100 years of school nurses in Seattle

For the past century, they've tended to Seattle schoolchildren's scraped knees and bloody noses, admonished countless thousands to wash their hands and occasionally just offered a shoulder to cry on.

School nurses have always had a vital role, making sure students were healthy and ready to learn. And even though their responsibilities have increased as modern medicine has evolved, the heart of the job hasn't changed.

"We no longer have to deal with outbreaks of scarlet fever or mumps, but we still have illness, chronic diseases, controversy over vaccinations," said Ballard High School nurse Meg Wakeman. "The more things change, the more things stay the same."

Seattle schools' first two nurses were hired during the 1907-08 school year, and the district has marked the centennial with a presentation to the School Board and a display of historic photographs and memorabilia at the district headquarters.

The first nurses were charged with curbing school absenteeism and stemming the spread of communicable diseases. They often made house calls to check on ill students, and occasionally would end up treating the student's family members or taking them to the hospital.

These days, the district's 65 nurses are more likely to field phone calls or e-mails from parents than make house calls. Two of the nurses are men, and all the school nurses have at least a bachelor's degree in the field. Much of their time is spent conducting state-mandated health screenings or developing emergency-care plans for students with life-threatening illnesses.

"Our job is so broad, and what people think we do is so limited," said nurse Marie DeBell, who conducts preschool health assessments and splits the rest of her time between West Woodland Elementary and John Stanford International School.

"We're the people who are looking for and trying to eliminate any barriers to education," she said.

That may mean finding eyeglasses for a nearsighted child without health insurance, connecting a troubled teen with a counselor or screening children for scoliosis, or hearing and vision problems.

At Van Asselt Elementary, where nearly half the student body is bilingual and learning to speak and read English, routine hearing screenings are crucial, said nurse Carol Chellino.

"If you can't hear, you aren't going to learn the language," she said. But if she can identify students who may have difficulty hearing, she can connect them with the district's audiologist or specialists at Children's Hospital -- before the impairment can set them back academically.

Though enrollment in Seattle Public Schools has slowly declined in recent years, more students are coming to school with chronic health problems. Cases of asthma and allergies are on the rise, and there are about twice the number of students with diabetes today as 10 years ago, said Jill Lewis, manager of the district's Student Health Services program.

The district can't afford to provide a full-time nurse at every school because of budget cuts. The city's Family and Education Levy helps supplement the cost of providing some school nurses, but inflation has meant the money doesn't go as far as it used to, Lewis said.

Nurses are usually assigned to schools based on such factors as the number of medically fragile students there, or the percentage of students from low-income families. Some schools opt to set aside money in their budgets or hold fundraisers to pay for a nurse to work extra days.

With so many responsibilities and limited time, the job can be chaotic -- especially when dealing with day-to-day sicknesses and injuries.

Wakeman recalled a particularly hectic recent afternoon: "I had a student with a finger that needed stitches and a student with appendicitis and a roomful of firefighters and paramedics," she said.

Still, most school nurses say they thrive on the fast-paced atmosphere and the interaction with students.

Nursing in the private sector is often more lucrative, but "most school nurses choose this because it's where their heart is, and where they can make a difference," Lewis said.