The School Nurse "Behind The Scenes"

Most people think of the school nurse as the place you go for a stomachache. Then you hear what Tami Hale BSN, RN, NCSN actually does before the first bell and all day after that, and the whole picture changes. Tammy is a Worcester Public Schools nurse with decades of experience, and she walks us through the reality of student health in a busy K-12 building where “normal” rarely exists.

We talk about the clinical side of school nursing that families may never see: daily medication schedules, diabetes support that includes blood sugar checks, carb counts, and insulin, plus the constant triage of injuries, illness symptoms, and head concerns. Tami also explains the hidden backbone of the job, documentation in electronic student health records. Those notes are not busywork; they are how schools prove care, track trends, meet state requirements, and keep kids in class instead of sending them home by default. We also get into immunization records and why accurate documentation matters even more for students who move frequently or come from different countries.

Some of the most meaningful moments happen in quieter ways. Tami describes scoliosis screening as a chance to teach body awareness and build trust, and she shares how students bring anxiety, stress, and trauma into the health office. Her approach blends privacy, humor, and a steady presence, while leaning on teamwork with teachers, counselors, and families who know the child in different contexts. The stories land hardest when you hear the outcomes: a student empowered to manage a procedure on their own, and a child seeing clearly for the first time after getting glasses through community support.

If you care about student wellness, school health services, and what it takes to help kids learn, listen all the way through. Subscribe, share this with an educator or parent, and leave a review so more people understand why school nurses matter.

Thanks for listening! 🙏🏼

If you picked up a new idea or felt inspired by today’s episode, I’d love to hear from you and if your interested in being a potential guest on the show; email mahperdpodcast@gmail.com Please take a second to follow the show and share it with another educator who’s passionate and let’s keep the conversation going!” 

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Transcript

Welcome And Why School Nurses Matter

Jake 0:15

Hello and welcome to Voices from the Field, a MAHPERD podcast where we talk with educators in the field to hear about their perspectives and experiences. My name is Jake Bersin, advocacy chair for MAHPERD. Today I have the pleasure of speaking with Tami Hale. Welcome, Tammy.

Tami 0:32

Hi, thank you for inviting me. It's a pleasure to be here.

From Hospital Floor To Schools

Jake 0:35

Awesome. I'm so I'm so happy you're with us. Just a little background. Nurses play a huge role in schools, but often they work quietly behind the scenes. If you work in a K through twelve setting, you definitely have had interactions with the school nurse. School nurses are so much more than a place to go when you just have a stomachache. They're caregivers, advocates, first responders, listeners, and sometimes they want to save adult a student knows that they can turn to. As I said, in this episode, we're sitting down with nurse Tammy Hale. Tammy has been a nurse since 2000. She graduated from Quinsigamond Community College, and her first job was at St. Vincent's Hospital on a medical surgical floor. After having her second child, she decided to look for another area of nursing that would allow her to spend time with her children, and that's when she found school nursing. She started with the Worcester Nursing Department in 2006. Tammy has a bachelor's in nursing, a national school nurse certification, as well as a teaching licensure. She has worked at five elementary schools in Worcester and will be finishing out her career at her current school. Nurse Hale will shed some light on what the job really looks like from the everyday moments to the challenges that people don't always see and the impact this role has on students, families, and school communities as a whole. Whether you're a parent, educator, student, or just somebody curious about how schools support student health, this conversation is for you. I can't wait to get started, Tammy. Let's get started. So, what made you decide to become a school nurse?

Tami 2:06

Um, well, I kind of touched a little bit on it um, you know, in the bio about having my second son and working at St. Vincent's Hospital. And I

Speaker 2:15

worked second shift and the hours were long and hard, and weekends and holidays, and there was just so much that I was missing from my family, um, not being there for them. And I just, you know, I could see myself getting burnt out, you know, even after only a few years working in the hospital. I didn't really know anything about school nursing. I just was like, oh, well, that sounds interesting. There's there's so many different areas you can go with a nursing degree. Um, and a friend, another nurse that I knew was looking into school nursing. So the two of us went and, you know, had our interview, and they were both like, you're both hired. And I was like, all right, here we go. You know, not knowing all of the details of what was involved in it. So, really, that's kind of what got me there was my family looking for another way to, you know, use my skills and still be there for my family. And that's what school nursing has been able to give me.

The Daily Rush In The Health Office

Jake 3:08

That's awesome. What a great story. So you see many students throughout the day, obviously. What does a normal day look like for you if normal even exists? What does your day-to-day look like?

Tami 3:18

Yeah, the best laid plans they never happen. Um, you know, so my day typically starts, you know, at the school that I'm at currently, I have two diabetic students. So really my morning starts getting them prepared, getting them their breakfast, you know, going through how many carbs in their breakfast, what are they gonna eat, what is their blood sugar look like, you know, and then administering insulin for both of those students. Um, you know, a lot of times that's when the students always come in and say hello in the morning, you know, especially after the weekend, we get a quick hello chat, how are you? You know, how things going. Um, and then once those kids are done, the day just starts rolling. Um, I think I see kids right from the get-go all the way to the end. The bus is sitting outside waiting for them, and I'm still seeing students in the office. Um, I do have my okay, go ahead.

Jake 4:10

No, go ahead, go ahead.

Speaker 4:11

I was gonna say I do have my set schedule with some of my students, you know, my daily meds that I need to see, any procedures that I need to do. So I have certain things that have to be done at a specific time throughout the day. Um, but it's it's you know, kids come in all day all throughout the day.

Jake 4:27

So you mentioned a couple students uh that had some some needs, um, some insulin needs. Um, is that common for your school nurse to have special specific needs that need to be tended to, or does it vary depending on the school, or how does that all come into play?

Tami 4:44

Well, it definitely depends it depends on the school. It varies, um, but I think overall, the majority of Worcester Public Schools, and I'm sure other places as well, um, have students that have specific needs that require a nurse. Um, it's you know, you don't usually see a school with nothing that re- You know what I mean, that that um whether it's medications or procedures or anything like that, these kids with medical needs or complex needs are in the schools. And so that's that's one of the important things about why we're there is because you need that that nurse, that licensed person to be able to help with those kids.

Jake 5:22

Right. No, that makes sense.

Speaker 5:23

Pretty typical.

unknown 5:24

Yeah.

Jake 5:25

So what what are some of the most common reasons that students might come to see you?

Speaker 5:30

You name it, they come to see me for it. Um stomach aches, headaches, you know, injuries, especially on gym day. That's like my, you know, that's my busiest day. Um, but really that's it. And then there's the kids that, you know, just pop in and they'll come up with an excuse to come and see me. Oh, I have a headache, and then they'll come in and they'll start telling me about something that's totally unrelated, but it still probably leads to why they have a stomach ache. You know, it's it's more emotional kind of stuff that they come in for.

Jake 6:01

Um just for that level with seeing all these different students, how do you decipher what's what's kind of real and what's not real? Do you treat everything as um like it needs there needs to be a a direct response, or do you kind of wait, or how does that how does that work with so many kids wanting to see you? Because like you mentioned, some kids might say they have a stomachache, but maybe they ate their lunch too fast. how do you decipher what how to give them an ice back versus how to you know what I mean?

Speaker 6:32

Yep, and that's where experience comes in. Um, first of all, I I would say that everything is real, at least to them. You know, like I try not to say you're not sick or you don't have a stomach, I because to them it is. So they'll come in and say, I don't feel good. Okay, well, let's talk about why you don't feel good, what part of your body doesn't feel good. Um and you know, uh throughout experience, I've definitely been able to give an eyeball on a kid and know right away this kid needs to be seen, this kid can wait 10 minutes, whatever it is. It's all about triaging. When it gets super, super busy, that's what you need to do. Medications always take precedence, diabetes always takes precedence, you know, those kinds of things, head injuries will take precedence. Um, you know, even while somebody's vomiting, I can, you know, manage them as while I'm cleaning up somebody who maybe fell and now is bleeding because they cut their leg or something. So um you you get you get good at it. You get good at it after a while. I'm a mom, so I'm used to multitasking as well. So that definitely helps out.

The Hidden Work Of Documentation

Jake 7:37

Yeah, I can imagine there's a lot of multitasking, especially with the types of reasons you might they might see you. So um what's the hardest part of your job that people don't usually see?

Speaker 7:50

Uh see you ask uh when you show me these questions, I said, Oh, that's a tough one. I think there's a few things um that people don't see that I do and they don't understand what I do. Um one of the things too is we do a lot of documentation, and that's a big thing that people don't know that we do. So every single student, every interaction I have with a student or a parent or a staff member has to be documented in the student's electronic medical health record, right? That's how we that's how we see what we're doing, and the state looks for specific things that we do as school nurses. Um, so that that can be very time consuming, and a lot of that is done afterwards, like not necessarily while I'm sitting with the student. Maybe I might pull up their name to remember who I saw at what time, but a lot of that is done later on when I have a moment to stop and think and and really get in there and document on that kind of stuff. So people don't realize that. Um like I had just before this um podcast, I just kind of pulled up some numbers, and thankfully I do do my documentation because how else would you know what I do, right? Like um, so for this year alone, I've already since August when we went back to school to now, I've already seen um a total of 1,443 not students, but visitors into my office, right? Visits. So for injuries, illnesses, you know, even if I'm in a meeting or phone call with parents, that's where all that information comes from, documentation. So if I didn't do that, there'd be no proof or no evidence on what I do every single day.

unknown 9:34

Right.

Speaker 9:35

And some of this stuff is this the state looks for that as well. They want to know how many times did you treat a student for injuries, how many times did you send a kid home or send them back to class? That's a huge thing. Like, I'm not there to send kids home, I'm there to help them to be able to be productive and stay into school. So they want to know how many times I'm sending kids home versus how many are going back to class.

Jake 9:59

Right, right. That makes sense, right? Um, so I'm thinking, you go to the doctor and you have the my chart, right? Where you can see um and that's something that we can see as adults, but the students obviously, you know, they you need to keep a record of what's happening with them, and if their parent ever asked, or if the like you said, the state ever asked, there needs to be that documentation of this is what happened, this is how it was handled, and kind of cross those T's. That's really that's interesting.

Tami 10:25

Yeah. Yep, yep. And even like immunizations, so that's part of my responsibility too, is is keeping up with children's immunizations. And so with so many students coming and going um, you know, from other countries, their schedules of immunizations are not always the same as ours. So it's super important to have that documentation and be able to pull up those records. Um, and if a student leaves, I can send that record with them so that follows them. There's no duplicating of anything, they don't have to have these things done over again because we have that documentation to show it.

Jake 10:59

So I'm gonna ask you a question that's that's not on the podcast, but it's something that I'm just curious about. So being a PE teacher myself, we've had to do scoliosis screening. I've done it at different levels at the middle school. What uh what's happening um right now, currently? Uh what's what are some guidelines in the state? Like what are we are are nurses doing it, or is the doctor doing it? What's the what's going on with the scoliosis? Is that something that that teachers are helping with, or does it depend on the school? Go ahead.

Tami 11:30

So it is the responsibility from what I understand. And you told me you were not gonna throw any loops in there.

Jake 11:37

I know, we gotta mix it up a little bit.

Speaker 11:39

I know, I know, I know. Um so the way I understand it, it is the responsibility of the um the Fitz Ed chief teachers, the gym teachers to do this. However, if say, you know, it's you and I working together, obviously I would do the girls and you would take care of screening the boys, right? Um I really, really enjoy that hands-on time with kids. And for me, I'm not just simply looking at their spine. Like I'm looking at that for sure, but I'm also looking at other things, um, you know, and having conversations with them and talking to them about them and their bodies and and how are they feeling, and do they have any concerns? And you know, oh, you I just notice you have a rash on your back. So for me, it's so much more than just scoliosis screening. Um, and and I I really enjoy doing it. I I have a great time with the kids, teaching them about why I'm doing this and what does it mean and how important it is. And it's not just a task to me, it's it's so much more. It's the it's an opportunity to make a connection with the kiddo and to teach them about themselves and and why this is important. Um, and I have actually found multiple kids, not a huge number, but multiple kids over my years who had scoliosis and it wasn't caught anywhere else. So it is super important.

Jake 13:00

So you mentioned connection and then the why that's so important, like what the rationale for it. That's really that's interesting.

Tami 13:06

And their kids, they you know, I don't want them to feel like I'm just telling them you have to do this and not, you know, they should know what's going on with their bodies. Why is this so important? And and maybe maybe they're gonna say to me, you know, I uh my shoulders have been really bothering me. You know, do you know why my shoulders are bothering me? And it's because they're carrying a backpack on one side that's you know weighs 15 pounds. So let's talk about body mechanics and how could you help that? And so yeah, it's just a great opportunity to connect with them.

Teamwork With Teachers And Families

Jake 13:35

So they may bring up points to you, and you you're able to read between the lines and say, Oh, it might be this reason or it might be that reason, and make that that makes sense. Yeah, so you work with a lot of students, but are you also work with teachers and counselors and parents and administrators? How do you juggle all that or how do you manage all that? Give us some background on that, working with different um super

Speaker 13:56

important to have that connection with staff because even though I do see the kids a lot and and form those relationships with them, the teachers have them in the classrooms, right? They see them every single day. And so where a kiddo may come to me and you know they say they don't feel good or I have a cough, and I'll, you know, take a listen to their lungs and assess them and check their oxygen levels and listen to what the cough sounds like and go through all of that. And to me, they sound okay, like medically they're fine. But the teacher will come and say, Well, no, no, no, I feel like there's something else going on. They're never this quiet in class. So there's also that part of it, they know them too, and they know them very well. So where I may just look at that one little thing and think the kid is fine, there's the other piece of that kid's usually bouncing bouncing around in the classroom and happy and cheerful. Maybe there's something else. Maybe there's another reason why they're seeking to come to questions about what's going on in your world? Are you having trouble with friends? Are you having trouble in the class? Did something happen at home? So there's, you know, you have to, you can't work in a silo, right? You can't work alone. You have to rely on everybody else in the building to make sure that we're hitting all those points that we're not missing anything with the kids.

Jake 15:13

That's a great point because I mean, we do as teachers, we see them a lot and you see them a lot, but getting other people's perspectives about what they think and what might be leading or causing the issue or challenge, that's really important.

Speaker 15:26

So that's when I worked at Gates Lane, we have a lot of special ed kids there, a lot of nonverbal autistic kids, and that was really, really important where they can't actually physically or you know, they can't verbally tell me what's wrong, and I'm only seeing them for the minute that they're with me. Whereas the staff member who has been with them every single day and knows them so well can say to me, No, I really feel like there's something else going on. So you you gotta work with everybody, you can't do it alone.

Anxiety Support And Better Sleep

Jake 15:53

So, no, I totally agree. So, our next question is how do you support students dealing with anxiety, stress, or trauma? You know, I walk by your office and I see the jokes you have on the on the wall. So that's a great, I think it's a great opener. But what are some other things that you see or are witness with students in regards to that anxiety?

Speaker 16:14

Yeah, yeah. It's so much more nowadays than than when I first started in this career. And and it could be two things. It could be one, I'm much more aware of things and can see things that maybe 10 years ago or 20 years ago when I first started, I didn't pick up on it like I do now. Um, there's just a feeling you kind of get with a keto. It's something in their eyes, it's something in their mannerisms that you can say that there's something else going on. So, first of all, I try to make sure that they know that they can always come to my you know to my office. And um, I mean, they don't get the reference when I say, you know, my office is like Vegas, what happens here stays here. But that's how I feel. Like whatever you say to me in my office, unless you're going to hurt yourself or somebody's, you know what I mean? I'm not gonna tell anybody. You can tell me what's going on and I can help you. And I've definitely made quite a few connections with kids in that sense where they feel comfortable coming to me and saying, Can I talk to you about something? We'll shut the door and we'll sit down. You know, unless there's an emergency, you're in my office and you're important, and let's talk about what's going on. Humor, I love humor. That's just kind of my go-to, and the kids enjoy it and they get it, and it makes them take a deep breath and relax. Um, so they, you know, they look forward to that as well. And that definitely helps get them to open up and and relax and know I'm not scary and I'm not gonna hurt them, and they can talk to me about stuff.

Jake 17:38

That's right. And you're building that relationship with them too. So that's that's key. Um, so just moving on to a different track. What are some health habits you wish or or kind of promote you want students to learn every day?

Speaker 17:51

Yeah, yeah. So many, so many, definitely. Um, I think one important thing that has come up again over the last say five or six years is sleep. So many, many kids are not getting enough sleep. They're not getting um quality sleep. They're just it's not high on the list of priorities, whether it be because they have so many activities to do, or their family life is chaotic, or they, you know, they're um taking care of siblings. But the foundation of so of your well-being, but whether it be mentally or physically, revolves around having really good quality sleep. And and so to teach them, you have to shut the tablets off, you have to shut the light off, you have to shut the phone off, you know, you need to let your body rest. If you don't, you're not, you're gonna get burnt out, you're gonna, you're gonna get sick more often, you're gonna feel lousy, your brain can't function well. So to teach them about how important, and some kids think it's a waste. Why am I sleeping? Who cares, right? No, it's it's actually really, really important. And a lot of the kids now don't get enough sleep. Um, so I try to talk to them about how important that is.

Parent Communication That Actually Helps

Jake 19:05

That seems like such a simple thing that they can do too. It's just a matter of following through with it, right? Put the tablet down, go to bed at a decent hour, um, you know, stay hydrated, all that stuff. So, what can uh parents or caregivers do at home to support what we're doing at school or what you're doing at school? What can parents do?

Speaker 19:24

Uh communication, I think, is big. You know, I have a lot of parents now. I I was never one to want to use my cell phone, my personal cell phone. Um, and but I've definitely changed over the years where I find being able to reach out to them or have them be able to reach out to me and send me a quick, hey, this is what's going on. Can I send them to you? I don't know what to do. Or, you know, I can reach out to them in the middle of the day and say, hey, just want to let you know this is what's going on. Um, I mean, we do have email at school and we do have um parent square and things like that. Um, but I find just reaching out to them, giving them a connection, you know, that quick and them doing the same with me. You know, they're like, I don't know if I should send them to school, you know, send them to me. I'll take care of them while they're here. I'll let you know if you, you know, I'll I'll keep an eye on them. If there's something comes up, I will call you. Always let me know what's going on, because I can help. I can help with a lot of things, and I, you know, that communication between parents and and um the nurses is huge.

Moments That Show The Impact

Jake 20:25

Really is two-way communication, and that's one of our standards too, right? For DESI, having that caregiver communication, yeah, absolutely. Yeah, no, I agree. That is that's so important. So so they they know what's happening, and um we can also learn from them. So this is uh kind of a deeper question, and uh obviously we're not gonna use any student names, but is there a moment or or situation that reminded you of why your job is so important? Can you think of any story or situation?

Speaker 20:55

Yeah, quite a few, quite a few, actually. Um, and when I first started in school nursing, I thought, oh, I am gonna be so bored. Like going from a med surge floor where it was like go, go, go, go, go. What could school nursing possibly, you know, give me? Or what could I possibly give to the students that would make a huge difference? And I never in my wildest dreams could I have ever imagined uh how fulfilling this job is. Um, and there's been so many occasions where I'm like, yep, there it is, that's why I'm here, that's why I made that change, whether I knew it back then or not, this is why. Um, you know, being able to, you know, I recently taught a student how to do something, how to perform a procedure um that previously they didn't even want to know anything about. Like it was scary, it was weird, it was awkward, it was, you know, just the whole thing. But it's important. This is your body, this is your life. You should be able to take control of this, and I can teach you how to do this. I can help you to learn how to take care of yourself so you don't have to go to anybody else. I mean, sure, we're all here if you need us, but you know what how empowering that is to for a for a child to be able to not have to rely on somebody all the time to do something that seems So simple. But you just got to get over that initial hump and that initial fear. And for me to be able to do that, I mean, I was just, I was like, oh my God, who can I tell? But I can't tell anybody, right? Because this is between, you know, this person and myself. But oh, my heart was bursting, and I was so excited for this person and or this child. And to just to be able to help them feel successful and feel so good about themselves for overcoming something that they had been stuck on for so long. It's just, it's really, you know, the kiddo that I there's another one where I um got her glasses. Uh this this kid couldn't even see her parent at pickup. Like the teacher had to bring the student to the parent because nobody realized until I checked her eyes that she cannot see. And then I got her on the field trip and they went to mass college pharmacy through the Worcester Eyes program. And when she put those glasses on for the first time at school and was like looking around, like, oh my God, this is what the world really looks like.

Jake 23:12

Wow.

Speaker 23:13

That is why I do what I do. You know, that is why it's so important to have nurses in the building because you pick up on things and you can help with things and you can make those connections with services that people don't even know that are there. Um, so yeah, it's that's that's awesome.

Advice For Future School Nurses

Jake 23:30

I wish I had a lot of what a great story though. I mean, it's uh, and I'm sure that happens a lot with with you and uh and the students in the situation. So that's great. Really, really do make a difference. So somebody who might be interested in becoming a school nurse, uh, what would you what kind of words of wisdom would you say to them or advice would you give to them if they were interested in becoming a nurse?

Speaker 23:53

Right, right. Um I don't think, well, hmm. First of all, look into what it takes, right? Like there are you you definitely have to have, you have to have your certification, you minimum of a bachelor's, there is a lot of education, there's a lot of um continuing education that you have to do. It's not a one and done, so it's definitely like any other nursing job. But with school nurses, you you have to, you know, you have to have your RN licensure and keep up with that, you have to have either your national certification or you have to get your master's. I mean, there's all there's a lot to it, a lot of education that you have to make sure that you do. So it's not just get in and be done. Um I worked on the med search floor, right? Had a lot of experience doing that kind of work. Yes, school nursing is they're both nursing, right? But kids are not just little adults. It's they're they're very different. So, yes, I have a lot of the skills coming into it, but it took years to develop and feel very, very confident in what dealing with children versus adults, right? They're big, big difference. Um, so really look into it and say, you know, is this the move for me? And then go for it. I mean, it's it's such a rewarding job. It really, really is. It's like I said, it's beyond what I could have imagined that it would be, right? So just kind of look into it. I wish I had known that there was more, not that it would have deterred me, but going into it, I wish I had um learned ahead of time what it was going to take. I would have felt more prepared in in taking those steps with my degrees and things. Um definitely go for it.

What The Public Misunderstands

Jake 25:28

I mean good advice. Look into it, prepare yourself, and then be prepared to to have continuing education and continuing uh learning. So that's that's so important. So, Nurse Tammy, as we come to a close, what's one thing you wish maybe uh community folks would understood more about your role?

Speaker 25:48

I I think I struggle with this a lot. Um I really don't believe that the general population or the general public or even the school population understands what school nurses really, really do. It's not we're not just sitting there handing out band-aids and ice packs. And I try, you know, really hard. Anybody that I talk to about my job, they're like, oh, you're a school nurse. And they try to move on. And I'm like, wait, but wait, do you realize what I do every single day? Do you, you know, this is I I play such a huge role in the in the school and the health and the wellness of the kids that there's so much more to it. And I don't think people really understand. I I, you know, we just kind of get lost. We're like, just the school nurses, move on, you know. Um, so I struggle with that. That's I think one of the things I wish people understood and were more interested in what we do. And so things like this, like this podcast, what a great way to get people to to hear the stories and to know what I'm doing there. Um, you know, I laugh and joke about how I'm just sitting there looking good, but really there's so much more to it, you know. Um, and I wish more people understood that.

Jake 26:56

Right. No, that's great. And I think thank you for being on this podcast and sharing your voice, because that's the whole goal of this podcast is to share um advice and and expert um, you know, expert insight into what you do. So I really appreciate your time.

Speaker 27:12

So yeah, and thank you so much for inviting me. I this was huge. This was really cool.

Thank A School Nurse This Week

Jake 27:18

Oh, you're welcome. You're welcome. Yeah, well, well, um, we I learned a lot too. So it's and I I know our listeners are gonna appreciate this. So before we wrap up, I want to say a huge, again, a huge thank you to you, Nurse Tammy. Um keep up the great work, every school nurse out there. It's the important work you're doing day in and day out. Um and uh in this if this episode gave you a new perspective, here's your call to action. This week, reach out to a school nurse in your life, send a quick thank you, introduce yourself, or simply ask how you can support them. If you have believe student health service deserves more attention and resources, share this episode with another person or an educator or community member. Thanks for listening, and we will be back soon.