School nurse's office is a whirlwind of activity

Madison School nurse Becky Ebbing looks over the mouth of first-grader Cory Miles after the youngster bumped his mouth on the playground. (H-W Photo/Phil Carlson)
Posted: Oct. 21, 2013 9:47 am Updated: Mar. 19, 2014 8:14 am

Herald-Whig Staff Writer

For 20 years, Becky Ebbing has been the go-to person for hundreds of students with tummy aches, skinned knees, bee stings, bloody noses, cuts, bruises and other ailments.

As a school nurse in the Quincy School District, Ebbing has seen it all. The door to her office in Madison School — the one with the heart-shaped "Welcome" sign adorned with an American flag — is always open. And it's a sure bet the kids know where to find her.

"We have had days where they're lined up outside of my office," Ebbing said. "Sometimes during recess we might get five or six kids injured at a time."

Whenever those outbreaks of injuries or illnesses occur, the kids invariably head straight for Ebbing's office, where they are greeted warmly and given whatever first-aid treatment is needed.

Some of the worst days are when a vomiting bug is going around the school and Ebbing's office becomes a sick bay full of unhappy children waiting for their parents to take them home. Ebbing will never forget the time she sent 22 kids home in a single day.

But it isn't just kids that Ebbing helps out. She also gives flu shots and blood pressure checks to school staff members. And she's available whenever unexpected health incidents pop up — like when a mother started having chest pains after coming to pick up her child. Ebbing provided emergency care to the woman while an ambulance rushed to the school.

What Ebbing likes most about her job is the opportunity to help elementary-age children.

"I love kids, and I like helping, obviously, or I would not have become a nurse," she said. "The kids are my favorite part. I mean, they can be crying and everything, but before they leave they usually have a smile on their face."

More than Band-Aids

Ebbing is one of a team of school nurses who tend to the health needs of students. Nursing Director Jeannie Martin says  the district employs the equivalent of 17 full-time nurses. Each elementary school has one nurse apiece, while Baldwin Intermediate School has three and Quincy High School, Quincy Junior High and the Early Childhood and Family Center each have two. Martin supervises them and assists with vision and hearing screenings and other duties.

"It's not just sitting there handing out ice packs and Band-Aids anymore," she said. "It's grown to be such a multifaceted position."

School nurses are involved in health promotion and education. They also administer medications, oversee immunizations and other health records, and deal with an array of chronic health issues.

"There are a lot more chronic health conditions now than we used to see," Martin said. This includes children with diabetes, asthma, heart conditions and severe allergies that periodically require first-aid intervention.

In addition, school nurses have to provide "a lot more specialized procedures" for children with complex health issues, Martin said.

For example, some nurses help children with daily catheterizations to drain urine from the children's bladders while at school. Others might have to suction out tracheostomies, clean gastrostomy tubes, empty colostomy bags, give insulin injections, administer blood tests, keep track of inhalers and provide daily checks of the automated external defibrillators placed in every school building for heart attacks.

Plus, there's the litany of cuts, scrapes, bruises and lice cases that invariably come along.

"You just never know what's going to walk through the door," Martin said, noting how each school nurse's office "is like a little mini triage center."

Last year alone, she said, school nurses in Quincy logged 115,000 student contacts.

"I see us as a support system for education," Martin said. "Our goal is to keep the students in school, keep them in the classroom, because they can't learn if they're not in the classroom."

Public schools are not required to have nurses in every building, but the Quincy does.

When she was a student years ago at Monroe School, Ebbing said, the school's secretary served informally as nurse. But that's no longer practical, she said.

"With today's health issues, it's just not a safe environment for a kid unless you have someone who is trained to take care of them," Ebbing said. "It's not a luxury. It's a necessity in order to keep our kids safe."

Houdinis and hugs

It's a Monday morning in October, and a little girl walks into Ebbing's office holding her forefinger.
"I got a bee sting outside," the girl told Ebbing. "I was touching my head, and I didn't know a bee was on it."

Ebbing quickly mixed together what she calls her "famous potion" to make the bee sting feel better. It was a paste made from baking soda and water that she spread onto the girl's finger to draw out some of the toxins. Then she had the girl hold an ice pack on the finger and sent her on her way, already feeling better.

A short time later, another girl came from the playground and pointed to her foot.

"My toe is bleeding," the girl said.

Ebbing cleaned the girl's toe and applied a Band-Aid. The girl smiled at Ebbing and got up to leave.

"I come here a lot," she told a visitor.

Then it was time for Ebbing to call down several students who hadn't shown up at her office as scheduled to take their daily medications. Moments after she telephoned a teacher in an upstairs classroom, a skinny boy walked through the door. As always, Ebbing asked him to say his name and describe the pill he needed to take, even though she already knew the answers.

The boy complied and was given his pill along with a cup of water. He put the pill in his mouth and swallowed.

"Show me," Ebbing told the boy, who proceeded to open his mouth to prove the pill was gone.

After the boy left the room, Ebbing explained: "We have some that like to hide their pills. We have all kinds of little Houdini people with their medications, so we have to make sure they go down the hatch."

Ebbing keeps all of the students' prescription medications under lock and key, and she logs every pill and shot she gives out. She also tracks the names and health conditions of every child seeking her services.

On a typical day, Ebbing will see about 35 children, or about 10 percent of the school's student body. On her busiest day, she saw 92 students.

The most common complaint she deals with "without a doubt" is stomach ache, she says.

"When you get anxious, what do you get? Adults get headaches. Kids get stomach aches," Ebbing said. "If it's a test day, I can guarantee you I'm going to have children with stomach aches before they take their tests. That's how their anxiety manifests itself."

Ebbing has been a school nurse for 20 years. She started at Irving School and moved to Madison 15 years ago.

She has seen a lot in her years as a nurse, dealing with everything from simple scrapes to monitoring children who are recovering from surgeries and cancer treatments. At one point, she said, four children in the building were being treated simultaneously for leukemia.

Ebbing also keeps her eyes peeled for any signs of physical problems or emotional distress. For example, Madison students can check their pulse rates with equipment a gym teacher bought with a grant. On several occasions, Ebbing has referred children to doctors for hidden medical conditions indicated by uncommonly high pulse rates.

Three years ago, a new kindergarten student was "crying herself sick" each morning from separation anxiety. So the girl would come to Ebbing's office for consolation and a big, warm hug.

Then, feeling better, the child would gamely head off to start the school day.

"She's now in third grade, but she still drops by for her daily hug — just because," Ebbing said.

"That's fine with me. One of the favorite parts of my job is giving out hugs."