Beyond Band-Aids: A Day In The Life Of A School Nurse

About ten minutes past 8 am, Rachell Lindsay pulled into the Tecumseh High School parking lot—coffee, phone, and medical kit near to hand—for her third work stop of the morning, Feb. 28.

As a School Nurse for Tecumseh Public School District, Lindsay’s day started at a breathtaking pace, jumping between Cross Timbers Elementary School, Tecumseh Middle School and Tecumseh High School in the span of approximately fortyfive minutes.

At each site, she checked on the students with diabetes, helping make sure that they were tracking their food and insulin doses correctly during their school breakfasts.

Months of practice has made this a smooth flowing process, and each visit only lasted a few minutes.

With the younger students, she provided more specific guidance, while with the older ones, she primarily checked the numbers the students had already done. Some students preferred to meet with her in the school office, while others were comfortable meeting in the cafeteria or other more public place.

When one student forgot to bring their own supplies to check their blood sugar, Lindsay pulled out a kit of her own, and watched as the student pricked their finger and read the results.

The friendly banter she shared with the student bore witness to the familiarity of this ritual to both parties.

Using their own supplies to supplement the schools’ resources in order to do their jobs is no less familiar to school nurses like Lindsay than it is to teachers.

“Having the time and the funding to do everything that you need to do with everybody at the same time is difficult,” she said. “There’s not enough time or money in a day to do everything for everybody.”

Despite these challenges, Lindsay clearly loves the relationships she forms with the students.

“You learn who they are. You love them like they’re part of your family,” she said. “So everything is more—I don’t want to say emotional—but it just matters more. You know what I mean? You really want them to do better. It’s not just ‘here’s your insulin, take it;’ you really want them to be good with it because it’s important.”

These relationships that the nurses build with students can pose challenges.

“They see us around a lot and we’re not their teachers. So it’s kind of a different relationship with them. We’re not their principal. And so they are a little more apt to talk to us, friends,” she said. “So, when they tell you certain things, you have to acknowledge that and you have to have those conversations and so it makes it difficult because it puts you in a position where you have to start moving that up the chain and you don’t want to break trust but you have to, in some situations, so it’s difficult.”

There’s also blessings that come from working with the students on a daily basis.

“I had one kid at Cross Timbers race me in the cafeteria,” Lindsay said. “I was leaving from dosing (a student) there and we were, he was making car sounds and pulled up to me with his tray and I’m like, ‘Are we racing?’ And he’s like, ‘Yes.’ I’m like, ‘Well, let’s do it’.”

After her breakfasthour school visits, Lindsay had some time at the desk in her classroom at Krouch College-Career S.T.E.A.M. Center, waiting for either an emergency call from one of the school sites or for lunch hour to arrive.

Prior to the COVID-19 pandemic, the two school nurses at Tecumseh taught a health careers course in their classroom. Lindsay began working at Tecumseh Public Schools during the pandemic, moving to the school from working at the health department, so the classes had been taught by her predecessor and her coworker, fellow Tecumseh School Nurse Jeseca Townsend.

Now, the classroom functions almost more like Lindsay’s office, when it’s not the site of CPR training days run by the school nurses.

The space’s use wasn’t the only aspect of the school nurses’ work that was changed by COVID-19.

“Rachell (Lindsay) and I make all the, you know, contact, if somebody is positive, or somebody, the secretaries will get the information, and then they relay it to us,” Townsend said. “So that’s covering the whole district, whether it’s staff or students, so that very easily turns into a time consuming job.”

The protocols for responding when a student or staff member tests positive for COVID-19 has gotten simpler with experience.

Townsend and Lindsay said that earlier on the school nurses had to go into classrooms and measure things to determine who was a close contact whenever there was a positive case, a job that could take hours per positive COVID case.

“More people are knowledgeable about what is contact tracing and who’s what and so, for that, I think it’s helped a lot, too, for us to just be able to do the contact tracing calls and notifications,” Lindsay said. “But even that takes a good 50 percent of our day, when we have positives, I mean, at least two thirds.”

On those days, COVID-19 issues become the primary priority.

“That turns into your main job, whenever COVID cases are high is that’s really what you’re doing,” Townsend said. “And you’re just trying to do all your other stuff, too.”

Around 9 am, Lindsay left her office, this time heading back to Cross Timbers to complete a vision screening.

After a few moments of set up, she walked the student through a series of exercises to check his vision with ease and efficiency, asking him to identify letters on cards she held up. Within ten minutes, the student headed back to his class, and Lindsay was ready to leave.

Then around 10 am, she was called to the high school. A student was experiencing back pain, and Lindsay listened as she described her symptoms. Then she measured her vitals and recommended ibuprofen, telling the student to let her mom know if she had further symptoms.

Then it was back to the office at Krouch, before heading to the middle school to start the lunch round of checking on student’s blood sugar and carbohydrate numbers.

Lindsay’s own lunch time can vary widely, she said, depending on if there’s a medical emergency at the school, so she kept snacks with her just in case she didn’t get the chance to stop and eat a meal.

On Feb. 28, though, she went across the street to grab Taco Bueno with me, while Townsend completed checking on the students during their school lunches.

After the meal, it’s back to Krouch yet again, to work on various other projects, such as planning for an upcoming CPR training, until if or when an emergency call comes in from one of the schools.

If no calls or text messages come in, she’d leave the office at 3:45, after the last bus had already rolled out, to return and repeat the next school day.