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StateImpact: School Nurses Aren't What They Used To Be

For a growing number of students across Florida, a visit to the school nurse isn’t what it used to be. Many schools now have clinics with doctors and specialists available during school hours. There’s evidence that what’s good for students’ health is good for their grades.
Last winter, Nicholas Boothe developed a cough. The high school junior from North Miami Beach didn’t think anything of it, until one day.

"I was in class and I couldn't barely breathe", remembered Boothe. "I thought I was choking. Its like you can’t breathe and you’re gasping for the last air."

Boothe’s teacher sent him to the school clinic. The nurse practitioner on staff saw he was in the middle of an asthma attack. While she helped stabilize him, the office staff could pull his electronic health records and insurance information while they arranged for him to go to the emergency room.

After a day stay in the hospital, Boothe came back to school and was able to get follow-up care at the campus clinic instead of having to miss school to go to a doctor’s office.

"I was taking some pills the hospital told me to take and I came here to take them", Boothe said.

There are more than 240 full-service primary care clinics located in Florida schools.

The clinics enroll students with their parents’ consent at the beginning of the year. And then when students aren’t feeling well, they can take themselves to the doctor’s office on campus. Parents don’t have to leave work unless a child is severely ill or injured. For everything else, kids are able to return to class as soon as they’re seen.

Dr. Joycelyn Lawrence is medical director for the John T MacDonald School Health Initiative—that’s the network of school-based health clinics in Miami that includes the one Boothe goes to.

Each of the clinics under Lawrence’s supervision has a telemedicine unit—kind of like a fancy Skype setup—that allows students at school to connect over the internet with a specialist at the University of Miami hospital or another school site.

If a child needs something more than primary care—a cardiologist, a dermatologist, a nutritionist—no problem.

Medical assistant Sandy Joseph is waving to a television with a camera mounted on top of it. An elementary school-aged boy waves back. This is a live video hookup. Joseph and the student are more than a mile away from eachother.

Through headphones, Joseph can hear the young man’s heartbeat as a stethoscope is held to his chest. Research shows school clinics like this cut absenteeism in half. African American boys who used school-based health clinics were three times more likely to graduate than peers who didn’t.

School immunization rates at the Miami clinic sites are much higher than state and national averages.

"We’re able to provide linkages between a child’s health care and academic wellbeing", said Lawrence.

Some of the money for the clinics comes from enrolling the students in Medicaid or subsidized insurance through Florida Kidcare.

The rest comes from grants and partnerships with hospitals and universities.

Last year the federal government awarded the Miami initiative 4 million dollars for dental and mental health services. There’s no co-pay at these clinics.

Nicholas Boothe says it’s more than a doctor’s office.

"It’s a like a family," Boothe said, "It’s like my aunts and my moms.

Boothe is a senior now. He’s on the water polo and swim team—breaststroke is his favorite. When he graduates from high school, he hopes to get a scholarship to a small college out of state. Unfortunately for him, there’s no definitive cure for senioritis.