Ten Things Teachers Can Do to
Create Healthy Classrooms
Gerri Harvey, RN, MEd
1. Reinforce and make time for healthy practices: covering sneezes, hand washing with soap.Contrary to popular belief, most cold germs are passed on hands, not by sneezing.
2. Encourage kids to go outside for recess. The outdoor air, especially in the winter, is more humid, and much fresher than the air indoors, which tends to be drying to the mucous membranes , increasing the incidences of nosebleeds, impetigo, chapped lips, ear infections, and upper respiratory infections. Heated indoor air is germ-laden and dusty. Although some asthmatics have attacks from air that is too cold, usually below 20 degrees, children with colds benefit from the humidity of outdoor air.
3. Find alternatives to having kids stay in for recess to make up unfinished work. Kids need the change, exercise, and sunshine, especially in the winter, when outdoor time is so limited anyway. Unproductive, restless or unmotivated children probably need it the most.
4. Create opportunities to drink water. Don't think of trips to the water fountain as time-consuming side trips. Most kids drink only the few ounces of fluid that comes with lunch through the entire day. Too little fluids contribute to poor hydration. Poor hydration results in dry mucous membranes (see above), constipation (the cause of most belly aches in school), headaches (the reason for most visits to the school nurse), fevers, bladder infections, and dry itchy skin.
5. Empower kids by encouraging self-responsibility for maintaining health and comfort by giving positive reinforcement for healthy food choices in the snack or lunch, for appropriate dress, for self-care. Don't foster the idea that health and comfort only come from medicine, a nurse "fixing" it, or others taking care of everything for them. You can do this by: having kids wash their own minor scrapes, hang nails and paper cuts in the classroom, and applying band aides themselves; having kids apply pressure to minor nosebleeds right in class; offering drinks, rest, time out, a change of activity etc. for vague complaints of not feeling good. In this way, you respond to the real need without providing pay offs for being sick. Often, a trip to the nurse is a payoff in that itprovides a diversion, an out when the child doesn't want to do the class work, and this reinforces that being sick or hurt is a way to deal with frustration. Choose not to send kids to the nurse to borrow sweaters, coats, sneakers, boots etc., when these needs arise out of poor choices made by the child. While nurses are happy to give these items to children who do not own them, or who have had a bathroom accident, loaning dry clothes to kids who have rolled in the snow, or who left the needed item home, or in the classroom , encourages continued irresponsibility. Find some natural consequences that reinforce remembering instead. Point out the pay-offs for making good choices, and don't provide pay-offs for poor ones.
6. Think about the messages you are sending to children when you send them to the nurse for minor discomforts associated with normal life events such as loose teeth, choices in clothing, old scrapes or bruises that are obviously well-tended and healing, stuffy noses, invisible itchy spots.
7. Consider hunger or needing to use the bathroom when a child complains of a belly ache, especially if it is late morning or early afternoon. Ask the child to try eating a snack or using the bathroom before sending him to the nurse with a sick message. These are probably the first things she will ask, and many belly ache visits can be attributed to one of the two.
8. Let the child name or describe the problem. Well-meaning teachers often tell children that they look sick, and children buy into the idea because the compassion that accompanies it provides a psychological hug. As an example, recently a child was sitting in the health office waiting for his mother to arrive with pants because he had torn his, and the nurse didn't have any in his size. The child was embarrassed and upset, and had been crying a few minutes before. A staff member stopped in for something else, and asked if he was waiting for his mother. He nodded yes, and she said, "Oh, I'm so sorry, I can see you're sick, you look just awful, you go home and get better. " The child began to cry when his mother arrived with the pants and told her he was sick.
9. Express the expectation that your class will be healthy . Like the expectation of success, children believe you, and will fulfill your expectations. One second grade teacher I know tells her children that for some reason she always has the healthiest class in the school each year. She tells them that it must be the beautiful view from the classroom window, the "feel better" place that she has behind the piano, complete with mats and pillows, or the excellent health practices like hand washing that her students always remember to do because she provides special soap and hand lotion. All of these things help, no doubt, but the most powerful preventative is this teacher's willingness togive psychological and physical hugs, and her expressed expectation of wellness.
10. Convey the message that nurses and other health care workers are resources to help us stay well. If every teacher in your school did just the nine things listed above, there would be fewer sick children in your school and fewer needless visits to the nurse. With all her newly- free time, your school nurse could spend more time on prevention activities such as screening , health education, counseling and safety.
