Healthful Living from Your Arlington School Nurses - Issue 003 • … · 2020. 6. 1. · 0 of...
Transcript of Healthful Living from Your Arlington School Nurses - Issue 003 • … · 2020. 6. 1. · 0 of...
Issue 3 • Newsletter Contributors Susan Almquist • Susan Franchi • Carol Howard • Michele O’Toole • Arielle Petti • Amy Volante • Andy Winther
Definitions to help you navigate in a COVID-19 World By Susan Almquist RN, MS, NCSN You may have questioned the meaning of various terms that are being used frequently these days in regard to the coronavirus SARS-CoV-2 and the disease it causes, COVID-19, specifically:
Isolation versus Quarantine:
• Isolation: separates sick people with a contagious disease
from people who are not sick.
• Quarantine: separates and restricts the movement of
people who were exposed to a contagious disease to see if they become sick,
The Center for Disease Control and Prevention Requirements for when a person no longer requires isolation or quarantine is set by State and Local
guidelines.
Testing: Appropriately validated serology tests (antibodies specific to SARS-CoV-2), when used broadly as part of seroprevalence studies, can be useful in understanding how many people have been infected and how far the pandemic has progressed. These tests can also be useful to examine demographics and geographic patterns, to determine which communities may have had more cases, suggesting more ‘herd immunity’ which reflects the degree of resistance to infection in a population. Various tests, specific for the virus SARS-CoV-2 can identify if an ill or exposed person has been infected by the virus.
Basic reproductive number, R0 (Rnaught): Basic reproductive number (R0); defined as the expected number of additional cases (infections) that one case (infection) will generate, on average, over the course of its infectious period in an otherwise uninfected population. N Engl J Med 2020; 382:1199-1207 Basic reproductive number, depends on the biology of the virus and it's environment, for example the level of crowding R0 of COVID-19 is 2.2 to 2.5
ASK THE NURSE • QUESTION OF THE WEEK
What is Herd Immunity?
Herd Immunity (also called Herd Effect or Herd Protection): Individuals who are immune to a disease act as a barrier in the
spread of disease, slowing or preventing the transmission of
disease to others. An individual's immunity can be acquired via
a natural infection or through artificial means, such as
vaccination. When a critical proportion of the population
becomes immune, called the herd immunity threshold (HIT) or
herd immunity level (HIL), the disease may no longer persist in
the population, ceasing to be endemic. Merrill, R. M. (2013).
Introduction to Epidemiology. Jones & Bartlett Publishers. pp.
68–71. ISBN 978-1449645175. Retrieved 29 March 2015.
Please see the diagrams on page 2
Congratulations Class of
2020 2020
Issue 3 • Newsletter Contributors Susan Almquist • Susan Franchi • Carol Howard • Michele O’Toole • Arielle Petti • Amy Volante • Andy Winther
Diagram 1 - Left side of the diagram displays the situation
with established Herd Immunity, where susceptible individuals
are not infected and the virus dies out.
The Protection Given a Population Through Immunity.
_______________________________________________________
_ _ _ with social distancing ____ without social distancing
Diagram 2 - Right side of the diagram displays a situation
similar to COVID-19 where with an Ro of 2 and over half the
non-immune population still susceptible to infection.
_______________________________________________________
Flattening the Curve: Until Herd Immunity is established either by natural immunity acquired
by infection or by immunization, social distancing can slow down the
spread of infection, allowing time for establishing the best care
protocols to protect and support ill individuals to a return to health.
Time
Number ofInfected
Individuals
Area Under the Curve(number of infectedindividuals) is the sameon both curves.
Issue 3 • Newsletter Contributors Susan Almquist • Susan Franchi • Carol Howard • Michele O’Toole • Arielle Petti • Amy Volante • Andy Winther
Massachusetts Leads the Way in Contact Tracing By Michele O’Toole, MEd, BSN, RN
Governor Baker is making contact tracing and testing a priority
for the State of Massachusetts. The Contact Tracing Collaborative
(CTC) as it is called, will help us in the fight to contain the virus and
to get people back to work and back to a new normal. Countries
such as South Korea, China and Germany, had success with contact
tracing early in the spread of COVID-19. The MA contact tracing
program was piloted in April and now has a workforce that is
scalable to meet the need anywhere in the state. Partners in Health
(PIH), a non profit Massachusetts based company, with a wealth of
experience around the world protecting people from diseases such
as HIV/AIDS, Cholera and TB, has created, collaborated and
implemented this ambitious and exemplary initiative. PIH is
working with the Massachusetts Department of Public Health
(MDPH), 300 local MA Boards of Health (LBOH) and academic
health departments to reach out to those who test positive for
COVID19 and their contacts. The program can connect infected
individuals with testing, health providers and supports as needed.
Timely intervention is vital to the health and safety of everyone.
One thousand contact tracers have been hired to work on a
mission that is anticipated to last for at least a year, maybe longer.
The workforce is anticipated to reach 5-10 thousand people a day
by phone with initial calls lasting 30-40 minutes.
In addition to contact tracers, PIH has hired “case investigators”
who supervise a team of contact tracers. It is the case investigators
job to initiate the dialogue over the phone with the COVID positive
patients and ask them to recall when they first noticed symptoms,
who they were in close proximity with from two days before the
start of the symptoms through the time of their diagnosis. The
“contact tracers” are then assigned to follow up with the contacts
of the patient and in some cases may need to do detective work to
find them. “Care resource coordinators” will then help the most
vulnerable contacts. The care resource coordinators are nurses,
social workers and those knowledgeable about the community and
it’s resources.
The CTC model is being shared with other states around the
country. This program brings hope that we will be able to keep the
virus under some control. Of course the program is voluntary and
confidential. It is important that people believe in, understand and
trust CTC. People should know that information kept in
Massachusetts Virtual Epidemiologic Network (MAVEN) is private
and secure. People will see an identifier on their phone “MA COVID TEAM” when the phone rings. So pick up the phone if you see this identifier, the team is there to help. Social
distancing, contact tracing, testing, quarantine/isolation and
treatment are five elements that experts advise will make the
difference in reducing the spread of the virus. The human element
exemplified in this program, is an important reason why this
approach has proven to be so effective all over the world. People
need human connection and to know that other people have their
back. Contact tracing if done correctly provides that human touch.
Resources: - Mass.gov/covid19 -PIH COVID19 Webinar Series, April 28, 2020
- PIH.org, Partners in Health website
- ‘A way out’: Inside the ambitious Mass. coronavirus contact tracing
effort by Victoria McGrane, Globe Staff, Updated April 25, 2020
- An Army of Virus Tracers Take Massachusetts by Ellen Barry, The New
York Times, updated April 17th, 2020
Issue 3 • Newsletter Contributors Susan Almquist • Susan Franchi • Carol Howard • Michele O’Toole • Arielle Petti • Amy Volante • Andy Winther
Three Types of Support Dogs By Andy Winther R.N., B.S.N You may have seen a dog in your school and wondered what is
the dog doing in my school? It is very likely that the dog you
saw was a Therapy dog, but did you know that it could also
have been a Service Dog or Emotional Support Dog. There is
often some confusion about the different jobs that these
support dogs do so let’s try to clarify them. We won’t go into
details about the specific jobs they do, but we will cover the
basics. In separate articles we will cover each support dog’s job
in more detail, so look for it in this newsletter and future
newsletters.
What is a Therapy Dog? A Therapy Dog’s job is to
provide emotional support to a group of people in a situation,
not just one person. They have had formal training and they
need to pass a standard test for certification. The training they
experience is basic; they have to be able follow basic
commands, and have a good temperament. You may see a
Therapy Dog in schools, hospitals, nursing homes and other
places. Some of the schools in Arlington utilize Caring Canine
Visiting Therapy Dogs to come and socialize with the students.
You can pet a Therapy Dog, (that’s why they are there) but you
should always ask for permission first.
What is a Service Dog? A Service Dog is
specifically trained and
certified to assist the
needs of just one
person. They have been
individually trained to
perform specific tasks for individuals who have disabilities.
There are many different kinds of Service Dogs. Some can aid
in navigating people who are hearing or visually impaired,
some can assist people who are at risk of seizures by alerting a
person before the seizure happens, and some dogs are trained
to use their nose to help people with diabetes by alerting the
person if their blood sugar is high or low. Service dogs are
protected by the American with Disability Act and are allowed
in all public places. They can also go in the cabin of airplanes.
You are not allowed to pet a service dog because it could
distract the dog from doing its job.
What is an Emotional Support Dog? An
Emotional Support Dog
provides emotional support
to a person with a disability.
They are not trained or
certified for a specific skill,
their primary function is to provide emotional support, through
companionship. Emotional Support Dogs help people who
struggle with stress, anxiety or depression. They are allowed to
fly in the cabin with the owner with proper paperwork from a
medical professional. You may be allowed to pet the dog but
only with the owner’s permission.
As you can see, dog’s capabilities go way beyond “man’s best
friend”. Dogs can have many different and complex jobs. Isn’t
it amazing that we can utilize a dog’s intelligence, instincts and
natural senses. Hopefully, you have less confusion about the
roles of Support Dogs. Coming soon, more details about the
different kinds of Support Dogs and what their jobs entail in
this newsletter and future newsletters. They are amazing!
Issue 3 • Newsletter Contributors Susan Almquist • Susan Franchi • Carol Howard • Michele O’Toole • Arielle Petti • Amy Volante • Andy Winther
The Superheroes of The Dog world: Diabetic Service Dogs By Andy Winther R.N., B.S.N Service Dogs are specifically trained to help and support
humans in times of need. There are many different kinds of
service dogs. Just a few of them are: guide dogs for a blind
people, seizure response dogs, mobility assistance dogs, and
dogs who are trained to use their nose to help humans. We are
going to learn more about a Diabetic Service Dogs that has
super hero skills.
The Bode family of Arlington has a very special family member,
a Diabetic Service Dog named Atlas. Atlas’ family are his big
human mom and dad Crista and Jim, and little humans Anna,
Luke, and Matthew. Anna has Type 1 Diabetes, so Atlas’ job is
to help Anna. Anna is 6 years old and is a student at Stratton
Elementary School. Anna and her mom Crista have been so
kind to help us all learn what a Diabetic Service Dog can do
and what it is like living with a superhero working dog. Before
the Bode family got Atlas they did not have any animals, so
having a dog with superhero powers has changed their lives.
Now, they could not imagine a life without their dog Atlas.
Talking with Anna’s mom Crista it was clear that the whole
family is absolutely in love with Atlas Bode. Join us for a few
minutes to learn all about diabetic service dogs from Atlas’ big
human mom; Crista Bode.
What is the dog's name, breed and age? “Atlas Bode. Atlas’ Breed is a Golden Doodle; Age, 1 years
old”.
People may not appreciate the extent of the training a
specialized service dog must engage in prior to matching
with its owner. Can you briefly describe the training
involved to become a diabetic service dog?
“We worked with a Diabetic Alert Dog organization that
services people of all ages affected by diabetes. Atlas was
selected at four months old, very carefully, based on Anna’s
age, her typical daily activities, personality, and our family
lifestyle. The questionnaires and in depth discussion with the
organization director helped determine which dog would have
the right temperament and energy level for Anna.
Atlas lived with an experienced certified dog trainer for 6
months and was put through advanced training that included
three levels: Obedience, Public Access and Scent Training.
We froze numerous samples of Anna’s saliva on cotton balls.
Anna’s saliva samples were used to train Atlas before he was
delivered to us. He was trained to alert us in advance of low
(hypoglycemia) or high (hyperglycemia) blood sugar events and
more specifically when Anna’s blood sugar levels were out of
range, which for her, is below 80 and above 150. Dogs are able
to do this through smell. Dogs have a naturally heightened
sense of smell. There are distinct odors that accompany blood
sugar levels.
Do you know how sensitive a dogs nose is?
Here are some fun facts.
• A dog has 300 million olfactory receptors in their nose, compared to about 6 millions in humans.
• The part of a dog’s brain that is devoted to analyzing smells is 40 times bigger than humans;
Think about that for a second;
• A dog can smell something that is a mile away.
• A dog can smell an item buried 40 feet under the ground, and 80 feet under the water.
Issue 3 • Newsletter Contributors Susan Almquist • Susan Franchi • Carol Howard • Michele O’Toole • Arielle Petti • Amy Volante • Andy Winther
Atlas was trained to Anna’s specific scent which allowed for a
much shorter transition period after he arrived here. Ten
minutes after walking into our home, Altas alerted us to Anna’s
high, out of range blood sugar level.“
When the service dog needs to signal Anna, what is the process? “When Anna is out of range or is heading either up or down
quickly, Atlas will start sniffing the air and pacing around one of
us. He will then start smelling Anna and will place his paw onto
Anna’s lap to alert her that she is not in range or heading out of
range quickly. Then he will alert again by placing his paw on
any of the other family members nearby, either Anna’s parents
or siblings. Altas will not stop alerting us until he is given a
special treat and told, “Good alert, Altas, Good boy” over and
over again. This is the only time Atlas receives treats which
keeps him motivated. The treat also signifies to him that he can
stop alerting in that moment and that we have it under control
(we will give Anna what she needs to address the high or low
blood sugar event). Altas alerts us ahead of the Continuous
Glucose Monitor almost 99% of the time.”
Does the dog need to maintain the training? If so, how do you refresh its skills?
“Atlas came to live with us when
he was 10 months old. Even
though Atlas graduated from a
vigorous training program and
was ready to work immediately
upon his arrival to our home, we
continue to reinforce his training
and skills on a daily basis. We
followed along with
videos/demonstrations during
Atlas’ training and then we were
trained by his trainer upon
delivery to us. It has
become part of our daily routine to use basic commands with
him (sit, down, come, stay, etc.) as well as play scent games
to keep him motivated to respond to treats for smelling out of
range blood sugar levels. Consistency is necessary with service
dogs so they continue to alert and we have made the
commitment to keep up with his training.”
We hear that people should not pet a service dog; if so, why is that and are there times when it's ok? “When we are out in public and Atlas is with Anna, he is
“working.” If others pet him and try to engage him, it is highly
likely he will get distracted and not catch the scent of Anna’s
blood sugar changing. If he has recently alerted and/or we
know Anna is in range, then we make a decision to let
someone pet him. 99.9% of the time, individuals that we do
not know, will ask us permission to pet him or will inquire about
his job. We love having the opportunity to educate the public
and bring awareness for this invisible disease.”
What is the relationship between Anna and Atlas? “Atlas provides a tremendous amount of love and emotional
support for Anna. He intuitively goes to her when she has to
have her insulin pump and glucose monitor injections. He
provides comfort and a wonderful distraction during these
times. It is evident each day that he knows that he is her
companion. Atlas responds to Anna’s guidance and
commands wonderfully. He listens to her, follows her around
and clearly adores her.”
Issue 3 • Newsletter Contributors Susan Almquist • Susan Franchi • Carol Howard • Michele O’Toole • Arielle Petti • Amy Volante • Andy Winther
What is special about him? Does he do anything funny? “Atlas wants to be
in the middle of
everything we are
doing. His tail is
always wagging.
We giggle
because
sometimes he
thinks he is a “small, lap” dog and he lays his 65lb. body on us
and snuggles in tight. He nudges us to rub his belly and scratch
his back. He communicates with his big, brown eyes, exactly
what he needs whether it is to go potty or that he needs more
water or food.”
When not "in service"; does he like to play? “Absolutely!!! Atlas loves to play ball and run around outside
with us. He figured out the game of fetch very quickly. The
moment he gets outside, he looks for his ball and brings it to
us. He is super playful. “
Is there anything else you think that is important to know or misconceptions to clarify? “Some people suggested that a service dog would inhibit
Anna’s ability to live independently and that she would not
learn how to “feel” her lows and highs on her own and that a
dog wearing a vest would impact her sense of self. We were
also cautioned that siblings would feel left out and not bond
with the dog and that “a service dog could be robotic and not
provide the emotional love and support that other dogs
provide.” Thankfully we have not had difficulties with any of
these potential situations. In fact, we have experienced the
exact opposite with Atlas. He is incredibly affectionate and
playful and fun with each family member. He loves to be
snuggled and prefers to be close to one of us at all times.
When Anna was diagnosed and
before she got the CGM, we
checked her blood sugar levels
every hour of the day. It was
extremely overwhelming. Caring
for a child with T1D is a 24 hour a
day job with no break. Our
decision to get Atlas was made
after weeks of research, learning
about how a service dog could
help us manage the life changing
diagnosis and connecting with
families that were already living the experience. Having a
diabetic service dog is not a replacement for checking blood
sugar levels. Anna is fortunate to have a CGM, an insulin pump,
a blood glucose meter and a great exercise and nutrition
management plan. For us, it’s extra peace of mind, being able
to have Atlas around to alert us before things get to a
dangerous level.”
Thank you to the Bode family for sharing your incredible
story about living with Atlas.
Issue 3 • Newsletter Contributors Susan Almquist • Susan Franchi • Carol Howard • Michele O’Toole • Arielle Petti • Amy Volante • Andy Winther
Adapting to Change When an unexpected curve in the road throws you off course, there are ways to get back on track By Amy Volante RN, BSN
Change is constant but when a worldwide pandemic is the
source of change, it can send us reeling. Life is especially
unpredictable and scary right now. What can we do to cope
with the fallout from the Covid-19 crisis? Let’s start by looking
at stress.
There are two types of stress--eustress and distress. Eustress is positive stress. It feels exciting and it is
perceived as something within our ability to cope. Examples of
eustress include earning an award, graduating from high
school, getting a job, going on a trip, etc. Eustress brings with
it good feelings and makes good memories. Distress is
negative stress. It causes anxiety and feels unpleasant.
Examples of distress include failing a test, getting sick, financial
problems, being abused or neglected, or loss of a loved one.
Face it head on. Not everyone reacts to change the same
way. Some people accept and address it as soon as it occurs.
Others take more time. If you actively participate in the
process, you will adjust faster. Define the challenges you face.
Give yourself permission to feel. Avoiding your
feelings hinders healing. It is okay to be sad. It is okay to feel
angry. Expressing your feelings is the next step. Whether you
write down your feelings in a journal or share them with a
trusted confidante, expressing them is essential.
Surround yourself with supportive people. Stay
connected with friends. Include others like a teacher, sibling,
grandparent, or a mental health care professional. When we
are in the presence of people we trust, with whom we feel safe
and able to share, we feel better about ourselves. We are
better able to cope.
Maintain a daily routine that stimulates your mind and body. Having a set time to do activities provides
structure and predictability. Eat healthy and exercise. Exercise
wards off depression and improves sleep. Reward yourself with
some creative and fun activities like reading, yoga, a calming
bath or video game.
Put your plan in writing. Goals can range from taking the
dog for a walk to making a new resume. Be realistic. Small and
steady progress is still progress. Periodically evaluate your plan
and adjust as needed.
Do things for others. Some activities take very little time
and have big rewards. Clean the aquarium or donate blood.
Load an app on your Grandma Ipad and teach her to play a
game. Babysit your sibling. Making a difference in your family
or community brings good feelings to all involved.
continued on next page
Issue 3 • Newsletter Contributors Susan Almquist • Susan Franchi • Carol Howard • Michele O’Toole • Arielle Petti • Amy Volante • Andy Winther
Reach out. If you see someone struggling, talk to them. it is
okay to grieve the loss of different things. For example, my son
is sad because his construction safety internship is cancelled.
His friend is sad because his dad is sick with Covid-19 induced
pneumonia. Their circumstances are different. However, the
need to talk is universal. Talking about our experiences is
mutually beneficial because it helps us to feel heard, validated,
supported and loved.
Give yourself permission to be happy. Negative
feelings associated with change will gradually be replaced with
positive ones. Joy will come in pieces. It is okay and important
to find humor even during the hardest times.
Trust the process. Although we cannot control all aspects
of change, it presents us with opportunities to grow. You are in
the driver’s seat. With planning, perseverance, and time, the
road will become clear. Navigate with purpose and caution
when necessary. No doubt, you will soon be traveling at full
speed in your pursuit of a happy future.
_______________________________________________________
Three Fruit Smoothie Refreshing and delicious, fun and nutritious: strawberries, banana and orange juice make
this smoothie a favorite!
Yogurt is another key ingredient.
It is made by fermenting milk with a yogurt culture. Some
yogurts contain living bacteria called probiotics. Probiotics
promote digestion. Some yogurts have more health benefits
than others. The most nutritious yogurts are low in fat, and high
in protein, calcium, vitamins and probiotics. Avoid over
processed yogurt with added sugar, artificial dyes and
flavors.
Fresh or frozen fruits provide sweetness and color
to smoothies. Strawberries contain fiber and are rich in
Vitamin C. They contain manganese, folate and
potassium. Bananas are a good source of potassium and
magnesium. They are high in fiber and low in fat.
Orange juice is a good source of Vitamin C, potassium
and folate.
Look forward to more smoothie recipes in this
newsletter. We invite you to send in a recipe if
you would like to share!
Three Fruit Smoothie Recipe
½ cup plain yogurt
¾ cup strawberry yogurt
¾ cup orange juice
1 ½ cups fresh or frozen strawberries
1 sliced frozen banana
1. Pour plain and strawberry yogurts into a blender or food processor and gently blend.
2. Add orange juice and blend for 10 seconds.
3. Place strawberries and banana into the mixture and process until smooth.
Pour into glass and enjoy!
Issue 3 • Newsletter Contributors Susan Almquist • Susan Franchi • Carol Howard • Michele O’Toole • Arielle Petti • Amy Volante • Andy Winther
Poison Ivy/Oak/Sumac By Arielle Petti, R.N., B.S.N.
Spring has sprung! The warmer weather is upon us and that means more adventures outdoors! Outdoor activity is an excellent way to decompress and get exercise but poses additional health considerations. Our current circumstances can make it challenging to see or speak with a healthcare provider regarding basic health concerns. This issue
will discuss a common seasonal-specific health concern and give tips for how to manage it at home • Poison ivy vines usually have solid green and pointed leaves that hang from the stem in groups of three. Remember: "leaves of three, let them be". Poison ivy most often grows as a vine, but can also be a shrub. As the seasons change, the poison ivy vine often produces yellow-green flowers and white berries in the spring and early fall, and the leaves can change to yellow and red in the Autumn. Poison oak and sumac leaves are very similar but are usually shrubs. • All three plants can cause a rash when they come in contact with skin, whether the leaves are fresh or dried up. The reaction is caused by Urushiol, an oily sap in the stems and leaves. You should avoid touching these plants and never use them as a fire-starter or in a bonfire, as the Urushiol is released in the atmosphere and can cause severe breathing problems, if inhaled, requiring immediate medical attention.
What are the symptoms of a poison ivy/oak/sumac reaction?
• Rash (redness and usually weeping blisters) in streaks or lines • Extreme itchiness • Onset 1-2 days after exposure to a wooded area or field
Home Care • Wash hands and affected area immediately with soap and warm water to remove the oil and prevent its spread to other parts of the body and other people.
• Remove and wash clothing to remove any residual oil. • Soak affected area in cool water for 20 minutes or massage with an ice cube to reduce itching and oozing. Cool or lukewarm showers and baths can also be effective, especially with oatmeal bath products. (Warm or hot bathing can exacerbate the itching and discomfort.) • Apply 1% Hydrocortisone Cream 4 times per day.
• Take oral antihistamine, such as Benadryl/Diphenhydramine, every 6 hours, if the itching persists.
• Avoid scratching the rash, which can cause infection and increase the spread of the plant oil via your hands and nails, if the area has not been washed. • Do not touch or disrupt blisters, if present, as they are the body’s way of protecting itself from infection. (If the blisters break, cleanse with warm soapy water and cover the area.)
When should I seek medical attention? Call 911 for difficulty breathing or severe cough following exposure to any burning plants or weeds, regardless of whether they were known poison ivy/oak/sumac.
Be seen by a healthcare provider today for severe swelling, (e.g. eyes are swollen shut); for affected area covering ¼ or more of the body; for a history of severe poison ivy reactions; or if the rash looks infected: increased pain, spreading redness, increased swelling, purulent drainage, or the area feels warm or hot to the touch.
Be seen by a healthcare provider by tomorrow for affected areas involving the face, eyes, lips, or genitals; for severe itching that will not subside, despite home care interventions; for very large blisters or oozing sores; if you have already been on oral prednisone for >24 hours and symptoms worsen.
Other helpful hints… • The reaction usually lasts about 2 weeks. Treatment reduces the severity of the symptoms but not their duration.
• Poison ivy/oak/sumac oil can remain on pet fur and hair, which can promote spread of the oil to others.
• If new blisters develop several days after the initial lesions, you are likely being repeatedly exposed to the oil. Ensure all clothing, shoes, linens, pets, and surface areas that may have come in contact with the oil are washed.
• Fluid from the blisters or rash is not contagious and cannot cause a poison ivy/oak/sumac rash.
Issue 3 • Newsletter Contributors Susan Almquist • Susan Franchi • Carol Howard • Michele O’Toole • Arielle Petti • Amy Volante • Andy Winther
Welcome Back to Meet the Nurse By Amy Volante RN, BSN
Susan Almquist is the
school nurse at Peirce
Elementary School.
Let’s get to know her a
little better!
Susan, please tell us a little bit about yourself.
Q. Did you live and grow up in Arlington?
A. No. You could say I’ve
been around. I was born in
Colorado and lived there through middle school, so I’m
comforted whenever I see a mountain top. I then moved with
my family to Kansas where I remained through undergraduate
school. After my husband's graduate school stint in Minnesota
we moved to the San Francisco Bay area where I got my
Master’s degree in Medical Microbiology at Stanford, and
started my career in research in the pharmaceutical industry.
That continued when we moved to Lexington MA, where I still
live, right across the border from Arlington.
Q. How long have you worked at Peirce as a school nurse?
A. I’m finishing up my 5th year at Peirce.
Q. Where did you work before then?
A. As I said I had a career in research in the pharmaceutical
industry, first in California then at Vertex Pharmaceuticals in
Cambridge MA. What I loved about that career was gaining a
deep understanding of the diseases we were working to treat
and also, noticing that I most enjoyed working directly with my
colleagues, I realized I was a real people person. My daughter,
who I’d encouraged to become a nurse practitioner urged me
to combine those interests with nursing so I went back, got my
RN and happily ended up first as a one on one nurse at Hardy
then the nurse at Peirce.
Q. Susan, you and the other school nurses were sent home on March 13 just like the students and teachers. What have you been doing to support students and families from home?
A. I’ve done a little checking in and reading to students in
virtual classrooms, and I’ve delivered school based medications
to families both to their homes and from the school. This
helped overcome, just a little, my sadness at not getting to see
the kids regularly. I’ve also had the pleasure of working with
some amazingly creative nurses on the Healthful Living
Newsletter. I act as an editor, get a chance to use my science
background and occasionally get to contribute to the articles.
Q. What do you do when you are not taking care of students?
A. Until the social distancing requirements my husband and I
sang in our church choir and in a hospice choir called Sounds of Grace. Because I love to cook, and doing it more with social distancing, frequent bike rides have become essential. I’ve even had the occasional chance to wave at Peirce students from the bike path.
Issue 3 • Newsletter Contributors Susan Almquist • Susan Franchi • Carol Howard • Michele O’Toole • Arielle Petti • Amy Volante • Andy Winther
Q. Can you tell us about your family? A. I come from a family of 7 kids. We are still having fun with
family Zooms. Now, besides my husband, I have 2 daughters,
one is working on a farm in the Asheville North Carolina area.
The other, the Nurse Practitioner, is on the Emerson College
Health Care staff. She and her husband and his high school age
daughter are all taking care of the newest addition to our
family, 5 month old Addison. They are in Northborough MA
and we see them (at 6 feet) as much as we can and look
forward to babysitting regularly soon.
Q. What can you tell us about yourself that might surprise us?
A. As a younger woman I completed nine 26 mile marathons
and 2 triathlons, the last (and shortest) in 2015.
Q. What have you learned about yourself through your work as an Arlington school nurse?
A. That as long as I can get one smile a day from a Peirce
student, for me it was a day worth living.
Issue 3 • Newsletter Contributors Susan Almquist • Susan Franchi • Carol Howard • Michele O’Toole • Arielle Petti • Amy Volante • Andy Winther
Computer Break Exercises; Ease Tension in Your Face and Jaw By Michele O’Toole, MEd, BSN, RN
Without even being aware of it, we hold tension in our faces.
Often the tension causes creases between our eyes and on our
forehead. The tension in our jaw may cause us to grind our
teeth at night. You can try the exercises below at any point
during the day, when you feel stressed or need a break. Before
you begin, wash your hands well! You will be touching your
face. It might be best to do these exercises in a quiet place
without distraction.
1. Take a deep breath in while reaching your arms above your head. Exhale and bring your arms behind you, clasp hands if you can, lift your chin, squeeze your scapula/wing bones firmly together. Release your clasp on exhale. Roll your shoulder backward and forward a few times, then sit still.
2. Close your eyes and imagine tension streaming off your face, especially your forehead and jaw. Take your time.
3. With clean hands, place several fingers on your jaw joint
or TMJ /temporomandibular joint, and press down gently moving slowly in a circular motion around the TMJ and down the jaw bone.
4. Continue these small circles slowly up to your temples and forehead.
5. Find your hairline or top of forehead, pick a spot for each fingertip and massage in small circles with gentle pressure. Continue this movement through your scalp, top of head, back of the head and back of the neck. Give both your shoulders a squeeze or two.
6. Rub your palms vigorously together creating a feeling of warmth between them. Gently place your clean warm palms over your closed eyelids. Feel the muscles of your eyes relax as you cover them. Release your hands and shake them out.
7. Jut your bottom jaw out. Imagine a figure eight in your mind, and draw the figure slowly with your jaw. Try and make your figure eight as smooth and relaxed as possible. Change directions a few times.
8. Open your mouth wide, stick your tongue out as far as you can. Make a “ahhh” sound on the exhale. Exhale completely. Inhale, through your nose, drawing the breath into the back of the throat. Make a whisper sound or wind in the trees sound with your breath. Try a few more times.
Notice how you feel after these exercises; repeat as necessary and have fun.