Health & Fitness
Dose for Dose

Each day some 3 million students in this country receive medication while at school, and increasingly large numbers of these students have complex medical conditions. Yet many school personnel aren't aware of safety and legal issues that surround this important task.

Are any of these scenes familiar to you?

• Children line up to have the school secretary give them their medication while the secretary simultaneously answers phones, performs administrative duties, and responds to parent, teacher, and administrator requests.
• Teachers administer medications to students from envelopes or baggies sent to school by parents with written requests, such as "Please give Suzy one tablet at noon."
• Parents send medication in their child's lunch with verbal instructions like, "Johnny, take the white pill with your lunch."
• Children dig through a pile of medication bottles, select their own, and self-administer their medication.

Fact is, these scenarios play out over and again at schools across the country. Not surprisingly, the risks for students are high. Researchers report that 75 percent of medications given in schools are administered by someone other than a professionally registered school nurse. When that happens, the research shows, children are three times as likely to miss getting their medication than when a licensed nurse administers it. The data is troublesome and suggests a need for increased awareness among educators about the gamut of legal and safety issues surrounding medication administration at school.

Here are the main issues to know and consider:

• The right of children to receive medications while at school is protected by law.
• Teachers should assist children in their medication management plan.
• Discussion of students' medication needs in front of others violates privacy rights.
• Teachers should know which students are taking medication, the expected outcome of that medication use, possible adverse reactions, and to whom such reactions should be reported.
• Parent permission must be obtained before the school nurse can discuss medical diagnoses and medications with teachers.
• Teachers and support staff can refuse to administer medication they have not been trained to give.

Take this checklist to school!
The National Association of School Nurses recommends these guidelines to ensure safe medication administration for students. Carry this checklist to school and do your part to make sure colleagues are following them regularly and wisely.

• Adhere to written school and district policies and state and federal laws to ensure safe medication administration by trained individuals in compliance with federal and state mandates.
• Keep medications under lock and key.
• Only give medication for which there is a written request from the parent or guardian.
• Give only medication that is in the original container and properly labeled with medication name, dose, route of administration, and dose interval.
• Always follow the "Five Rights of Medication Administration."
  Right child
  Right medication
  Right dosage
  Right time
  Right route
• Document the date, time, and dosage given and the signature of the person administering the medication.
• Never accept a "no-show," especially for seizure medications and antibiotics.
• Don't allow substitutions or use of one child's medication for another.
• Request training from your school nurse in administration of medications, including use in special situations. These include the use of epi-pens for anaphylactic allergic reactions or extreme respiratory distress, proper metered dose inhaler use for asthma, and medication administration procedures on field trips or while students are being transported.

--Janet Shackelford, B.S.N., N.C.S.N.
National Association of School Nurses

For More:
Visit the National Association of School Nurses website at www.nasn.org or call 866/627-6767.

What's Up at HIN?

Talking About Sex
The Sexuality Information and Education Council (SIECUS) of the U.S. recently released a report that could help parents looking to communicate better with their children about sex. Called "Innovative Approaches to Increase Parent-Child Communication about Sexuality," the report is a resource for educators who want to help parents seeking answers. Included in the assessment is HIN's Can We Talk?-?Conversamos? Program, which educates parents on how to communicate with their children on difficult topics. For more, visit www.siecus.org or call 212/819-9770.

Marijuana--Stamping out the Myths
Marijuana is the most widely used illicit drug among America's youth. Despite propaganda to the contrary, the drug is harmful to developing bodies and minds, and puts kids at risk. The National Youth Anti-Drug Media Campaign has launched a new initiative to dispel myths and misconceptions about marijuana and teach prevention. Want to join the campaign? Three websites have been developed. Educators can visit www.teachersguide.org, parents can visit www.theantidrug.com, and youth can visit www.freevibe.com.

Beating Asthma
The Centers for Disease Control and Prevention (CDC) recently released "Strategies for Addressing Asthma Within a Coordinated School Health Program," a new 12-page guide designed to help state and local education and health agencies and schools support students with asthma. It presents six strategies for schools to consider when addressing asthma within a coordinated school health program. To access the document, visit www.cdc.gov/nccdphp/dash/asthma.htm or call 888/231-6405 for hard copies.

New EPA "Healthy Schools" web portal
The Environmental Protection Agency has launched a new webpage intended to serve as a portal for online "healthy schools" resources. The portal is designed to help people who are addressing environmental health issues in schools. Numerous ideas and resources are available on the site. Visitors can browse by topic or by geographic area, or search all resources by entering specific keywords into the search box at the top of each page. Visit http://epa.gov/schools.

Matters Of the Heart

If you're totally stressed, can't remember the last time you took a brisk walk, are eating way too much--and you're a woman--consider yourself a good candidate for heart disease.

After decades of being identified as mainly a man's concern, heart disease has finally caught up with American women. And for educators--85 percent of whom are women--it's hardly a fact to tuck under the test papers and forget.

Heart disease now surpasses breast cancer as the number one killer of women, according to The American Heart Association (AHA). In fact, half a million women will die this year from it, far surpassing heart-related deaths for men.

How did this preventable disease make such a lethal descent on women? Dr. Rose Marie Robertson, professor of medicine at Vanderbilt University and former president of the American Heart Association, says the problem has actually been growing steadily over the years, as more women have taken on high-stress jobs and become more sedentary and overweight. And while men still are at high risk--it's their number one killer after cancer--women are often the ones who remain in the dark about the disease.

No, not me
Unfortunately, experts say, many women miss the early warning signs. "Most women just don't think about heart disease as something that can affect them," says Robertson. According to one survey, only 8 percent of American women believe heart disease and stroke are health threats that apply to them. While most women were aware of the classic signals of a heart attack--shortness of breath, tightness in the chest and pain in the arm--many were unaware of specific signals for women. Nausea, fatigue, dizziness, vomiting, and neck and shoulder pain can indicate a problem specifically for women. Even chest pains may be different; they may be light twinges that come and go, or simply be so vague a woman is inclined to dismiss them. Don't!

But I'm so young!
The risk of heart disease increases as you grow older because estrogen--which older women stop producing--is believed to somehow help shield the arteries. But that doesn't mean Generation Xers should ignore the disease. Incidents of sudden cardiac arrests are now occurring in women 15 to 34 years-old, so be aware.

The culprits
Smoking, poor eating habits that lead to high cholesterol, lack of exercise, and excess weight are all bad news--and they are highly destructive factors that increase the risks of heart disease. "Our environments don't foster healthy living," says Robertson. "We have become extremely sedentary."

Another culprit, especially in the African-American community, is hypertension. According to the AHA, hypertension escalates the symptoms of heart disease. So does diabetes. A recent report by the National Women's Health Resource Center says diabetic women are three to seven times more likely to have a heart attack and are twice as vulnerable to a second attack. Stress and a family history of heart disease are also both significant factors. Even body type can raise your risk: If your waist is nearly as large as, or larger, than your hips, this could be a problem--even if you're not overweight.

Beyond the Big Attack
Heart attacks are more lethal than other heart disorders, but the others are important to know because they can be just as deadly if left untreated. They include angina, a decrease in oxygen flow to the heart; Silent X, an irregular dilation of small blood vessels; and cardiac arrhythmias, which cause irregular heartbeats. If left unchecked these heart abnormalities can eventually lead to strokes and heart attacks.

Protect that ticker
While staying heart healthy may seem like yet another chore, it's one of the most important things you can do. "You are in training for your life," says Robertson. Become more familiar with the risk factors and your family history, kick the bad eating to the curb, and regularly monitor your cholesterol.

--Leah Lakins

For More:
Visit www.healthywomen.org and www.americanheart.org.

Your heart is the life center of your body. To help it be its best, make a real effort to "do the right thing." Start with these tips:

Stop smoking
See a health professional if you're drinking heavily
Build a network of friends who give you emotional support
Monitor caloric intake, cholesterol, and blood pressure
Eat more Omega-3 fatty acids (found in fish and nuts)
Eat high-fiber foods instead of high-fat junk food
Get moving! It promotes weight loss and relieves stress

Heart Healthy For Life

Healthy Bites

• Brown Baggin' It
  Fall in love with leftovers! They are easy, convenient, and can provide a lot of nutrition. Even if leftovers means a couple of pieces of take-out pizza from the night before, you can work with it. Chicken, ham, or veggies are good topping choices, and you can order them with "half the usual amount of cheese, please." Pack a container of pre-bagged salad mix, or baby carrots and sugar snap peas, and you're set.
  Another idea: When you cook, make extra, then freeze lunch-size portions. Heart-healthy warmers for this time of year include chili made with beans, and lentil or split pea soup with vegetables (lean ham optional). You can boost the power of the iron in those legumes if the recipe is tomato-based, or includes vinegar, lemon, or red wine.
• Inspire Me!
  I have been walking 4 miles a day, every day, for a year and a half. These walks have helped my husband and I survive cancer, meningitis, and a deep vein thrombosis (blood clot), while getting us more healthy in soul, mind, and body.
  --Dr. Monica M. Rogerson
  Carver Elementary School
  Long Beach, California
• Good Question!
  Q:What types of cooking oils are best?
  A:When choosing cooking oil, monounsaturated oils are the best. Some good sources: olive, canola, safflower, sesame, peanut, and walnut oils. All of these oils are healthy additions to your diet, but use in moderation. One serving of oil equals one teaspoon, so try to use cooking sprays made with these oils or use an oil mister to control the amount you use.

Talk to Us
This is the fifth in a series of articles designed to help NEA members develop healthy habits that tackle stress and overeating. Questions or comments: e-mail mmilloy@nea.org.