Notes From a School Nurse

From asthma to AIDS, her role has undergone a revolution

Markeia Johnson, usually quiet and reserved, breaks into the broadest, brightest smile--so big it's visible from the top rows at the back of Roy Wilkins Auditorium. It's graduation night for the seniors of St. Paul's Central High School. As Johnson's name is called, she walks across the stage, her stride slightly lopsided. Before descending the stairs, she flips the tassel from one side of her mortarboard to the other. The 19-year-old has been practicing that for days.

High up in the audience, Johnson's family jumps up, shouting, applauding, and whistling as Johnson smiles so far below.

In another corner of the auditorium, someone else watches just as excitedly--a person who has become as much a part of Johnson's family as the group high up in the stands: Sue Will, licensed school nurse. Will has been a constant presence in Johnson's life since last fall, when Johnson suffered a massive stroke. Doctors did not believe the senior would survive, let alone graduate, so it's something of a miracle that she's with her classmates today.

"Oh my gosh," Will says later. "There are things in life that move you substantially. Being able to see her walk across that stage, and that big smile. It gives me chills.

"You just don't think about these things with kids," she says. "Kids are supposed to go to school and graduate and all these things. But some kids have a harder struggle with it than others."

 

Sue Will is one of those instantly likable people, with an easy laugh and an inquisitive nature that makes you feel like whatever you're telling her is extremely interesting. Her mind seems capable of following a dozen scattered threads of information at any given time, dropping one thought for another, then another, then refocusing on the first. ("I'm so used to distraction," she jokes. "If I have a full thought it scares me.") Her figure, at once matronly and compact, is nimble as she chases through Central's hallways (at her side is her "squawkie," a walkie-talkie that alerts her to any crises in the building), fetching kids who have medical needs.

At first it may seem that Will's job is simply handing out Band-Aids and taking care of tummy aches--like a lunch lady with a first-aid kit. But it soon becomes apparent that her real, often unrecognized mission, is to protect the public health. These days, she and her school-nurse colleagues train a watchful eye on as many kids as they can, all the while adapting to the intensifying dangers to students' health, from poverty to unstable family life to serious disease.

Will offers a history lesson to emphasize the point. This year marks the 100th anniversary of the hiring of the first public-school nurse in New York City, she explains. Back then the major concern of school nurses was containing and preventing contagious diseases. Today the main goal is to curtail threats to the public health while helping students stay in school.

"This job has changed, the issues have changed," Will muses. "But kids are kids, and families are families. Our role continues to be to try to reduce the health barriers to kids' success."

But the challenges are far broader, from immunizations to ADD and chronic fatigue syndrome to broken legs to depression and suicide to tobacco to pregnancy and AIDS. And the trickiest part of the job is that the nurses have no idea which of the problems might arise on any given school day.

It's a warm May morning, a little after 7:00 a.m., and Will has only just opened her office door when the kids start pouring in. One girl needs a note to get out of gym class (they have swimming today, and she had her period). One boy shows Will his jammed finger and asks her to wrap it up ("It's called a buddy tape," Will edifies as she tapes the swollen finger to its neighbor for support). Another girl wonders why her arms are so sore (repetitive stress from the girl's assembly-line job, the nurse hypothesizes as she hands her an ice pack).

All the while a seemingly endless parade of teenagers seek their daily medications: anti-depressants, asthma and allergy pills, drugs to counteract Attention Deficit Disorder. They come in even as Will is talking with other students, taking temperatures, assessing symptoms. The nurse goes to the cabinet where she stores the prescriptions, then doles out the correct dosages. The interactions are routine and brief, and Will sends the students along to class with a standard phrase: "Make it a good day!"

Though the time she spends with each student is minimal, it's clear that Will has gotten to know the kids over months, even years. This morning one student comes in, eager to share pictures from the school's recent prom. The girl hands the nurse one photo to keep--a snapshot of Will sitting with Markeia Johnson. Will tacks it up on the wall next to her desk. When Johnson comes in later, Will shows her the photo, beaming, even as she checks to see how the student is feeling today.

With some of the students who march through the nurse's office, Will might have to do a little detective work, try to figure out whether they are physically ill, or depressed, or both, or neither. Often enough the ailments are simple viruses, and Will instructs the kids to drink lots of liquids and get lots of rest, sometimes directing them to one of the two cot rooms (one for girls, one for boys) to sleep for an hour. Her tone is at times skeptical, especially if it seems that a student might be pulling a fast one. But it just as quickly melts into a gentle compassion when she's talking to a student with a genuine problem.

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