Health Services Department • Lincoln Public Schools • 5901 O Street • Lincoln, NE 68510 • (402) 436-1655 (Fax) 436-1686

May2010

“What we do for ourselves dies with us.What we do for others and the world remainsand is immortal.” –Albert Pine

English author, d. 1851

Inside:NASN ConferenceBirthdayCelebrations pg 2

PLC pg 3, 4

Judy’sRetirement pg 5, 6

Year End CommitteeReport pg 7, 8

In the Spotlight pg 9

Gayle’s Grab BagCommunityResources pg 10

Vol. 5 • Issue 4

Judy Zabel, Health Services Supervisor,Bids LPS Farewell After 22 Years of Service

School Nurses Day was celebrated on May 12th, during Nurses Week May 6th through May 12th, 2010. This was indeed a good time to think about being a nurse and what it is all about. Nursing – a profession – a vocation,

a calling, requiring considerable training and specialized study. A profession has standards, specialized knowledge, a code of ethics, and licensure/certification.

As I reflect on my 22 years as a school nurse, I think about all the students I have seen at their best and at their worst. Their families, how they support and sometimes how they hinder the student; the staff working daily to provide the learning environment and educational plans to meet the diverse needs of each student. School nursing is so different from the usual nursing role, but we still deal with people and their human needs for learning, health, love, support and independence. For the school nurse, the joy is seeing the tears of pain break

out in a triumphant smile when the splinter is removed. The thank you notes for School Nurse Day showing the student’s picture of you and the Health Office, “priceless.” Then meeting a former student in a store or restaurant, and they recognize you and say, “you were my school nurse at,” a particular school (naming the school).

The face of education and school nursing has changed. The demand to do more with less; the mandates to have health plans as well as educational plans for students, and the increasing numbers of students with physical and mental health issues (which affect their education) has made the role more complicated, but also more rewarding. As I speak with new school nurses, I tell them it takes about 3 years to discover all the things needing to be done. There is always something new to learn, and then they change the terminology, requirements, schedules, computer software and it starts over again.

This is an exciting time for all school nurses, a challenging time, a time for growth and change. Best wishes to Marge Theel as she assumes the Supervisor of Health Services

position. I know she will do well and that each of you will support her and the students we all serve, to make each day, a day of learning for

today and for the future.

I am preparing for a new role in my life - that of retired school nurse. Thank you all for your support and encouragement over the last 22 years. It has been a great ride.

Judy

School Nursing–The Opportunity

to make a difference

in a child’s life every day.

Judy Zabel

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Newsletter Committee Contact InformationPlease forward any questions, comments or contributions to any member of the Newsletter Committee.

We would like to hear from you.

Hollis Alexander-Ramsay, RN(Editor)

halexan@lps.org

Jody Geer, RN jgeer@lps.org

Elizabeth Post, RN epost@lps.org

Barbara Ramsey, RN bramsay@lps.org

Kathy Burke, Health Technician kburke@lps.org

Other ContributorsGayle Thomas, Executive Secretary, Health Services

NASN ConferenceThe National Association of School Nurses (NASN) will host their 42nd Annual Conference in Chicago from June 29th-July 3, 2010. The theme this year is Vision, Voice, Visibility: Charting the Course for a Healthy Future. According to the Association, there are many reasons to attend this annual conference.

Here are some of the reasons:

• Further your career by investing in professional development

• Increase your knowledge about current research in school nursing and school health

• Explore health promotion and disease prevention efforts for your school community

• Meet and learn about key partners to support your policies and programs

• Expand your collegial network – connect with old friends and make new ones

• Prepare to meet the challenges that come with the unique role of the professional school nurse

• Make a lasting contribution through your participation and comment on this year’s program

• Return to your practice vitalized and equipped with new strategies and ideas

• Be recognized as an engaged school nursing leader

For more information on this conference, please visit the NASN website at www.nasn.org.

CELEBRATIONThe following Health Services staff, have upcoming/recent birthdays:

AprilJoan Creger, Kathy Froscheiser

Kay Duncan, Pat UllrichLinda DeBoer

MayMarge Theel

JuneSara Bennett, Renee Lahm

JulyCathy BruggemanAmber Highsmith

Loree KirilloffSusan K-Moore

AugustKim Sparks

Kim Nelson, Rita McClureSheryl Woodward

Phyllis BoshaeSandy Carlson

Congratulations on another milestone!

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Nurses Professional Learning Community-Decreasing Health Office Visits by Utilizing Assessment Tools to Develop Interventionsby Hollis Ramsay, RN, MSN

PLC Team

Patty Baker, RN Julie Frederick, RN

Maralee Cloran, RN Heather Perkins, RN

Gloria Hernandez, RN Hollis Ramsay, RN

Sheila Lemmert, RN Barb Ramsey, RN

Susan Kehrli Moore, RN Kim Sparks, RN

Pediatric Symptoms Checklist (www.brightfutures.org) was identified and reviewed as a psychosocial screen that would help determine if there were cognitive, emotional and behavioral concerns prior to intervention. This consisted of two versions: (i) the youth, self report (Y-PSC) and (ii) the parent-completed version (PSC). Youths and parents were asked to complete a checklist which was scored to determine a positive or negative score. The scoring system varied for children, ages 4 and 5, and for children and adolescents ages 6 through 16. (See LPS, Docushare for further information). The PLC team used the Youth Self-Report tool in health offices to see how user friendly it was, and the results were favorable. A positive score on either of these tools suggested that there would be need for further evaluation by a licensed provider.

The next step, was to use the Health Assessment Tool from the School Health Manual of the Massachusetts Department of Public Health. As summarized by Julie Frederick, RN., “the tool provides recommendations for assessments and integrates current LPS policy to guide interventions and referrals.” Using the nursing process, 4 top health office symptoms were examined: headaches, stomachaches, sore throat and general malaise. Our PLC team brainstormed the subjective assessment data to determine the appropriate questions when children presented with these 4 symptoms. What resulted is a guide that can be used to help determine the students’ needs – physical, emotional, or psychosocial. These tools are in Docushare and can be printed for use in the Health Office. Our PLC team hopes that with the utilization of these instruments, “frequent flyer” visits will be decreased. These tools are designed to be used by the school nurse – the use of the physical assessment tools and good clinical judgement to problem solve, intervene, nursing diagnose, and treat. The goal is to promote health and well-being and decrease classroom absenteeism.

According to Wikipedia, the Nursing process is a patient centered, goal oriented method of caring that provides a framework to nursing care. It involves five major steps of assessment, nursing diagnosis, planning, implementation/intervention and evaluating. Our PLC group decided that we would start with an assessment which would help determine what the problem was, for many frequent visitors.

As a result we began looking for an assessment tool (to determine health impairment(s)/psychosocial issues which could be used) in the health office when students visit often with complaints. The

As school nurses we are sometimes inundated with familiar faces that come over and over to the Health Office for what may seem to be an unnecessary health office visit. Some students may come more than once in 1 day or many times per week or month. These health office visits do take valuable time from the classroom. From the tiny superficial scratch or the playground accident with no visible signs of injury, the reasons for the visits can be quite perplexing at times and of times leave nurses scratching their heads as to why the student was in the health office (especially, if this student seems to be a frequent visitor for minor ailments).

Known as “Frequent Flyers” these students may come from their homeroom or from “specials” such as computer, art, PE, media or music. Many times, their home room teachers or their parents are not aware of the lost classroom time spent by being in the health office. Nurses and Health Technicians at LPS can run a computer report to see how many times a student has been in the health office. Also important, is the time of day that these visits are made. Is it during Math or Reading? Since, it is important for students to be in the classroom to learn, our PLC group decided that we would take a long hard look at health office “frequent flyers.” Many questions can be asked. Are these students really ill? Are they trying to get out of class? Are they having friendship issues? Are they getting enough rest, coming to school prepared to learn? The fact that a student is in the office so often, tells us that there is a problem that needs to be identified and corrected.

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By Loree Kirilloff, RN

What have you had to drink today? This is a great question to ask teenagers who are not feeling well. Too much caffeine or additives can result in nausea, vomiting, jitteriness, racing heart rate, hallucinations, panic attacks and chest pains. Some kids are using these drinks as a breakfast drink. Some kids use them to get an edge in sports or just because they taste good. Unfortunately, over consumption of these drinks has led to emergency room visits.

The middle school nurses PLC focus was to explore the student health implications of the use of energy drinks/sports drinks. Nurses presented a Flex offering to 25 LPS teachers, coaches, and nurses on February 2 withDr. Robert Rauner and UNMC dietitian students. The title of the presentation was Boost Your Awareness, Energy Drinks and Your Students Health.

We also developed teacher/coach handouts and pamphlets for sharing information with students and family. We collected numerous power points, articles and videos for class room presentations. Included in this teacher tool box are a collection of empty energy drink bottles/cans with a list of the caffeine, sugar, and additive facts.

Please check out Docushare under Health Services File/ Middle School PLC for a listing of the teaching tool box items which is open to LPS Staff use.

Below is one of many recipes from Joan Creger, RN (Culler

Middle School). More of Joan’s recipes are included in the Docushare listing for low cost, low calorie summer drinks to replace soda, sports and energy drink consumption.

Cran-Raspberry Iced Tea

4 cups water

1 cup frozen or fresh raspberries

4 teaspoons sugar

8 individual raspberry flavored tea bags

4 cups reduced sugar cranberry-raspberry juice

In a large sauce pan, bring the water, raspberries and sugar to a boil. Reduce heat: cover and simmer for 10 minutes. Remove from the heat, strain and discard the raspberry seeds. Add the tea bags. Let stand for 4 minutes. Discard the tea bags. Stir in the cranberry-raspberry juice, serve over ice. YUM!

The appeal to kids comes through the packaging with neon, shiny metallic colors and drama. Energy drinks are more expensive than soda pop but the marketing has attracted teenagers. Consumption of these drinks can lead to obesity and sleep disturbances. Kids have disposable income to

buy these drinks in spite of the economic recession.

Keep your eyes out for students drinking energy drinks at school. The health office will be glad to give them accurate information to help them make healthy choices.

Energy Drinks: Power and Dominance in a Can?

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Emergency Response Committee–Myrna Stannard, RNWork was done on the Health Services Handbook Emergency Section, updating information and reviewing procedures, which included recommending topics to the Staff Development committee for in-services. The emergency response outline was reviewed and revised for new employee orientation.

A school direction guide was produced this year which included simple instructions to drive to each school in the district. The guide is available in Docushare.

We met with Mr. Kuehn, LPS Director of Security, and learned about the Grant he received from Homeland Security. Each Middle School and High School received a ‘Mobile First Aid Station’ as part of the grant.

All Health Service staff took the Federal Emergency Management on line Incident Command Training which will help Health Services staff with preparation in the event there is a disaster involving multiple injuries or emergencies. Currently we are discussing additional training for Health Service staff for emergency response.

Immunization Committee – Cathy Bruggeman, RNThe Immunization Committee has worked diligently at preparing the community for the addition of Tdap (tetanus, diphtheria and pertussis) to the 7th grade requirements for 2010-2011 school year. Information has been sent to the medical community as well as all 6th grade parents throughout the school district. Additionally, school nurses have implemented individualized plans for each of their schools.

The Nebraska statute also requires an additional varicella vaccine but it is expected that this additional requirement will not begin until the 2011-2012

school year. Judy Zabel, Health Services Supervisor along with other school district personnel throughout the state, testified at the Rules and Regulations committee hearing. Testimony was given requesting a delay of one year before the varicella change happens. School nurses were also instrumental in monitoring H1N1 activity at their schools, as well as educating students and families about the need for flu vaccine and other wellness measures to prevent H1N1.

LPS school nurses were all trained to access the state immunization registry which has been helpful in monitoring compliance with immunizations. The immunization committee continues to monitor communicable disease developments and plan immunization services as needed.

Infection Control Committee – Heidi Stange, RNThe Infection Committee continues to meet and discuss infection control issues and concerns throughout the year. Some of the topics of interest this past year included: H1N1 and LPS response, flu education and seasonal flu activity, health services and custodial actions in response to the flu; the planning and implementation of the Pandemic Flu Plan.

The Infection Control manual was revised and is now on Docushare. A topic of discussion was the Material Safety Data Sheets (MSDS) books for the district and plans for a web based program to help manage current and new products in the building. Also discussed was tuberculosis (locally and nationally), Indoor Air Quality and the use of outside cleaning products which should not be brought into LPS buildings. Other topics included Workers’ Compensation concerns related to infectious disease, and new immunization requirements for all 7th grade students for the 2010-2011 school year. MRSA (methicillin resistant Staphylococcus aureus) and Hand, Foot and Mouth disease were added to the list on the contagious and infectious disease chart.

The Lincoln Lancaster County Health Department continues to provide the Infection Control Committee with flu activity and communicable disease updates both in the community and nationally. They also provide helpful information regarding infection control issues. Judy Zabel, Health Services Supervisor continues to report absences of 10% or greater to the Health Department.

It is due to the great work and support from LPS and Health Services staff, that infection control practices are continued and reinforced, helping to keep our staff and students safe and healthy!

Newsletter Committee – Hollis Ramsay, RNThe Health Focus Newsletter has just completed its 5th anniversary. Approximately 1600 issues of the newsletter were distributed over the past 4 quarters of the school year. The newsletter is disseminated to administrators at the District Office and to each principal and their office staff at the various schools. Information is also shared with nursing schools, the Lincoln City Health Department and other health related affiliates. Left over copies are kept at the district and are available to subs and itinerants. These are kept on the counter by Gayle Thomas’s desk.

While the newsletter committee has changed this quarter, we are still open to new members who are willing to research and write articles. I would like to take this opportunity to thank Elizabeth Post, Barbara Ramsey, Jody Geer, Kathy Burke, Gayle Thomas and Judy Zabel for the contributions and hard work which shows in the quality of the newsletter. It is my wish that we return with continued focus, to meet the changes that are ahead health wise in our community. We will continue to write on health updates, community resources and pertinent health-related information.

Continued on Page 8

Year End Committee Report

Nurse Practice Committee - Sharon Dickinson, RN We successfully met our goals for 2009-2010:

1. Nursing Handbook- has been successfully revised and is on Judy’s desk for final approval. It will be available for use via docushare next fall. The committee would like to recognize Lynn Morehead-Fischer and Kay Duncan for the many hours that they contributed to this project.

2. Diastat Administration - the Diastat Administration Guidelines have been completed and approved by the Medical Advisory Committee and will be initiated in the fall of 2010.

3. Communication between the Nurse Practice Committee and Nursing Staff - we initiated an online publication of monthly agendas, which invites any staff member to bring to the committee their concerns regarding practice issues. The publication of the monthly minutes disseminates information in a timely manner so that practice issues can be resolved in a relatively short time.

4. It is our ongoing goal to promote consistency of practice throughout the district.

Participation on this committee requires a commitment to not only attend monthly meetings, but also to review materials throughout the month. I would like to personally thank Diane Frydendall-Smith, Kim Nelson, Tonya Hartsook, Susan Kehri-Moore, Maralee Cloran, Judy Zabel, and Kay Duncan for their service on this committee.

Social Committee – Kay Duncan, RNThe Social Committee had a busy year. We sent cards/gifts for deaths, surgeries and celebrations. Gifts were given to Gayle Thomas for her birthday and Administrative Professionals day, and to Judy for her birthday and Boss’s day. We also planned Judy Zabel’s retirement dinner for School

Nurses Past & Present on May 12th at the Knoll’s, and worked with Student Services to plan a district retirement for Judy on May 27th. The Committee was also in charge of the annual Soup Lunch for the Health Techs to celebrate their day. The Social Committee asks that if you know of a Health Services staff member who has something to celebrate (new baby, etc) or has had surgery or experienced a loss to let one of the committee members know. Committee members this year are Kay Duncan, Heidi Stange, Kim Nelson, Liz Post, Heather Perkins, & Tonya Hartsook.

Staff Development Committee – Kay Duncan, RNThe Staff Development Committee has provided several flex programs for school nurses and other district staff this school year. In-services were held twice for the health technicians. CPR, First Aid, and Orientation have also been under the direction of the Staff Development Committee this year.

Year End Committee ReportCurrently the committee is in the process of finalizing Flex Time programs on June 9th & June 10th, as well as Flex Programs for next school year. We will again provide in-services for the Health Techs next year. All health services staff will receive information on the August in-services over the summer months. Committee members included Kay Duncan, Judy Zabel, Patty Baker, Sharon Baker, Maralee Cloran, Joan Creger, Julie Frederick, Susan Kangas-Packett, Nancyruth Leibold, Liz Post, Wendy Rau & Sheryl Woodward.

Save the Date26th Annual School Health Conference

June 7 & 8, 2010

Midtown Holiday Inn

2503 South Locust

Grand Island, NE 68801

Info: email Carol Tucker

Carol.Tucker@agps.org or

Call 402-618-7430

HIGHLIGHTSPlease congratulate

Kim Nelson, RN

who is the winner of theHelen Krieger Award

for 2009 school year.

Well done Kim!

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Tammi Weihe, RN, School NurseAdams Elementary SchoolPound Middle School

I was born and have always lived in Lincoln. Each summer and winter when the weather is extreme I wonder why I stay. I am the youngest of 4 girls, all born within 5 years. As a child we moved around a lot within northeast Lincoln. I attended Pershing Elementary K-3rd grade and 6th, and Riley in 4th & 5th. I’m old enough that my principal at Pershing was Loretta Mickle. If memory serves me correctly, Loretta was the wife of Robin Mickle. Mrs. Mickle was a very kind person, easy for anyone to talk to, and shorter than most of the kids in the school. She always kept a Kleenex tucked in her sleeve and had to stand on the benches in the cafeteria to be seen, so she could dismiss lunch tables.

I attended Mickle Jr. High school for 3 years, despite moving 2 blocks away from Dawes midway in my 9th grade year. I’m a graduate from Lincoln Northeast and in my senior year I joined the Air National Guard (as a way to get assistance with college tuition). I look back and wonder what in the world I was thinking; this was 1976, the year after the fall of Saigon and the end of the Vietnam War. I spent the summer after my senior year in Texas for Air Force basic training and technical school. That summer I learned what hot weather was really like. Basic training

was in San Antonio and we marched and trained in the sun from dawn until lights out. I also learned a lot about red ants that summer. While standing guard for a parade I was positioned at a driveway in the dirt, over a red anthill. By the time the parade was finished and I was allowed to move, my legs were covered with red ant bites. This experience afforded me a brief trip to a medic, complete with air conditioning.

I did end up using my tuition benefit for education. I completed the Licensed Practical Nursing program at Southeast Community College in March 1980. The first 6 months of the program were located in the old Southeast Community College building, which is now Bryan Learning Center. I’ve returned to school a number of times over the years. I attended Bryan Hospital School of Nursing, completed the program in 1989 and became a Registered Nurse. I worked on my bachelor’s degree very slowly and completed my Bachelors in Nursing in 1999.

I worked for the previous 20 years at the Lincoln Lancaster County Health

Department as a public health nurse, prior to joining LPS in November 2009. I have thoroughly enjoyed joining LPS and the challenge of learning new things.

When not at work, I enjoy hanging out with my family. I am married and have 2 daughters, ages 24 & 18. Kristen is the oldest and has a bachelor’s degree in Philosophy & English; she has plans to complete a master’s degree in Library & Information Science and works for Lincoln City Libraries. Kristen is married to a man she met during a study abroad in Aberdeen, Scotland. Her husband will be immigrating to the U.S. this summer.

Lauren is a senior at Lincoln Southeast. She will be attending Doane College next year and plans to study biology and psychology. Two Golden Retrievers round out our family, Josie is 8 and Chloe is 6 ½ years old. I volunteer with

Golden Retriever Rescue in NE (www.grrin.org) where I’ve helped find foster homes for surrendered dogs, arranged transportation for incoming dogs, coordinated vet care, and fostered 2 dogs. My volunteer work has been rewarding beyond words.

In the Spotlight

“I have thoroughly

enjoyed joining LPS

and the challenge of

learning new things.”

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MYTHStudents are too young to develop sleep disorders.

FACTNarcolepsy often develops by puberty and may worsen over time. The average age of onset is the late teens. Other sleep disorders can also occur in young children.

For more information, please contact:Narcolepsy Network, Inc.Toll-Free (888) 292-6522Tel: (401) 667-2523

Under the MicroscopeKeeping tabs on what’s new

New EmployeeTheresa Curtis, RN Substitute

Sheryl Sanders, RN Substitute

Lin Hansen, LPN Substitute

Theresa Swisher, LPN Substitute

Mary Jo Linke, LPN Treatment Nurse

Jana Spilker, Belmont Health Technician

Change of Assignments:Carolyn Gillispie, Belmont Health Technician to Schoo Health Technician

Jean Gottula, Schoo Health Technician to Mickle Health Technician

Marge Theel, Mentor and Lux Nurse, to Health Services Supervisor

ResignedJudy Zabel, Health Services Supervisor

Jody Rudd, Rousseau Health Tech

Gayle’sGrab BagThe 2009/10 school year is coming to an end there

are some final tasks that need to be done.

Please examine your equipment to see if it needs to be repaired such as cots and blood pressure cuffs. If a cot needs to be repaired, please e-mail me with the school, the cot’s location in the Health Office and then mark it with a piece of paper indicating the problem.

All laptop computers, cell phones, audiometers, etc. need to be returned to the District Office at the end of the school year.

Please be sure to turn in the following: 1) Health Tech Skills Checklists, 2) Mileage Forms and Time Sheets, 3) Enhancement Fund Requests and 4) School Nurses Annual Summary.

As the school year comes to a close, I would like to take this time to say THANK YOU to all of our Substitutes that are always willing to help fill the void when someone is absent. Your dedication to serving the needs of our students is greatly appreciated. YOU are the BEST!!

Enjoy rest and relaxation and have a fantastic summer break. I look forward to seeing you all back in the fall.

Gayle Thomas Executive Secretary, Health ServicesBox 18, LPSDOlthomas@lps.org(402) 436-1657

Hea

lth Focu

s BCommunity ResourcesSummer CampsCamp SuperkidsAmerican Lung Association

Location-YMCA Camp KitakiEligibility-open to children in Nebraska, 7-17 years, who take daily asthma meds.

Camp offered June 13-19Phone: 402-502-4950E-mail: pfoster@breathehealthy.orgFor more info, visitwww.breathehealthy.org

Bright LightsSummer Learning AdventuresOnline registration @www.brightlights.org

Mail in RegistrationPO Box 67160Lincoln, NE 68506-7160Contact office 420-1115Scholarships available

RECYCLE

Help save the environment.Help slow climate change.Recycle at home, school and at work. This helps to cutcarbon emissions from extracting new materials and saves landfill space.

• Newspapers• Cardboard boxes• Cans• Glass bottles and jars• Plastic #1- #5 containers• Residential mixed papers

Curbside Recycling HaulersJournal Star Recycling473-2695Midwest Refuse 475-0244Recycling Enterprises424-6655RecycleLink 466-0412Star City Recycling 890-4320Palmer & Sons 474-6814Schaaf Refuse Service423-5705

Recycling 441-8215Landfill 441-8102/441-8104Lincoln Lancaster Health Dept. 441-8024Household hazards waste program/ and collection information.Keep Lincoln & Lancaster BeautifulNeighborhood, community schools and lake clean-up.441-8035

Nurse HumorFive Minutes

A hospital posted a notice in the nurse’s lounge saying: “Remember, the first five minutes of a human being’s life are the most dangerous.” Underneath, a nurse had written: “The last five are pretty risky, too.”

Peek-A-Boo

The famous female Olympic skier, Picabo Street (pronounced Peek-A-Boo), is not just an outstanding athlete, she is also a nurse. She currently works at the Intensive Care Unit of a large metropolitan hospital.

She is not permitted to answer the telephone, however, as it caused simply too much confusion when she would answer the phone and say, “Picabo, ICU.”

“Doctor, doctor, what’s the prognosis?”

“I’ll give you just two months.”

“Could I have July and August?”

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