By Mary Beth DeCecco
During my formative K-4 school years, I visited the school nurse only once. In third grade I got slammed in the face with a kickball during gym class and was sent to the nurse. When I walked in I blurted out, “I got hit in the ball with a face.” That was the last time I was there. Never a sick child, there was no reason for me to visit the school nurse in elementary, middle or high school, aside from the mandatory hearing and eye tests. In fact, it was the place you didn’t want to have to visit.
At Forest Park Elementary School in South Colonie, it’s a different story. All day long kids stream into the nurse’s office, beginning in the morning before classes begin to say hello to Registered Nurse Suzanne Rubino, or to just give her a hug. It’s no wonder she garners this much attention—her adoration for the children is obvious, not only in her motherly actions (reminding them to tie their shoes, tousling their hair and squeezing their cheeks, or asking them what they ate for dinner the night before), but in the fact that she knows every child’s name—a total of 365 students.
I quickly learned that a typical day for a full-time school nurse is not at all what I had imagined —it’s full of constant movement, juggling multiple tasks simultaneously and soothing many tears and fears.
“I Pledge Allegiance….”
I arrived at the school at 8:30am, the same time the children started pouring in. After signing in at the main office I met Nurse Rubino, who gave me a quick tour of her office.
Her medicine cabinet (always locked) was full of a little bit of everything—Epi-pens for bee sting allergies and peanut food allergies, band-aids, Tylenol, Ibuprofen, inhalers, and various creams, including Vaseline, which she claims to be the “cure-all” for everything.
Though she’s well stocked with various medicines, she isn’t allowed to give any to a child unless directed by a doctor.
A large supply closet is stocked with more band-aids than I’ve seen on a pharmacy shelf, a wheelchair sits in another closet and there are two cots in the corner.
There are also a few touches that make the office seem less sterile and more kid-friendly. On her desk is a decorative band-aid holder with the words “Nurse Rubino’s Magic Band-aids” made by one of the parents, and a window box “garden” comprised of over a dozen pictures of each child’s face pasted onto sticks that are planted in pseudo grass sits near her window.
“That was given to me from the Kindergarteners for School Nurse Appreciation Program,” she proudly said.
During the tour, a gaggle of little girls (and a little boy or two) came in to talk to her. It was the day after Halloween and the kids were still buzzing with excitement. The previous day was the school’s final Halloween Parade around the parking lot, one of only a few schools in the area that still held one. But, due to security reasons, the district decided this was the last year.
Today, Nurse Rubino was asking the group how their Halloween was. One little girl requested to speak to her in private. I heard her assuring the student that she was safe in the building and that every door is always locked.
“She’s a worry wart and has a lot of fears,” she told me later, explaining that she was scared the boys who were breaking bottles on her street the night before would come to the school.
Aside from the locked doors, a new measure of security implemented by the school district this year is that every staff member must wear photo identification badges. Also visitors must sign in at the office and wear a temporary badge.
After giving the kids a star stamp on their hands, she shooed them to class and stood outside her door. I followed her lead and watched as she greeted the hoards of kids who walked through the main door, telling them how great they looked in costume the day before.
“How was your Halloween?” she asked one girl, who looked to be in third grade.
“I had a headache and puked,” she responded, which made me chuckle. Nurse Rubino, still smiling, reminded her that that wasn’t the right term to use.
We then made our way to the cafeteria, where the Morning Program takes place everyday except Thursdays. Upbeat music welcomes the large crowd of kids and teachers each day; today it was the “Friends” theme song, which had a few teachers doing their own little dance in the back of the room.
Each day a different teacher (today, both music teachers) briefly speaks to the kids about character traits, delivering a different message daily. This month, the trait was “cooperation”. The program is also a time to recognize birthdays of students and employees. Finally, the program concludes with the Pledge of Allegiance. (Yes, I remembered all the words, even though it’s been…more than a few years. And if the Pledge of Alliance wasn’t enough to transport me back to my school days, I also went on a fire drill with the kids later that morning. Luckily, I wasn’t mistaken for a new student. Trust me, that has happened before.)
Once back in the office Nurse Rubino’s busy day began and I simply watched from the sidelines.
Every few minutes the phone would ring with parents calling in to report their children out sick. If a parent doesn’t call in an absentee child, Nurse Rubino makes the call herself.
“When 10 percent of the children have the same thing, I have to call the NYS Health Department. This way, they can see how many children have the same illness, in which schools and decide if the school has to be closed due to an epidemic.”
In addition, she calls the Health Department every Wednesday to report how many kids were out sick for the week.
Nurse Rubino, an energetic woman with a hearty laugh and smiling eyes, reminded me of a younger version of actress Dixie Carter (of Designing Women fame). The Capital District native, is a mother of three grown children and has been married to her husband, Jimmy, for 35 years.
Her career in nursing began 1970 when she was a member of the first class of registered nurses to graduate from Maria College in Albany. From there she did her training at St. Peter’s Hospital, just down the street from the college. After the birth of her first child she went into private duty nursing for the next 18 years. When her kids were older she worked part-time at Sand Creek Middle School for two years, then went on to become a full-time traveling school nurse for six years in the Colonie School District.
Seven years ago, she was hired to replace the previous school nurse at Forest Park who was retiring.
“I like having my own school because I get to know the children and the families,” she said. “It’s very rewarding.”
“Oh, my aching head…”
The most fun part of my day was watching the nurse interact with the children. In just five hours, roughly 15 kids came in and three were sent home. The majority of complaints were headaches and stomachaches, something, she said, the kids sometimes confuse.
“Most kids have butterflies and think it’s a stomachache.”
Or, it could simply be a case of eating just a little too much. One little boy came in with a stomachache and Nurse Rubino first made sure his pants weren’t too tight, and then asked him what he ate for lunch.
“Pizza!” he excitedly shouted, and they laughed together as she told him he probably just ate too fast and, after giving him his star stamp on the hand, sent him on his way.
“This [the stamp] is so parents know their kids were in the nurses’ office. Many times by the time they get home they forget to tell them.”
One adorable special needs boy in Kindergarten had a rather large bump on his head and was brought in by his concerned teacher. After asking him how it happened (he fell off the couch), who helped him (nobody) and if he put ice on it (he did), Nurse Rubino let him go back to class.
“I document everything,” said Nurse Rubino, as she took out his file to mark down his visit. This is also done to make sure abuse isn’t occurring at home.
“I’m a mandated reporter. If anything is suspicious to me I need to report it to Child Protective Services.”
In her seven years, she’s only had to do that twice.
Another little boy, just back from vacation with his mother, also came in for a bump on the head. She directed him to the refrigerator for an ice pack and as he crossed the room he said, “I missed you” and gave her a hug.
One girl lost a crown, but also showed the nurse a rash on her side. After looking it over and not recognizing what it could be, the nurse called her mother and suggested she make an appointment with a dermatologist.
“You can’t be in school with a rash of unknown origin,” she told me after the girl had left. If a rash, such as ringworm, is identified and treated for 24 hours, the student can return to school.
Similar rules for fevers—children must be fever-free for 24 hours before returning to school. But, many times, with both parents working, sending a sick child to school is sometimes their only choice. When this happens, Nurse Rubino calls them at work and requests that the child be picked up.
“When a school nurse calls a parent for a sick child, the parent must come pick the child up,” she said. “An employer cannot reprimand an employee for that.”
Since recess was underway, there were a couple of playtime injuries. One boy suffered a kick to the head and another was kicked in the eye—both required ice packs.
When there were two or more kids in the office at once, I found it amusing how they looked at each other with curiosity, almost like criminals in a jail cell.
“What are you in here for?”
“Bump on the head.”
One little boy visited the office twice. He was uncomfortable because of a rather large crusty sore on his lip. I learned that it was impetigo (a contagious skin disease) that he also had last year. (Being a self-admitted germ-a-phob I was sure to wash my hands repeatedly throughout the day.)
Even though he said his mother had applied ointment to it that morning, it still hurt him, even just to smile. With nothing to do for him, Nurse Rubino gave him a pep talk and eventually sent him back to class. But, shortly later, he was back, accompanied by his teacher, who said he just wasn’t himself.
“I didn’t even have cake at the birthday party,” he told us, clearly upset.
This time, the nurse called his mother at work and when she put him on the phone, he started sobbing and asked her to pick him up.
The children that visit the nurse’s office on a regular basis are called “frequent flyers.”
“They just need a little extra TLC, “said nurse Rubino”.
The majority of students complain of general colds and fevers, but sometimes there are fractures and breaks. Her most severe case was three years ago when a child almost died of appendicitis, but thanks to her insistence that he be taken to the hospital, he survived.
Students aren’t the only ones to visit her; teachers come in as well. “I’ve had to call 911 for three staff members,” she said. Two had peanut allergies, the other had an allergic reaction to an antibiotic.
The beginning of the school year is the busiest time for Nurse Rubino because of all the paperwork—she has to make sure all the immunizations are up to date and conducts hearing and eyesight tests. She actually tested me, and I’m glad to report that I passed both with flying colors.
January, she said, is a busy “sick time” for the students, as is any change of season.
To keep up on new mandates, she takes continuing education classes, attends conferences and writes a monthly column in the school newsletter, focusing on topics such as the importance of hand washing or how to protect oneself from the cold or flu.
The part of her job she likes the least is the paperwork. The best part is watching the children grow up. “I love being allowed to be a part of their growth. They’re all so innocent, giving and kind.”
But, more importantly, she makes sure the needs of the kids are being met. “We’re supposed to make it safe for a child to attend school.”
School nurses do more than put a band-aid on a cut or scrap—they care and nurture the children when a parent can’t be there to do it.
“It’s a lot of work and takes a lot of energy,” said Nurse Rubino, who clearly loves what she does.
Perhaps a pin that she got from a School Nurse’s Association conference sums it up best: “Every child needs a school nurse.”