community response
Running Head: CLINICAL REFLECTION 1
4
CLINICAL REFLECTION
Clinical Reflection
Ashleigh Jacquez
Patty Hanks Shelton School of Nursing
Clinical Reflection
The clinical site that I am going to discuss is a local elementary school. There is a single school nurse that provides the care. The care that the nurse provides varies based on what is needed by the students when they come and see her. Examples of care given include assessment of physical injuries, administration of medication for both acute and chronic conditions, and making referrals when necessary. Referrals can be to primary care providers or specialists. The nurse also provides screening for issues including vision, hearing, and scoliosis. She may also provide screening for unusual circumstances, such as child abuse. The nurse also acts as a consult to the teachers and other faculty, giving advice and information when needed. She also discusses the kids’ health with their parents, and teaches the parents how to best continue care at home. Lastly, the nurse is a teacher to the students. She teaches them about their bodies and how they will change as they get older. She teaches them how to care for their bodies and how to care for their mental state. She fosters a sense of independence and autonomy, so that the kids can make their own decisions and can be confident when doing so. The nurse is also very important for mental and emotional health and is “integral to the academic success of the nation’s 74 million youth under the age of 18” (Willgerodt, Maughan, 2018, p. 232).
The population that this service provides care for is primarily students. The school is pre-kindergarten to fifth grade. The kids can be aged anywhere from four to twelve years old. The school nurse can also provide care to the faculty if needed. The students mostly come from middle-to-upper class families. All ethnicities are represented in the school, but the population is mostly white.
The most common illnesses that are seen by the school nurse are acute. Examples of this include the flu, strep throat, and undiagnosed “stomach bugs.” The nurse can give over the counter medications, but they must ensure to have all of the students’ allergies on file and confirmed to ensure no adverse events. Medications that can be given include Claritin, Tylenol, and cough drops. The nurse must double check the appropriate dosage, especially because this can vary for each student given the level of physical development. The nurse can give prescription medications, but must have a doctors’ orders and have to speak with the parents to confirm all of the details. Common indicated medications include ADHD medications, asthma medications, and insulin. However, school nurses are not able to administer narcotics regardless if there is a prescription. The nurse does do the three medication checks seen in the hospital for prescription medications. A common chronic illness that is seen in these settings is type one diabetes. In this scenario, the nurse works very closely with the students’ parents to ensure that the blood glucose levels of the student are within expected range throughout the day, starting with the first reading at home. During my clinical, I observed the nurse administer insulin before student went to lunch. The student was able to do her own glucose reading. After showing the nurse the reading that the student obtained, the nurse figured out the amount of insulin needed and prepared the insulin pen. She then asked another faculty member to check the dose, and then administered the insulin into the student’s abdomen. The nurse then texted the student’s mom and let her know the reading and the administered dose. Later in the afternoon, the same student experienced a hypoglycemic episode. The nurse had the student sit down and she gave her a snack, and then rechecked the blood glucose reading again 15 minutes later. Her reading was then within normal limits.
This school is funded by the parents of the students, who pay tuition for the students to attend. The school is nonprofit and they use the money to improve the school environment and pay for student experiences such as field trips.
Overall, I enjoyed my clinical rotation and was able to observe the nurse perform plenty of interventions. I was able to do some vision and hearing screenings for the younger kids. It takes patience and understanding to work with children, especially with those who are so different in age and developmental levels. The nurse must be very knowledgeable about the different physical and health expectations for each age group in order to intervene when it is necessary. The nurse displayed great relationships with her students and I’m glad I was able to observe someone who cares very deeply about her job and those that she takes care of.
Reference
Willgerodt, M, A., Brock, P. D. M., & Maughan, E. D. (2018). Public School Nursing Practice in the United States, Journal of School Nursing, 34(3), 232-244. http://eds.b.ebscohost.com.ezproxy.hsutx.edu:2048/eds/detail/detail?vid=1&sid=aaf926b 3-ac72-4085-a106-5b6587c07846%40pdc-v- sessmgr01&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=129 533946&db=rzh
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