Episode 315: School Nurses: A Vital Part of the Education Team

Student health is a group effort! Join us in conversation with Forsyth County school nurse, Susan Kawecki, and specialized instruction teacher, Sydney Bramblett, to learn how nurses and teachers collaborate to improve student physical and academic health at Coal Mountain Elementary School.

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TRANSCRIPT

 

Ashley Mengwasser: Hey, Georgia Educators, we have new discussion guides available to use with Classroom Conversations episodes. These discussion guides include open-ended questions to facilitate great discussion and professional learning. After listening to each podcast, find the new discussion guides posted with the Classroom Conversations episodes and blogs in Georgia Home Classroom. Hello again, Georgia Educators. We're bringing you a special episode of Classroom Conversations. I'm Ashley Mengwasser, your host. Our presenting partners, the Georgia Department of Education and Georgia Public Broadcasting have convened us in honor of certain professionals who keep the vitality flowing in Georgia's schools. My guests are going to inject you with some enlivening prophylactics, and this won't sting a bit. Trust me, I care. I'm averse to needles. My whole life, I've been a patient, but not a very patient, patient. For those of us who are unwell or uneasy, we have the supportive care of skilled nurses. It's to the nurses' office for students and staff in our schools who might be facing an illness or medical emergency. And there they take comfort in the wellness sustaining powers of their school nurse. Which brings me to today's topic. How do school nurses collaborate with classroom teachers for both day-to-day attention and the heart thumping emergency response situations? What better time than the present to discuss this matter, because May 10th is National School Nurse Day, a day to honor the critical work that our school nurses perform year round. So for a healthy, hearty dose of wisdom, I've invited in a duo as mutually interdependent as vitamins and minerals. Nine year school nurse Susan Kawecki and specialized instruction teacher, Sydney Bramblett, Susan and Sydney expertly demonstrate the community benefit of a seamless nurse-teacher collaboration. These two have been recognized for their local emergency services at their school, Coal Mountain Elementary and Forsyth County. Welcome in, Susan and Sydney. Hi.

Susan Kawecki: Hi. Thank you, Ashley.

Ashley Mengwasser: How are you?

Sydney Bramblett: Good.

Susan Kawecki: Very good. Thank you.

Ashley Mengwasser: Everyone's wellness is at a high level today with Susan in the room. And you're wearing your scrub, Susan, which I appreciate.

Susan Kawecki: I am.

Ashley Mengwasser: Is this your day-to-day uniform?

Susan Kawecki: It is, minus the lab coat because some of our kids have white coat... Oh, actually, some of our staff have white coat syndrome, so sometimes it's the scrubs and just a jacket, but yeah.

Ashley Mengwasser: It's very official. Hello Nurse. Absolutely.

Susan Kawecki: Right. Well, we're proud to get Forsyth County School nurses in there.

Ashley Mengwasser: I like that emblem. It's beautiful. How are you classroom teacher Sydney?

Sydney Bramblett: Living the dream. It's a Friday.

Ashley Mengwasser: Living the dream, wearing a different version of white, the teacher version. An animal print.

Sydney Bramblett: An animal print.

Ashley Mengwasser: Which animal print is that?

Sydney Bramblett: I'm actually not sure. I'm pretty sure it's giraffe though. Maybe.

Ashley Mengwasser: Giraffe. Oh, that's unusual. I need something giraffe print. Yeah, thanks for that reminder.

Sydney Bramblett: Yeah, it's very comfy.

Ashley Mengwasser: Coal Mountain Elementary. Would you tell me Sydney, just briefly what your school's like?

Sydney Bramblett: It's a wonderful school. We always have this motto saying, "It's great to be on the mountain." It's one of the small, or it is the smallest school in Forsyth County. And so it's a nice little humble little abode where we just love children.

Ashley Mengwasser: Keep the learning going.

Sydney Bramblett: Keep it going.

Ashley Mengwasser: Wonderful. Well, Susan, tell us exactly who you take care of at Coal Mountain by the numbers and tell us a little bit about certain ailments that you've treated.

Susan Kawecki: Okay. Yeah, so we are the smallest school, but we still stay very busy in the clinic. I am there for the health and wellbeing of both the students and the staff. I have approximately 750 students and 90 staff. I see on average about 45 students a day. That could include daily medications, my diabetic students, as well as the skinned knees, the head bumps, the headaches, and sometimes unfortunately more severe injuries. Broken bones, lacerations that require stitches. And then we do have sometimes the seizures, the emergency allergic reactions, the asthma. And I also see approximately 30 staff a month in the clinic.

Ashley Mengwasser: 30 staff a month. I don't know why it surprises me, but obviously staff can go to the school nurse as well. She's for the school or he's for the school.

Susan Kawecki: Correct.

Ashley Mengwasser: Why did I think only students came and saw you? But you just reported that you see quite a few staff members actually.

Susan Kawecki: I do. I do.

Ashley Mengwasser: And 45 students a day. My mom's a nurse, Susan, and I know she gets stressed when she has more than six patients a day. And you're seeing 45?

Susan Kawecki: Approximately 45, yeah. Sometimes it's less. There might be a day where I see 30 students. Last Tuesday I saw 60.

Ashley Mengwasser: Oh my gosh. How much time do you think you spend with each of them?

Susan Kawecki: It really varies. Each student is going to present with different symptoms. Sometimes they're in there for just a moment to collect a daily medication, have that administered. Sometimes they're in there, probably the longest stay is our head bumps because we monitor them for 30 minutes after the event. So it varies.

Ashley Mengwasser: A little bump to the head. Well, you two have been practicing this whole handling emergencies together thing and you've actually streamlined the emergency process at your school so much that you were recognized for demonstrating superior communication as a teacher and nurse collab. So Sydney will you tell me how you were recognized?

Sydney Bramblett: So, I teach a severe and profound intellectual disabilities class. So I have a lot of medically fragile students and with that comes seizures and things like that where our temperatures can drop and everything under the sun very quickly. So we got recognized by our SRO and by our county EMTs, and they just wrote some letters and put them and just told us that when they came in to handle our emergency situations, they were able to allow me and Susan to stay in the emergencies instead of just kind of kicking us out, which is generally what EMTs do. And we had it to where we had it down to the second for seizures for our note-taking and everything like that. They were able to allow... I know I got to stay with my student to help them kind of prep them for the blood pressure cuffs and even an IV at the time. And so things like that. And so they wanted to recognize us for just how we handled the emergency situation to make sure that the child got the best care that they needed.

Ashley Mengwasser: Wow. So you went beyond the typical bystander of a medical emergency and became collaborators in the medical emergency. That sounds like why you were probably awarded. Great job there. And you said you have specialized instruction class. How many students?

Sydney Bramblett: In my class right now, I have five. So my class is a severe and profound intellectual disabilities class, and I have a lot of medical needs that can range from seizures, feeding tubes, something called MCAD, which is an autoimmune disorder. Things with temperatures. They all have ranging medical needs and a lot of things kind of on their plate with medicines and such like that.

Ashley Mengwasser: Well, we're going to get more into your plan and how you actually tackle some of these situations a bit later. But first I want to know more about each of you personally. So tell me what you enjoy in your personal life outside of Coal Mountain. Susan?

Susan Kawecki: Oh, well, the kids can probably tell you that. I am a big animal lover and I have photos of my animals on the wall, but it serves a purpose. I enjoy my animals, but I enjoy sharing with the kids. I don't have an animal in the clinic, and there are a lot of therapy dogs throughout the school and throughout the county. But within the clinic, we often talk about the chickens, the horses, the turtles, the hamsters and the kids, I say, "If you were going to name that black and white chicken, what name would you give it?" And sometimes it calms them down.

Ashley Mengwasser: To talk about the animals.

Susan Kawecki: Right. They get to share about their pets, and so the student and I get to know each other, and the nurse sometimes becomes a little less of a scary entity when we get to talk about the animals.

Ashley Mengwasser: So when they're comfortable to go and visit. How many horses do you have?

Susan Kawecki: Currently just one.

Ashley Mengwasser: What's your horse's name?

Susan Kawecki: Taylor.

Ashley Mengwasser: Taylor.

Susan Kawecki: Taylor's an off-track thoroughbred. He's retired.

Ashley Mengwasser: Who's he named after?

Susan Kawecki: He was actually my daughter-in-law's horse. And then my daughter rode him in competition and his track name was Stratumus. And then his barn name is Taylor.

Ashley Mengwasser: I love it. I was going to see if there was any Taylor Swift homage there. What with the Taylor Swift tickets being so hard to get.

Susan Kawecki: Yeah, right.

Ashley Mengwasser: Sydney, what do you enjoy in your personal life?

Sydney Bramblett: Honestly, I just love going to the gym and going to my church, and I coached here, so that's all my fun things.

Ashley Mengwasser: Oh, that's perfect. A lot of social time outside of school for you.

Sydney Bramblett: Yes.

Ashley Mengwasser: Do you have any alone time in your life?

Sydney Bramblett: I really like to take naps and go to sleep.

Ashley Mengwasser: There you go.

Sydney Bramblett: It's really fun.

Ashley Mengwasser: Napping is on my special list of to-dos as well. Well, I want to do a little temperature check on this one, Susan, on nursing myths.

Susan Kawecki: Okay.

Ashley Mengwasser: Are there any that you would like to set straight about school nurses in particular?

Susan Kawecki: Yeah, I would. I think it is great that kind of the first image that comes to mind when you think of a nurse is that caring adult who's going to hand you an ice pack or a cracker. And we do a lot of that because it takes care of about 90% of what comes in the clinic, and we will continue to do that. But the school nurse is a licensed professional who has been educated, at least their associates, and most school nurses have much more education in healthcare than that. And you have the education and you absolutely cannot discount the experience, whether it's in the school system or in a hospital, a physician's office, whatever it may be. So, while I think school nurses definitely feel appreciated to be thought of as a very caring person, a caring adult, I don't think you should overlook the amount of education and professionalism that the school nurses also bring to the educational environment. And the school nurses are also required just like other nurses to have continuing education hours every year. We can do that on our own or great opportunity is the Georgia Association of School Nursing and the National Association of School Nursing provide conferences every year that allow us to get continuing education credit hours. We also have a lot of affiliations where the Department of Education provides us opportunities, links through local hospitals, et cetera, where we can get our continuing education hours. So I just think it's important to realize that while it's a caring heart, a hand, that these are professionally educated and you might be surprised on what all they do know.

Ashley Mengwasser: From just technique and skills.

Susan Kawecki: Absolutely.

Ashley Mengwasser: Absolutely. You're having to respond to who knows what could come into your clinic every day.

Susan Kawecki: Right. We don't diagnose, but we do assess and we look at signs and symptoms, and between our education and our experience, we are oftentimes able to say, "Let's see the medical doctor and rule out X," because we're seeing signs and symptoms of that. And sometimes we are wrong, but oftentimes we're right and they come back and they say, "Oh, she did have this, he did have that. Great catch." We didn't diagnose, but we saw the signs.

Ashley Mengwasser: That pointed people in the right direction.

Susan Kawecki: Correct, correct.

Ashley Mengwasser: Awesome. That's what families need. Sydney what has surprised you as a classroom teacher about school nurses through working with Nurse Susan?

Sydney Bramblett: Honestly, just how willing she is to just train. So she doesn't just sit here and say, "Okay, let me take over and do all the nursing parts." She lets me kind of get in there and be like, "Oh Sydney, this is how you do this piece. Or if you're looking at this, this is what this symptom is and this is what this medication is for." When we're looking at, especially into my students with the list of medications and things like that, she's like, "Oh Sydney, this is what this is for. And so these are things that you should look for in your classroom," and things like that. So typically I would just think a nurse would just want to do her job and then let me do my job, but she's really willing to let me just kind of step into her world a little bit too, so that we can both have this collaborative team.

Ashley Mengwasser: Right. It helps you respond better and it helps your interaction better in some of these dire moments. Well, we know that school nurses have a major significance. They have a national holiday for goodness' sake. Share some of your roles at your school, Susan, if you were just going to give us a jot list.

Susan Kawecki: Absolutely. So initial training is very important, continuous training throughout the year. The school nurses are responsible for the screenings. Hearing, vision and also in the middle school and high school they're responsible for the scoliosis screenings. In elementary, I screen all first, third, and fifth grade. That's a mass screening process. We can have some volunteers, but then there is a second vision screening by the nurse, so anyone who would fail that first screening is then screened by the nurse. And then I would do a referral for vision. Hearing, I will do a second screening for anyone who fails the initial hearing screening. And then if they failed the second screening by me, then I call in the county audiologist who then would screen them. If they fail her screening, then there is a referral that goes home to parents, and then the nurse is also responsible for following up on those referrals. So once those are sent home, that's not the end of the story. We need to make sure that the student was taken to see a doctor to see if they have a vision issue. Sometimes it's glasses, sometimes it's surgery. You can find out some things that you did not even know were wrong. My own son had a flat lined tympanogram in third grade, meaning he wasn't able to hear out of one side. He didn't even know. He was compensating and reading lips-

Ashley Mengwasser: With his other ear.

Susan Kawecki: And turning his head. And so as a parent, I was blessed and had benefit from the mass screening process that takes place in the school. So we handle that. We do all of the follow-up. We also are responsible for 3231s, which is also the immunization record. So the shot records, especially... Well, any student comes into our school, that information is entered. We pull information, it's either supplied by the parent, we have to make sure that it is the proper information, or we can pull it from the Georgia registry. Then that information is loaded, by the nurse usually, into a system. So we are monitoring that. All of our kindergartner immunization records are audited by the county, so that is early in the school year that we need to make sure that that is all ready. We also have, there's a 3,300 for our kindergartners where they see a medical professional and they look at hearing, vision and dental. They also look at nutrition. If there is a needs follow up, checked on that, the school nurse is asked to follow up with the parent again to make sure that the student is being cared for and getting the proper follow up that was marked by the physician. We also, throughout the year, audit our care plans, provide the teachers updated healthcare lists, showing them any student who may have a health condition anywhere from glasses to seizures to a new allergy. So that is not just a once a year at the beginning of the year, bring in the care plans. We need to continue to audit those and update those and make sure the teacher has the information. We are also part of the safety team. And then we do in addition to that training up front, we also do a lot of informal training throughout the year. We may be on the morning news talking about hand washing. I send out emails talking about season pollen. The pollen season in Georgia is real.

Ashley Mengwasser: Georgia snow we call it here.

Susan Kawecki: Absolutely. And that's a really tough time to be able to tell if a child is sick or having to deal with allergies and just saying that it's allergies. It can be really serious and debilitating and get in the way of their educational experience. So anyway, I sent out a communication when it became pollen season. And I actually tracked the numbers in my clinic and talked to the teachers about some things that they can do with their students after recess, having them wash their hands, wash their faces with some cool water to get rid of the pollen and some of the symptoms that might come with that. So in addition to all of the kids coming through and the staff who may need your services, you have to take those very, very few moments that you get during the day and be entering things in the system. Also, some people don't realize that when a student or a staff member comes in, with a staff member, there's some minor documentation. So, we have some different rules around staff health conditions, but with the students, there's documentation as to what time they came into the clinic and our clinic notes. And so that's also somewhat time-consuming that we do all the documentation for every student, the time they came in and then the symptoms that they presented with. And then anything that we did as far as a solution and if they were sent home, what time they were sent home, who picked them up, that type of thing.

Ashley Mengwasser: You're busy, Susan.

Susan Kawecki: We are. And it's not just me. I mean all the nurses in our county. We have weekly nurse calls and we talk about what we're seeing. We may see, for example, a spike in strep or a spike in flu, and we talk about that and we talk about what we're seeing and maybe different ways to approach it.

Ashley Mengwasser: So much that you're doing, so many individuals that you're seeing, adults and young students. Sydney, as a classroom teacher, what roles do you see the school nurse in and how do you utilize Susan in your teaching?

Sydney Bramblett: So, I'll tell you, in our school, she's definitely seen as a superhero for our school.

Ashley Mengwasser: I believe it.

Sydney Bramblett: And so, I see it looking at the gen ed world and things like that, how she is just used as sometimes that nurturer and everything like that. And the teachers all can have such a great relationship and just call her and be like, "Hey, friend needs a moment." And she is amazing with that. And I know with my classroom, I use her definitely as a resource. I'm like, "Hey, this friend is acting kind of weird. This friend doesn't normally act like this. What can I do? What would be the reason for this? What's something that I can do to help aid him and bring them back to baseline?" And things like that. And I don't think there's a day that I don't go without calling you, where I'm just like, "Hey, so just a quick question. This is..." Because I also change diapers and things like that. And I'm like, "This is how this looked today. What am I supposed to do?" And she's just like, "Well just do A, B, and C." And I'm like, "Okay, great. Thank you so much." And so really she's just-

Ashley Mengwasser: A resource.

Sydney Bramblett: ...someone I can lean on throughout the entire day. And she's like that to all the teachers. Any teacher can call her at any point and ask her a question, and she's so willing just to help us in any way.

Ashley Mengwasser: And she's in the classroom a fair amount. So the students know her?

Sydney Bramblett: Yes.

Ashley Mengwasser: They recognize her. Like you said, a superhero. Well, it's great when you're a frequent flyer on an airplane that comes with perks. Not so great when a student is frequently in the nurse's office, Susan. What strategies and plans do you have to determine the root cause of some of those frequent visits?

Susan Kawecki: Well, some of my frequent visits are there just to say hello to Zazu, the fish.

Ashley Mengwasser: Who can resist.

Susan Kawecki: Right? And we can identify that pretty quickly when they hop up five seconds into their clinic visit and say, "Zazu, hey!" But the more serious situations, it is a team. It's a whole student and it's a whole team at the school. So I assess that student from both a health perspective, and I'm also listening to them and what they're having to say to me. It may be a call directly to a parent. It may be to the teacher, it may be to the counselor. It may be to an administrator. It may be the school social worker. And we talk about what is going on with that student if it's not from a health perspective. If it's from a health perspective, may call the parents straight away. And that helps me to find out if we have a true issue, am I missing something? When Sydney talked about communications, communication, and collaboration, I don't always see a student present the same way in the clinic as they present in the classroom. So I need to see, I need to hear from the teacher. I don't want the teacher to think sometimes when I send a student straight back to the classroom that they go, "Why did you send... He's not feeling well at all. His head is now back down on his desk." Then I need to know that because in the clinic maybe he was bouncing off the walls. So it's communication. And I know the-

Ashley Mengwasser: Dialogues.

Susan Kawecki: ...I know the teachers are very busy in the classroom and I don't want to take any time away from the educational process, but if they can give me a quick call or shoot a quick email or send a quick note and the teachers are learning how to communicate with me, it helps so much. It helps me to see the whole picture for the student. And once we've got the whole picture, now we can decide, do we think we have something medically going on that maybe isn't a fever or an injury, a visual injury? And then we'll call parent, I'll say, "Susie has been in the clinic multiple times and I'm concerned." And sometimes as a nurse, based on your education and experience, there's somewhat that fifth sense, that gut sense, that tells you something's just not right.

Ashley Mengwasser: Something's off.

Susan Kawecki: Right. And you share that with the people who can help take care of that student if it's not you at that given time. And so they stay on our radar. And then maybe whatever that is develops into something that we can treat, either physically, emotionally, mentally, somehow we can support that student.

Ashley Mengwasser: So, to use the original metaphor, you're tracking that flight pattern, you know what is going on, exactly where that student's going, as long as that dialogue stays open. And something you referenced, which I think is important, is when it is time to reach out to a parent and notify a parent. How do you guys handle communicating with a parent when there's a concern with a student?

Sydney Bramblett: I know with us it's pretty similar where a lot of times we just decide based off if it's more medical, if it's more from a teacher's side, sometimes I'll just call. Sometimes she'll just call. Sometimes we'll call together. And that's one that I really like to use, is when we're coming as a collaborative front of like, "Hey, these are the things that we're seeing presented. We want to let you know A, B, and C. And this is both Nurse Susan and Miss Sydney. We just wanted to let you know here's going on. Here's what we're seeing at school. Is there anything that's happened at home?" Those type of calls are really calls that we try to do together just so that we can both have that same page of she's seeing something in the clinic, I'm seeing something in the classroom. We need an even fuller picture of what happened at home. And I know I want to say it's pretty similar too with all the other teachers as well, from what I've heard is a lot of times Nurse Susan will say, "Do you want to call together?" If it's something that needs to be called together or Nurse Susan is great about calling parents, and the parents love her as well.

Ashley Mengwasser: And do you know what that does though, for the parent? It presents a united front. Because then they don't have to ask, "Well, do they go to the nurse?" "They already have and here's the nurse and here's what we're both saying from our collaboration," which I think is really important. Anything to add to that, Susan?

Susan Kawecki: Yeah. So a lot of times we do make the phone calls. We also, if I do have to email or I'm in a situation comfort level with a parent that I'm going to email them directly, I try to always remember to copy the teacher. So I have 750 students. A teacher may have 20 to 25 students in our autism and SBA classes it's fewer, but they are, where I may see that student once a week, they're seeing them every single day. They're seeing that student, they're talking to these parents more frequently. So I want the parent and the teacher to also be aware of what's going on with the student in regards to their clinic visits.

Ashley Mengwasser: You may have different examples for this, but I'd love a story from each of you about a time when your nurse-teacher collaboration made a really positive impact on a student's life. You want to take this one first, Sydney?

Sydney Bramblett: So, from my point of view, I mean, my situations are definitely can sometimes be that life or death situation. We do have some severe emergencies in my classroom. So I mean, we've just had times where... I don't even know if there's a specific time because we work together so much where it's just those times where I call on that radio or I call her on that phone because we have radios, too, where we can communicate together. I call on that radio and I'm just like, "Susan, I need you down here." And I know that I where my book is that I need to write down my information. I've trained one of my paras to write the information so that I can be talking with the student. And then I know Nurse Susan's going to be there with her pulse ox and with her stethoscope, and she's going to be making sure all the vitals that I can't check that I'm not trained for, she's checking on those. I'm checking on seeing if I can get the student's attention during these situations. And I know I've got my para checked, I know the admin has got it where they are sitting there calling 911. They're doing all the things to make sure the playgrounds are clear, the medical lockdown is going on. They know students can't go down my hallway and things like that. So, it's just kind of a big collaborative team that I think we've just unfortunately had these situations so often where there's not a time where we haven't worked as a collaborative team. We have just always been on top of every single situation to where I know that if I look at Susan and I'm just like, "Something's turned. Something is really wrong right now." In any of those situations, we generally look at each other and we're both just like, "Okay, we need to change our game plan right now." And we don't even have to speak. We can almost just look at each other's eyes and just turn to whatever we need to do.

Ashley Mengwasser: Teacher-nurse telepathy.

Sydney Bramblett: Yes.

Ashley Mengwasser: An untapped skill. That's really impressive. So what you're saying right now, Sydney, is that there really hasn't been a time when your interaction hasn't impacted a student's life because all of what you do together is so impactful. Do you have a specific anecdote maybe from another classroom, Susan, that you've worked with? Or from Sydney's?

Susan Kawecki: Right. And it's also important to note because there could be a teacher out here saying, "I'm the one who's going to go get the AED, I'm going to make the 911 call, but I'm not comfortable putting pressure on a wound." And that's okay. And you need to have that conversation with your nurse and let them know that that's who you all are and your nurse is going to be just fine with that. And she knows what roles you are comfortable with and that helps her during an emergency situation. I collaborate on the front end with a lot of teachers, including Sydney, when it comes to getting the care plans for our students. I know a lot of students, we get in and parents are so busy at the beginning of the school year getting school supplies and new clothes and et cetera. But the care plans, some are great about getting those to us, some are not. And you cannot guarantee that day one of school, a student isn't going to have an emergency situation. Kindergarten, first day. I know we had a little girl who ate peanut butter. So, it's a first time and she's allergic to peanuts. So we're in a new environment and the peanut butter is accessible where it wasn't accessible-

Ashley Mengwasser: Before.

Susan Kawecki: ...at home. Right. So those care plans and those emergency medications. Now we do have stock emergency medications. We have albuterol, we also have Benadryl, diphenhydramine and our EpiPens. But with our seizure students, their medication is going to be for them, brought and written for them by a doctor. And those care plans are important to have day one. And so I'll work with the teacher. The teacher will help me. Again, that goes back to where I have 750 students plus the 90 staff. They have the smaller classroom environment. They're talking to their parent more frequently, either through class notes or class newsletters and frequent emails. And they can help me carry that message and get the information we need.

Ashley Mengwasser: Get it out there. Well, Sydney, you mentioned your classroom, you have complex medical needs, and Susan is your partner in that you guys have been recognized for responding to medical emergencies so well. I'd love you to share the factors that make your dynamic work. What are your fundamentals? If you had to give me the bulleted list?

Sydney Bramblett: Well, I would definitely say communication. Communication, collaboration. Like not just communication, but open communication of just knowing that if I bring something to Susan, even if she's thinking it's the silliest thing ever, she's not going to tell me she just going to, she’s like, "I'm hearing you and I'm listening to you." And just having that open communication, not between just us, but honestly throughout the whole building. And I think one thing that I will praise for Forsyth County schools for is we have a system of, for lockdowns and things like that specifically, if we want to talk medical lockdowns and things like that where we have door hangers where they get pulled down during any lockdown and it tells us exactly what we're supposed to do. And we have all these trainings that we're supposed to do up in the front end. And I think being as proactive as possible is also a key fundamental, is just making sure that we are trained, we are ready, your staff is ready. Everyone knows their roles. We have safety teams within the school for each type of lockdown. There's a safety team of teachers that get pulled and that are trained in those pre-planning times. Because you can pre-plan for a lesson, but you also need a preplan for emergencies.

Ashley Mengwasser: Exactly.

Sydney Bramblett: And so, I would say communication, that-

Susan Kawecki: Planning.

Sydney Bramblett: ...proactiveness, just being proactive and making sure that as much as we don't want to think about any type of emergency, emergencies happen all the time. And so just making sure you're prepared is-

Ashley Mengwasser: Preparedness. Because it is-

Sydney Bramblett: ... and collaboration.

Ashley Mengwasser: It's a bit of choreography. And you can't do the dance unless you've practiced it and you know exactly what you need to do. Are there any other fundamentals we haven't touched on, Susan?

Susan Kawecki: I would say trust.

Ashley Mengwasser: Trust.

Susan Kawecki: I mean, trust takes time, but we've developed... And if you don't have it, you sit down and you have a conversation as to why you don't have that. But I feel like I have trust. I also trust my administration. They're fantastic at Coal Mountain Elementary to support my assessment and recommendation. It is ultimately the responsibility of the principal to make the call when we are going to call 911. But I've never had a situation where our principal has not trusted my assessment.

Ashley Mengwasser: Your expertise.

Susan Kawecki: Absolutely.

Ashley Mengwasser: Wonderful.

Susan Kawecki: And the other thing is knowledge seeking. I think the teachers, they seek knowledge. When I have a parent who brings in a student who has a particular health condition, I know that parents can... I'm a nurse, but there's very good possibility they know more about that particular health condition than I do. Because if my child had health condition, I guarantee you I'm going to read.

Ashley Mengwasser: You'd be researched.

Susan Kawecki: Absolutely. Absolutely. So I want to hear them. And also, every health condition is different in each individual. So let's learn about how diabetes affects your child. What does a high look like for them? What does a low feel like for them? And so we need to talk about the individual, and then the teacher will get to know that individual and what is in their classroom. They will seek to understand how to administer that particular medication. What does the care plan exactly say when I get ready to go on the field trip? I don't always have to give epinephrine, but sometimes there are students who have to have that EpiPen straight away. And we need to learn. We need to seek the knowledge so that we are prepared.

Ashley Mengwasser: Because everybody's different. Literally means everybody is different. And you have to respond to the individual student or staff as independent people. Nurses, Susan, you guys keep a lot of great supplies. My mom, I used to love to go through her nursing bag. I'd like you to supply classroom teachers and school nurses listening with some just final tips or tools for success with our last words here today. What do you have, Susan?

Susan Kawecki: Well, I think the training upfront is very important. If the administration can, as our administration does, give them the opportunity... I am fortunate to have, I have 90 minutes in the pre-planning days to go over those very important topics. A lot of that training we're lucky is crafted for us by the county, by our health services director. But we take everyone through the hands-on portion. CPR, AED, how to use an EpiPen. And there are other topics that we cover during then. We also do continuous training throughout the year. And I think that is very important. I also think, again, communication has to be highlighted. It's the constant communication. The communication with your school social worker, your administration, your teachers, your parents, and your students. And then finally, one of the things that we have found that serves us really well is debriefing after an emergency situation. What did we do well? What can we do better? And then you also remember as a nurse, you have more than one victim, often. You often have the teachers who need that moment or the staff members that were involved in that emergency, and you need to go to them and check on them and see how they're doing. And then you talk, you step aside with just them away from your students. And you say, and I learned this in nursing school after my first emergency situation I was involved in as a nursing student. And they said, "What did you see? What did you hear? What did you smell?" You talk about the senses and what you experienced, and that allows people to heal.

Ashley Mengwasser: Yes. That's beautiful. You need the whole picture.

Susan Kawecki: Absolutely.

Ashley Mengwasser: Sydney, anything in your toolbox for teachers out there?

Sydney Bramblett: I say just keep on learning and just lean into your nurse whenever you need to.

Ashley Mengwasser: Thank you guys. There's only one thing that you haven't covered satisfactorily for me, Susan, who is Zazu the fish?

Susan Kawecki: Zazu the fish is a beta fish that's in the clinic and the kids love him. You would not believe the amount of joy that a $2.99 cent fish brings to the-

Ashley Mengwasser: Well, we can't put a price on Zazu, honestly.

Susan Kawecki: You're right. You cannot. Absolutely.

Sydney Bramblett: He's famous as well.

Susan Kawecki: All right. And I guess thank Ms. Kelly for feeding Zazu today.

Ashley Mengwasser: Oh, thank you, Ms. Kelly. Zazu's got to eat. What color is Zazu?

Susan Kawecki: Zazu is blue.

Ashley Mengwasser: Blue. We'll end on the image of a bright blue fish.

Susan Kawecki: Absolutely.

Ashley Mengwasser: Thank you, Sydney.

Sydney Bramblett: Thank you, Ashley.

Ashley Mengwasser: And thank you, Susan for being here today.

Susan Kawecki: Thank you, Ashley.

Ashley Mengwasser: You guys are excellent guests. As always, we hope that you'll continue to take your weekly dose of Classroom Conversations. It's the platform for Georgia's teachers. As you know, school nurse-teacher collaborations, like we've heard about today, help students and families address health concerns, reach academic milestones, curtail absenteeism. These are all important things. And this is the part of the show where I have to say goodbye and depress my tongue until they revive me for another episode. But before we go, a robust thank you to our school nurses out there, and for those non-nursing professionals in the classroom, you're a great teacher. A new regimen of Classroom Conversations will be prescribed very soon. Until then, just go back and listen to episodes you may have missed on tailoring instruction, 3D science, Georgia historical figures, adapted sports programs, and so much more. Better give them a listen. Nurses orders, right, Susan?

Susan Kawecki: Right.

Ashley Mengwasser: I'm Ashley. Goodbye for now. Funding for Classroom Conversations is made possible through the School Climate Transformation Grant.