presentations on various health topics for staff and students. Some of the presentations are routine while others pop up based on certain circumstances. For instance, if one child has cancer, Malone will teach other students about cancer to allow them to understand what their fellow student is going through. Some of the more routine presentations are on subjects like basic hygiene and its importance. When needed, she discusses social manners with students, too.

For teachers, she teaches about such subjects as seizure precautions and basic first aid.

Malone has been invited to sit on a health and wellness committee and she’s working with other staff to create a sex education/abstinence program for the district.

Malone said one of the aspects of her job that some might not expect is finding clothes for children in need, such as children who don’t have proper winter clothing to play outside. She said community members often donate clothes to give to children who need it.

Malone said her favorite aspect of the job is working with students.

“The kids are fun. I see them in Wal-Mart and they come up and hug me,” she said.

She said when students hug her and tell her they love her, it just melts her heart.

The biggest challenge in her position is seeing children who really need to see a doctor, but the parents aren’t being compliant. She said she also sees instances where students who are blatantly sick are sent to school by their parents, which can lead to a lot of other students getting sick needlessly.

She said another challenge is dealing with head lice.

“When we find head lice, the child has to go home and can’t come back until it is completely gone,” she said.

She said she does routine checks for head lice in every classroom. She also does scoliosis checks in the middle school.

Malone said she wasn’t quite sure what being a school nurse would entail.

“It was hard to know what to expect. I talked to Jeanne and I have a friend who is a school nurse, but I was worried that I’d get bored,” she said. “I thought, ‘What am I going to do all day?’ Working in home care is go-go-go. It shocked me the amount of students I see every day.”

She’s already had some off-the-wall situations come into her office.

“On my first day, I had a girl come in whose gums were bleeding,” she said. “The problem ended up being a sequin being stuck between her teeth. I asked her if she ate her shirt instead of her lunch.

“When I was going to nursing school, I never thought my nursing career would lead to me taking a sequin out of a child’s teeth,” she said with a chuckle.

She’s also had to pull some loose teeth, which she found a little unsettling at first.

“I’ve never even pulled my own teeth,” she said.

In another instance, a boy came into her office complaining his ear hurt. Come to find out, he’d been sticking a pencil in his ear. Now whenever a child comes in complaining of a hurting ear, she asks, “Did you put anything in it?”

Malone said many students ask for ice, even if they really don’t need it.

“They want ice for everything. They think it’s a cure all,” she said.

She said some students think she’s a doctor and tell her they’d like to become a doctor some day just like her.

Over the years, she’s bound to collect plenty of funny stories, and she said she’s writing them down in a journal.

She’s also had some scary moments. She said a middle school student had a seizure one day and the school couldn’t get a hold of the family right away. The student went to the hospital and is now fine — and the school did finally got a hold of the family. It’s moments like this that Malone is very glad she can be of assistance.

“It’s a relief for (the staff) to have a nurse here,” she said. “I’m glad I’m here. A lot of schools don’t have a school nurse. If a student needs medical care, I don’t know how it would be done without a nurse. As a parent, it’s scary to let your child leave you if they have a medical condition. They want to know their children are in good hands.”

As for the school nurse at Cass City schools when Malone was a student, Malone said she has fond memories of her.

“Her name was Jane Mitchell, and she was soft-spoken and sweet,” she said.

“I was probably one of those kids who faked being sick a lot,” she added with a grin.