Health Work in the Public Schools | Page 4

and in cases where treatment is important, parents are urged to consult with the school doctor concerning the nature of the difficulty and the best means of curing it. To supplement these interviews, the school nurse spends a large part of her time in visiting homes, talking with parents, noting conditions under which children live, and making suggestions as to home care.
[Illustration: Either doctor or nurse visits every school every day.]
Some idea of the complexity of this work may be gained from the Division records for 1914-1915. From the beginning of September to the end of June--a period of 38 school weeks--doctors and nurses examined 74,725 children; gave private interviews to 2,547 parents; made 5,675 visits to dispensaries; 10,603 visits to homes; and gave 76,240 treatments and dressings. In addition, they gave 775 toothbrush drills, and 19,406 individual or class health talks to the pupils of the public schools during the year.

THE SCHOOL NURSE
The value of the school nurse is one feature of medical inspection of schools about which there is no division of opinion. Her services have abundantly demonstrated their utility, and her employment has quite passed the experimental stage. The introduction of the trained nurse into the service of education has been rapid, and few school innovations have met with such widespread support and enthusiastic approval.
The reason for this is that the school nurse supplies the motive force which makes medical inspection effective. The school physician's discovery of defects and diseases is of little use if the result is only the entering of the fact on the record card or the exclusion of the child from school. The notice sent to parents telling of the child's condition and advising that the family physician be consulted, represents wasted effort if the parents fail to realize the import of the notification or if there be no family physician to consult. If the physical examination has for its only result the entering of words upon record cards, then pediculosis and tuberculosis are of precisely equal importance. The nurse avoids such ineffective lost motions by converting them into efficient functioning through assisting the physician in his examinations, personally following up the cases to insure remedial action, and educating teachers, children, and parents in practical applied hygiene.
Some idea of the work of the school nurses in Cleveland may be gained from the following record of what one nurse did during one day while the survey was in progress. It represents a typical day's work for a typical nurse and is not especially unusual.
8:30 A. M.
Home call to get permission to take child to school headquarters for mental examination.
Called at Case-Woodland School to examine child with sore throat.
Took a child home to have mother clean her up.
Called at Harmon School.
Treated 10 cases of impetigo, three of toothache, two of ringworm.
Took two children home to be cleaned up.
Inspected 50 children.
Gave health talk.
Tried to locate a boy who is to attend partial blind class at Harmon School.
Found boy was transferred from Harmon School to Marion School last year.
Called at Marion School but found no trace of boy.
Called at address to which child was supposed to have moved; no such number.
Called at Kennard School to see if Miss O'Neill remembered him at Marion School; found no trace of him.
Called at two homes in regard to enlarged tonsils and defective vision.
1:15 P. M.
Mayflower School: boy with sprained ankle, soaked in hot water, strapped with adhesive.
Treated four cases of impetigo, one cut finger, opened two boils.
Conference with mother at school.
Instructed her in case of child's discharging ear.
Inspected 62 children.
Called at two homes to secure treatment for defective teeth.
Advised mother to send children to Marion Dental Clinic.
To sum up the case for the school nurse: She is the teacher of the parents, the pupils, the teachers, and the family in applied practical hygiene. Her work prevents loss of time on the part of the pupils and vastly reduces the number of exclusions for contagious diseases. She cures minor ailments in the school and clinic and furnishes efficient aid in emergencies. She gives practical demonstrations in the home of required treatments, often discovering there the source of the trouble, which, if undiscovered, would render useless the work of the medical inspector in the school. The school nurse is the most efficient possible link between the school and the home. Her work is immensely important in its direct results and far-reaching in its indirect influences. Among foreign populations she is a very potent force for Americanization.

CLEVELAND'S DISPENSARIES
Cleveland has 86 school dispensaries, or what are usually termed "physicians' offices." These are rooms about 20 feet long by 15 feet wide, located in the basement or on the first floor of the school building, well lighted, and painted in white or light colors. Usually they contain one or two small white enamel tables, several