Hermosa School has a school nurse, but due to budgetary constraints she is only in the building one day a week, however, starting this month there is a robo-nurse available to students every day.
Meet Nurse Jo-Jo. She is an iPad mounted on a white cart with various examination devices attached. The e-nurse is connected via the internet to a hub in Sioux Falls where experienced school nurses can look at the pictures taken by Jo-Jo and help parents decide whether the child can stay in school or if she should be seen by a doctor.
One of the registered nurses who might be making that determination is Sheila Freed, the School Health Director for the eCARE School Health program in Sioux Falls.
Freed says if a student comes to the office with a health complaint on a day school nurse Lisa Parsons is out of the building Jo-Jo is there to fill the gap. Hermosa administrative assistant Connie Graziano has been trained in how to use the diagnostic tools on the cart to take pictures and video and gather other data which are then transmitted back to Sioux Falls.
“We interact directly with the kid via the video,” says Freed. “Let’s say they have a sore throat, so we say, ‘O.K. Connie would you help us,’ and then she uses the peripheral and she’s been trained, so puts it so we can see a good view of the throat.”
In addition to the tongue depressor-like device which takes high definition pictures of the throat, Jo-Jo’s peripheral devices include a stethoscope, an otoscope for looking inside the ears, a camera specifically designed to examine skin and a digital thermometer.
“What we see is amazing,” said Freed. “It’s just even hard to describe how well you can look at things.” She says the pictures and video she receives through the e-nurse are extremely clear and also magnified, “so in some ways you even see it better than if you were there in person, which is just crazy.”
The nurses don’t make diagnoses, but are able to give guidance to parents with regard to the child’s situation. “If we see a red eardrum or a throat that’s red, then we do the followup to the parents,” Freed said, noting that every student interaction results in a call to parents.
Often the e-nurse will see certain children on a regular basis to help them manage chronic issues like diabetes or asthma, but she is also there for everyday injuries and illnesses.
Freed says the No. 1 injury she deals with is “head bumps” that occur on the playground. “We are able to assess whether or not they need to be evaluated for a concussion,” she said. “We do an assessment and then we send home a sheet that tells parents what to watch for.”
The second most common complaint is earaches and sore throats, followed by rashes and skin disorders.
Freed acknowledges that sometimes students complain of pain simply because they don’t want to be in school, perhaps because they want to avoid a test. “We help them to say there’s really no reason for you to go home,” she said. “We try to keep kids in school so the educators can do their job.”
Hermosa is one of 24 schools across North and South Dakota participating in the program. Freed says the hub in Sioux Falls has done 894 “video visits” so far this year, averaging between 10 and 31 calls per day.
At Hermosa where Jo-Jo started service on Nov. 1, Graziano reports the e-nurse was used with eight students in the first five days of school. She is enthusiastic about the system.
“It gives me more thorough information to give to parents when a sick child comes to the office,” she said.
Graziano says the students are also excited about the technology, and the school even had a contest to come up with a name for their robo-nurse. The winning name Jo-Jo was submitted by a kindergartener.
Avera’s eCARE program for schools started as a pilot project in the Sioux Falls school district in 2015 and began to expand after receiving a grant in 2016 to help rural schools. Hermosa was able to join the program by taking advantage of that grant which runs through next year.
Freed acknowledges that the best model is to have a school nurse in the building every day to build relationships with students, but since that is not possible in many districts she says the e-nurse program is there to fill the gap.
“Lisa Parsons is the school nurse in Hermosa, and she has been so wonderful to work with,” said Freed, who also complements Graziano and Principal Lori Enright. “They are wonderful and such champions,” she said.