Confessions of a School Nurse

by Michael Alexander

  Alcohol is a common gift to staff from students – each nationality brings me their country’s best. From any student from Eastern Europe, vodka is the weapon of choice, with every vodka-producing nation naturally insisting its product is the best. From the Mexican students, it’s always tequila; cachaça from the Brazilians; and single malt whisky for most of the Western nations, as well as, perhaps surprisingly, the Saudi students.

  Usually parents buy the gift and send their child to school loaded with hard spirits. The gesture is always appreciated, and the child is proud to show off the finest alcohol their nation can produce.

  But sometimes people want to give more.

  Teenagers are spontaneous, their emotions high one moment, low the next. Their feelings are intense and these little gifts of appreciation are sometimes just not a big enough gesture.

  How can they find a way to express their gratitude to the person who changed their failing grade from a D to a B, especially when school is not just the biggest thing in their life at that time, it is their whole life? How can they thank the person who comforted them when they were homesick, or helped them fit in and make friends?

  ‘I can’t thank you enough. You’re the best’ – the note was signed ‘Priscilla’. The letter was for my friend, Brian, a maths teacher.

  ‘She worked for it,’ Brian said. ‘She went to every extra help session I gave, and still wanted more.’ Brian explained that she had been willing to pay for private lessons on top of the regular after school group sessions, but he’d refused. ‘You turned down 100 euros an hour?’ Maths and physics teachers were always in demand, and tutors could get away with charging such a heavy fee.

  ‘That’s actually why I’m here,’ Brian said. ‘I wanted your expert opinion.’ I motioned for him to continue. ‘Is she ADHD or something?’ he asked. ‘Or seeing the counsellor for any issues?’ I asked him why he thought she might have ‘issues’ and to tell me exactly what she does that makes him think so.

  Many teachers have concerns about their students, and often say things like ‘she’s ADHD’ or describe someone as ‘bipolar’. Even the most well-meaning people throw these terms out there, and nearly every time it’s wrong, but labels can stick. I need to find out what the student is actually doing that is causing concern.

  Do they talk non-stop in class? Do they interrupt others? Are they aggressive or act like a bully? Do they do their work? Do they say strange things?

  Priscilla, Brian explained, did all of the above, particularly constantly talk in class, disturb others, and struggle with work – hence the extra help to enable her to pass Maths. Like many fifteen-year-old girls, she lived her life as if on a permanent emotional rollercoaster. Fortunately for her, and us, it was a rollercoaster with peaks of pure joy, and not particularly deep lows.

  But it wasn’t this behaviour that bothered him, as it’s pretty normal.

  ‘She follows me … everywhere,’ he added. Priscilla had changed her activity from volleyball (which she loved) to hiking (which Brian led). ‘She won’t stop staring at me in class, and is always the last to leave. She’s even got her mum on her side, insisting I continue with her private lessons. She’s obsessed. She’s even said she’s got a surprise for my birthday next week.’

  I promised to pass on his concerns to the counsellor, although I didn’t think the matter urgent. ‘A bit of a crush,’ I remember saying so clearly. No one could have anticipated the surprise she had in store for him.

  It wasn’t just any birthday, it was Brian’s fortieth and understandably his students enjoyed teasing him about becoming officially old (or ‘ancient’, as they called it). Priscilla didn’t join in the banter, instead she enlisted the help of her peers.

  As Brian turned up to class the following week on the day of his birthday, he did what he always did at the start of a lesson and took the register. Everyone was present bar one. When he called out ‘Priscilla’ the music began.

  Priscilla entered the room, dressed in a flimsy white dress, and began to sing happy birthday. It wasn’t your typical ‘happy birthday’ where everyone joins in. Priscilla must have seen Marilyn Monroe singing happy birthday to a naughty president at some stage, and thought Brian would appreciate the gesture.

  What does one do when confronted by a flirtatious teenager?

  You politely interrupt, say ‘thank you’ and explain that the classroom is not the right place for such behaviour.

  Of course, it’s not always that easy. ‘She was so serious,’ Brian described later, ‘it would’ve crushed her if I’d made her stop straight away.’ Instead, he ended up saying things like ‘it’s unique’ and ‘unforgettable’ while trying to avoid actual words of encouragement.

  Priscilla cut her performance short, but she was not discouraged, and after being sent away to get changed, she came back ready for the grand finale.

  It was the last class of the day, and Priscilla waited until everyone had left the room, whereupon she threw herself at Brian.

  Brian disentangled himself from her clutches and sprinted to the headmaster’s office.

  Priscilla did see the counsellor, that same day. She was immediately transferred to another Maths class, and her mother notified.

  Fortunately, Priscilla wasn’t too upset, or overly embarrassed, which is unusual, and she quickly stopped pursuing Brian. Her new maths teacher, Mr Cooper, seemed a bit nervous when she asked him for extra lessons but by that time I think Priscilla had grown out of teenage infatuation and started dating someone her own age. Ah, teenage love – how quickly it can come … and go!

  Using your assets

  Some kids will go to any lengths to get what they want.

  ‘Sir, can I …’ Stacey asked.

  ‘No.’

  ‘But you haven’t …’

  ‘No.’

  It’s very educational watching a teenager’s reaction when you not only give them an answer they don’t want to hear, but don’t give them a chance to finish. This may sound cruel, but Stacey was supposed to be in class. She was physically well, and she knew better. She had been at the school for three years, yet even at nearly nineteen years of age, she still stretched the rules. I explained to her that as it wasn’t urgent, she could come and see me during the designated clinic times. Seeing how a person reacts tells me a lot about who they are and what they’ve learned from their parents.

  The reactions come in a variety of forms, most of them unpleasant. Sometimes the pupil storms out, slamming the door; others beg and plead; some just refuse to leave; a portion of them will dial their parents and hand their phone to me (I no longer accept phone calls from parents in this particular situation); a rare few simply accept that they should be in class, and quietly leave without putting up a fight.

  I know teenagers are difficult, and I do worry about my own children when they get to that age. I worry that I’m tempting fate by judging too harshly, but I have standards. I was a good teenager. I never spoke back and I never slammed doors. I did what was asked, and if I disagreed with a teacher, I’d talk about it with my parents later that evening. If my parents agreed, they’d contact the school and discuss the matter rationally, without shouting or threats. This ‘normal’ behaviour is becoming rare, not just in elite boarding schools, but in your average public school.

  What only a handful of the students at my school realise is that if they’re nice, I give in. I let them have their Strepsils, lip balm, or moisturiser, before heading back to class. These are not exactly urgent needs, and the student should be made to wait until the appropriate time, but I can’t say no when they’re polite enough.

  Stacey was a challenge for me because she was polite and insistently apologetic.

  ‘Please … I’m sorry … you have to help.’ What was I doing so wrong that children had to plead with me? ‘It won’t take long, but it’s urgent.’ She looked ready to cry.

  Within a few months of working as a school nurse, I realised I have a talent for making girls burst into tears.
Ten years later I’ve become used to it, but I’m still not immune. Besides, how can I refuse someone with an ‘urgent’ health problem? I had to at least find out what was going on with Stacey, even though she looked well and healthy. Apologising some more, she made it into my office and sat down opposite me.

  Historically, whenever Stacey had made it this far into the health centre, she always got what she wanted. She knew she already had me.

  She started: ‘I can’t go skiing this afternoon …’ I cut her off, ‘You said it was urgent.’

  Any sign of those ‘tears’ that had seemed so close before had disappeared. ‘How do you expect me to ski when I’ve hurt my bad knee?’

  All kids have a bad something, whether it’s a knee, ankle, or back, which always seem to flare up when the clouds roll in and the temperature drops; they’re like old grandmas.

  The problem with knees is that they usually look fine, so it becomes a matter of trust, of which I had none when it came to Stacey.

  I reminded her again that we were only to see urgent problems outside clinic times, but she chose not to understand. ‘Please, it is urgent. You have to excuse me.’

  Stacey leaned forward as she pleaded with me, and I was willing to give her a break, just to get her out of my office. Here we hit the crux of the matter.

  To Stacey, as well as most teenage girls, school uniforms are not something to take pride in, but something to be manipulated into showing as much of their body as possible. Stacey, for example, had more than the normal number of buttons on her blouse undone, and I found myself staring out the window, at the ceiling, anywhere that was not in her direction because when she leaned forward, on the already low chair, with half her buttons undone, well … you can understand my discomfort. This was not a new tactic and most of her male teachers had said it’s easier just to give her what she wants and get her out the room as quickly as possible.

  That was Stacey’s modus operandi. She would plead politely, then expose, plead again and expose again. I didn’t know where to look. I never did. I was tired of feeling uncomfortable whenever she came into my office.

  To make matters even worse, Stacey would also hike her skirt up even higher than most of the girls. Normally it’s rolled up four inches or so around the hips.

  I couldn’t go on working like this. At eighteen years of age, Stacey was fully developed and with her make-up on looked like someone in their mid-twenties. If you saw her at a pub, anyone would mistake her for a mature adult.

  I was being manipulated, and we both knew she had the upper hand. But I was sick of her behaviour. I decided to take control. This stopped now.

  ‘Stacey, do you not know how to dress?’ She sat back in her chair, feigning shock, her hands folded on her lap.

  ‘What do you mean?’

  I had no choice, but to be blunt. ‘Stacey, you need to do the buttons up on your top.’

  She didn’t move. ‘I know how to dress fine. It’s not my fault you’re uncomfortable.’ She actually looked down at her chest when she said this.

  ‘I can see nearly everything, and when you lean forward I can see the rest. You need to do up your top, now.’ She still didn’t make a move to do up her top buttons, instead she leaned forward again, while looking down as if to judge just how much she did expose.

  ‘Stacey, I’m trying to help you here. I’m a nurse. Do you know what that means?’

  She shrugged her shoulders, my words having no impact.

  ‘It means I’ve seen hundreds of breasts. Put them away and save them for someone else.’

  ‘You … you can’t say that!’ Stacey repeated those words as she hurriedly did up her blouse and left my office.

  I never did get to look at her knee but it turned out to be nothing and she ended up having to go skiing. I never heard another peep out of her.

  Stacey was not the first – or the last – young woman to try and use their feminine assets to get their way. It would also be wrong to deny that this is something I rarely have to deal with, because as a male nurse it’s something I do need to be aware of, as well as be extra sensitive to the fact that I’m a male in a predominantly female profession.

  I don’t always know the best way to deal with some of the rules in these situations, especially the first time I encounter them, but as a general rule of thumb, I try to confront the issue as it happens – even if the only thing you want to do is run as far away as possible.

  Long weekends

  ‘My flight is booked, I have to go. Please,’ Mary pleaded. Mary had booked a flight to Barcelona for a long weekend to celebrate her sixteenth birthday. ‘I’m going to be with my parents the whole time. I won’t be doing anything bad.’

  Mary had recently been caught lying to us. She had come to my office and claimed she was sick and couldn’t play sport, but later that evening had been caught leaving one of the local restaurants, cigarette in hand. The punishment for her deception was that she was not allowed to travel for the long weekend and had to serve detention.

  But things are never simple in boarding schools. With the airfare already booked, and the parents arguing that the school was being unfair, the headmaster had left the decision up to me – the original victim of Mary’s lies – to decide if she could travel on the long weekend, and have her punishment deferred to the following weekend.

  ‘This isn’t the first time you’ve been caught lying to us, Mary,’ I said, raising my eyebrow to silence her when she started to protest. ‘I think this is a lesson you need to learn. You can’t keep abusing the health centre.’

  Mary changed tack.

  ‘I know I’ve not been good. But I’ve really learned my lesson. Please, sir, please let me go.’ As I mentioned earlier, I’m a sucker for polite pleading. I really did want to let her go. I had hoped the headmaster would not leave the decision to me. I’m a nurse, not a headmaster, and I’m often a pushover. Mary sensed my doubt and pushed her case.

  ‘I’ll do anything, sir, anything you want.’ I told her to stop there. I needed some time to think. But Mary wasn’t finished. ‘Sir, when I say anything, I mean it. I’ll do anything.’ Mary chose that moment to put her hands on her knees …

  Was I imagining things, or did she pull her legs slightly apart? Was I reading more into the situation than was really there?

  I panicked and chose the easiest way out. I let her go on her trip and made her promise not to come to my office again. She squealed with delight, jumped to her feet and tried hugging me, but I pulled away.

  ‘Thank you so much, I’ll never forget this,’ she said, as she skipped out of the room, while I walked quickly to the headmaster’s office.

  ‘I just don’t know,’ I found myself saying over and over after explaining what had just happened, pacing up and down within Mr Driscoll’s office. ‘Was I imagining things?’ There is no way to know for sure, but I’ve learned to trust my instincts. Being open and honest with the headmaster seemed the best course of action.

  Mr Driscoll reassured me that I was not the first person to express concerns about Mary’s behaviour, that a number of staff, both male and female, had mentioned her name. Often it was the little things she did that, on their own, don’t seem to be too big of a deal, like being late to class once too often, or claiming illness when a test was due, or always being on the periphery of any mischief. But when all these loose ends come together, they paint quite a worrying picture. This made me feel like I made the best decision to bring it to his attention. When it comes to working alongside school kids, the best policy is always honesty … no matter how vulnerable it can make you feel.

  Veronika

  At eighteen years of age, Veronika was another boarding school veteran who knew how to get her way, no matter what.

  ‘You have to see me, it’s urgent,’ she insisted.

  It was her third visit to the health centre this week. Every time she had said it was urgent, and every time it had turned out to be nothing. The problem I have is that when people say it�
�s urgent, I have to see them, because the one time I don’t make the effort to even listen, and shoo them away, I know it really will be an emergency.

  Her first urgent visit had been on Monday morning. She was worried about her shoulder. ‘It’s painful when I go like this.’ She then swung her arm around rapidly, indicating a pain deep inside her shoulder. ‘Don’t swing your arm like that,’ I advised her, and sent her on her way. She seemed mildly unhappy.

  The second ‘urgent’ visit had been on Tuesday. She thought she had pneumonia because when she had woken up in the morning she had coughed up a lump of nasty looking sputum. Other than a slightly sniffly nose, she was fine, and after giving her a complete check-up (nothing less would have satisfied) she left the clinic with some nose spray. She seemed even less happy than she did the previous day.

  She managed Wednesday without coming to see me, but Thursday morning she returned with a new problem.

  ‘I need something, anything,’ she pleaded. ‘I haven’t slept for a week.’ I get a regular stream of students with sleep problems, and it’s usually simple to treat:

  • No sugary drinks after 5pm

  • No caffeine after lunch

  • No laptop, iPad, or other electronic gadget for two hours before bedtime

  • One hot shower, followed by herbal tea one hour before bedtime

  • A book, not a game or surfing the net, but an actual book to read for pleasure

  • No study one hour before bedtime. If you haven’t learned what you need for the next morning’s exam, you’re not going to learn it by staying up all night. You’re better off getting the rest

  I went through the usual steps, but Veronika refused to leave. ‘You’re not ignoring me this time. I want something to make me sleep.’ I was about to explain that I never give sleeping pills to students, but she cut me off.

  ‘Do you not like me?’