Massachusetts School Nurse Outlook - · PDF file · 2013-05-15abdomen. She carries...

Massachusetts School Nurse Outlook

copy 2013 Massachusetts school Nurse orgaNizatioN May 2013

Inside this issue

School with a LVAD 1-5

Opportunity 5

Facebook 5

Outgoing President 6

Incoming President 6-7

Nurse Admin of 2012 8

Nurse of Yr 2013 9-10

Community Award 10

SBIRT 12-15

Saying Goodbye 15

Save the Dates 16

Did You Know 17

Certification Info 18

Annie McKay 19

Are You Prepared

The Mission of the Massachusetts School Nurse Organization is to promote and advance quality school health services throughout the Commonwealth and to promote the rights interests and professional growth of its members

Clickable links to Advertisers this Issue

BMCHPCambridge CollegeSNAP Health Center

Not a member Click here to join

Like us on Facebook (continued on next page)

Expanding Frontiers in School-Based Care

Back to School with an LVAD

By Lorri Devlin MS BSN RN

As medical technology advances so does the role of the school nurse Just ask Ann Doherty Couite MEd BSN RN school nurse at Dennis-Yarmouth Regional High School on Cape Cod This year one of Annrsquos students returned to school while awaiting a heart transplant

Kyah DeSimone a shy determined 14-year-old student at D-Y High has a condition known as dilated cardiomyopathy which resulted in acute decompensated heart failure Without drastic intervention she would not have survived On November 12 2012 surgeons at Boston Chil-drenrsquos Hospital implanted a left ventricular assist device (LVAD or VAD) in her left ventricle The devicersquos titanium pump pushes blood through Kyahrsquos body keeping her alive as she waits for a new heart Instead of a pulse her artificial pump emits a continuous hum as it moves blood through her system

Nearly two months after life-saving surgery Kyah came home and began planning her return to Dennis-Yarmouth Regional High School Her mother Danielle DeSimone related that at first her daughter was apprehensive about returning to school but missed her friends and wanted to be with them

D-Y High School nurse Ann Couite literally took Kyahrsquos situation to heart ldquoIt was critical to have key players informed about Kyahrsquos unique needs

What Is a Ventricular Assist Device

By Suzanne Wallace MSN CRNP Clinician and Patient Education Manager Heartware Inc

Editorrsquos Note the following information is pre-sented as a generic overview of left ventricular assist devices and to enhance the information provided by Ms Devlin in Expanding Frontiers in School-Based Care MSNO has no affiliation with Heartware Inc or any other LVAD manu-facturer and does not support the use of any one ventricular assist device over another

A ventricular assist device (VAD) is a surgically implanted mechanical pump designed to supple-ment the reduced blood pumping capability of a patientrsquos failing heart VADs can assist either the right ventricle left ventricle or both They are predominantly used for left-sided support thus the term ldquoLVADrdquo LVADs have been in clinical use for more than twenty years Their primary purpose has historically been to support patients while they wait for a heart transplant1-4 How-ever there has been an increase in world-wide use for LVADs as permanent support (destina-tion therapy) for those patients not eligible for

(continued on page 3)

2

Massachusetts School Nurse Organization May 2013

MSNO TELEPHONE NUMBER 508-921-8972 Executive OfficersPresidentJudy Styerstyermsnoorg

President-Elect Legislative ChairCarilyn Rainsrainsmsnoorg

Past President Pamela Riversriversmsnoorg508-921-8972

NASN DirectorMarie DeSistodesistomsnoorg

SecretaryKristen Carlson-Lewiscarlson-lewismsnoorg

TreasurerKatie Vozeolasvozeolasmsnoorg

Vice-PresidentProgramsDoreen CrowecrowemsnoorgStanding Committee ChairsMembershipTerry Grimmgrimmmsnoorg

ProfessionalPay EquityLee Waingortin waingortinmsnoorg

MSNODOE LiasonBarbara Hedstromhedstrommsnoorg

ResearchKatherine OrsquoNeilloneillmsnoorg

Vocational Technical SchoolsBeth Ziemba (Chair)ziembamsnoorg

MSNO ArchivistOpen

Newsletter Editor Virginia Curciocurciomsnoorg

Webmaster (Temporary)Kathy Hasseyhasseymsnoorg

Public RelationsKathy Hasseyhasseymsnoorg

HistorianDorothy Keeneykeeneymsnoorg

Program Vendor Chairopen msnoorg

Bylawsopen msnoorg

(EXPANDING FRONTIER from previous page)

to assure a smooth transition We worked closely with the team at Boston Childrenrsquos Hospital led by pediatric cardiologist Dr Christina Vander-Pluym and Stephanie Porter MSN RN Pro-gramProject Coordinator for MASSTART (Refer to Editorrsquos Addendum for detailed information on MASSTART next column) We were tasked with pioneering a first-of-its-kind care plan for a teen-age student with a HeartWare LVAD in a public school setting

Kyahrsquos LVAD is connected to an external battery pack via wires that exit her body through her abdomen She carries the pack slung over her shoulder like a purse and recharges the devicersquos batteries by plugging into a wall outlet or car battery charger

To prepare for Kyahrsquos return Ann and her team (which included Kyah mother Danielle Dr VanderPluym Stephanie Porter school principal Kenneth Jenks guidance counselors and other support staff) met to map out a plan In addition to medical safety concerns the team addressed the socialemotional issues a shy teenage girl with an artificial heart pump might encounter ldquoWe were committed to normalizing Kyahrsquos ex-perience as much as possiblerdquo Ann said

To that end Dr VanderPluym visited Kyahrsquos class-room to talk to her classmates and answer their questions She brought along a HeartWare Ven-tricular Assist Device like the one Kyah uses and allowed students to handle it and ask questions

Kyahrsquos Individualized Health Care Plan includes her baseline status for emergency responders should they need to be called Local EMS staff has received basic training about LVAD includ-ing the fact that Kyah lacks palpable pulses or measurable blood pressure Responders must check for a right carotid vibration to assess whether the machine is functioning The Heart-Ware brand Ventricular Assist Device has a text feature that displays any identified device prob-lem and provides a solution

Kyahrsquos care plan includes directions to keep the LVAD controller away from water and static electricity All potential problems and associated symptoms are listed on a chart along with reme-dial actions Almost all potential symptoms (fe-

ver shortness of breath nauseavomiting cyano-sis headache) require Ann to page the Childrenrsquos Hospital VAD attending physician for guidance

According to Ann ldquoKyah is a resilient young woman with strong family and medical support She has the good fortune to attend school in a district that understands the value of full-time nurses in every buildingrdquo

Medical advances will continue to offer new hope to patients and new responsibilities in the aca-demic setting School nurses like Ann Couite dem-onstrate that school nursing practice is continually rising to the challenge without missing a beat

Addendum by the Editor MASSTART the Massachusetts Technology Assistance Resource Team is a free program providing services for children with specialcomplex health care needs and who may be assisted by medical technology in a school setting In partnership with the school and school nurse MASSTART provides consultative servic-es technical assistance training school planning and guidance This service is available to families of children ages 3 years up to 22 years

MASSTART will work collaboratively with families and school personnel tobull Help the school team understand the special health

care needs of the childbull Work with schools and families toward resolving

issues impacting the childrsquos health needs in the school day

bull Train school personnel to meet the health care needs of individual children

bull Assist in the development of the childrsquos individual health care plan and emergency plan for the school

bull Provide educational programs about children with special health care needs in school

bull Provide information referral and community re-sources

To obtain MASSTART services contact the Massachu-setts Department of Public Health Community Support Line for children with special healthcare needs at (800) 882-1435

Regional MASSTART ContactsGreater Boston Region

Northeast RegionStephanie Porter MSN RN (857) 218-4333

stephanieporterchildrensharvardeduSoutheast Region

Maureen Pursley RN MS (857) 218-4331Maureenpursleychildrensharvardedu

Central RegionDorothy Page FNP MSn (508) 856-4155

PageD02ummhcorgWestern Region

Carrie Somppi RN BS (413) 794-9591carriesomppibaystatehealthorg

3

ScholarshipsAwardsJanis Townsendtownsendmsnoorg

Private SchoolsAdria Pavelicpavelicmsnoorg

Marketing DirectorKathy Hasseyhasseymsnoorg

NBCSN LiaisonPatricia Hobanhobanmsnoorg

Educational Collaborative SchoolsBarbara Doucettedoucettemsnoorg

Gmailopen msnoorg

Regional Chairpersons Region I Judith McAuliffe Co-ChairmcauliffemsnoorgMary Ellen Conley Co-Chairconleymsnoorg

Region IIBarbara Hedstrom Co-Chairhedstrommsnoorg

Region IIIAnnette Hanson Co-Chairhansonmsnoorg

Region IVCatherine Caruso Draghettidraghettimsnoorg

Region VCarilyn Rainsrainsmsnoorg

Region VIopen msnoorg

Region VIIPatty Wright Co-ChairwrightmsnoorgMary Zentis Co-Chairzentismsnoorg

Region VIIIRosemary Connors Co-Chairconnorsmsnoorg Rosealine Kolch Co-Chairkochmsnoorg

Region IX Kristen Carlson-Lewis Co-Chaircarlson-lewismsnoorg Jenny Gormley Co-Chairgormleymsnoorg

Region XJudy Aubin Co-Chairaubinmsnoorg

Mass Charter School Nurse GroupGayle Nutile-Pimmgnutile-pimminnovationchar-terorgMarge Maurukasmmaurukasinnovationcharterorg

heart transplantation Improvements in technol-ogy have led to an expansion of VAD use for all patients and the newest technologies available in the US are continuous flow or rotary blood pumps These devices have resulted in increased use as they address many of the technical limita-tions of first generation pulsatile devices5-7

The original VADs used in patients with ad-vanced heart failure were pulsatile by design These devices utilized a blood sac or chamber that filled with blood similar to the left ventri-cle When this chamber was full it would eject blood into the systemic circulation This mim-icked normal cardiac physiology However these devices were typically large and associated with multiple limitations including size noise and device malfunction8 With the advent of con-tinuous flow VADs those limitations were ad-dressed The most recently approved VAD is the HeartWarereg Ventricular Assist System (Heart-Ware Inc Framingham MA) Its size enables its use in smaller patients as it is implanted directly within the pericardial space It also contains no mechanical bearings so is a ldquowearless systemrdquo which leads to increased durability as there is no friction on the internal moving parts9

All continuous flow devices are attached to the heart and implanted within the body but they require external power to run the pump The two commercially available devices in the US ndash the HeartWare Ventricular Assist System and the HeartMate IIreg System (Thoratec Corporation Pleasanton CA) ndash both have a small driveline (cable) that exits the body through the subcu-taneous tissue in the abdomen and connects to a controller The controller collects information from the pump and maintains the settings as programmed by the clinician The controller re-quires power to run and power may be in the form of batteries AC (wall) power or DC (car) power When a patient is ambulatory and mo-bile they should be connected to the batteries When they are home and resting or sleeping at night they should be connected AC power It is important to maintain power to the pump and controller If a patient disconnects their de-vice completely from power the pump will stop and the patient will have an abrupt stoppage of cardiac support and may respond by feeling

(WHAT IS A VAD from page 1) acutely symptomatic or even experience syncope

Managing a PatientManaging a patient with a continuous flow LVAD has unique challenges The majority of patients implanted with this type of device do not have a palpable pulse Since continuous flow VADs pump blood to the patient during both systole and diastole there is a very narrow pulse pressure between systole and diastole This nar-row pulse pressure diminishes the ability to con-sistently palpate a pulse and also makes it diffi-cult to obtain a blood pressure or pulse oximetry On physical assessment it may be difficult to auscultate heart sounds over the ldquohumrdquo of the device but the rest of a physical assessment for a VAD patient is no different than for any other patient

While patients are supported by a VAD there are certain instructions they should follow daily including taking all medications that are pre-scribed Regardless of the device used patients will almost always be prescribed anti-platelet and anti-coagulation medications (for example aspi-rin and warfarin) These medications are impor-tant because they keep the blood from clotting as

(continued on next page)

HeartMate II (Thoratec Corporation Pleasanton CA) Reprinted with the permission of Thoratec Corporation

4

it flows through the device Patients are also taught to check their weight daily to obtain blood pressure if possible and to document the VAD parameters The VAD provides the patient with parameters specific to the device For example with the HeartWare device the controller displays pump flow in Litersmin speed in RPMs and power consumption in watts Documenting these things will help the implanting center identify trends that enable better patient management The patient also needs to care for the driveline site as it exits the abdomen and connects the pump to the controller and power sources The care requires a sterile dressing change The frequency of the dressing change may be different de-pending on hospital protocol but usually ranges from daily to weekly

Risks and BenefitsAs is true with all medical devices and procedures there are certain risks and benefits associated with receiving a VAD Most patients when faced with the option of receiving a VAD have New York Heart Association (NYHA) class IV heart fail-ure This means they are ldquofrequent flyersrdquo in the hospital and symptomatic at rest from heart failure Their degree of illness

(WHAT IS A VAD from previous page) not only contributes to the risk of complications that occur during the surgical implant itself but also can affect the lon-ger term recovery for the patient The surgical implant usu-ally requires a full sternotomy and being placed on cardio-pulmonary bypass The recovery from implant can take days to weeks depending on the patient

After initial recovery the patient still faces risks associated with ongoing support of the device The most common risks are infection stroke and bleeding The most common site of infection is around the driveline exit site because it is considered an open wound6 10 However despite the risks associated with support there are significant benefits of this life-saving therapy Most if not all patients improve their symptoms and return to a NYHA classification I or II This enables patients to return to a near normal life and to resume many daily activities Patientsrsquo ability to walk further and for longer distances also improves and they report significant improvements in their quality of life 3 11

In summary ventricular assist devices are life-saving devices implanted in patients with advanced heart failure to help them circulate oxygenated blood to the body VADs have grown in acceptance and adoption over the past several de-cades concurrent with advances and improvements in the technology While the therapy is not without risks it is an excellent option for many patients and has demonstrated a reduction in symptom burden and an increase in quality of life For more information on VADs please visit mylvadcom

HeartWare Ventricular Assist System (HeartWare Inc Framingham MA) Reprinted with the permission of HeartWare Inc

5

NASN 45th

Annual Conference Orlando Florida

to be at Walt Disney World

June 27-30 2013

1 Slaughter MS Pagani FD Rogers JG Miller LW Sun B Russell SD Starling RC Chen L Boyle AJ Chillcott S Adamson RM Blood MS Camacho MT Idrissi KA Petty M Sobieski M Wright S Myers TJ Farrar DJ Clinical management of con-tinuous-flow left ventricular assist devices in advanced heart failure The Journal of Heart and Lung Transplantation 201029S1-S39

2 Pennington DG McBride LR Peigh PS Miller LW Swartz MT Eight yearsrsquo ex-perience with bridging to cardiac transplantation J Thorac Cardiovasc Surg 1994107472-481

3 Aaronson KD Slaughter MS Miller LW McGee EC Cotts WG Acker MA Jessup ML Gregoric ID Loyalka P Frazier OH Jeevanandam V Anderson AS Kormos RL Teuteberg JJ Levy WC Naftel DC Bittman RM Pagani FD Hathaway DR Boyce SW Use of an intrapericardial continuous flow centrifugal pump in patients awaiting heart transplantation Circulation 20121253191-3200

4 Miller LW Pagani FD Russell SD John R Boyle AJ Aaronson KD Conte JV Naka Y Mancini D Delgado RM MacGillivray TE Farrar DJ Frazier OH Use of a con-tinuous-flow device in patients awaiting heart transplantation New England Journal of Medicine 2007357885-896

5 Hunt SA Ea R The rematch trial Long-term use of a left ventricular assist device for end-stage heart failure Journal of Cardiac Failure 2002859-60

6 Schaffer JM Allen JG Weiss ES Arnaoutakis GJ Patel ND Russell SD Shah AS Conte JV Infectious complications after pulsatile-flow and continuous-flow left ventricular assist device implantation The Journal of Heart and Lung Transplantation 201130164-174

7 Park SJ Milano CA Tatooles AJ Rogers JG Adamson RM Steidley DE Ewald GA Sundareswaran KS Farrar DJ Slaughter MS Investigators ftHIC Outcomes in advanced heart failure patients with left ventricular assist devices for destination therapy Circulation Heart Failure 20125241-248

8 Frazier OH Delgado RM 3rd Kar B Patel V Gregoric ID Myers TJ First clinical use of the redesigned heartmate ii left ventricular assist system in the united states A case report Texas Heart Institute journal from the Texas Heart Institute of St Lukersquos Episcopal Hospital Texas Childrenrsquos Hospital 200431157-159

9 LaRose JA Tamez D Ashenuga M Reyes C Design concepts and principle of op-eration of the heartware ventricular assist system ASAIO Journal 201056285-289 2101097MAT1090b1013e3181dfbab1095

10 Holman WL Pamboukian SV McGiffin DC Tallaj JA Cadeiras M Kirklin JK Device related infections Are we making progress Journal of Cardiac Surgery 201025478-483

11 Rogers JG Aaronson KD Boyle AJ Russell SD Milano CA Pagani FD Edwards BS Park S John R Conte JV Farrar DJ Slaughter MS for the HeartMate II Inves-tigators Continuous flow left ventricular assist device improves functional capacity and quality of life of advanced heart failure patients J Am Coll Car-diol 2010551826-1834

(WHAT IS A VAD from previous page) Find Us on

FacebookMSNO is now on Facebook

Go to FacebookcomMSNOpage or just click the link at the page bottom here

There are many postings and links to resources on our page

You can post on the wall and join those who LIKE us Call it online networking

Camp Romaca an all girls sleep away camp located in Hinsdale MA is seeking a seasoned RN for their summer program The camp population consists of approximately 250 girls ages 7-15 years old For more information contact Ellen Stacom Well-ness RN in charge of recruiting Ellen can be reached at (203) 858-3508 or emstacomgmailcom You can visit Camp Romacarsquos website at httpwwwromacacomf

Camp Nursing

Opportunity

6

And the Beat Goes OnMessage from the Outgoing PresidentBy Pamela Rivers

It has been a pleasure and a privilege to have held the MSNO Presidency role for the last two years I feel very fortunate to have had this amazing opportunity to learn grow net-work build relationships and advance school nursingschool health advocacy

MSNOrsquos growth despite some challeng-es would not have been achieved with-out the supportive board their trust in me as a leader and their willingness as board members to work collaboratively

MSNOrsquos mission has been furthered over the last two years through the de-velopment of vision working groups The vision working groups included 6 Communication 6 Membership 6 Advocacy 6 Leadership development 6 Organizational developmentMonthly board meetings were designed to allow sharing of ideas provide men-toring value forward thinking and en-suring all membersrsquo voices

Membersrsquo voices were obtained through sur-vey tools and welcomed suggestions As a result MSNO has updated its website grown in membership offered innovative confer-ences remained current in its practices and as a professional organization

During the last two years I have also had the true fortune of getting to know and work with our next MSNO president We have both worked very hard (often outside our com-fort zones) taken informed calculated risks trusted our judgments learned from history and our peers in our efforts toward innova-tion leadership and professionalism I enthu-siastically support Judith Styer as she moves forward from the President-Elect role to the Presidency role I am eager to continue the work with Judy and the MSNO board mem-bers as I transition to the Past-President role

Thank you again for your support and trust

Message from Incoming PresidentBy Judy Styer

Dear ColleaguesOn April 6 at our Spring Conference ldquoSchool Nurses A Leader in Every Schoolrdquo I was rec-ognized as the incoming President of MSNO I am pleased to serve for the next two years as your president

I have worked in school health since 1998 I provided direct school nursing services for nine years first in Weston MA In 2000 I began working for Framingham Public Schools I have been the Director of School Health Services in Framingham since 2007 The nurses I have encountered in these workplaces have been integral to my development as a school nurse a director and now President of MSNO

Massachusetts has a rich history of school nursing leadership beginning in 1905 MSNO has been the voice of school health through promotion and advocacy since 1970 Strong school nurse leaders in MSNO and from the Massachusetts Department of Public Health School Health Unit and the Northeastern School Health Institute have been vital to the development of our nursing specialty as we know it today

During this past year MSNOrsquos focus has been on the development of leadership capacity in our members Our conferences have included dynamic speakers on the subject of leadership We have made changes in our organization to promote and provide leadership opportunities by updating our website changing our board meeting structure and by increasing our mem-bership

What do you think of this idea of school nurses as leaders in every school at every level As

Outgoing President Pamela Rivers (left) and incoming President Judy Styer (right)

7

your new president I ask you to think personally about your own leadership capacity and ask yourselves these questions

6 How do you see yourself 6 Do you believe that some people are leaders and others are followers 6 Do you think of yourself as a leader 6 Are you a follower 6 Do you fear the responsibility that may come with taking a leadership role 6 Do you prefer to stay on the sidelines ndash in your office 6 Are you concerned that you may fail or be judged if you step in from the sidelines

Think about this

6 We are responsible for the health safety and well-being of our students and staff 6 We work autonomously and are at times faced with life and death decisions 6 We know what the pieces are of the puzzle of our studentsrsquo health and growth and achievement

If these realities and the many others that inform our practice as school nurses do not inherently make us leaders I donrsquot know what does

I challenge you to in the coming year step in from the sidelines No one listens to the person on the side of the room And we have a lot to say

6 Make connections 6 Become an integral member of your school teams 6 Continue to develop your expertise and share it with your administrators teachers school communities and your professional organization 6 Market your success 6 Seize every opportunity to lead 6 Donrsquot be invisible 6 Step in from the sidelines

MSNO is a growing dynamic organization of over 900 members Join us Become active with us We can use your knowledge your skills your energy and your commitment to supporting our students to achieve their highest potential Take this and every opportunity to lead and advance our organization and school nursing in Massachu-setts Imagine the difference that we as 900+ leaders in MSNO can bring about together

Editorrsquos Note Carilyn Rains RN BSN MEd will assume the position of President-Elect vacated by Judyrsquos ascendance to President Currently Carilyn is Co-Chair for Region V

(INCOMING PRESIDENT from previous page)

The Master of Education in School Nurse Education does not off er state certifi cation A student must be a licensed reg-istered nurse prior to joining the Cambridge College program The student must have a BABS Cambridge College is accredited by the New England Association of Schools and Colleges (NEASC) Applicants are responsible for reading the academic catalog and getting all the information needed to make informed decisions

SchoolNurse

Master of Education ProgramContact us now to learn more

designed specifi cally for the unique demands faced by school nurses

intensive summer residency in Boston followed by distance learning

wwwcambridgecollegeedunite8008774723 x 1107

C L I C K A B L E A D V E R T I S E M E N T

wwwBMCHPorg

David VillanovaBoston

617-748-6039

Brenda ViveirosNew Bedford

508-990-2435

COMMUNITY OUTREACH SUPERVISORS

Contact BMC HealthNet Plan at 800-792-4355 or on the Web For all your MassHealth health plan options call 800-841-2900 (TTY 800-497-4648) M ndash F 8amndash 5 pm For all your Commonwealth Care health plan options visit mahealthconnectororg or call 877-623-6765 (TTY 877-623-7773) M-F 8 am-5 pm

8

communicate various health and wellness topics to school families and the community through the school nurse website she encourages them to report their school health concerns to their legislators Her nurses report that Judy inspires them daily

Judy promotes school health in various arenas She works closely with the school administration to be prepared for any possible health problem She is the chairperson of the Community Coalition where for example work has focused on substance abuse prevention mock accident and other health pro-grams outside of school hours She will pull together people from all areas of the school staff and town departments to plan health and wellness programs Judy is a mem-ber of the MSNO board working as a regional chairperson as the Vice President of Programs (plan-ning this conference) and as the Conference Vender Chairperson Judy was a founding member of MASRN (MA School Nurse Re-search Network) and has served on the oversight board She pre-sented research at both the 2009 and 2010 National Conferences

Last year Outlook was not published at the end of the year As a result MSNO failed to recognize the School Nurse Administrator for 2012 To make up for this over-sight today Outlook introduces Judy Aubin School Nurse Administrator for 2012 Judy received her award and recognition at the MSNO 2012 Spring Conference Here is what Rosemary Peterson said as she introduced Judy

School Nurse Administrator of the Year ndash 2012

Today we are honoring Judy Aubin as the Massachusetts School Nurse Administrator of the Year 2012 Judy began her nursing career at Rhode Island Hospital in 1972 af-ter graduating from Faulkner Hos-pital School of Nursing She fur-thered her education with a BSN in 1980 from Salve Regina Univer-sity Soon after in 1986 Judy be-came a part-time school nurse and began the journey that brought her here today She accepted the Nurse Leader position in North Attleboro in addition to her duties in an el-ementary school in 1993 In 2000 she became the full-time Nurse Leader Judy continued her edu-cation with a Masterrsquos Degree in Education from Cambridge College in 2002 her NCSN in 2004 and a Masterrsquos degree in Nursing from the University of Massachusetts in Dartmouth in 2007

Judy manages eleven nurses in nine schools While furthering her own education she has encouraged her staff to further their education At this time four have Masters De-grees and four have their national certification She is a firm believer in a full-time nurse in every school and advocates for this coverage whenever possible during these tight economic times Judy pres-ents opportunities for her nurses to

Judy Aubin School Nurse of the Year 2012

Judy collaborates with local busi-nesses such as dentists optom-etrists supermarkets and phar-macies to provide low cost services and supplies for students She has joined with the local Board of Health to plan and provide flu clinics for both the school commu-nity and the public Judy provides commentaries to the local newspa-per on health programs wellness issues and the role of the school nurse As if all this isnrsquot enough Judy passes on her knowledge in her role as a CNA (Certified Nursersquos Aide) instructor at a com-munity college

Judyrsquos supervisor Joel Antolini As-sistant Superintendent of Schools said ldquoJudy is passionate about her work as nurse leader never ac-cepting anything but the best for the students and the school com-munity she servesrdquo

Please join me in congratulatng Judy Aubin

our School Nurse Administrator of the Year 2012

9

This yearrsquos recipient of the annual William P Doran Excel-lence in School Nursing Award was presented to Barbara Singer School Nurse of the Bennett-Hemenway School in Natick The award was presented by Maureen Foley MA DPH School Health Nurse Advisor standing in for Ann Sheetz Director of School Health Services at DPH Here is what Maureen had to say

It is an honor to be here to present the Annual William P Doran Excellence in School Nursing Award The award was established in memory of Bill to honor School Nurses who ex-hibit the same qualities that he held most dear

Bill Doran was a beloved member of the School Health staff who was in charge of the Vision and Hearing Screening Pro-gram He died in 1994 Bill loved school nurses and when the award was set up in his honor criteria were chosen that he would appreciate The criteria for the award include

bull effectivenessinpromotingthehealthoftheschoolpopulation bull sensitivitytotheneedsofchildrenandtheirfamilies bull arecordofintegrityinprofessionalschoolnursingpractice bull commitmenttohighstandardand bull anabilitytocollaborateeffectivelywithcolleaguesinboththe school and the local community

The award is decided using a scoring method for each of the criteria the scores are based on review of the nomination let-ter there must be a minimum of three Needless to say there were many fine applicants making the decision very difficult We only wish we could give more than one award

School Nurse of the Year ndash 2013

The award was presented by Maureen Foley MA DPH School Health Nurse Advisor stand-ing in for Ann Sheetz Director of School Health Services at MADPH

This yearrsquos recipient of the annual William P Doran Excellence in School Nursing Award was presented to Barbara Singer School Nurse of the Bennett-Hemenway School in Natick

This yearrsquos recipient of the award is Barbara Singer School Nurse of the Bennett-Hemenway School in Natick There were many letters of support for Ms Singer and here are a few quotes from them

From her Nurse Leader Barbara operates a very busy clinic she manages the largest and busiest elementary school in the district and always has a smile and encouraging word for anyone who enters the clinic student parent staff or peer The Nurse Leader goes on to cite many of Barbararsquos accom-plishments (a) completing a Masterrsquos degree (b) bringing the Special Olympics to Natick (c) successfully writing grants including one to bring funding for a special vision and hearing machine and sharing it with the local collaborative (d) devel-oping a Kindergarten ldquoFrequently Asked Questionsrdquo for par-ents and(e) implementing the ldquoKids on the Block Programrdquo a disability awareness program for students grades 1-4 in all Natick Public schools She has also conducted research on school nurse perceptions of caring for students with disabili-ties she will be publishing the article in the Journal of School Nursing

From her principal Barbara sees the big picture when it comes to health and wellness Her comprehensive lens on student wellness combined with her drive to serve manifest in so many programs and services for our students From before school fitness programs to in-class lessons on hygiene and food allergies to starting and sustaining the Natick Special Olympics Barbrarsquos positive indelible additions can be seen throughout the Natick Public Schools

10

Another Stand-Out Massachusetts School Nurse

MSNO is pleased to announce another award recipient Roselaine C Koech RN BSN MEd school nurse at the West Roxbury Educational Complex was named Nurse of the Year in Community and Public Health Nursing by the March of Dimes of Massachusetts Roselaine is a member of MSNOrsquos Board of Directors and is the Co-Chair for Region VIII

Some of the highlights of Roselainersquos career include her work in creating the ldquoHealthy Connectionrdquo a peer-mentor-ing program that helped give immigrant students the bond that they needed while trying to adjust to a new environ-ment and a new school

In 2010 Roselaine assembled a wellness team composed of an administrator teachers and students and worked with The Alliance for a Healthier Generationrsquos Healthy Schools Program in order to improve nutrition services and physical activity for staff and students which earned National Recognition

Roselaine has made a significant impact on her students and her peers using her enthusiasm to inspire others to reach for higher goal She believes in working together around a common idea to bring positive impact

Congratulations Roselaine

(SCHOOL NURSE OD THE YEAR from previous page)

From a colleague in the high school Barbara has been my co-worker since 2002 She has become a role model for my practice as a school nurse in the Natick High School Barbara is always looking for ways to improve the health of our students in Natick She received grants for a town-wide wellness fair as well as an exercise program She is an AHA CPR and First Aid Instructor and has encouraged me to take the course and be certified She is a resource for all the Natick school nurses and also mentors nursing students from local universities

From a parent of a child with diabetes It is dif-ficult to overstate how Barbararsquos actions at the time of our childrsquos diagnosis and for several years thereafter encompassed everything we could have hoped for in a school nurse By handling the management of our childrsquos illness discreetly yet firmly she enabled him to understand that his difference is nothing to be ashamed of or embarrassed by yet it must be prioritized We are truly blessed to have a compassionate unwaveringly conscientious collaborative and experienced professional nurse such as Barbara to take care of our chil-drenrsquos health needs

And so this year the Bill Doran award goes to Barbara Singer ndash Congratulations

We also want to thank all you school nurses in Massachusetts for your wonderful care of our students ndash so thank you

Get to Know Your Board MembersThanks to the multi-talents of Barbara Doucette RN BSN member of the Board and Chair of the Educational Collaborative Schools photos of the Board members will soon be available on the website In addition to her duties as a school nurse Barbara also does photography Barbara has gra-ciously agreed to a photo session during the up-coming Board meeting in May As a reminder to all Board members please be prepared to have your picture taken sometime during the board meeting Hopefully all Board members will be present for the May meeting

Roselaine C Koech RN BSN Med (center) school nurse at the West Roxbury Educational Complex was named Nurse of the Year in Community and Public Health Nursing by the March of Dimes of Massachusetts

11

wwwpromedsoftwarecom

Corporate Office phone (800) 889-762728 Charron Avenue fax (603) 882-2165Nashua NH 03063 email salespromedsoftwarecom

Revolutionizing Electronic Health Documentation

For more information contact PSNI at 800-889-7627 or visitwwwpromedsoftwarecom

Today you are being asked to do more than ever Let our EHR software support you in this role SNAP Health Center provides complete and secure clinical management software and services for school districts of all sizes and does it better than anyone else

Evaluate your EHR How well does your documentation system work for you

Does your software

bull Automatically alert you to potential health trends and outbreaksbull Instantly report students without a Tdap vaccine if there is a case of Pertussisbull Include hundreds of professionally written care plansbull Have an integrated drug database with the latest medications side effectsbull Offer support by experienced RNs who understand your questions

SNAP Health Center is a comprehensive EHR designed with the intimate knowledge and understanding of school nurse needs Experience the difference

12

Note from the Editor at the 2013 Spring Conference Lee Ellenberg LICSW presented information on a protocol to identify students at risk for substance use-related prob-lems For those of you unable to attend the conference and hear Leersquos presentation the Protocol is reprinted be-low The following excerpts are taken from Leersquos presenta-tion and followed by the reprinted protocol

SBIRT is a low intensity low cost public health approach to iden-tifying and addressing substance use in schools It is a collabora-tion with MA DPH Through Massachusetts SBIRT Training and Technical Assistance (MASBIRT TTA) resources are available to assist with implementing SBIRT in your schoolsdistrict Imple-mentation includes screening brief interventions and referrals It provides an opportunity for health providers to take proactive measures for patients who may be engaged in risky use of sub-stances but are not currently seeking treatment and are not in need of specialty treatment SBIRT demonstrates that a rapid and simple set of procedures has the potential for impacting the pub-lic health burden of substance abuse SBIRT goals include

bull foraddictionndashreferbull forriskyusendasheducatebull forlowrisknoriskndasheducate

Through brief non-judgmental non-confrontational inter-ventions collaborative conversation that enhances motiva-tion can lead to change by resolving ambivalence about change A brief intervention may also offer the perfect op-portunity to advise and education about substance use

SBIRT Protocol for School Nurses and Other School Staff toIdentify Students at Risk for Substance Use-Related Problems

INTRODUCTION

Because school nurses and counselors are uniquely posi-tioned to influence substance use among young people it is recommended that schools allow for opportunities for appropriately trained staff to

bullscreenforsubstanceusebullprovidecounselingandbullmakereferralsasnecessarytoalladolescentsaswell as children in upper elementary grades

The adolescent Screening Brief Intervention and Referral to Treatment (SBIRT) tool focuses on early detection risk assessment grief counseling and referral intervention that can be utilized in the school setting This tool will enable school nurses and counselors to detect substance use-relat-ed problems before they start or to address them at an early

stage in adolescents

The tool is empirically based and developed through primary research It can be incorporated easily into student discussions during routine visits to the school nursersquos or school counselorrsquos office or other urgent care visits to the health office

WHY DO THIS SCREENING

The Surgeon Generalrsquos Call to Action to Prevent and Reduce Underage Drinking (2007) has reported that screening for substance use among adolescents combined with appropri-ate intervention and follow-up can help to reduce substance use-related harm during adolescence Substance use among young people is common itrsquos risky and can result in other unintended issues and problems It may result in long-lasting functional and structural changes in the brain Itrsquos a marker for other unhealthy behaviors for many young people it is the first risk behavior tried This SBIRT tool can alert school nurs-es and other school staff to students who may need attention for other risky behaviors as well

The purpose of the screening should be made clear to keep all students healthy and to provide appropriate intervention and referrals as determined necessary ndash not to get anyone in trouble As trusted healthcare providers in the school the school nurse and other school counseling staff are in the posi-tion to identify substance use related risks and problems in students and to intervene as appropriate The brevity the ease of use and the predictive strength of the SBIRT tool will assist trained school staff to identify substance use and to provide appropriate counseling and referral as necessary to prevent harm at the earliest possible stages among students

ROLE OF SCHOOL PERSONNEL IN SCREENING INTERVENTION AND REFERRAL

Student Assistance ProgramsStudent Assistance Teams

A Student Assistance Program (SAP) sometimes referred to by schools as a Student Assist Team (SAT) provides the necessary link between a schoolrsquos instructional functions and its guidance counseling and health service delivery programs A SAP is a prevention and early intervention program that has the following functions

bull identifyingandreferringstudentsbull providingongoingcasemanagementand

13

bull recommendingpolicyandprogramchangesto improve the schoolrsquos climate and education and support services

Its primary goal is early intervention Policies must be de-veloped for SAPs and should include provisions for parentguardian notification consistent with Massachusetts Gen-eral Law and FERPA regulations

Role of the School NurseThe school nurse plays a pivotal role in the screening for substance use in multiple ways

bull preventioneducationforbothindividualsandgroupsbull riskassessmentespeciallyforanyco-morbidities (overall health status)bull counseling(egmotivationalinterviewing)bull collaborationwithparentsguardiansandotherschool support team members andbull referralsasneeded(in-schooloroutsideresources)

In some cases the nurse may need to provide emergency treat-ment for substance use in the school until the emergency med-ical services arrive In addition the school nurse is a health re-sourcehealth educator working with the student and parentguardian to assist in accessing appropriate treatment programs These responsibilities are always performed in collaboration with other members of the Student Assistance Team

Role of the School Counseling and Psychological Services StaffIn some school districts a substance abuse specialist or counselor may be part of the Student Assistance Team Such specialists may be district or school employees or may provide services on a contract basis If a substance abuse specialist is available on-site he or she may perform tasks such as providing

bullfollow-uptoinitialscreeningsbullassessmentandreferralfollow-upbullonsitesubstanceabusecounselingbulldeliveryofasubstanceabusepreventioncurriculumbullconsultationtoteachersandotherappropriateschool

personnel bullcrisisinterventionandreferralasneededandbulleducationalworkshopsrelevanttosubstanceabusefor

parents and school personnel

For many schools providing intensive substance abuse counseling services may not be a possibility However re-cent research indicates that brief interventions can be ef-fective for youth with moderate substance abuse problems and such limited interventions may be more accommodat-ing to resources and training levels of school counselors

TO ESTABLISH THIS SMIRT TOOL IN YOUR SCHOOL

bull Administrativesupportincludingthatoftheschoolphysician of the use of any substance use screening tool such as the recommended SBIRT is essential to establish monitor and evaluate its proper use in the appropriate school setting

bull Aldquoteamrdquo(whichshouldincludebothschoolnursingand school counseling personnel) approach should be used to implement use of this tool and to provide ap-propriate interventions and referrals for any student identified as being at risk

bull Schoolstaffinvolvedintheuseofthisscreeningtoolmust be properly trained in its use and the guidelines carefully followed

bull Sufficientcommunityresourcesforfollow-upservicesshould be established prior to the use of any screening tool in the screening Without the necessary resources available consideration should be given to conducting such screens

bull Parentsshouldbeinformedutilizingtheusualmeth-ods of communication that the use of this screening tool is part of all routine school nursing interventions for students Students are not ldquopre-selectedrdquo or identi-fied for this screening

bull The school system should determine the population of stu-dents to be screened it may be that all 8th grade students who utilize school nursing services prior to a specific school social event are screened perhaps all junior or senior stu-dents will be screened pre-prom or graduation events

bull Additionalindicatorsforstudentswhoshouldbein-cluded in this screening should be predetermined ie sleeping in class tardiness absenteeism etc

bull Adefiniteperiodoftimewhenthesescreeningswillbeconducted should be pre-determined

bull Aprotocolforfollow-upandin-schoolreferralforthose students who are identified at risk should be es-tablished These students must be monitored with a follow-up within two weeks

bull Itmaybeappropriatetoscheduleaconvenienttimefor the student to return to the health office for follow-up This should be at a time when other student visits to the office will not interfere with the follow-up

bull Ifastudentdoesnotreturnforfollow-upasindicatedor refuses further follow-up it may be necessary to in-form the studentrsquos parents or guardians so an appropri-ate referral can be made

bull It should be determined how and when breaking confiden-tiality will occur in order to facilitate a referral or additional treatment beyond the school systems resources for students

14

who are re-screened at follow-up and may be escalating in the use of substances or other risky behaviors

ADDITIONAL CONSIDERATIONS

PLEASE NOTE THE PURPOSE OF THE SBIRT TOOL SHOULD BE MADE CLEAR TO KEEP ALL STUDENTS HEALTHY AND TO PROVIDE APPROPRIATE PREVENTION INTERVENTION AND REFERRALS AS DETERMINED NECESSARY ndash NOT TO GET ANYONE IN TROUBLE

bullScreeningsmustbedoneinprivacyandresultskeptconfidential

bullSufficienttimeshouldbeallottedforthescreeningtooccur

bullTheschoolsystemrsquosconfidentialitypolicyshouldbereviewed with all students parents and guardians students should understand that conversations will remain confidential unless the risk of harm to them-selves or others is a concern

bullItshouldbeexplainedtostudentsparentsandguard-ians that you are not singling out or screening selected students but that all students in a selected population will be screened

bullScreeningallstudentsndashnotjustselectedstudentsndashshows them that you care about their health and are concerned about the risks they may be taking Dis-cussing these concerns with every student who is en-countered in the school nursersquos office helps make sure that no one falls through the cracks and that those who are not using are encouraged in the smart and healthy choices they are making

bullTheAmericanAcademyofFamilyPhysicians(AAFP)advises that ldquoa reasonable effort to encourage the stu-dent to include parents or legal guardians in all health-related decisions be maderdquo

bullIf however parent involvement would not be considered beneficial to the student the American Medical Associa-tion (AMA) advises that ldquoparent consent or notification should not be a barrier to carerdquo (AMA Policy H-60965)

bullConsiderationmustbegiventothereportofanysub-stance use-related behaviors or associated risks of sig-nificant injury as well as the presence and seriousness of any co-morbid conditions (such as depression risk of suicide poorly controlled insulin diabetes) when determining appropriateness to break confidentiality

RESOURCES

State and Federal Laws that Govern Minor Rights to Confiden-tiality of Information Shared With Health Care Providers

LawsRegulations Concerning Drug and Alcohol-Related Treatment

Under Massachusetts law (MGL c112 s12E) drug-de-pendent minors may consent to medical treatment related to their drug dependency The law states

ldquoA minor twelve years of age or older who is found to be drug dependent by two or more physicians may give his consent to the furnishing of hospital and medical care related to the diagnosis or treatment of such drug dependency Such consent shall not be subject to disaffirmance because of minority The consent of the parent or legal guardian of such minor shall not be necessary to authorize hospital and medical care related to such drug depen-dency and not withstanding an provision of section 54 of chapter 123 to the contrary such parent or legal guardian shall not be li-able for the payment of any care rendered pursuant to this action Records shall be kept of such care The provisions of this section shall not apply to methadone maintenance therapyrdquo

In instances such as drug overdose MGL c112 s12F which governs emergency treatment of minors also ap-plies Section 12F states

ldquoNo physician dentist or hospital shall be held liable for dam-ages for failure to obtain consent of parent legal guardian or other person having custody or control of a minor child or of the spouse of a patient to emergency examination and treatment including blood transfusions when delay in treatment will endan-ger the life limb or mental well-being of the patientrdquo

It is important to note that under MGLc111B s10 the consent of the minor and a parent may not be needed for some substance treatment programs

Federal medical privacy rules under the Health Insurance Portability and Accountability Act (HIPAA) allow adoles-cent health care providers to ldquohonor their ethical obliga-tions to maintain confidentiality consistent with other lawsrdquo For example HIPAA only allows parents to have access to the medical records of a minor child if that access does not conflict with a state or other confidentiality law

Additionally federally funded treatment centers are subject to the Code of Federal Regulations (42CFR Part 2) which protect the confidentiality of records on and drug use of minor patients These records cannot be shared with any-one ndash including a parent or legal guardian ndash without writ-ten consent of the minor patient

Confidentiality of Student Health InformationSchool health records are temporary records governed by the Massachusetts Department of Educationrsquos record regulations Student Records 603 CMR 2300 Maintaining and accessing school health records must also adhere to the federal Family Educational Rights and Privacy Act of 1974 (FERPA) In addi-tion certain transactions may have Health Insurance Portabil-ity and Accountability Act (HIPAA) implications

15

Not all health information belongs in the student health record While it is appropriate practice for a nurse or other health professional to document observable facts with re-spect to a health condition health needs treatment plan and the care provided some information is not sufficiently related to the educational progress of a student to be ap-propriate for documentation in the student record In ad-dition health professionals may have an ethical and legal duty to protect certain medical information which they possess Placement of medical information in the school record where persons other than the school nurse may see it may violate this duty

Given these statutes concerning confidentiality it is recom-mended that information of the types covered by the statutes (and other sensitive material) be placed in a nursersquos personal files and regarded as confidential According to Department of Elementary and Secondary Education regulations 603 CMR 2304 information maintained in the personal files of a school

employee is not accessible to or revealed to school personnel or third parties is not considered part of the school record Such information may be shared with the student parent or a temporary substitute of the maker of the record but otherwise should be released only with proper consent or court order Such records should be kept in a separate locked file acces-sible only to the nurse or the nursersquos substitute Federal regu-lations provide that once information in a nursersquos personal files is disclosed to a third party it must afterwards be included as part of the studentrsquos health record and will subsequently be subject to all the provision of 603 CMR 2300

Please feel free to contact Mary Ann Gapinski at DPH at marygapinskistatemaus if you would like any addi-tional information concerning this initiative in school nurse delivered behavioral health services And thank you to all school nurses who are continuing to meet the growing needs of the students they serve

It is with great sadness that we say good-bye to Susan Glenny Susan has been a member of the Board of Direc-tors for eight years where she has been a Vice President Program Chair (2008-2010) represented Region VI served as Vendor Chair and most recently has served as Constant ContactGmail Editor In all capacities Sue has performed her duties and responsibilities with the utmost profession-alism and as I imagine is her trademark with absolute or-ganization Sue will be sorely missed We wish her well in her retirement and envy her leisure time

Unfortunately Suersquos departure leaves three positions open on the Board of Directors To continue the effectiveness of the Board they should be filled hopefully by September 2013

bull Region VI Chair - It is vital that every region is represented on the Board to ensure that all members have a voice Region VI needs representation As Region VI Chair you have an op-portunity to bring your Regionrsquos voice to the table

bull Vendor Chair - Vendors support MSNO by providing much of the funding that allows the Program Chair to bring us the fabulous speakers that have graced our recent conferences focusing on leadership We want to continue Suersquos excellent work with vendors so that MSNO can continue to offer con-ference topics of interest and invite qualified and engaging speakers Using ldquoSuersquos 3-ring binderrdquo this should be an easy task to pick up where Sue leaves off

bull Gmail Chair - Managing MSNOrsquos email list is essential to the organizationrsquos ability to communicate effectively with our membership This position requires a person comfortable

with Gmail and email contact lists by importing files (CSV) from our Membership Chair Terry Grimm The Gmail Chair and other Board members contribute timely information to the MSNO President who edits approves and then submits the email to the Gmail chair to send to the membership

Individuals interested in any capacity as Region VI Repre-sentative Gmail Chair or Vendor Chair can contact Sue to discuss the roles and various responsibilities in greater detail The recent meeting schedule of every other month helps to alleviate the frequency of travel and lessen time constraints while giving members the time they need to ac-complish their tasks Even with a lighter meeting schedule the Board has made much progress over the past two years moving MSNO forward making MSNO as strong as it can be for its members Now is the time to join the Board new members with fresh ideas are always welcome

Suersquos contact information email susanpglennygmailcom Cell (978)582-6958 or in NY (518) 483-4786

In addition to the positions vacated by Suersquos departure two other positions on the MSNO Board of Directors are open MSNO Archivist and By-Laws Chair If you are interested in ei-ther of these positions contact Past President Pamela Rivers or President Judy Styer at riversmsnoorg and styermsnoorg respectively Remember ldquoAdvocacy and activism are essential for the advancement of the nursing professionrdquo - Advocate amp Author Terri Arthur MS BS RN

Saying Good-Bye

16

save the datesUpcoming Educational Opportunities

May 29 Waltham MA

Crisis Resource Management Simulation Goes to School A Nursing Approach

Hosted by Childrenrsquos HospitalFor additional information contact

Program Content

Stephanieporterchildrensharvardedu Maureenpursleychildrensharvardedu

Registration jludinaarchildrensharvardedu

[

June 27 ndash 30 Orlando FL

NASN 45th Annual ConferenceHosted by the National Association of School Nurses

For additional details see httpnasnorg

August 5 ndash 7 Hyannis MA

Summer Institute 2013Hosted by School Health Institute

For additional details see httpsneushiorgshow-programpltype=liveampid=213

[

August 21 ndash 22 location

Pediatric Health AssessmentFor School Nurses amp Healthcare Providers

Hosted by Community Education Initiative of Boston Childrenrsquos Hospital Medicine Patient Services

For additional information contact

Program ContentStephanieporterchildrensharvardedu Maureenpursleychildrensharvardedu

17

US News amp World ReportHealthDay News (92112) An online survey conducted by Northwestern Univer-sity researchers showed that 70 of children with food allergy symptoms received a physicianrsquos diagnosis but 32 did not get a screening test Minority and low-in-come children were more likely to have untreated food allergies and only 20 of children who had a diagnos-tic test had an oral food challenge which is considered the gold standard Results were reported in the Journal of Allergy and Clinical Immunologyhttphealthusnewscomhealth-newsnewsarti-cles20120921untreated-food-allergies-more-likely-in-poor-minority-kids

Los Angeles Times (tiered subscription model) Booster Shots blog (311)Neodymium-iron-boron magnets are 10 to 20 times stronger than ferrite magnets and pose a greater health risk for children if swallowed according to a study in the Canadian Medical Association Journal In the case of a 3-year-old boy who swallowed three of the rare-earth magnets the magnets eroded through the intestinal walls causing perforations that were repaired in sur-gery ldquoMultiple magnets especially when swallowed at different times can attract each other through loops of the gastrointestinal tractrdquo lead author Dr Daniel Rosenfield said

Did You Know That

httpwwwlatimescomhealthboostershotsla-heb-magnet-swallowing-2013031107794355story

Medscape Medical News (3252013) New guidelines in the journal Pediatrics say physi-cians should be aware that blood disorders can cause bruising and bleeding that may raise alarms about the possibility of abuse or neglect Comprehensive lab and physical screenings and a medical history can help distinguish illness from abuse according to the report from the American Academy of Pediatricsrsquo Section on HematologyOcology and Committee on Child Abuse and Neglect

Note additional material will require a free registration at httpsloginmedscapecomloginssogetloginurlCache=aHR0cDovL3d3dy5tZWRzY2FwZS5jb20vdmlld2FydGljbGUvNzgxMzUwampac=401

Family Practice NewsThe AHArsquos examination of a sample representing more than 33 million US adolescents showed that less than 1 had an Ideal Diet score Less than half of adoles-cents achieved an ideal score in 5 or more of the 7 car-diovascular health comoponents measured in the study None had ideal levels in all 7 categories This snapshot of cardiovascular health in todayrsquos youth bears no good news for their adult years or the future of the countryrsquos public health unless there are immediate and sweeping social and cultural changes according to the AHA httpwwwfamilypracticenewscomindexphpid=2633ampcHash=071010amptx_ttnews[tt_news]=142085

18

National Board for Certification of School Nurses

NBCSN Certification Examination and

Recertification InformationRegards to all who took the certification examination in FebruaryMarch 2013

Certification Examination dates JulyAugust 2013

Application Deadline Examination Deadline May 31 2013 July 20 to August 3 2013

Recertification dates 2013

NCSN Expiration Deadline to Submit Month Recertification Materials

February March December 15 June April 1 August May 31 2013

See National Board Certification of School Nurses website for details httpwwwnbcsncom

Candidates for the NBCSN Examination JulyAugust 2013 Study Groups

If you wish to form a study group please email the information below to me patchobanverizonnet As the NBCSN state liaison I will (with your per-mission) email this data to all who sign up so you may form your own study groups

NameSchool DistrictTownHometownEmail address

Certification

A Mark of Distinction

19

By Dorothy Keeney MSNO Historian

People visiting the Public Health Museum in Tewksbury Massachusetts will undoubtedly wonder ldquoNow who is thatrdquo when they see the large picture of Annie McKay However quickly they will be able to answer their own question by reading the inscription along side

On Monday April 1 2013 this picture of Annie McKay Massachusettsrsquo first school nurse was installed at the Pub-lic Health Museum The ceremony was officiated by Alfred DeMaria MD a member of their Board of Directors The installation coincided with National Public Health Week as school nurses play a key role in public health

Guest speakers besides Dr DeMaria included Anne Sheetz Director of School Health in Massachusetts In her remarks Anne talked enthusiastically about a cur-rent study revolving around school nurse visits and their cost effectiveness which we found very encouraging This study may be on the cusp of something big She said ldquoAnnie McKay would be proud of the work school nurses are doing todayrdquo

Dr DeMaria commented on the strong role that school nurses play in public health He said that is why school nursing was invited to be a part of the museum Katie Vozelas MSNO Treasurer represented the Massachusetts School Nurse Organization at the event Katie thanked the museum for adding school nursing to the museum Doro-thy Keeney MSNO Historian thanked the Public Health Museum for including Annie McKayrsquos picture represent-ing school nursing in their public health nurse collection adding that it is an honor to be part of the museum

Various MSNO memorabilia were rediscovered dusted

off and brought in for the occasion They included visit-ing nurse uniforms recreated for the 100th Anniversary of School Nursing in 2005 the eight foot long poster made for the 100th Anniversary event of nursing registration several of past president Judi McAuliffersquos albums of MSNOrsquos events and the citation honoring school nurses impact on education dismissal rates in 2010 from past president Mimi Stamerrsquos term Another highlight at the event was the power point presentation on the history of nursing made by Beth Thomson for the 100th Anniversary of School Nursing in 2005 This was followed by a table filled with bountiful refreshments that were enjoyed by everyone

Please visit the museum Promote school nursing Carpe Diem Have your regionrsquos next meeting there

Public Health Museum365 East St

Tewksbury Massacusetts 01876

You can contact the museum staff at (978) 851-7321 ex-tension 2606

Annie McKay in

Public Health Museum

Open Board Positions 2
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Page 2: Massachusetts School Nurse Outlook - · PDF file · 2013-05-15abdomen. She carries the pack slung over her ... Kyah’s care plan includes directions to keep ... onstrate that school