By Mitchell Krugel
Having finished greeting hundreds of students as they step off the bus this morning, school nurse Nancy Hatke walks into her office at Kiel Elementary School in Kinnelon to find an emergency roomful of need for her attention. Kyle, a second grader who is diabetic, needs to check his blood sugar this morning. Two more kids come in complaining about stomach aches, and they have to answer Hatke’s magic question: “Did you eat breakfast?” They will get some water and a nutrition bar and be ready to head back to class in a few minutes. By 9:15 a.m., two more cases of stomach aches will arise, as well as two more with headaches.
By 9:30 a.m. Hatke will have seen 11 students and by day’s end, she will treat more than 100 cases. Some will be kids with mystery coughs trying to get away from math tests. Some will need medicine administered. There might be Asthma attacks, allergic reactions to lunch and maybe even one or two who have lost a tooth during the day. Some need just to “talk.” Some students come in for vision or hearing screenings but, hopefully, nobody will be coming in after recess with a broken bone. And a teacher might need a lesson in using an EpiPen. Nobody leaves without getting proper attention and then some. An emergency room should experience such success and efficiency as what has taken place in Nancy Hatke’s room.
“We can depend on Nancy for anything,” asserts Kiel Elementary School Principal Ivonne Ciresi. “She has tremendous knowledge, she is resourceful and she is involved with every aspect of our building functions. She is part of the culture of our school.”
Hatke is not only a Certified School Nurse, who not surprisingly started her career as an ER nurse Overlook Hospital; she is a Certified Emergency Medical Technician. She has Master’s in Education. And because she showed us how the school nurse just might be the one person in the school who makes an impact from the classroom to the staff room to the lunchroom, and beyond, Nancy Hatke is the January 2014 Think Teachers Magazine Teacher of the Month.
For several months, we have been looking for a school nurse to spotlight, believing the nurse plays an integral role in the education environment at any school. We had no idea, however, of the breadth of her contributions. Hatke has put together a chart that hangs in her office for non-verbal students in special education classes to communicate how they are feeling. She reviews the school lunch menu to ensure no foods are being served that risk allergy exposure. And she is one of a few people at Kiel who knows each and every student by name.
“You want to know what nurses do: We do everything,” submits Hatke, showing her direct yet disarming way that truly makes the nurse’s office at Kiel Elementary a comfort zone. “School nurses contribute to the education of children by keeping healthy students in school and by intervening with skilled nursing for the ill/injured students so that they receive the proper treatment to regain their health and return to the classroom. You cannot teach a child who is not healthy, and you cannot keep a child healthy who is not educated.”
Not just band-aids
So the refrain comes from Hatke, making sure to dispel the stereotype of the school nurse. Actually, less than 10 percent of her calls are for band-aids, and on the particular morning when she treated 11 people during the first 30 minutes of school, only one required a band-aid. And that was for a teacher.
When Principal Ciresi describes Hatke, she uses words and phrases like: “Depend on her for anything;” “creative thinker;” “go-to person;” and “go-go-go-type person.”
“She has a strong knowledge base in many areas,” Ciresi continues. “She’s right on top of what students need and showing teachers what to expect in the classroom. And she’s like the mom. She will come into my office to ask, ‘have you eaten? Have you had your snack?’”
Hatke’s vast knowledge base prompted Ciresi to add her to the school’s Emergency Response Team. She put her creative thinking into writing a grant that earned Kiel a new Automated External Defibrillator (AED), and she recently completed a project with a nurse at another Kinnelon school to check if the district’s medical policies were in line with state law and compare them to best practices in other districts. The reports was submitted to the superintendent and brought the district schools some tools they needed to maintain proper health support.
“She’s pretty remarkable with the things she’s able to find,” Ciresi adds. “Whatever we need in school, she will go through her home and see what she can bring in.”
The warmth Hatke brings to Kiel seems to make her integral to the school’s learning environment. Students might come to her office wearing that face that cries, “My tummy hurts and want to go home to my mommy.” All teachers know that face. Hatke responds with a treatment suggestion, a little time to let it get better and, well, love, which is the fuel to her power of healing. Students trust this response. They trust her, and most go back to class feeling better.
“I teach students how to figure out what they need to do to stay healthy,” Hatke explains. “I teach students how the choices they make today can impact how they feel tomorrow.”
Like every teacher, Hatke has developed a few tricks to meet the array of challenges she faces each day. Some are as simple as her first rule of nursing to treat the mystery cough: “Never have good-tasting cough drops,” she says. Some are borne of, well, love. “I have been known to write letters to the Tooth Fairy when a child loses a tooth on the playground and cannot find it to bring it home.”
And some are shear genius like when she has to treat a nose bleed: “When students come into my office with nose bleeds, they are more scared of the blood than anything else,” Hatke begins. “I tell them, ‘don’t think about elephants’ because as soon as I do, they say they cannot think about anything but elephants.” She also has a picture of a purple elephant hanging in her office. “When they see that, they start laughing and forget about the blood coming from their nose.”
She runs through the menu of day-to-day reasons students come to the nurse, and it’s just what we expect: Cuts, scrapes, bruises and other playground injuries; stomach aches due to missing mom, dad or the dog or not liking the substitute teacher; and the mystery cough. But there’s a lot Asthma and severe allergy issues to deal with and administering all types of medication to more and more kids who seem to get it prescribed these days. Clearly, it’s not just band-aids.
“My most important job might be serving students who require and depend on skilled professional nursing care to maintain optimal health while living with a chronic illness,” Hatke submits. “The school nurse is the reason that these students can attend public school and learn with their peers.”
More than a nurse
Get the feeling that Hatke can be rather direct about the importance of the school to education? Early in her school nursing career that is now at 20 years, Hatke was sitting in the staff room during lunch time when a colleague happened to blurt out that, “I was not a teacher. I was only a nurse,” she recalled.
Only a nurse?
After getting her Bachelor of Science in Nursing with a minor in Bio-Chemistry from Trenton State College (now The College of New Jersey), she started as an ER nurse before moving into public health and working for the Visiting Nurses Association of Morris County and later the Rockaway Township Health Department. During that time, she conducted state-mandated health screenings and found that students were her calling. So in 1993, she earned her School Nurse Certification from Caldwell College and in 2004 she became a teacher by completing her Master’s in Education at Seton Hall.
“A school nurse is a teacher,” she underscored. “She is teaching students (and adults) all day, every day. This teaching can be direct: This is how you wash your hands; or more subtle – modeling good health habits and guiding others to make good choices.”
Few teachers would challenge that there are some contributions to the school only the nurse can make. Hatke takes that to the 10th power. Perhaps it’s the residual of her days in the ER where nurses are required to move…stat. So she constantly looks for ways to impact students. This past year that led to dealing with the growing childhood obesity problem by advocating for “no food birthday celebrations.” Students no longer bring in cupcakes or other snacks on their birthdays. That’s eliminating 20 snacks times 20 birthdays in a class during a given year: do the math about the amount of calories cut. Instead, once a month students who have a birthday that month eat lunch with the principal and pick out a book to donate to their classroom library.
Clearly, Nancy Hatke is the type of professional a school wants in the nurse’s office, the kind a successful education environment needs in the nurse’s office.
Compassion, no doubt, drives her approach.
“I love that I can have a student come to me crying, and 10 minutes later have her skipping back to class,” she notes.
And protection, no doubt, is the outcome of her approach.
“I am first and foremost an advocate for my students’ health needs,” she reiterates. “I will not give medication in school to a student without doctor’s orders ‘just this once,’ as some parents have requested, or do anything that might harm a child physically or emotionally. Everything I do as a nurse has a scientific and logical reason behind it.”
Clearly, not just band-aids.