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"I'm here full time, thank you God for that"

September 2, 2005 -- Today the MetroWest Daily News (Framingham, MA) ran a short but very good piece by Norman Miller about local school nurse Mary Lou Rivernider, who saved a six-year-old student's life after he had a severe reaction to a bee sting. The story, "School nurse praised for quick thinking," does not just offer the standard "hero" comments. Instead, in an era in which school nurses have been cut back despite the increasing complexity and importance of their care, the piece includes powerful quotes from Rivernider and a fire lieutenant that stress how critical it is that nurses be available at school. The article, unlike many, tells us several of the specific things Rivernider did for the boy. And we can't resist any piece whose headline includes the words "nurse" and "thinking."

The piece reports that Rivernider, the school nurse at Henry Warren School for the last 23 years, "saved a little boy's life yesterday." The boy had never before had an allergic reaction to a bee sting, but after he was stung twice during recess, he was brought to Rivernider's office. She cleaned the wound and applied ice to stop the swelling. The boy complained of itching, and she gave him Benadryl (diphenhydramine). However, she noted that "[h]e developed hives from head to toe...His face began to swell up. He started to cough." Rivernider got consent from the boy's mother, who had arrived at the office, to give epinephrine, which she did. The boy was then taken to a local hospital, and although his condition was "unavailable," we assume that all concerned had a reason to believe he was doing all right.

Fire Lt. David Iarussi stated flatly that Rivernider saved the boy's life, and also noted that her "quick action proves that school nurses do more than just give aspirins": "I think we underestimate our school nurses...It's refreshing to see the system works." The comments of Rivernider herself similarly reflected the complexity of her work, and the importance of her being available. She noted that she had dealt with bee stings before, but that this was the first time she had this kind of problem with someone who had never before had a reaction. She also, without boasting, made an implicit comment as to what might have happened had no one with her skills been present: "I'm here full time, thank you God for that." The school principal, Kathleen Cullinane, said she was proud of Rivernider, noting that "[s]he's an excellent nurse in every respect."

The comments of Rivernider and Iarussi show why skilled nurses should be available all the time at every school. Of course, this is just one of many critical health activities in which school nurses are involved. Today, youngsters face a range of difficult health issues, and an increasing number attend school with serious health problems, such as asthma, diabetes, and food allergies. Yet many schools today face daunting budget pressures, and in many places one nurse must try to handle more than one school, which obviously means that the nurse is present at each school only half the time, at most. In other words, the "system work[ed]" here, but it is not clear what would have happened if no nurse had been present. The piece might have gone further, to note the extent to which reductions in school nurses have been an issue in Massachusetts since at least last year (see other analyses that we have done on school nurses 1, 2, 3, 4). But the piece effectively underlines the value of school nurses even without getting into specific policy implications.

We thank Mr. Miller and the MetroWest Daily News for this article. Feel free to send Norman Miller a note of thanks at and please copy us at

See the article "School nurse praised for quick thinking" in the September 2, 2005 edition of the MetroWest Daily News.

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