The second-grader, covering one eye, rattled off a series of letters. School Nurse Germaine Robinett gestured at a row halfway down an eye chart.

“Can you see these?” she asked. “Or are they getting too tiny?” The boy read aloud the letters. “Good job,” said Robinett.

Robinett, who has worked for the district for 10 years, is one of 20 nurses in Vancouver Public Schools. Vision screenings are part of a day’s work. However, she and her peers say that for them every day is atypical.

The demands of these professionals, who are licensed as registered nurses and certificated by the state, have changed over the years. Today’s school nursing extends well beyond treating scraped knees and dispensing hot water bottles.

Complex health care needs

Valerie Hunt, nurse, Fort Vancouver High School

Meet School Nurse Valerie Hunt.

The school nursing profession has adapted to meet contemporary challenges, according to Fae Jackson, a 28-year VPS veteran. Compared to when many students’ parents were in school, “the health care needs of our students are so much more complex,” Jackson says. This includes increased developmental health issues and authorizations to administer almost 1,300 medications across the district.

Nurses are instrumental in working with parents and medical providers to create and manage students’ health plans—more than 1,600 district-wide. “Students aren’t with us most of the day. They’re with teachers or coaches,” says Jackson. So equipping other staff members with the knowledge needed to provide appropriate accommodations also is an essential duty.

Their expertise can be critical when the stakes are high—advocating for a student with an identified seizure disorder, for example.

Using her connections and background in telemetry, Robinett has advocated for professional evaluation and treatments that, as a result, have significantly reduced the incidence of seizures.

Enabling learning

Often nurses help families navigate the health care system. That can mean guiding them on routine issues, referring families to providers, consulting with doctors, conducting home visits, ordering and picking up prescriptions and assisting families who do not have medical insurance.

In an emergency, it’s the school nurse who advises on care. When a student recently was injured in class and required transportation to the hospital, the child was accompanied by Nurse Carrie Mason, who has worked for the district for 17 years.

Says Mason, “We can help those parents navigate the system and get them where they need to be, but also be there for those kids, too.”

Minnehaha Elementary second-grader Miranda Aguilar Mendoza thinks that nurses are important. “Whether you’re throwing up or you have diabetes, you’ll be healthy if the school has a nurse,” she says.

Working with school counselors and psychologists, VPS’ nurses are educators, too. They teach students how to manage their health and overcome barriers to “give them a normal day, where they’re able to learn,” says Mason. The difference between controlling one’s condition and being controlled by it also may be the difference between an education and an inability to focus on schoolwork.

Sometimes though, small gestures toward social and emotional wellness can go a long way. Says Mason, “You try to say good morning to everybody every day. You say, ‘I’m glad you’re here.’ Let them know that they are important. We want them to be at school.”

All in a day’s work. Jackson says, “No two days are ever the same. I like that.”

This and other stories originally appeared in the January 2015 issue of Inside Vancouver Public Schools.