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All “Kidding” Aside: A School Nurse Finds Her Niche

Some nurses wear scrubs. Others wear military uniforms. But Joan Aurenrieth, RN, the school nurse at Mt. Marion Elementary School in Saugerties, N. Y., has been known to wear more unconventional work clothes, such as when she dresses up as the nurse from the Harry Potter films, or as a hippopotamus.

Although she now works with elementary school kids, Joan discovered school nursing only after 25 years in the operating room. After receiving a nursing diploma, she spent eight years at the University of California at San Francisco, where she got her hardcore O.R. experience. (“Hearts, brains, whatever was on the table, I did,” says Joan.) She then moved to upstate New York to raise a family and continue her O.R. work.

Still, Joan yearned for a true college experience. When her children were older, she returned to school for her bachelor of nursing (B.N.) degree. Says Joan: “It was the best thing I’ve ever done because it broadened my horizons. I realized there was life outside the hospital.”

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One day, a good friend—a school nurse—asked Joan if she would occasionally fill in for her. Joan’s response? “Absolutely not. No way you’re getting me into a school.” Eventually, however, Joan gave in and agreed to help—occasionally. But the more often she did, the more fun it was for her.

“Lots of the problems in the operating room are ones that you don’t really solve,” reflects Joan. “[But as a school nurse], you make decisions and do lots of problem solving.”

Joan’s been problem solving at Mt. Marion Elementary for the past eight years. Her job, she explains, is part nurse, part baby-sitter, part social worker, part psychologist, part public-health advocate, and part detective—as when she figures out the true origin of the kids’ illnesses. Sometimes it’s a physical problem, but all too often, family trauma causes kids to feel sick. “I’m good at solving mysteries,” says Joan. “I could probably have found Osama Bin Laden in six weeks.”

Her job also includes administering state-sanctioned exams, such as hearing or vision screening; dispensing medication, such as antibiotics or inhalers; monitoring diabetics; and dealing with contagious diseases, like strep throat, pink eye, and the dreaded head lice. “[Head lice is] not a serious problem,” she says, “but it’s an annoyance that makes families, teachers, and school nurses crazy.”

Joan sees the usual assortment of kids complaining of sore throats, sniffles, and the typical schoolyard injuries. Plus, she’s come to expect a crisis du jour, which sometimes involves a child with emotional problems. With no on-site social worker, it’s up to Joan to fill that role until parents can be reached.

Then there are public health issues: Foreign students may need immunizations, or there may be a potential epidemic, like SARS. “There’s a certain amount of surveillance involved,” says Joan, “because I’m responsible for noticing trends. What if a number of kids have high fevers? I have to be current with the CDC Web site.”

She keeps a photo of herself in her O.R. scrubs on her desk to show the kids what her nursing life was like before coming to their school. “The O.R. is like your first love,” says Joan, nostalgically. “I think about it now and then, but without dwelling on it—although sometimes I get the urge to go someplace and line up instruments.”

How has school nursing changed Joan’s life? “It’s really nice to wake up in the morning and come to a job you really like,” she says. “Kids are incredible; they just love you. You can be in a miserable mood but when you walk by a group of kindergarteners, everything changes.” Perhaps most importantly, she adds, “Every day I truly make a difference.” And there are notes of gratitude all over her office that prove it.