Narrative Report on School Nursing (Spring Hills Elementary School)

Submitted by: BSN II-2b

Cacho, Abigael

Carasi, Jerome

Concepcion, Angelo

Danglose, Kyrene

De Castro, Michelle

Estaris, Mark Anthony

Gaengan , Karen

Galacgac, Jasmine

Galzote, Meilin

Submitted to:

Ms. Cristina Juan(Clinical Instructor)

I.INTRODUCTION

School nursing is a specialized practice of professional nursing that advances the well being, academic success, and life-long achievement of students. To that end, school nurses try to facilitate positive student responses to normal human development; promote health and safety in the school environment. School nursing is to assists physicians, provide first aid services, and to teach in classroom in the area.

Health assessment have four methods: Inspection, palpation, percussion and the last one is auscultation, and also, a plan of care that identifies the specific needs of the client and how those needs will be addressed by the facility, discover the sign of illness and physical defect in order to protect them, we check on the health habits of pupils and prevent progress of those which cannot be corrected.

In some schools, many of the pupils have a health deficiency like pediculosis, defective teeth , dirty teeth & finger nails which affects the students performance in the class. Students tend to be inattentive and uncomfortable in the class.

II.Activities

The concept of integrating the activities in school health necessitates the develop of policies and guidelines that should give all the school health personnel specifically school nurses whether public or private a guide in order to fulfill their roles in the provision of effective services.

Every child deserves to be as fit and as healthy as possible to gain maximum benefits from each education.

We , the student nurses of the University of the Cordilleras conducted our school nursing duty at Spring Hills Elementary School last August 12-14, 2010, under the supervision of our Clinical Instructor Mrs. Cristina G. Juan.

We were oriented by the school nurse, Mrs Agnes O. Totaan about our activity, the school and its environment.

The school Principal and the teachers in the said school was accommodating and they warmly welcomed us.

During our first day of our duty in the school, we felt so nervous because it’s our first time to be exposed in school nursing. Though we were nervous, we were able to compose ourselves and did our mission. Our activities includes, physical assessment, visual acuity, height and weight taking and BMI computation. We also conducted health teachings to all students of the said school. We rendered our services to students of Grade 1 to Grade 6 .

We distributed ourselves into five groups. Jasmin Galacgac and Angelo Concepcion is for grade I pupils, they conducted visual acuity only, while the other groups they conducted complete physical assessment.

III. Interpretation(Nutritional Status)

GRADE 1

VISUAL ACUITY

GENDER POPULATION FRQUENCY PERCENTAGE

Boy 31 31 62%

Girl 19 19 38%

TOTAL 50 50 100%

INTERPRETATION:

Table shows that all of the pupils in grade 1 passed the visual acuity test we conducted last Thursday, August 12, 2010. This is probably due to the fact that they are fed on nutritious foods like fruits & vegetables by their parents that help them in developing the vision of the students’ eyes.

GRADE 2

HEALTH DEFECTS

Health Defects

(By Percentage)

FREQUENCY PERCENTAGE1. COLDS 3 6.38%2. DEFECTIVE TEETH 36 76.59%3. PALE

CONJUNCTIVA2 4.25%

4. PEDICULOSIS 6 12.76%TOTAL: 47 TOTAL: 99.98%

The table shows that Most Grade 2 pupils has Defective teeth with a percentage of 76.59. second most common health defect is the Pediculosis that has 12.76% of the student is affected.

PERSONAL HYGIENE

FREQUENCY PERCENTAGE1. DIRTY EARS 40 39.2%2. DIRTY TEETH 38 37.3%3. LONG

FINGERNAILS24 23.5%

4. HALITOSIS 0 0%5. BODY ODOR 0 0%

TOTAL: 102 TOTAL: 100%PUPIL ASSESSED: 42 PRESENT, 3 ABSENT

- Forty two (42) grade 2 students were assessed out of forty five ( 45) students, three (3) were absent. We also figured out the three main problem of Grade 2 students are the following : dirty ears with 39.2%, dirty teeth with 37.3% and long finger nails with 23.5%.

VISUAL ACUITY

PASSED (FREQUENCY) PASSED (PERCENTAGE)LEFT 42 90.3%RIGHT 42 90.3%

TOTAL: 90.3%

- We come out with this incomplete percentage because of the three pupils that has been absent when we do our health assessment.

CHANGE TABLE SHOW BOYS AND GIRLS FREQUENCY NOT LEFT AND RIGHT

Grade III: HEALTH ASSESSMENT

Interpretation:

Table shows that the first 3 common deficiencies on the male students are: (1) dirty teeth with a percentage of 21.87%, (2) dirty ears with a percentage of 17.70%, (3) defective teeth with a percentage of 15.62%. For the girls, the 3 common deficiencies are: (1) defective teeth with a percentage of 35.93%, (2) pediculosis with a percentage of 20.13%, and (3) dirty long finger nails with a percentage of 17.18%.

VISUAL ACUITY

GENDER FREQUENCY(NO. OF STUDENTS)

PERCENTAGE(%)

MALE 20 43.47%

FEMALE 26 56.52%

TOTAL: 46 99.99%

BOYS PERCENTAGE GIRLS PERCENTAGEPEDICULOSIS 6 6.25% 13 20.13%COLDS/NASAL DISCHARGE

7 7.29% 1 1.56%

COUGH 9 9.37% 1 1.56%DEFECTIVE

TEETH15 15.62% 23 35.93%

TOOTHACHE 7 7.29% 5 7.81%HEADACHE 2 2.08% 0 0%DIRTY EARS 17 17.70% 6 9.37%

DIRTY TEETH 21 21.87% 4 6.25%DIRTY LONG FINGERNAILS

12 12.50% 11 17.18%

TOTAL 96 99.97% 64 99.97%

INTERPRETATION:

Table shows that all of the grade III students have passed the visual acuity test we conducted last Thursday, August 12, 2010. This is probably due to the foods they are taking up and their genes.

Grade 4

FOR GRADE 4 INCLUDE THE TOTAL NUMBER OF STUDENTS IN THE TABLE

Number of Students:

Boys: 22

Girls: 13

Total: 35

Boys Percentage Girls PercentagePediculosis 1 2.32% 8 8.60%Colds 0 0% 1 1.07%Deffective Teeth 0 0% 3 3.22%Dirty Ears 10 23.25% 30 32.25%Dirty Teeth 14 32.55% 19 20.43%Dirty long Fingernails

18 41.86% 32 34.40%

Total 43 99.9% 93 99.9%

Interpretation:

The table shows the 3 common deficiencies on Grade IV male students are (1): dirty long fingernails with a percentage of 41.86%, (2) dirty teeth with a percentage of 32.55%, (3) dirty ears with a percentage of 23.25%. For the girls, the 3 common deficiencies are (1) dirty long fingernails with a percentage of 34.40%, (2) dirty ears with a percentage of 32.25%, (3) dirty teeth with a percentage of 20.43%.

Grade 5 INCLUDE THE TOTAL NUMBER OF STUDENTS IN THE TABLE

Number of Students:

Boys: 13

Girls: 12

Total: 25

Boys Percentage Girls PercentagePediculosis 1 2.77% 8 20%Colds 0 0% 0 0%Defective Teeth 9 25% 11 27.5%Dirty Ears 6 16.66% 3 7.5%Dirty Teeth 10 27.77% 12 30%Dirty long Fingernails

10 27.77% 6 15%

Total 36 99.2% 40 100%

Interpretaton:

The table shows the 3 common deficiencies of the grade 5 students boys are (1) dirty teeth and dirty long fingernails with a percentage of 27.77%, (2) defective teeth with a percentage of 25%, (3) dirty ears with a percentage of 16.66%. For the girls, the 3 common deficiencies are (1) dirty teeth with a percentage of 30%, (2) defective teeth with a percentage of 27.5%, (3) pediculosis with a percentage of 20%.

Grade 6 INCLUDE THE NUMBER OF STUDENTS IN THE TABLE

Number of Students:

Boys: 11

Girls: 9

Total: 21

Boys Percentage Girls PercentagePediculosis 1 3.84% 3 12%Colds 0 0% 0 0%Defective Teeth 8 30.76% 8 32%

Dirty Ears 3 11.53% 2 8%Dirty Teeth 8 30.76% 8 32%Dirty long Fingernails

6 23.07% 3 12%

Deffective Speech 0 0% 1 4%Total 26 99.9% 25 100%

Interpretation:

The table show the 3 common deficiencies are (1) defective teeth and dirty teeth with a percentage of 30.76%, (2) dirty long fingernails with a percentage of 23.07%, (3) dirty ears with a percentage of 11.53%. For the girls, the 3 common deficiencies are (1) defective teeth and dirty teeth with a percentage of 32%, (2) dirty long fingernails and pediculosis with a percentage of 12%, (3) dirty ears with a percentage of 8%.

LEARNING INSIGHT

-CONCEPCION, JOHN ANGELO L.

August 12 – 14 is our 3 day on-the-job training in Spring Hills elementary school, Loakan-Apugan, Baguio city. When we arrive at the venue, I was scared at first and at the same time was so tense because I am not that ready I school nursing because of the fact that children are really hard to handle.

But as we go on to our job, I realized that I had learned many things during our 2nd exposure in the said elementary school. One of the many important things that a student nurse like me should learn in school nursing is to have a very long patient because we all know that kids in the elementary school thinks more of playing than studying because they do not fully understand the importance of studying. Another thing

that I have learned in the area is all about further health teachings. I’ve observed that children do not yet fully know on how to observe even a simple hygiene technique like hand washing. They need thorough study about how should they do it and what is the purpose of it. We should also discuss or illustrate to them the consequences of their actions. Third thing that I have learned is about adjusting with the environment. Environment of teens are very different from the environment of older people, and younger people like those grade schoolers in terms of communicating with them. For example, we have to be child-like so that they can relate to what we are saying. Also, in teaching them, we should avoid using words that children particularly the grade schoolers will surely not understand. Another thing that I have learned in this exposure is on how to appreciate and love those children. Which reminds me, as I step in their campus, I saw children playing, running around, they let me get back in time when I use to play and run around our school’s quadrangle together with my fellow classmates and friends.

And as a conclusion, school nursing is not that kind of hard. It’s just that you have to have more and more patience and understanding to children so that children will be able to trust you and cooperate with you. Being exposed in an elementary school during on our on-the-job training will surely reminds you of you back in your elementary days. Even though I’m with those children for a short span of time, they gave me those precious moments that I will surely treasure for the rest of my life.

-DECASTRO, MICHELLE

After our duty in Springhills Elementary School, I have learned a lot of things. One thing that I have learned is to have more patience especially to the children. As we conducted our physical assessment, the children are so naughty that they sometimes we have hard time to handle their attitude because they are more focused in playing than in studying because they are not yet matured enough to think about serious things. More than that, I have also developed my skills in assessed like how to do proper physical assessment and visual acuity. When I first entered the school seeing those children running, playing around, I saw myself when I was in my grade school time. I realized that what those children are is what I am during my younger years. And as a conclusion, school nursing is an enjoyable experience for me and I will surely treasure it forever.

Carasi, Jerome

I learned that in school nursing we need a lot of patience in dealing with them. We need to act a little childish in communicating with them. I also learned how to communicate well with the elementary students while giving health teachings.

The next time we will be going to another school to do health teaching. We will provide large visual aids because students in elementary school learn a lot when there Is a visual aid so that they will know what we are discussing. I observed that the students don’t pay attention on their hygiene although when we ask some basic hygiene technique and they know it, but they don’t do it in their everyday life. We also do health assessment to the children like getting and computing BMI and its Nutritional Status.

I also learned to be a flexible nurse in dealing the different students. I know that teaching and communicating to children is difficult to do because you don’t know what the right thing on how to deal to them. This experience will remain in me. As a student I should be patience, because in my profession patience is the most important thing to consider. In school nursing, it is the most toxic part that I’ve done, when I started the real life situation as a nurse.

Estaris, Mark

Based on our visit on the Spring hill Elementary school we do perform our health assessment to the pupils were we assign to. On our first visit we assessed for the visual acuity, getting the Body Mass Index (BMI) and also do physical assessment. Within this day me and my group mates test our patience to deal with different children with different types of personality. And on the second day of our visit. We do health teachings about proper hygiene and proper nutrition that is needed to be intake by the children. And also I figure out the methods and techniques how to teach the children. First we must get their attention by showing them a clips or pictures. Because children like grade 2 pupils are more on visual effects and they are more attentive to listen when showing some pictures. We do have enjoy our visit because of the great company by the folks on the spring hill elementary school.

Gaengan, Karen

Our first exposure as school nursing in Spring hills Elementary School gave me a set of experience in nursing field and it reminds me of being elementary student, like the way our teachers treat us in our school and on how we reacted to new things we have seen in our environment.

Being a school nurse, I learned a lot in dealing with children, I also learned to extend my patience to discipline the class and to be able to do the health assessment and the visual screening without encountering problems between us and to the pupils.

Our last day in the school, we conducted health teaching in every room but I and my one classmate assigned in grade six pupils. In conducting health teaching, it took a lot of effort to make the discussion effective but during the discussion, the pupils make me smile because they cooperated and they are attentive during the discussion although I felt nervous in front of them.

Even if we are all tired at each end of our duty, we are glad that we are successful with our task in the area and had helped the pupils on how to have a good and healthy hygiene.

Meilin Galzote

Being exposed for 2 days in an elementary school gave me many learning and develop my skills and since this is my first duty in an elementary school I felt that this children needs to remind about other important things about being healthy like proper nutrition proper hygiene and grooming regarding the attitude of the children, we knew that they are in the stage of discipline and therefore we should teach them on how to act properly , in a sense that they will perform on the right conduct.

School nursing teaches me man values that school nurse should acquire so that we can easily handle children with no hard.

Galacgac,jasmin L.

After two days of duty in Spring Hill Elementary School, I became matured how to handle my times and needs. I learned more about other techniques of assessing, especially the visual activity, about nutritious foods, those needs of child, about hygiene, drugs, pros and cons of sexual activity. I learned to be alert through my experience, also those different records and how to make it. My self confidence was developed, my skills become wider and bigger, and become open minder. My vocabulary about medical terms and diseases was improved.

I therefore experience to assess educate in reality, explore about health teaching, expose and learned about the different behaviors, attitudes, lifestyle, likes, and wants of the people/ community.

Cacho, Abigael

As we start the day with our school nursing in Springhills Elementary School,at first i felt not so excited because i was expecting that we are going to handle big numbers of students and i was surprise that they are only 221 students that we are going to assess. I felt slight nervous because its my first time to handle other kids aside from my son. When we were assessing the kids i also felt irritable because the kids were so smelly,so dirty and are sweating but as we go on i slowly felt the enjoyment handling different kind of kids. After a while i am deeply enjoying thier company because they were so funny and sweet.

When it comes to our physical assessment i observed that most of then has dirty ears,dirty teeth and long finger nails which made me feel so pity to the pupils for their parents dont have time to maintain thier good hygiene, and in my opinion kids like them needs a proper hygiene because they are more susceptible to the diseases.

As we ended our duty with them, we do health teaching to the grade 2 and grade 3 pupils, i observed that most of them knows already about proper nutrition , what is good and bad for them, and they know what is proper hygiene but if they know the proper hygiene ,why are they still have long fingernails and dirty ears? So it means that their parents has no time for their child to maintain hygiene.

And its so touching because as we said goodbye to them after we finish the health teaching the kids were run to me and said "Ate pa-kiss" and i let them kiss me to show them appreciation of thier willingness to learn.