Kiddizzy

I’ve talked before about the smells of my nurse’s office but it occurred to me how noisy my office can be at times too. Following are some of the typical sounds I encounter. Although they don’t always sound “healthy”, they are indeed pretty interesting at times.

My thoughts are in italics.

Slam

Bang, bang, bang.  What’s that noise from?

Burp, slurp

Ferrrrap! Giggle, giggle.  Oh yeah, that was a good one.

Waaaa!

Huh?

Bang, bang, bang   Why do kids like to kick my beds?

Veeerrrrrraaaah!  Veeerrrraaaah!  Oh, such a rainbow of colors on my floor.

Sniffle, sniffle. Big sucked in wet sound.   Who needs a diet when the sounds of kids can take away your appetite?

Waaaa!  Waaaaa! Waaaa! Waaaa! Waaaaa!

Plop, pssssst, flush.

Drip, drip, plop, ting.  I don’t even want to know.

Waaa!

Rrrrrrip!

Waaa!

Glad to know I don’t scare the kids. They seem comfortable letting it allllllll out here at the Health Office.

Jeffery, a first grader, came to me with a pass that read: not feeling well. Since this is not too specific, I ask

Jeffery, what doesn’t feel good to you?

I’m very sick!  (Now just an hour ago his mom was volunteering in the classroom)

What makes you think you are so sick?

Because I am.

What feels sick?

My stomach. I have the stomach flu.

Did you throw up?

When I went camping I threw up a lot!

No sweetie, I mean today. Have you thrown up today?

With perplexed look, “No!. Yuck!”

I take his temperature, 97.7, and encourage him to lay down and rest.

Why?

It will help your body feel better.

No it won’t. I should go home.

Suspecting that Jeffery is probably missing his mom…

Your job is to be in school Jeffery. The day will be over and you can tell your mom about everything you got to do today, right now though it is recess time.

It is? I feel better already!

Wow, it’s a miracle. He’s cured! Wish this would work on my bills.

Recently I posted about a little boy who got upset about his orange being taken by another classmate. Since then, I’ve seen this same young man four more times for crying. His teacher explained to me he actually cries two to three times during each school day, usually over something he doesn’t get his way about. The little boy gets sent to my office as a last resort when the crying turns into screams and is too disruptive for the balance of the class to function.

Situations like this are not uncommon in the school setting.

When children are infants, crying is how an infant communicates they are needing something. Whether it means,”I’m hungry”, or “I’m wet”, or even “I’m too hot.”  Parents know to respond to the tears, check for needs, and then everyone is happy again. As a child’s ability to talk develops, they then must learn how to make their needs clear by speaking and that crying is no longer necessary. Crying tends to remain as a way to relieve stress, fear, respond to physical discomfort from a scrape or bump, and sometimes when over tired. Ideally, this becomes less and less as the child grows, develops, and matures.

As children approaches the age to enter pre-school and Kindergarten, some don’t understand enough that the new environment can be fun. They may have fears of the new adults, teachers, and other new children they don’t know. Crying can beone way they express themselves. With adults’ help, they can learn to become less fearful and anxious, understand that mom and dad will be back, and feel happy when attending. Most children reach this point, but what happens if your child doesn’t?

It is imperative to develop a good relationship with your child’s teacher. Work together to develop a plan of action to change the behavior. Some kids scream, others lash out, neither is acceptable. Don’t assume the teacher is doing something wrong. With a class full of little ones, safety is a must, and working to teach each active body can be difficult, especially with a behavioral concern taking place. Your child may need to be removed from the class and provided a place to “chill out.”

If the problems continues into the school year, consult with your child’s pediatrician. There may be some underlying medical concern that is causing the problem. Children can be allergic to just about anything, including food colorings and variable surfaces and symptoms are not always easily recognizable. The pediatrician can also offer a parent tips and guidelines on handling the behavior and even resources for parenting classes specific to the behavior. Parenting is always a learning process and the wise parent knows when to seek help.

Consistentency is key with any child behavioral issue. If certain tactics are being used at home, they should also be used at school and vice versa. It can be very confusing to a child if one thing happens at school, but something else occurs at home.

If the behavior continues it may be that your child is simply not ready for the classroom structure. That doesn’t mean you’ve failed as a parent, it could just mean your child needs more time to mature. Work with your child at home, inquire about any pre-K programs or developmental pre-school options. Consider half day sessions if the original sessions were a full day. If you work, and need a full day with the school, switching to a half day structure and having a half day day-care could be very helpful.

Lastly, keep in mind that a child’s behavior can literally change moment to moment. What is occuring now, doesn’t mean it will last a life time. I’ve seen many, many children change each school year and into some of the most wonderful young people I’ve ever known.

Most people grumble when they get their jury summons, but I’m one of those nuts who actually likes it. I’ve gotten to serve on a jury for a civil and criminal case. It is like participating in a real life mystery and we, the choosen jurors, get to pull the clues together for a verdict. Upon arriving and checking in, they immediately called the first panel. I wasn’t called.

I brought my Biology studies with me, just in case, but truly had hopes I would get called. I was starlted by the over head paging when it was announced we were released for a break. I hadn’t realized I’d fallen asleep. It was already 10 a.m. Wiping the drool from my lips I got up and got some coffee at a nearby kiosk. I was good to go again. Got two chapters of Biology read. A second panel was then called. I wasn’t called.

There are so many different people who come to jury duty. It became fun to just sit and watch everyone. Based on behaviors and where they were sitting, you could tell who was a lawyer, who was a realtor, who was a doctor, and who was even retired. Professionals are either glued to their lap tops at the tables or outside on their cells. Everyone else sat reading the paper and pretty much never left their seats. Many older woman are very good at striking up conversations with other woman and I think they had the best time all day.

We were released for an hour and a half lunch break. I had a nice lunch, outside, it was a really nice weather day. Good day to get picked for a jury. Once back from lunch a third panel was called. I wasn’t called.

I got up to powder my nose, go to the bathroom, and got stuck in the stall. The lock, which locked very well, would not unlock. Since most individuals by now have been called to a panel, there was no one in the bathroom with me. That was good in one way, as I was alone in my embarrassment, but not so good in that I had no one to help me get out. What if they call another panel and I finally get called? I’ll miss the chance! With a hard pull on the door, I was finally able to get it open.

I settle back into my seat and starting reading my fourth chapter of Biology. Have I been here that long? What happened to chapter three? After chapter four I went back to the bathroom, mostly to stretch my legs. Apparantly that coffee wore off as I had not realized I went to that stall with the broken lock again. After about five minutes I managed, again, to get myself out. I made it back to the seating area and the lady who had been calling panels was now at the podium again. Yeah! What? Oh, we’ve been dismissed for the day.

Oh well, no mysteries today. I very much now look forward to returning to work. Suddenly the thought of boogers and bandaids sounds so much more interesting than today.

Over the last four years Federal mandates have been set regarding party foods in the school setting. Many parents are still expressing concerns that they can’t make cupcakes and bring for their child’s birthday to be shared with the class.  That they feel their child is being punished for some other child’s food allergy. So here is some information that I hope will help explain this rules and why they exist.

If you were to walk the school grounds during a recess period, it would be easy to spot the number of overweight children running around. If they are physically participating why are they overweight? Studies were done that tracked the amount of sugared items children were receiving in any given school week. Findings showed that with the amount of birthdays, holiday parties, rewards, and even Halloween, children were receiving a consistent flow of sugary items. In addition foods such as pizza and chips containing a higher number of fat were also available. The amount of exercise at recess just wasn’t enough to burn all those calories from treats. The balanced diet wasn’t being balance while in school. And since the rise of obese related diabetes has been on the rise, among children, a change had to occur.

It is also a fact that there is a large increase in the number of food allergies among children. Those allergies are not just peanuts, but gluten, wheat, milk, eggs, even certain food colorings. So if one parent brings cupcakes to a classroom, and there is no way of checking the ingredients because the item is homemade, than the teacher could be dealing with a serious allergic reaction from a child who ate that food. Sounds so innocence but let me tell you, as a nurse at a school THIS HAS HAPPENED!

So what is the bottom line on rules?

Always check with the teacher if it is okay to bring a treat for the celebration of your child’s birthday. Obtain approval of the choice by having the contents checked for amount of fat and sugar. There are guidelines at schools for checking.

Treats should be geared towards fruits and vegetables, waters and juices. Goodie bags filled with pencils, erasers, and other kid friendly items in place of food is always a welcomed change.

Always bring prepackaged items so that ingredients can be checked. Any child with a serious food allergy may need to avoid your choice, but they should also have their own supply of “safe” snacks, just for them, for just these occassions.

Join in the cause to keep children healthy by creating a health committee among the school’s PTA. Work in conjunction with the School Nurse.

Cafeteria foods are carefully structured to be within certain limits of fat and sugar. Teach your child what foods contain higher amounts of sugar and fat and how to create a balance in their diet. Teaching early on also helps nutrition become a habit, one that can last your child’s life time.

If you would like more information on this topic, go to the CDC.gov website. There is also a BMI calculation section that can help you determine if your child is on the right track. Know that because a child spends an average of 30 hours per week in school, schools are always looked to promote wellness and safety … and that usually results in rules that everyone must follow.

Today I received a call to my office from one of the Kindergarten teachers asking if I could come and retrieve a child. Usually when I get one of these calls it is because a child is crying and won’t stop. It wasn’t the crying so much that was concerning the teacher, but the volume he was crying. It was creating a disturbance to not only the class, but to the classroom next door. So over I went and truly, I could hear him even before entering the Kindergarten area.

“Come with me Derek. You can be with me and cry all you need to at my office.”

Sniff, waaaaaa, big snotty sniff was the reply.

Once at the office I gave him a chance to settle in and he had stopped hollaring by the time he sat down.

“So what’s wrong Derek? Why are you so sad?’

“I’m not sad! I mad!

“Why?”

“Matthew took my orange! The teecher said he could. He can’t. It’s mine. Matthew took my orange!

“Oh! That is a problem. Why did Matthew take your orange?”

“Because it’s mine!”

“Did he take it from your hands?”

“No, from the bowl.”

“What bowl?”

“The one in the class. On the table.”

“Were there other things in the bowl?”

“Yeah, but I don’t like apples. Like oranges.”

“Sounds like there was a misunderstanding. Maybe Matthew didn’t know you wanted the orange. Maybe he thought you liked apples.”

“Don’t like apples. Like oranges!”

“Will I don’t have oranges but I do have Graham crackers. Would you like some of those?”

“Yes.”

So Derek sat eating the Graham crackers and there were no more tears.  As he headed back to class, he replied, “No crackers for Matthew.”  Apparantly even Kindergarten children can be competitive.

I saw Val Gal today and poor thing had a blow out. Not a temper tantrum type blow out, but a filling of one’s pants with poo blow out.  She had tried to get to the bathroom but luck would have it, her body didn’t let her make it. I was called out towards the playground. She was just standing there, afraid to move. I managed to get her going and we walked together back to my office.

In the bathroom I started the process of getting her all cleaned up. Poop was down her legs and even into her shoes. Unfortunately, being a kidney transplant survivor, the required medications can cause diarrhea. I knew mom had been working with the doctors on this as the last thing we want to see is dehydration and anything leading to malnutrition. It is a catch 22 situation.

Val Gal is very trusting of me. I feel honored that I have been able to care for her. I was able to provide her with fresh clothes and cleaned up her shoes. I rinsed out her panties so nothing gross would have to go home to mom. Mom works very hard as a single parent and then handling a child with a medical concern. I talked with mom also to let her know.  When all was said and done Val Gal left with smiles and returned to be being energetic and ready for more play.

I love Val Gal. Her spirit is spunky and she never stops trying to be a normal kid. Plus, she has the cutest tushy I’ve ever seen.

I’m not sure why, but as a nurse I find that people tell me all sorts of things. Maybe they feel safe with me? Maybe they hope I might have some magical piece of information to solve their problem(s)? I’ve often wanted to put out a glass jar, much like Lucy of the Peanuts would do, and charge 5 cents. Some of the comments are just in passing and can be quite helpful in caring for a student, but some details I don’t think it is my place to know about.

I’ve learned who has good sex and who doesn’t.

I’ve learned who sleeps with pajamas or underwear, and who doesn’t.

I know the details of back surgeries, neck surgeries, knee and arm surgeries, and yes, even vasectomies.

I know who is getting a divorce, who cheated on who, who loses a job, who hates which teacher, and/or the principal, and who cheated on their college exams.

I also know the full details of an individual’s colonoscopy.

Recently, while listening as kindly as I could to the details of an individual’s recent, and personal, procedure, a boy walked in and announced, “I’ve been to the swamp and back!”  He was covered head to toe in mud. Both myself and the parent I was talking burst into laughter. The parent departed and I was left to do my job.

I helped the boy get cleaned up and provided loaner clothes. I also got to listen to his details of how he got muddy and why he was calling it a swamp. I couldn’t have been happier to be involved in this conversation and listen to these details. He was funny and I was relieved.

Earlier this week I posted about a K student we suspected of having Down’s Syndrome. You may have asked yourself why would a school notice and not the parent so I wanted to add some information.

First, it is not uncommon that parents don’t notice disorders that may be developing in their children. Especially if it is their first child, normal childhood characterisitcs are so varied and wide spread that the abnormality can easily go missed. Even doctor’s can miss the most subtle of symptoms. If the child had been premature, say by a month, growth and development can be delayed and heighten the chance of missing symptoms. If you add in any financial restrictions a family can have, such as not having medical insurance, keeping up with regular physician checks will fall to the way side, physicals where the doctor may have picked up on a problem.

Schools see children of all sorts — literally. Not just in cultural backgrounds, but in disorders. No child is turned away as it is law that an education be provided. Therefore, it is not uncommon for a school to discover the abnormalities. We’ve discovered autism, ADHD, bi-polarism, even diabetes. We’ve also discovered drug abuse in parents, abuse in general, even divorces. The longer a teacher has been a teacher, the more frequently they notice these symptoms. We will never say we are always correct –we’d always prefer being wrong — but if a teacher makes a suggestion, as a nurse, I take it very seriously.

Schools have resources for parents as well. We can offer information  on where to obtain a free physical, immunizations, food, even clothes and school supplies. The district nurse especially is a good person to get to know as she always has connections to medical services to help those families without insurance or other resources for their children. Parents should never be embarrased to ask for help.

Regarding Down’s Syndrome, if you know someone with a child you suspect may be afflicted and you feel has been denying it, take a look at Down Syndrome for New Parents. This site, www.downsyn.com, offers a list of symptoms and a large resource of information and support. Children of Down’s can lead productive lives and the school can help a parent to do just that.

For other disorders in chidren you may have questions about, always try to educate yourself and keep a working relationship with your child’s doctor. If you need help obtaining services, be sure to contact the school and develop a relationship with the nurse.

Apparently not all of our parents get along. The mom of one kindergartener hates the mom of another kindergartener. They are neighbors and the one mom feels that the other mom’s son treats her’s very badly. From the first day of school when the two moms realized that their sons were in the same K classroom, things have been rocky.

Recently, one of the moms came to the office stating she had to call the police. That the other mom didn’t pick up her son but sent someone else to pick up him up and she did that to cause her distress. I think the other mom may have sent someone else to avoid this first mom. This must be awkward simply trying to pick up one’s child when you are getting glares and remarks at you each day. Our office manager explained she could use the office phone to call if she felt she was in some state of possible harm.

“Harm? I’m pregnant and shouldn’t be under stress. This other woman is causing me stress and that can be harmful to my baby!”

So the police came and talked with the mother, then talked with the principal. No one was arrested.

I think it is sad when we see parents behaving in a way I doubt they’d ever want their children to behave. Aren’t we all suppose to get along? They are kindergarteners for goodness sakes!

Sadly, the son of this “stressed” mother is already struggling in class. He’s very quiet, doesn’t answer questions appropriately, is not playing with peers, and has the appearance of a Down’s child. A request went to the district nurse who will be coming to do an initial assessment and if her findings are the same will be contacting the parents.  I fear how this might go over.

Saying prayers for this little guy, as well as mom. I fear her moments of stress may only just beginning.