More than just a nit nurse

Don't mention the words Nit Nurse!School nurses don't check for head lice any more –they advise parents instead, and there's a whole lot more to the job these days, as Health and Social Services Editor Tracey Sparling found out.

By Tracey Sparling

Don't mention the words Nit Nurse!

School nurses don't check for head lice any more –they advise parents instead, and there's a whole lot more to the job these days, as Health and Social Services Editor Tracey Sparling found out.

Aspects of the school nursing in Suffolk are to be copied thousands of miles away, but closer to home the pressures of the job are being keenly felt.

OUR corner of Suffolk and the richest Arab state may be worlds apart, but Barbara Richardson-Todd didn't hesitate to pack her bags when she was invited to spread the word about the school nurse's role.

She wrote a 150-page research dissertation for her degree, about how GPs didn't fully understand her job, which is due to be published soon in the journal Primary Health Care.

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Organisers of the First International School Health Conference in Abu Dhabi wanted to know more.

And on taking up their invitation to visit the United Arab Emirates, Barbara was quickly amazed at the differences – including their emphasis on the purely physical aspects of child health.

Barbara, who also presented her dissertation at an Ipswich Hospital nurses convention and had an article about her trip in Community Practitioner, said: "In England, we are concerned for the child's holistic health needs – physically, psychologically, emotionally - including issues about sexual health and teenage pregnancy."

She said: "We have 4,000 pupils and most of us work part time, while they have 500-900 and work full time. The school nurses in the Middle East have reams of medical notes about each pupil.

"But they seem very isolated and don't have organisations like the Royal College of Nursing to bring them together to share ideas.

"The school I visited also had its own dentist and a doctor three mornings a week, because so many pupils have rotten teeth from eating too many sweets. The pupils are either very obese of very malnourished."

"UAE nurses have a curative role, and deal mostly with dental care and nutrition."

Delegates at the conference had never heard of drop-in centres, and seemed keen to try and set some up.

Back in England, Barbara returned to a hectic job.

She said: "Our role is preventative health – immunisation, promoting healthy lifestyles and healthy schools, such as sexual health, working with parents to support families, drop-in-sessions, and working with other agencies – rather than dealing with sick children. School first aiders do that, and administer medicine. We are all registered nurses with something extra – extra qualifications in subjects like counselling, family planning or nursing sick children."

The former teacher and school nurse of 15 years, said: "When we explain to GPs what we actually do, they are usually surprised to see how much is involved. A lot of parents still see us as 'the nit nurses' but we have to be all things to all men – have a wide knowledge of all subjects."

Team leader, and Chantry and Stoke school nurse Pat Whebby joked: "I tell people the nit nurse died years ago!"

Barbara works 20 hours a week, looking after the East Bergholt and Westbourne pyramid schools, which include 12 schools and 4,000 pupils, and carries out screening for height, weight, vision and hearing, for every five-year-old.

She also covers five surgeries, and runs a drop in centre at Whitton Clinic, and has started another for three hours a week at People at the Centre of Ipswich base in Bramford Road.

and said: "Often a pupil will come to see us about a minor issue, just to sound us out and test the waters to see if they can trust us about something else."

Barbara said: "Westbourne has more unmet health needs than East Bergholt, but ideally it would be nice to have a nurse in every school, or at least one per pyramid.

"We are all desperate to try and improve the services we offer, but it's hampered by under investment in preventative health in general. It's difficult to compete for funding because it's hard to measure outcomes in preventative health."

Anne Percival, who looks after Holywells pyramid, agreed: "When you consider how many case conferences we attend for child protection cases, and the follow up work, school nursing could easily be a full time job."

There are also more children in schools than ever before as the population continues to rise, and more with special needs.

Pat said a programme to immunise every 5-18 year old against meningitis took 11 months, and created a huge backlog in other work.

She added: "There are many more improvement initiatives coming down from the Government, without the necessary funds."

Sherry Searles who looks after Stowmarket schools, said: "The frustrating thing for me, is finding that children need speech or language therapy, or have behavioural problems, and the help just isn't available for them."

Bernadette Smith who is the school nurse for Felixstowe, said: "I think that school-age children get a very raw deal out of the NHS unless they are in hospital. In the community there is nobody to speak up for the children. The parents whose children need help are often the least capable of asking."

But Anne said the best part of the job was feeling you had made a positive difference to a child's life.

She said: "The best thing about school nursing is the privilege of working with children and adolescents, and working with very special colleagues.

"I have great admiration for the work done by social services and education staff who so often receive unjust criticism whole coping with inadequate time and staff, as we understand so well.

"We want to help and support the pupils who don't seek our help, but keep all their worries to themselves and carry them alone into adulthood.

"There is a real lack of understanding of the depth of the school nurse's role, but tomorrow's adults are our country's most precious assets and they need the best health service and support – but lack of funding curtails our wish to provide this."


Barbara will have a display about school nursing at the Community Pride Fun Day on August 30, at Jubilee Playground, Victoria Street, Ipswich.

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