{"id":20078,"date":"2013-09-09T10:29:31","date_gmt":"2013-09-09T14:29:31","guid":{"rendered":"http:\/\/stateimpact.npr.org\/florida\/?p=20078"},"modified":"2013-09-09T18:23:16","modified_gmt":"2013-09-09T22:23:16","slug":"school-health-clinics-are-re-imagining-the-role-of-the-school-nurse","status":"publish","type":"post","link":"https:\/\/stateimpact.npr.org\/florida\/2013\/09\/09\/school-health-clinics-are-re-imagining-the-role-of-the-school-nurse\/","title":{"rendered":"School Health Clinics Are Re-Imagining The Role Of The School Nurse"},"content":{"rendered":"

It\u2019s a Wednesday morning and the waiting room is already starting to fill up at the North Miami Beach Senior High School clinic.<\/p>\n

\"The<\/a>

Sammy Mack \/ StateImpact Florida<\/p>

The school-based health clinic at North Miami Beach Senior High School is a full-service clinic.<\/p><\/div>\n

A 16-year-old girl with an enormous red bow pinned above her ear approaches the appointment window. A beveled glass pane slides open. The woman behind the desk doesn\u2019t ask for insurance information — she asks to see a hall pass.<\/p>\n

\u201cGo ahead and have a seat.\u201d<\/p>\n

Red Bow takes her place in a waiting room chair next to classmates who, between hushed exchanges of gossip, occasionally erupt in giggles.<\/p>\n

This school clinic at North Miami Beach is part of the Dr. John T. Macdonald Foundation School Health Initiative<\/a>\u2014a network of school-based health clinics in Miami, operated by the University of Miami M Miller School of Medicine. Connected to larger teaching hospitals and an array of specialists by electronic health records and telemedicine, clinics like this are re-imagining the role of the school nurse. And there\u2019s evidence that what\u2019s good for students\u2019 health is good for their grades.<\/p>\n\nhttps:\/\/stateimpact.npr.org\/florida\/files\/2013\/09\/SchoolHealth_web.mp3<\/a><\/audio>\n

<\/b>An Alternative<\/strong><\/h4>\n

\u201cMore and more, there will probably be a push for more school health programs\u2014we\u2019re an alternative,\u201d says Dr. Dr. Joycelyn Lawrence, medical director for the School Health Initiative clinics. \u201cWe\u2019re able to provide linkages between a child\u2019s health care, but also their academic well-being as well.\u201d<\/p>\n

According to the National Assembly on School-Based Heath Care, there are currently 242 full-service primary care clinics located in Florida schools\u2014twice as many as there were 10 years ago.<\/p>\n

The clinics enroll students with their parents\u2019 consent at the beginning of the year. And then when students aren\u2019t feeling well, they can take themselves to the doctor\u2019s office on campus. Parents don\u2019t 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\u2019re seen.<\/p>\n

\"Dr.<\/a>

Sammy Mack \/ StateImpact Florida<\/p>

Dr. Joycelyn Lawrence and Dr. Arthur Fournier are part of the Dr. John T. MacDonald School Health Initiative in Miami.<\/p><\/div>\n

As a result, research shows school-based health clinics can cut absenteeism in half. In one study of high-risk students, African American boys who used school-based health clinics were three times more likely to graduate than peers who didn\u2019t. School immunization rates at the Miami clinic sites are much higher than state and national averages.<\/p>\n

A Model For Other Places
\n<\/strong><\/h4>\n

Each of the clinics under Lawrence\u2019s supervision has a telemedicine unit\u2014kind of like a fancy Skype setup\u2014that allows students at school to connect on streaming video with a specialist at the University of Miami hospital or another site. If a student needs something more than primary care\u2014a cardiologist, mental health counseling, a nutritionist\u2014a consult can be arranged without ever having to take the child out of school.<\/p>\n

The School Health Initiative also employs community health workers who act as community liaisons and help enroll students in Medicaid or subsidized insurance through Florida KidCare\u2014some of which helps cover the cost of the clinics. The rest of the funding comes from grants and partnerships with hospitals and universities.<\/p>\n

In 2012, the School Health Initiative was granted a $4 million Health Care Innovation Award from the Centers for Medicare and Medicaid Services to develop oral and mental health care.<\/p>\n

\u201cThis model is great for inner cities, but it also could work for underserved communities in Nebraska, Oregon, Alaska,\u201d says Dr. Arthur Fournier, who helped develop the School Health Initiative and recently retired as the associate dean of community health at the University of Miami Miller School of Medicine.<\/p>\n

Fournier even borrowed some of the practices developed at the Miami school clinics and exported them to a health care partnership in Haiti. \u201cWe\u2019ve now set up a school health program in Haiti where we have mobile teams of nurses lead by a nurse practitioner and community health workers who go to 17 schools,\u201d says Fournier.<\/p>\n

Like A Family
\n<\/strong><\/h4>\n
\"Nicholas<\/a>

Sammy Mack \/ StateImpact Florida<\/p>

Nicholas Boothe (left) had an asthma attack last winter and Dr. Marcia Dodo (right) helped stabilize him at the North Miami Beach Senior High clinic.<\/p><\/div>\n

\u201cIt\u2019s a like a family, it\u2019s like my aunts and my moms,\u201d says North Miami Beach senior Nicholas Boothe.<\/p>\n

Last winter Boothe developed a cough that gradually worsened until one day, in the middle of a class, he had trouble breathing\u2014\u201cgasping for the last air,\u201d he says. His teacher sent him to the clinic and Dr. Marcia Dodo, the nurse practitioner on staff, saw Boothe was having an asthma attack. She helped stabilized him while the clinic arranged for him to go to the emergency room.<\/p>\n

After a day stay in the hospital, Boothe came back to school and was able to get follow-up care at the campus clinic. He didn\u2019t have to choose between going to school or going to the doctor\u2019s office.<\/p>\n

Boothe is doing better now. He\u2019s on the water polo and swim team\u2014breaststroke is his favorite. When he graduates from high school, he hopes to get a scholarship to a small college out of state.<\/p>\n

\u201cI like school, but I\u2019d really like to get out,\u201d says Boothe. \u201cI\u2019m glad it\u2019s my senior year.\u201d<\/p>\n

Unfortunately for him, there\u2019s no definitive cure for senioritis.<\/p>\n","protected":false},"excerpt":{"rendered":"

It\u2019s a Wednesday morning and the waiting room is already starting to fill up at the North Miami Beach Senior High School clinic. A 16-year-old girl with an enormous red bow pinned above her ear approaches the appointment window. A beveled glass pane slides open. The woman behind the desk doesn\u2019t ask for insurance information […]<\/p>\n","protected":false},"author":147,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[15],"tags":[433,867,866],"acf":[],"_links":{"self":[{"href":"https:\/\/stateimpact.npr.org\/florida\/wp-json\/wp\/v2\/posts\/20078"}],"collection":[{"href":"https:\/\/stateimpact.npr.org\/florida\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stateimpact.npr.org\/florida\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stateimpact.npr.org\/florida\/wp-json\/wp\/v2\/users\/147"}],"replies":[{"embeddable":true,"href":"https:\/\/stateimpact.npr.org\/florida\/wp-json\/wp\/v2\/comments?post=20078"}],"version-history":[{"count":11,"href":"https:\/\/stateimpact.npr.org\/florida\/wp-json\/wp\/v2\/posts\/20078\/revisions"}],"predecessor-version":[{"id":20094,"href":"https:\/\/stateimpact.npr.org\/florida\/wp-json\/wp\/v2\/posts\/20078\/revisions\/20094"}],"wp:attachment":[{"href":"https:\/\/stateimpact.npr.org\/florida\/wp-json\/wp\/v2\/media?parent=20078"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stateimpact.npr.org\/florida\/wp-json\/wp\/v2\/categories?post=20078"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stateimpact.npr.org\/florida\/wp-json\/wp\/v2\/tags?post=20078"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}