By Carolyn Cole/Staff Writer

El Reno school nurse Stephanie Gholston’s worst fear is getting to an injured student too late.

Although having multiple emergencies at several schools at the same time is rare, Gholston said it has happened and the best she can do is train staff to recognize true emergencies and if she can’t get there, to call 911.

Gholston is the lone nurse working for the El Reno School District, and she takes her responsibility to keep the district’s 2,470 students safe and healthy seriously. But she is one nurse serving seven schools, when the National Association of School Nurses suggests each district should have one nurse to serve every 750 students.

Due to a lack of funding and a nursing shortage, Gholstonis one of many school nurses facing a daunting task — state Department of Education statistics show on average, Oklahoma has one school nurse for every 3,100 students and some rural districts share nurses or partner with health departments.

“There are days I just have to prioritize,” she said.

Because Gholston travels between schools, school faculty and staff must make decisions regarding health that are traditionally considered the role of the school nurse. School secretaries keep students’ medications in the office and administer medicines following directions from parents and the child’s doctor. They often perform basic first aid for bruises and small cuts and judge if a child is sick and needs to go home.

“It’s like treating your own kids at home, almost, for them,” she said.

Gholston holds training sessions each year to help staff make these determinations and also to recognize signs of an emergency. She carries a two-way radio and a cell phone with her so staff can call for advice or help.

“You can always tell something is going on, even if they don’t say, from their tone of voice or the panic in their voice,” she said. “That’s how I learned to tell.”

In medical emergencies, staff should call 911 before calling her, Gholston said because seconds make a difference.

Gholston said she goes with children if they are taken to the hospital, and stays for a while after parents arrive.

“I stay and make sure they know what is going on,” she said.

Over the years, Gholston said she’s developed close relationships with parents and students who face serious illness. She said she encourages students to take control of their care, and in the case of juvenile-onset diabetes, the children mostly test themselves and administer their own shots. She said recently the district faced a decrease in the number of children with diabetes, but she’s seen a surge in other conditions — including peanut allergies and asthma.

“It seems like I see the same ones over and over,” she said. “There are some kids I will never see.”

When Gholston first started as a full-time employee, El Reno had two nurses for two years.

Then, she said she could spend more time with students and provide health education programs. For the last three years, Gholston’s been on her own and several of El Reno’s teachers have picked up the health education slack.

Gholston still serves as a sponsor for the district’s Stay Club, which trains high school students about HIV/AIDS risks, allowing them to take the lead in teaching prevention classes to seventh and 10th-grade students. She also leads discussions with fifth-graders about puberty and other growing pains, but has given up an abstinence education program for eighth-graders and is relying on health students at Canadian Valley Technology Center to teach prekindergartners and kindergartners about hand washing and disease prevention.

Gholston also dropped a teen mother support group, because of a dip in El Reno’s teenage pregnancy rate. She said she believes the rate is on a rise again and hopes to revive the support group.

If time permits, Gholston said she wants to spend more time in the classroom again, especially focusing on healthy lifestyles, diabetes and exercise.

“I would like to go into some of the classes and talk about nutrition,” she said.

Gholston also teaches faculty and staff classes on blood- borne pathogens and cardio-pulmonary resuscitation, with help from the El Reno Fire Department. Law requires at least two staff members in each school to receive CPR training, but Gholston said she hopes faculty will take a greater interest to better prepare them to cope with emergencies.

Gholston also helps El Reno’s faculty and staff stay healthy, administering hepatitis B vaccines to high-risk employees and flu shots, when the county health department has an extra supply.

But, Gholston said her most important role is as a resource to help school staff face medical issues and to give advice. She gets questions from parents and teachers ranging from head lice to the difference between eye allergies and pink eye, as well as when to seek medical attention.

“I can’t diagnose, I’m not a doctor, but I can tell you if I think you should call a doctor,” she said.