January 17, 2025 • 28 mins
We meet District Nurse Sarah Barrett and about all of the worries and responsibilities modern school nursing programs face. Also, since it’s peak season for respiratory viruses, we’re going to review when to keep your child home from school and when to send them in.
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Episode Transcript
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(00:00):
I can only remember going to the nurse's office once when I was in elementary school.
(00:09):
I had to have been eight years old when I slipped on some pea gravel on the sidewalk.
My hands must have been in my pockets or something because my forehead hit the sidewalk pretty
hard embedding a piece of that pea gravel deep in my forehead.
The nurse gave me a band-aid and a sprite and told me to wait for my mom.
(00:32):
There must have been tears and blood but I don't remember any of that as I sipped that
full sugar soda and waited in the quiet office.
I can still feel and hear the doctor's tweezers scratching at that pebble.
Welcome to the SMOA Podcast.
I'm Communication Coordinator Daniel Bader.
While I can't speak to the appropriateness of the treatment I got in that little office
(00:55):
all those years ago, I can tell you that we're going to hear from our district nurse, Sarah
Barrett, who's been in the district since October 2023 and all of the worries and responsibilities
that modern school nursing programs face.
Also, since it's peak season for respiratory viruses, we're going to review when to keep
(01:15):
your child home from school and when to send them in.
Grab your ice pack and a sprite if you've got one because we're going to the nurse's
office.
Sarah Barrett, welcome to the SMOA Podcast.
Hello.
Thank you for having me.
(01:36):
So tell us about yourself.
How long have you been with the district?
I have been with the district since last October.
And what brought you to South Milwaukee?
I have been at South Milwaukee because I'm kind of a local person from here.
I grew up in Oak Creek.
So I knew the community.
My grandparents grew up in Cotahoe.
So we just have always been part of that community.
(02:00):
And in my nursing background, I saw there was a position open and it was the progression
I wanted to take.
Tell me about that background.
How did you get into healthcare and why nursing?
So I decided to choose nursing when I was a junior in high school.
I originally wanted to be a child psychologist and then just wasn't the best fit for me.
(02:23):
And I've always wanted to be in the medical background.
My grandpa when I was young had a stroke and we helped take care of him in our household,
my mom and I.
So it kind of geared my mind to going towards nursing and then became a CNA while I was
in high school still just to see if I would like it and fell in love with it.
And here I am now.
(02:44):
Was Oak Creek where you went to high school?
Yeah.
And they had that certification in your junior year?
Yes.
I think I actually got it my senior year, but it's similar to what we have here at South
Milwaukee where students can get their CNA license, which I strongly recommend all students
to do just because it is a great experience and it's a good stepping stone to get anywhere
(03:05):
in healthcare just because you're getting experience with patient care.
And what happened for parents who might be interested in their children doing that, what
was your path after high school?
What did you have to do for that?
So in high school I took the CNA test and exam.
It was a semester long course I believe.
There were clinicals built into that.
(03:26):
So we went to area nursing homes and we did like practice our skills and did all of those
things.
And then once I got my CNA license, I went to school immediately afterwards.
But then I worked as a CNA in a nursing home up in Oshkosh where I went to college.
And then I came back down for summer and came back for breaks in Oak Creek.
(03:49):
So I ended up working at a local nursing home there for several years.
So it was really nice because I could do that.
And then as I progressed in my nursing education, I ended up working at a hospital in Oshkosh.
It was Aurora Oshkosh and became a CNA there.
And then tell us about your nursing career.
(04:09):
Where have you worked and what have you done?
Yeah.
I've been a nurse for about 10 years now.
I started at Aurora at St. Luke's.
I was a medical surgical nurse as well as telemetry.
I did that for about a year and a half.
I'm sorry.
What does that mean?
So medical telemetry.
So medical being you would get any kind of patient with any kind of medical diagnosis.
(04:33):
So we would have surgical cases or post-op surgical cases.
We would have cardiac patients.
So having heart attacks, congestive heart failure.
And then those patients would get to stay with us because we had telemetry, which is
essentially a monitoring of their heart.
But that was the only thing we dealt with it.
(04:54):
Medical being we dealt with pretty much anything under the sun.
So you'd have dialysis patients.
You would have even overflow patients being ortho patients.
It just kind of depended on.
Okay.
Yeah.
And then after that, what did you do?
I then spent my majority of my career at Children's in the Emergency Room.
I was there for about eight years, learned all of my nursing skills and then fell in
(05:18):
love with pediatrics, which if my mom listens to this, she's going to laugh.
She was the one when I graduated nursing school saying, you should really do pediatrics.
You'd be so good at it.
And I was like, absolutely not.
Am I going into pediatrics?
Got a job in the emergency room, fell in love with it.
So thank you, mom.
I appreciate you.
And then after eight years kind of decided that I wanted to take a step back.
(05:39):
I really enjoyed my experience there, but I needed to take a step back for my family
just because it was challenging and still wanted to work with kids.
So when I saw this position open, it was perfect because it worked with my family life, but
also allowed me to still work with the kids that I wanted to work with.
Yeah.
I know my heart breaks when my child is sick.
(06:03):
I can't imagine working day in and day out with sick kids all the time.
Yeah, it got challenging.
Like I said, I am so grateful for all that I learned and the doctors and nurses that
I worked with there.
I'm forever grateful and appreciative for them.
It was my time to take a step back.
Think back to Sarah Barrett, who graduated from Oak Creek with an idea of nursing.
(06:27):
What would you tell her now about nursing that you didn't know then?
Oh, that's such a great question.
I would say don't ever think that you can't do something.
So similar to what I said before about when my mom said you should work in pediatrics
and I was like, absolutely not.
I'm not doing that.
I would tell myself, don't ever turn down any opportunity.
(06:48):
Take any background you can and try to just get your feet wet and reposition because you
don't know what you're going to love.
You don't know what you're going to fall in love with until you find your niche.
And I would just say keep on trying to get as much experiences as you can.
Switching a little bit to this job now, what is it?
What do you do?
(07:09):
That is a big question.
So as a district nurse, there are a couple of things I do.
So my position, I tend to take care of the elementary level kids, but I still do work
with the middle school students and high school students.
With being a district nurse, it's not just sitting in a health room and passing meds,
(07:30):
doing band-aids, ice packs, the whole nine yards.
We definitely do that.
Myself and the middle school, high school nurse, Jessie, she also will cover in health
rooms where we need to, but we're also reaching out to families and making health plans for
students with chronic medical needs such as diabetes, asthma, allergic reactions, those
(07:53):
kinds of things.
So we're working with families to do that.
We do work in IEP meetings as well for kids with learning needs who also have medical
needs that we need to address within their plans.
We also help out with doing 504 plans, which are medical plans.
We, oh gosh, there's so much more.
(08:14):
For my role, I am a supervisor as well, so I do manage all six schools from a supervisor
aspect.
So training the health aides that are in every single health room, making sure their competencies
are up to date.
We are always having meetings and doing those things, trying to think of what else.
Now that I'm on the spot.
(08:35):
Sure.
Well, I can think of one thing.
When there happens to be something spreading around schools, you're also a point of contact
and tell us what students should be doing when they're not.
Maybe it could go into that one.
That's a really bad description.
You're good.
So on top of all of that, we also are monitoring trends within the community.
(08:57):
So trying to keep an idea of protestors being a big one that we've been seeing throughout
the state of Wisconsin.
So just keeping myself knowledgeable on what's going through our community, what's going
through our state.
If we are having protestors cases or any other cases, making sure we're reaching families
adequately, giving them the information they need.
Typically for specific communicable diseases, protestors is a little bit different.
(09:21):
We just notify families right away.
But for majority of communicable diseases within the classrooms, what we do is if we
have three or more cases of a communicable disease, let's say lice, for instance, if
we have three or more cases within a classroom at that point, then we would notify the classroom
where that is impacted so that families can take necessary precautions.
(09:42):
So we definitely do that.
We also are monitoring respiratory trends.
So right now with viral season being what it is, we are constantly looking at what's
going around.
So particularly right now we're seeing RSV, flu, COVID.
There is been some, it's called mycoplasma pneumonia.
It's walking pneumonia.
(10:02):
We've been seeing some of that.
And then on top of our gastrointestinal conditions like norovirus being a big one, which people
are seeing obviously in the news, pertussis.
So we kind of keep an idea of what's going around that way too.
And we maintain that knowledge.
We get updates from the state.
So there's a head nursing consultant through DPI that we get a lot of updates from.
(10:25):
So she will give us information of what is on trend right now.
What are we seeing?
I also have a lot of friends in the medical community, obviously working where I did.
So they sometimes will keep me up to date what they're seeing in the emergency room
so I can keep myself knowledgeable.
On top of just doing my own research and doing that.
On top of that, we also will respond to emergencies within the school.
(10:47):
So some schools have students that have seizure disorders.
So we will respond to those kids that have allergic reactions.
Another thing that we will respond to, making sure that we're training staff that need to
be trained on all those emergency protocols for their students to make sure that they're
staying safe.
Yeah, we do a whole lot.
(11:10):
We do CPR training with our students.
We just went through CPR training in our eighth grade science classes.
Thank you to Jim D'Angresha, who is a retired firefighter and sub that has come in and helped
us do that.
We also will do hands-only CPR for staff so that they have practice with it in the event
that we would never need to use it.
(11:30):
Well, and so it's a little scary hearing that list of things going around right now.
Generally though, how are our schools and you talked about how and when you notify,
but that idea that those things exist in Wisconsin, they are happening, it's part of cold and
(11:52):
flu season.
Where are we at?
Do you feel like there's a lot of it here?
There's a little bit?
It's average?
I was talking to the other nurse about it.
I feel like in general, we still are seeing a lot of illness and it's not just our schools.
I think it's pretty much everywhere.
I can speak even for my own children's school that there's a lot of stuff going around right
now.
(12:13):
I think because we are still not fully recovered and our immune systems are not up to where
they were pre-pandemic, we're still seeing a lot of viruses.
So right now, and it's very typical for this time of the year to have those viruses, but
I just think it seems like a little more so still because we're not quite where we need
to be at immunity wise.
(12:33):
From a school perspective, we do follow protocols for students that are sick.
So that is put out by Wisconsin DPI or the Department of Instruction.
So we follow if a student has a fever of 100.4 or higher, they would need to be sent home.
Typically, the only way that those students are allowed to return is if they are fever
(12:55):
free without the use of medication for 24 hours.
We will send students home if they have an episode of vomiting at school or three or
more episodes of diarrhea.
Similar to having a fever, they would need to be vomit free or diarrhea free for 24 hours.
For our respiratory precautions, we again, if the student has respiratory symptoms and
(13:18):
they have a fever, they have to stay home.
And we ask parents again, fever free for 24 hours without the use of medication.
And then the respiratory symptoms need to be improving.
We do strongly encourage students to wear a mask.
It's not necessarily required, but we would love for them to do it just to keep others safe.
(13:39):
And then obviously good respiratory hygiene.
So coughing into our elbows, not our hands.
If we're blowing our nose or we do cough under our hands, no big deal.
Just make sure we're washing our hands with soap and water.
Just being safe in that sense.
And then if we're in large groups and a student is sick or if they're on a family trip or
something and they're sick, similar to COVID, we just ask that we try to appropriately
(14:02):
distance ourselves appropriately.
That's a good segue about when students go home.
But I know, well, I guess the question is, how do parents decide when a student should
stay home or come to school?
Because I know we encourage all our students come to school every day.
(14:26):
We are trying to improve on attendance, but this is one instance where parents should
use their judgment.
Right.
Yep.
I would say for sure fevers are a no.
We would want to keep those kids at home because fevers typically mean that they're at their
highest point of spreading.
So we want to make sure that we're not sending those students to school because we don't
(14:47):
want to spread to other kids.
We of course want them to be here, but we also recognize that when they're having fevers,
they're sick enough where they need to be home, they need to rest, and they're not at
their best if they're not feeling great.
Similar to vomiting and diarrhea, there is a bigger risk of spreading it around just
given if we touch surfaces that a student doesn't wash their hands appropriately or
(15:10):
those similar things.
We ask them to stay home.
Again, using your judgment is the big thing.
I always say to parents, if you are uncertain or they've been sick for a prolonged period
of time, that's where their pediatricians or primary care doctors are really important
just so that we can make sure that these kids are getting seen and taken care of and making
sure that they're not spreading things around to their peers if there is something going
(15:32):
on.
That's typically what I will tell parents.
The hardest part is respiratory stuff because I think we're in a post-pandemic world where
we're trying to figure out what does that look like?
Most people aren't masking anymore.
A lot of times we used to just send kids to school when they had respiratory viruses.
COVID, that kind of flipped it all on its head and said, no, we're not coming in for
(15:56):
any respiratory viruses.
When deciding for respiratory viruses, I would say if your student is on the path of getting
better, if your student is able to appropriately manage any secretions, blow their nose and
make sure they're maintaining good respiratory etiquette of washing their hands after.
(16:16):
If you feel that your student is able to do that, then I would say absolutely let's give
it a try and just make sure we're being careful as long as they're not having a fever and
like we talked about.
Parents can also always send their kids with a mask.
If they're coming back after respiratory virus, nobody would ever be upset about that.
We'd actually look at it like, hey, you're taking the necessary precautions to keep us
(16:38):
all safe.
The respiratory part is really tricky, but I just say to parents, parents have a good
judgment of their kids.
They know their kids when they feel that they can do well in school versus not.
I would say if at all else fails, look at them and say, could they be at their best
right now?
Could they learn?
Or should I be keeping them home so they can get more rest so that I can get them back
(16:59):
the next day so they can learn effectively?
Sure.
As far as attendance and doctor's notes, what do you need to hear from a medical provider
to get that doctor's note?
Is that you?
Do you get them?
Yeah.
We work really closely with attendance too because obviously they're the first line
of who get the excuses just because they are right in the front of the office.
(17:20):
They are the ones that take all these notes.
Attendance if there is a specific condition that occurred or they were diagnosed with
something specifically, they will typically reach out to us and say, hey, this person
was diagnosed with this.
You may want to follow up with the family.
Sometimes we don't have to.
Sometimes we already know the protocol that is necessary for them.
Other times we'll follow up with the family to make sure that they were educated on when
(17:44):
the student can return.
We always ask if possible anytime a student goes to the doctor that we get an excuse just
because we want to make sure they have excused attendance.
We don't ever want to be in a position where they go to the doctor a bunch and then that
puts them into an unexcused portion, especially if they have a note.
Right.
So for folks who didn't listen to our episode titled Absent last year where we talked about
(18:10):
our absence saying, yeah, you get 10 days of unexcused absences and then you start running
in jeopardy of getting letters from school and stuff.
But medical excuses are clear.
They don't count towards those 10 because of that emphasis on keeping everybody healthy
and safe and having your student in school when they feel their best.
Absolutely.
(18:30):
How about some other things that are nebulous?
My son has had a sore throat once a week for almost a whole school year and we take him
in, they swab him for a strip.
It's not that we send him back, but he's missed half a day of school.
When should we worry about those things like sore throat?
I would say if you're just noticing a change.
(18:51):
So obviously if he has a sore throat and then all of a sudden he develops and has a fever,
that would be a reason where I would say, hey, okay, we need to get this checked out.
Specifically too, if you're noticing that your student or your child is having a fever
for, or I'm sorry, a sore throat for a prolonged time, then it might be the conversation with
the family of, hey, when you take them to the doctor, have they mentioned getting them
(19:14):
to see an ear, nose and throat specialist?
Because the hard part is a lot of families, if you don't have somebody in your house or
your household or even in your family who's medical, you don't always know what questions
to ask.
So that's another thing that we do in our roles here at the school is because we know
the health background and we know what questions to ask.
(19:34):
We can sometimes help families to get the resources they need so that they can get their
child seen.
So not along the lines of sore throat, but for instance, we had a student at one of the
elementary schools where the teacher noticed that she wasn't seeing the smart board really
well and was noticing that she would lean forward to see her Chromebook.
(19:57):
The teacher reached out and said, hey, I think that she may need a vision screening.
We reached out to mom and recommended that she go to the eye doctor and she said, well,
I don't really know where to go.
Could we just do a vision screen?
So then I went over to elementary school and very much indeed that student very clearly
needed to get seen by an eye doctor because I was concerned about her vision screening
that we performed at school.
(20:18):
So I reached out to mom.
Mom said, where do I take her and I gave her a list of places that she could go that are
local to hopefully help her.
I also told her, you could reach out to your primary doctor, but your primary doctor is
likely going to say, this is the route you go.
So that's just one example of how we can help families get the resources they need.
And sometimes primary care physicians are busy and they, yes, they remember who you
(20:43):
are, but they don't always keep track of, I've seen you this many times with a sore
throat and it kind of goes to the wayside.
So helping families know like, hey, you can reach out to us and we can try to lead you
in the right direction.
And for the instance of your son, get into an ENT.
Yeah.
Okay.
And then the other, I guess the opposite of that question is when do we send him?
(21:08):
Like, he's got a sniffle.
I'm just using him as an example.
He's got pretty good attendance, but in general, like that year after COVID, yeah, we missed
a lot because we were trying to follow the COVID protocols and it lightened up and whatever.
But when is a sniffle just a sniffle, a cold just a cold, then you should go through power
(21:30):
through it.
I will also use my son as an example.
He's my frequent respiratory child and he always has a lot of things.
So I kind of use him as my example here.
So with him, we can always kind of just, again, being a parent, you can kind of tell when
they're not their best and we just use our judgment there.
But what I do with him, because he, I mean, he coughs year round, you know, he's frequently
(21:55):
a kid that coughs and has an inhaler and all the things.
I just kind of will see in the sense of, is he doing his day to day?
Is he able to run around and play with his sister?
Is he able to complete his tasks and still focus on things at home?
Or is he kind of lagging behind and just like really struggling, you know?
(22:16):
And again, it's, it's challenging.
I get it's really hard, but it's just kind of learning how your kids look when they're
sick and I would ever say, like I would say, if you ever have a question of, oh, I don't
know how this is going to go today or they just really don't seem like they're up to
snuff, I'm of the mindset that I would rather just keep my kid home.
(22:38):
Now, granted, he can't be missing school all day long because that would not work either.
But just kind of looking at, even if you don't know medically, look at their day to day.
Are they able to play?
Are they able to eat normally?
Are they drinking normally?
And they're still functioning through all those things.
Then I would say, absolutely bring him to school.
He's you know, they're doing okay.
(22:59):
Is he, you know, just lounging on the couch?
Is he, you know, coughing a ton where he's using his belly muscles to breathe?
Is he not wanting to eat because the cough is so bad and he just wants to drink?
That to me would then say, okay, we need to stay home.
So just kind of looking at what their day to day like is like and if they're at their
baseline.
(23:20):
Sure.
And something that, you know, we were talking about cold and flu season, but it's also the
middle of winter.
When is a mental health day appropriate?
Like when if we're feeling down, if we're feeling, if they're not motivated.
I actually live in Illinois and they, they've, they put one in the schedule.
(23:41):
Like you're allowed one out of those 10 days.
One of them can be in mental health.
They need no questions asked.
The second one, they want you to talk to their therapist or the counselor or whatever.
But how about here?
I'm sure you hear that a lot.
I'm just not feeling well at all.
Yeah.
I feel like we hear it a lot more with our middle and our high school just because the
(24:02):
pressure is a little different obviously than elementary.
So I would say, you know, if you need to have a day, sure, but you have to be very self
aware of what that looks like because is it just, Oh, I'm having a rough day or have you
been having several rough days because you know, it's Wisconsin, as you said, it's winter.
(24:22):
And we all, I think suffer a little bit from having some winter blues.
It's a normal thing.
We don't see the sun a ton in Wisconsin during the winter.
So I would say if you're feeling like you're getting to a point where you're sad a lot
of the days or you're just not having interest in activity like you normally would like you
say, you know, you're a dancer and you just have no interest in doing it, but it's like
(24:44):
your passion at that point.
I would say you need to definitely touch base with either if you have an established therapist
or a lot of the primary care offices do have mental health resources built into their clinics.
Now I get that mental health is very difficult to get into because there's a lot of need
there.
So just trying to take the appropriate steps to make sure that you're taken care of because
(25:07):
we really do worry and care about students' mental health.
We understand that there's a lot of pressure that goes with being a student.
I mean, it's not easy by any stretch.
And I look at some of these kids and think I could never do what they're doing now.
So just, I guess, recognizing and making sure that you're talking to your people or talk,
(25:31):
whoever that is, whether it be your parents, your best friends, your dog, your fish, whatever
it is, but trying to recognize if you are having a hard time to reach out to the necessary
people to get the help you need.
And then how often and who should parents talk to at the school about medical sickness,
(25:54):
about their cold, about how often do you want parents communicating with you about how their
kids feel?
We have 2,800 students.
Right.
So every school has a health aid.
So you can always reach out to the health aid at the school because, I'll be honest,
the middle school, high school nurse and I, we're not always in the same building all
the time.
(26:15):
We rotate pretty regularly throughout the buildings.
So if we're not there, I would always recommend you reach out to the health aid or even if
you got in touch with the front office staff, they're all very good about getting us information.
And a lot of our health aides have a really good knowledge of all things medical.
So they oftentimes can answer a lot of the questions, but if it's something that they
(26:39):
feel they can't answer, they will always either shoot me an email or give me a call or whatever
they need to do.
And then I can then follow up with families.
I never have any problem with families reaching out to me.
I would rather you reach out than sit in limbo and be afraid to contact me.
I would rather you just reach out so I can help in any way that I can.
Well, Sarah Barrett, she's a district nurse for the school district of South Milwaukee.
(27:03):
Thank you for coming on the SMY podcast.
Thank you for having me.
Thanks for joining us on today's episode.
It's important to mention that while we have a district nurse who we really appreciate,
we also have school counselors, psychiatrists and social workers that are here to assist
students and families when it comes to mental health.
(27:25):
We appreciate all of them and the work they do and encourage you to reach out to them
if your child is struggling.
Another not so fun fact before we let you go.
Nurse Barrett is right about hand washing being the best way to stay healthy.
The Centers for Disease Control report that Neurovirus, which is making its rounds and
making people particularly miserable this year, can't be killed by hand sanitizer.
(27:50):
Let that sink in.
Remember Happy Birthday twice with lots of soap and hot water.
Thank you to Sarah Barrett for her time today and for you for being involved in your child's
school and education.
We'll see you next time.
I can only remember going to the nurse's office once when I was in elementary school.
(00:09):
I had to have been eight years old when I slipped on some pea gravel on the sidewalk.
My hands must have been in my pockets or something because my forehead hit the sidewalk pretty
hard embedding a piece of that pea gravel deep in my forehead.
The nurse gave me a band-aid and a sprite and told me to wait for my mom.
(00:32):
There must have been tears and blood but I don't remember any of that as I sipped that
full sugar soda and waited in the quiet office.
I can still feel and hear the doctor's tweezers scratching at that pebble.
Welcome to the SMOA Podcast.
I'm Communication Coordinator Daniel Bader.
While I can't speak to the appropriateness of the treatment I got in that little office
(00:55):
all those years ago, I can tell you that we're going to hear from our district nurse, Sarah
Barrett, who's been in the district since October 2023 and all of the worries and responsibilities
that modern school nursing programs face.
Also, since it's peak season for respiratory viruses, we're going to review when to keep
(01:15):
your child home from school and when to send them in.
Grab your ice pack and a sprite if you've got one because we're going to the nurse's
office.
Sarah Barrett, welcome to the SMOA Podcast.
Hello.
Thank you for having me.
(01:36):
So tell us about yourself.
How long have you been with the district?
I have been with the district since last October.
And what brought you to South Milwaukee?
I have been at South Milwaukee because I'm kind of a local person from here.
I grew up in Oak Creek.
So I knew the community.
My grandparents grew up in Cotahoe.
So we just have always been part of that community.
(02:00):
And in my nursing background, I saw there was a position open and it was the progression
I wanted to take.
Tell me about that background.
How did you get into healthcare and why nursing?
So I decided to choose nursing when I was a junior in high school.
I originally wanted to be a child psychologist and then just wasn't the best fit for me.
(02:23):
And I've always wanted to be in the medical background.
My grandpa when I was young had a stroke and we helped take care of him in our household,
my mom and I.
So it kind of geared my mind to going towards nursing and then became a CNA while I was
in high school still just to see if I would like it and fell in love with it.
And here I am now.
(02:44):
Was Oak Creek where you went to high school?
Yeah.
And they had that certification in your junior year?
Yes.
I think I actually got it my senior year, but it's similar to what we have here at South
Milwaukee where students can get their CNA license, which I strongly recommend all students
to do just because it is a great experience and it's a good stepping stone to get anywhere
(03:05):
in healthcare just because you're getting experience with patient care.
And what happened for parents who might be interested in their children doing that, what
was your path after high school?
What did you have to do for that?
So in high school I took the CNA test and exam.
It was a semester long course I believe.
There were clinicals built into that.
(03:26):
So we went to area nursing homes and we did like practice our skills and did all of those
things.
And then once I got my CNA license, I went to school immediately afterwards.
But then I worked as a CNA in a nursing home up in Oshkosh where I went to college.
And then I came back down for summer and came back for breaks in Oak Creek.
(03:49):
So I ended up working at a local nursing home there for several years.
So it was really nice because I could do that.
And then as I progressed in my nursing education, I ended up working at a hospital in Oshkosh.
It was Aurora Oshkosh and became a CNA there.
And then tell us about your nursing career.
(04:09):
Where have you worked and what have you done?
Yeah.
I've been a nurse for about 10 years now.
I started at Aurora at St. Luke's.
I was a medical surgical nurse as well as telemetry.
I did that for about a year and a half.
I'm sorry.
What does that mean?
So medical telemetry.
So medical being you would get any kind of patient with any kind of medical diagnosis.
(04:33):
So we would have surgical cases or post-op surgical cases.
We would have cardiac patients.
So having heart attacks, congestive heart failure.
And then those patients would get to stay with us because we had telemetry, which is
essentially a monitoring of their heart.
But that was the only thing we dealt with it.
(04:54):
Medical being we dealt with pretty much anything under the sun.
So you'd have dialysis patients.
You would have even overflow patients being ortho patients.
It just kind of depended on.
Okay.
Yeah.
And then after that, what did you do?
I then spent my majority of my career at Children's in the Emergency Room.
I was there for about eight years, learned all of my nursing skills and then fell in
(05:18):
love with pediatrics, which if my mom listens to this, she's going to laugh.
She was the one when I graduated nursing school saying, you should really do pediatrics.
You'd be so good at it.
And I was like, absolutely not.
Am I going into pediatrics?
Got a job in the emergency room, fell in love with it.
So thank you, mom.
I appreciate you.
And then after eight years kind of decided that I wanted to take a step back.
(05:39):
I really enjoyed my experience there, but I needed to take a step back for my family
just because it was challenging and still wanted to work with kids.
So when I saw this position open, it was perfect because it worked with my family life, but
also allowed me to still work with the kids that I wanted to work with.
Yeah.
I know my heart breaks when my child is sick.
(06:03):
I can't imagine working day in and day out with sick kids all the time.
Yeah, it got challenging.
Like I said, I am so grateful for all that I learned and the doctors and nurses that
I worked with there.
I'm forever grateful and appreciative for them.
It was my time to take a step back.
Think back to Sarah Barrett, who graduated from Oak Creek with an idea of nursing.
(06:27):
What would you tell her now about nursing that you didn't know then?
Oh, that's such a great question.
I would say don't ever think that you can't do something.
So similar to what I said before about when my mom said you should work in pediatrics
and I was like, absolutely not.
I'm not doing that.
I would tell myself, don't ever turn down any opportunity.
(06:48):
Take any background you can and try to just get your feet wet and reposition because you
don't know what you're going to love.
You don't know what you're going to fall in love with until you find your niche.
And I would just say keep on trying to get as much experiences as you can.
Switching a little bit to this job now, what is it?
What do you do?
(07:09):
That is a big question.
So as a district nurse, there are a couple of things I do.
So my position, I tend to take care of the elementary level kids, but I still do work
with the middle school students and high school students.
With being a district nurse, it's not just sitting in a health room and passing meds,
(07:30):
doing band-aids, ice packs, the whole nine yards.
We definitely do that.
Myself and the middle school, high school nurse, Jessie, she also will cover in health
rooms where we need to, but we're also reaching out to families and making health plans for
students with chronic medical needs such as diabetes, asthma, allergic reactions, those
(07:53):
kinds of things.
So we're working with families to do that.
We do work in IEP meetings as well for kids with learning needs who also have medical
needs that we need to address within their plans.
We also help out with doing 504 plans, which are medical plans.
We, oh gosh, there's so much more.
(08:14):
For my role, I am a supervisor as well, so I do manage all six schools from a supervisor
aspect.
So training the health aides that are in every single health room, making sure their competencies
are up to date.
We are always having meetings and doing those things, trying to think of what else.
Now that I'm on the spot.
(08:35):
Sure.
Well, I can think of one thing.
When there happens to be something spreading around schools, you're also a point of contact
and tell us what students should be doing when they're not.
Maybe it could go into that one.
That's a really bad description.
You're good.
So on top of all of that, we also are monitoring trends within the community.
(08:57):
So trying to keep an idea of protestors being a big one that we've been seeing throughout
the state of Wisconsin.
So just keeping myself knowledgeable on what's going through our community, what's going
through our state.
If we are having protestors cases or any other cases, making sure we're reaching families
adequately, giving them the information they need.
Typically for specific communicable diseases, protestors is a little bit different.
(09:21):
We just notify families right away.
But for majority of communicable diseases within the classrooms, what we do is if we
have three or more cases of a communicable disease, let's say lice, for instance, if
we have three or more cases within a classroom at that point, then we would notify the classroom
where that is impacted so that families can take necessary precautions.
(09:42):
So we definitely do that.
We also are monitoring respiratory trends.
So right now with viral season being what it is, we are constantly looking at what's
going around.
So particularly right now we're seeing RSV, flu, COVID.
There is been some, it's called mycoplasma pneumonia.
It's walking pneumonia.
(10:02):
We've been seeing some of that.
And then on top of our gastrointestinal conditions like norovirus being a big one, which people
are seeing obviously in the news, pertussis.
So we kind of keep an idea of what's going around that way too.
And we maintain that knowledge.
We get updates from the state.
So there's a head nursing consultant through DPI that we get a lot of updates from.
(10:25):
So she will give us information of what is on trend right now.
What are we seeing?
I also have a lot of friends in the medical community, obviously working where I did.
So they sometimes will keep me up to date what they're seeing in the emergency room
so I can keep myself knowledgeable.
On top of just doing my own research and doing that.
On top of that, we also will respond to emergencies within the school.
(10:47):
So some schools have students that have seizure disorders.
So we will respond to those kids that have allergic reactions.
Another thing that we will respond to, making sure that we're training staff that need to
be trained on all those emergency protocols for their students to make sure that they're
staying safe.
Yeah, we do a whole lot.
(11:10):
We do CPR training with our students.
We just went through CPR training in our eighth grade science classes.
Thank you to Jim D'Angresha, who is a retired firefighter and sub that has come in and helped
us do that.
We also will do hands-only CPR for staff so that they have practice with it in the event
that we would never need to use it.
(11:30):
Well, and so it's a little scary hearing that list of things going around right now.
Generally though, how are our schools and you talked about how and when you notify,
but that idea that those things exist in Wisconsin, they are happening, it's part of cold and
(11:52):
flu season.
Where are we at?
Do you feel like there's a lot of it here?
There's a little bit?
It's average?
I was talking to the other nurse about it.
I feel like in general, we still are seeing a lot of illness and it's not just our schools.
I think it's pretty much everywhere.
I can speak even for my own children's school that there's a lot of stuff going around right
now.
(12:13):
I think because we are still not fully recovered and our immune systems are not up to where
they were pre-pandemic, we're still seeing a lot of viruses.
So right now, and it's very typical for this time of the year to have those viruses, but
I just think it seems like a little more so still because we're not quite where we need
to be at immunity wise.
(12:33):
From a school perspective, we do follow protocols for students that are sick.
So that is put out by Wisconsin DPI or the Department of Instruction.
So we follow if a student has a fever of 100.4 or higher, they would need to be sent home.
Typically, the only way that those students are allowed to return is if they are fever
(12:55):
free without the use of medication for 24 hours.
We will send students home if they have an episode of vomiting at school or three or
more episodes of diarrhea.
Similar to having a fever, they would need to be vomit free or diarrhea free for 24 hours.
For our respiratory precautions, we again, if the student has respiratory symptoms and
(13:18):
they have a fever, they have to stay home.
And we ask parents again, fever free for 24 hours without the use of medication.
And then the respiratory symptoms need to be improving.
We do strongly encourage students to wear a mask.
It's not necessarily required, but we would love for them to do it just to keep others safe.
(13:39):
And then obviously good respiratory hygiene.
So coughing into our elbows, not our hands.
If we're blowing our nose or we do cough under our hands, no big deal.
Just make sure we're washing our hands with soap and water.
Just being safe in that sense.
And then if we're in large groups and a student is sick or if they're on a family trip or
something and they're sick, similar to COVID, we just ask that we try to appropriately
(14:02):
distance ourselves appropriately.
That's a good segue about when students go home.
But I know, well, I guess the question is, how do parents decide when a student should
stay home or come to school?
Because I know we encourage all our students come to school every day.
(14:26):
We are trying to improve on attendance, but this is one instance where parents should
use their judgment.
Right.
Yep.
I would say for sure fevers are a no.
We would want to keep those kids at home because fevers typically mean that they're at their
highest point of spreading.
So we want to make sure that we're not sending those students to school because we don't
(14:47):
want to spread to other kids.
We of course want them to be here, but we also recognize that when they're having fevers,
they're sick enough where they need to be home, they need to rest, and they're not at
their best if they're not feeling great.
Similar to vomiting and diarrhea, there is a bigger risk of spreading it around just
given if we touch surfaces that a student doesn't wash their hands appropriately or
(15:10):
those similar things.
We ask them to stay home.
Again, using your judgment is the big thing.
I always say to parents, if you are uncertain or they've been sick for a prolonged period
of time, that's where their pediatricians or primary care doctors are really important
just so that we can make sure that these kids are getting seen and taken care of and making
sure that they're not spreading things around to their peers if there is something going
(15:32):
on.
That's typically what I will tell parents.
The hardest part is respiratory stuff because I think we're in a post-pandemic world where
we're trying to figure out what does that look like?
Most people aren't masking anymore.
A lot of times we used to just send kids to school when they had respiratory viruses.
COVID, that kind of flipped it all on its head and said, no, we're not coming in for
(15:56):
any respiratory viruses.
When deciding for respiratory viruses, I would say if your student is on the path of getting
better, if your student is able to appropriately manage any secretions, blow their nose and
make sure they're maintaining good respiratory etiquette of washing their hands after.
(16:16):
If you feel that your student is able to do that, then I would say absolutely let's give
it a try and just make sure we're being careful as long as they're not having a fever and
like we talked about.
Parents can also always send their kids with a mask.
If they're coming back after respiratory virus, nobody would ever be upset about that.
We'd actually look at it like, hey, you're taking the necessary precautions to keep us
(16:38):
all safe.
The respiratory part is really tricky, but I just say to parents, parents have a good
judgment of their kids.
They know their kids when they feel that they can do well in school versus not.
I would say if at all else fails, look at them and say, could they be at their best
right now?
Could they learn?
Or should I be keeping them home so they can get more rest so that I can get them back
(16:59):
the next day so they can learn effectively?
Sure.
As far as attendance and doctor's notes, what do you need to hear from a medical provider
to get that doctor's note?
Is that you?
Do you get them?
Yeah.
We work really closely with attendance too because obviously they're the first line
of who get the excuses just because they are right in the front of the office.
(17:20):
They are the ones that take all these notes.
Attendance if there is a specific condition that occurred or they were diagnosed with
something specifically, they will typically reach out to us and say, hey, this person
was diagnosed with this.
You may want to follow up with the family.
Sometimes we don't have to.
Sometimes we already know the protocol that is necessary for them.
Other times we'll follow up with the family to make sure that they were educated on when
(17:44):
the student can return.
We always ask if possible anytime a student goes to the doctor that we get an excuse just
because we want to make sure they have excused attendance.
We don't ever want to be in a position where they go to the doctor a bunch and then that
puts them into an unexcused portion, especially if they have a note.
Right.
So for folks who didn't listen to our episode titled Absent last year where we talked about
(18:10):
our absence saying, yeah, you get 10 days of unexcused absences and then you start running
in jeopardy of getting letters from school and stuff.
But medical excuses are clear.
They don't count towards those 10 because of that emphasis on keeping everybody healthy
and safe and having your student in school when they feel their best.
Absolutely.
(18:30):
How about some other things that are nebulous?
My son has had a sore throat once a week for almost a whole school year and we take him
in, they swab him for a strip.
It's not that we send him back, but he's missed half a day of school.
When should we worry about those things like sore throat?
I would say if you're just noticing a change.
(18:51):
So obviously if he has a sore throat and then all of a sudden he develops and has a fever,
that would be a reason where I would say, hey, okay, we need to get this checked out.
Specifically too, if you're noticing that your student or your child is having a fever
for, or I'm sorry, a sore throat for a prolonged time, then it might be the conversation with
the family of, hey, when you take them to the doctor, have they mentioned getting them
(19:14):
to see an ear, nose and throat specialist?
Because the hard part is a lot of families, if you don't have somebody in your house or
your household or even in your family who's medical, you don't always know what questions
to ask.
So that's another thing that we do in our roles here at the school is because we know
the health background and we know what questions to ask.
(19:34):
We can sometimes help families to get the resources they need so that they can get their
child seen.
So not along the lines of sore throat, but for instance, we had a student at one of the
elementary schools where the teacher noticed that she wasn't seeing the smart board really
well and was noticing that she would lean forward to see her Chromebook.
(19:57):
The teacher reached out and said, hey, I think that she may need a vision screening.
We reached out to mom and recommended that she go to the eye doctor and she said, well,
I don't really know where to go.
Could we just do a vision screen?
So then I went over to elementary school and very much indeed that student very clearly
needed to get seen by an eye doctor because I was concerned about her vision screening
that we performed at school.
(20:18):
So I reached out to mom.
Mom said, where do I take her and I gave her a list of places that she could go that are
local to hopefully help her.
I also told her, you could reach out to your primary doctor, but your primary doctor is
likely going to say, this is the route you go.
So that's just one example of how we can help families get the resources they need.
And sometimes primary care physicians are busy and they, yes, they remember who you
(20:43):
are, but they don't always keep track of, I've seen you this many times with a sore
throat and it kind of goes to the wayside.
So helping families know like, hey, you can reach out to us and we can try to lead you
in the right direction.
And for the instance of your son, get into an ENT.
Yeah.
Okay.
And then the other, I guess the opposite of that question is when do we send him?
(21:08):
Like, he's got a sniffle.
I'm just using him as an example.
He's got pretty good attendance, but in general, like that year after COVID, yeah, we missed
a lot because we were trying to follow the COVID protocols and it lightened up and whatever.
But when is a sniffle just a sniffle, a cold just a cold, then you should go through power
(21:30):
through it.
I will also use my son as an example.
He's my frequent respiratory child and he always has a lot of things.
So I kind of use him as my example here.
So with him, we can always kind of just, again, being a parent, you can kind of tell when
they're not their best and we just use our judgment there.
But what I do with him, because he, I mean, he coughs year round, you know, he's frequently
(21:55):
a kid that coughs and has an inhaler and all the things.
I just kind of will see in the sense of, is he doing his day to day?
Is he able to run around and play with his sister?
Is he able to complete his tasks and still focus on things at home?
Or is he kind of lagging behind and just like really struggling, you know?
(22:16):
And again, it's, it's challenging.
I get it's really hard, but it's just kind of learning how your kids look when they're
sick and I would ever say, like I would say, if you ever have a question of, oh, I don't
know how this is going to go today or they just really don't seem like they're up to
snuff, I'm of the mindset that I would rather just keep my kid home.
(22:38):
Now, granted, he can't be missing school all day long because that would not work either.
But just kind of looking at, even if you don't know medically, look at their day to day.
Are they able to play?
Are they able to eat normally?
Are they drinking normally?
And they're still functioning through all those things.
Then I would say, absolutely bring him to school.
He's you know, they're doing okay.
(22:59):
Is he, you know, just lounging on the couch?
Is he, you know, coughing a ton where he's using his belly muscles to breathe?
Is he not wanting to eat because the cough is so bad and he just wants to drink?
That to me would then say, okay, we need to stay home.
So just kind of looking at what their day to day like is like and if they're at their
baseline.
(23:20):
Sure.
And something that, you know, we were talking about cold and flu season, but it's also the
middle of winter.
When is a mental health day appropriate?
Like when if we're feeling down, if we're feeling, if they're not motivated.
I actually live in Illinois and they, they've, they put one in the schedule.
(23:41):
Like you're allowed one out of those 10 days.
One of them can be in mental health.
They need no questions asked.
The second one, they want you to talk to their therapist or the counselor or whatever.
But how about here?
I'm sure you hear that a lot.
I'm just not feeling well at all.
Yeah.
I feel like we hear it a lot more with our middle and our high school just because the
(24:02):
pressure is a little different obviously than elementary.
So I would say, you know, if you need to have a day, sure, but you have to be very self
aware of what that looks like because is it just, Oh, I'm having a rough day or have you
been having several rough days because you know, it's Wisconsin, as you said, it's winter.
(24:22):
And we all, I think suffer a little bit from having some winter blues.
It's a normal thing.
We don't see the sun a ton in Wisconsin during the winter.
So I would say if you're feeling like you're getting to a point where you're sad a lot
of the days or you're just not having interest in activity like you normally would like you
say, you know, you're a dancer and you just have no interest in doing it, but it's like
(24:44):
your passion at that point.
I would say you need to definitely touch base with either if you have an established therapist
or a lot of the primary care offices do have mental health resources built into their clinics.
Now I get that mental health is very difficult to get into because there's a lot of need
there.
So just trying to take the appropriate steps to make sure that you're taken care of because
(25:07):
we really do worry and care about students' mental health.
We understand that there's a lot of pressure that goes with being a student.
I mean, it's not easy by any stretch.
And I look at some of these kids and think I could never do what they're doing now.
So just, I guess, recognizing and making sure that you're talking to your people or talk,
(25:31):
whoever that is, whether it be your parents, your best friends, your dog, your fish, whatever
it is, but trying to recognize if you are having a hard time to reach out to the necessary
people to get the help you need.
And then how often and who should parents talk to at the school about medical sickness,
(25:54):
about their cold, about how often do you want parents communicating with you about how their
kids feel?
We have 2,800 students.
Right.
So every school has a health aid.
So you can always reach out to the health aid at the school because, I'll be honest,
the middle school, high school nurse and I, we're not always in the same building all
the time.
(26:15):
We rotate pretty regularly throughout the buildings.
So if we're not there, I would always recommend you reach out to the health aid or even if
you got in touch with the front office staff, they're all very good about getting us information.
And a lot of our health aides have a really good knowledge of all things medical.
So they oftentimes can answer a lot of the questions, but if it's something that they
(26:39):
feel they can't answer, they will always either shoot me an email or give me a call or whatever
they need to do.
And then I can then follow up with families.
I never have any problem with families reaching out to me.
I would rather you reach out than sit in limbo and be afraid to contact me.
I would rather you just reach out so I can help in any way that I can.
Well, Sarah Barrett, she's a district nurse for the school district of South Milwaukee.
(27:03):
Thank you for coming on the SMY podcast.
Thank you for having me.
Thanks for joining us on today's episode.
It's important to mention that while we have a district nurse who we really appreciate,
we also have school counselors, psychiatrists and social workers that are here to assist
students and families when it comes to mental health.
(27:25):
We appreciate all of them and the work they do and encourage you to reach out to them
if your child is struggling.
Another not so fun fact before we let you go.
Nurse Barrett is right about hand washing being the best way to stay healthy.
The Centers for Disease Control report that Neurovirus, which is making its rounds and
making people particularly miserable this year, can't be killed by hand sanitizer.
(27:50):
Let that sink in.
Remember Happy Birthday twice with lots of soap and hot water.
Thank you to Sarah Barrett for her time today and for you for being involved in your child's
school and education.
We'll see you next time.
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