We hear a school nurse’s perspective on healthcare from Tina Mahoney in this episode of the Perspectives on Healthcare Podcast with Rob Oliver. Tina Mahoney has years of experience as a nurse in a variety of settings, most recently she has been servicing the community as a school nurse. A member of the Baby Boomer Generation, Tina Mahoney is in Arizona.
I apologize for the banging and clanging that you hear throughout the interview. About two minutes in, my microphone became detached from the desktop, and I had to hold it in my hands for the remainder of the interview. I tried to edit out as much as possible, but sometimes it happens while I am talking. My apologies!
Here are 3 things that stood out as Tina Mahoney gave us a school nurse’s perspective on healthcare:
- • The stereotypical view of a school nurse is “Band-Aids and crackers and we send you on your way.” The current reality is that they work with a variety of children, many of whom have complex medical needs.
- • By having a school nurse in the building, students who may have been otherwise homebound can now attend school in person.
- • Quality healthcare is about access to care and transparent communication! It also includes wraparound services for every family.
You can connect with Tina Mahoney through the links below:
Here is the transcript of Tina Mahoney giving us a school nurse’s perspective on healthcare:
Introduction to Tina Mahoney
Rob Oliver: Thank you and welcome to another episode of perspectives on healthcare. Today’s perspective comes from Tina Mahoney. She is located in Arizona. She is a school nurse. She’s a member of the baby boomer generation. Tina, welcome to the podcast.
Tina Mahoney: Thank you. Thank you for having me Rob.
Rob Oliver: Absolutely. So we’ll start right off with this one. Tell me a little bit about yourself and your role in health care, please.
Tina Mahoney: Ah Well, I have been a nurse for 33 years, I started my Journey in massachusetts. I went to curry college just outside of boston um Started my career at boston’s children’s hospital in a psychosomatic medical Joint Unit, Division 72. And after a few years there, my husband and I decided to venture out west. He had been in the Navy. I grew up in a small town my whole life, south of Boston. Wanted to get out for a little bit. Had relatives in Arizona. Came out here. Did some psychiatric nursing out here, then home health, and then landed in the school setting. I taught for a little while at EVIT. in Arizona, Mesa, Arizona, and then landed in Mesa Unified School District. And I’ve been here for this time around seven years. First time around six years, then taught for a while, then came back.
Rob Oliver: Okay, so talk to me about the difference between your experience as a school nurse and your experience in some of the more traditional settings.
Tina Mahoney: I think the biggest difference is the autonomy that you have in the school setting. With other settings, you have like, let’s take the hospital, for example, you have a medical director, you have standing orders, you have a team around you that assists you in making decisions on a regular basis, and you have guidelines and protocols that the hospital has. You do have those things in the school setting as well, but much of your day, the decision is made for the care of a student or the care of a student and family. based on your training and your experience. You always have somebody to call to double check things with, you do have your guidelines in your school protocols that you follow. But really your day to day decision making and assessment skills and intervention. You rely on yourself and your skills to do those things.
Rob Oliver: Okay, just pardon my ignorance on this.
Tina Mahoney: It’s okay.
Rob Oliver: My experience with a school nurse is Like you have somebody that comes in with an upset stomach. And I’ll be brutally honest about this, that I would go and my school nurse would give me like some kind of coke syrup or something to calm down my sick upset stomach, and then send me back to class. How much are you dealing with that is, that doesn’t fit into that stereotypical model?
Tina Mahoney: Well, and it’s funny you should say that because we always, laugh about the typical viewpoint of a school nurse is band-aids and crackers and we send you on your way. But more and more as medical techniques and technology has increased, we are seeing very complex kids in the school setting. Kids that may, you know, when I was a kid may have been homebound or had an alternative for schooling are now coming to the school setting. So we are seeing and caring for children. that have complex diabetes, that have seizures, that have trachs and vents and G-tubes and need feedings. In addition to all of our other kiddos on the playground that do fall and scrape their knees or get tummy aches, or we have severe allergies that we’re seeing on a daily basis. So there’s lots more to school nursing than band-aids and pats on the head. But, and we don’t, I don’t think we do the… I’m trying to remember what the syrup was, but I don’t think we do that anymore.
What does quality healthcare mean to you?
Rob Oliver: Well, let’s just say I was in school a long time ago, so things have changed since then. What does quality healthcare mean to you?
Tina Mahoney: I think I could equate it to access to care and transparent communication. The thing that… I see most often, especially in the school setting, is it’s very difficult to get wraparound services and resources for children and for families, I should say. You have a wide variety of socioeconomic and cultural backgrounds. And some communities, especially here in Arizona, are very remote. Some are very transient and the ability for families to seek out the needed health care and the services for not only daily medications but follow-up care is few and far between. It may be out there but it’s not well known, I guess, to the community and many of our families especially here in Arizona either. don’t have the financial capability of accessing some of that care or the means to do it. And there is a little aspect of fear of not wanting to put themselves out there. So I see that as a huge hurdle. So access good healthcare to me or quality healthcare, I think truly is wraparound services for every student and family.
Rob Oliver: I mean, I would imagine that for you, you’re doing it, you’re doing this because you’re being paid by the school district, not by the individual health insurance. So every kid in the school, every student in the school has access to the school nurse, even though there may be some differentiation in the type of access that they have to health care in the community. Is that fair enough?
Tina Mahoney: Absolutely. Yeah. It is. School health is a different being because every state has their own way of handling how they deliver school health in the setting of the school. So for health care in the setting of the school. So for instance, I know there’s a great number of communities back East who the nurses are hired through the health department and then placed in the schools. So the nurses report to the health department. but they’re housed within the school setting. And that I know is true in a lot of states. There are some states that the nurses are hired through Arizona Department of Education, they’re placed in the schools and there’s requirements for the qualifications for the person being in the health office. Arizona is one of those states that does not have anything that speaks to the personnel that must be in the health office. in your school. So many people will tell you they have a school nurse, but that person at the school may be playing that role. They may be the secretary that’s handing out the medication, or they may be the volunteer parent who is housed in that health office for a couple of days a week. So the qualifications, the abilities, the skill level are quite varied in Arizona, and we would love to be able to have a nurse in every school, but there is nothing in legislation that says that must happen. And ADE does not have, they have a health and wellness department, but there’s not a nursing department in there. So they don’t really, we are kind of, we are over, our oversight is the school that we are hired by or the district we are hired by. So you’re gonna see quite a very varying skill level amongst us and you know those that have nurses have an Easier way of finding those resources and delivering that care those that do not especially in the outskirts like Tuba City and Yuma where they have a little bit more trouble
Can you give me an example of quality healthcare?
Rob Oliver: Yeah, such an interesting thing. I’d never thought of as to where the Where the nurse is hired and actually who does who fulfills that role? Thank you for sharing that. Can you give me an example of quality health care?
Tina Mahoney: I would say that, well, for me, quality health care is my, I have a student that comes into my school that has a seizure disorder, and the parent comes to me and gives me all the information that I need to care for that student. However, I need to contact the physician to maybe clarify a medication or to find out if there’s a specific part of the school health plan that I would like to implement that might be a little bit different from what they have. Having that ability to pick up the phone and speak with the community healthcare team and for the parent and the community and that outside team to understand that. The school setting is where your child lives for a good portion of the day. And we are there to continue what you are doing in the community and in your clinic. So that open line of communication and transparency of care really creates that wraparound that student needs to make them successful. Because if a student is not healthy, they’re not ready to learn and they won’t have the access to the education all of our other children should have. And I live in the world of complex medical needs. That’s kind of the role I play in my district, but we are there for all students and we don’t want anybody slipping through the cracks. You have your students that come in every day for a stomach ache, but you have to be able to identify, is that… Is that really a physical issue or are they having difficulty in their class or are they having difficulty at home? so that Transparency and that communication amongst the family the caregivers in the community and the caregivers in the school is Is what I consider quality care Yeah And it goes back to as you mentioned earlier It starts with communication.
What do you wish people understood about your role in healthcare?
Rob Oliver: So Very interesting. Yeah, what do you wish people understood about your role in health care? And I think we’ve started to touch on that a little bit.
Tina Mahoney: Yeah. That I guess my biggest takeaway or communication on that would be to say that we’re there as an extension of the family and the care team in the community. So we want to do things as close to how the parent and the doctors and physicians and nurses and the healthcare team in the community want things done in the home. And so it’s very important for us to try and create a transition that is seamless. That the parent feels comfortable dropping their child at school in the morning and knowing that we are going to provide the best care possible for their student. And that allows them to go about their day with less worry. You know, I don’t care if it’s your student has never had an incident at all when you drop them off in the morning. We want those parents as well as those parents who have kids with complex medical needs to feel comfortable when they say, my school is caring for my child or my school is taking care of things and really feel that and feel comfortable when they drive away after dropping their child off.
Rob Oliver: Yeah, that’s so important. Listen, as a person with… a disability, I understand how much self-advocacy I have to do and how much education I have to do of my medical providers. And I can’t imagine what that’s like for a parent who is leaving their child and that child doesn’t have the same self-advocacy skills that I’ve developed over the course of almost 30 years living with a disability. And so you having the… you know, having the parent in mind and the peace of mind for that parent, so important. Can you just give us a quick definition? You’ve spoken about wraparound services several times. What exactly does that mean?
Tina Mahoney: For, I can give you my definition. I know that there’s, you know, probably better definitions than what I have, but. We’ve worked really hard with our community partners. So Phoenix Children’s Hospital, Banner Healthcare are very large hospitals in our county. We’ve worked very hard with them to create an understanding and a communication level where we don’t always have to have that formal. paperwork signed. If a care plan comes from the hospital to us and we are being asked to do services within the school setting, as nurses, obviously if you’re not a nurse, you have a few more papers you need to get signed, but as nurses, part of our role and part of our licensure says that if we have questions or concerns or clarification is needed, we can call the providers. And that’s really important to have that line of communication from A student that or I would say a child, I don’t want to say a student because any child that is in the community that has a health condition that maybe has been hospitalized or is being followed on outpatient setting, when they come into the school setting, wraparound services would be coming with a plan, coming with an action plan, let’s say if they have a seizure or maybe they’ve been hospitalized for behavioral or mental health condition and they’re coming with a transition plan that. speaks to the school as far as what we can do to support that child in the school setting and to keep them in a learning mode and in an educational setting that supports the family and the student. And then vice versa, if the student is in the school setting and that is where we’re identifying the issue, we have to have really clear communication with the family and with the care team. by sending any necessary paperwork, any explanations of what has happened, any information that we have for the family or for the care team that’s going to be receiving that child so that it’s a seamless transition. So it’s almost like that complete circle. You’re going to wrap up the care around that student from the time they leave your services till the time they are received for whoever is caring for them. And that means outpatient long term as well.
Rob Oliver: I mean, I would use the word seamless so that it sounds like no matter where they are, they’re getting the same care, they’re getting, they have the same plan and all of that is covering them no matter whether they’re in school, in the home, in the community or where it is. So thank you for that definition.
Tina Mahoney: You’re welcome.
What excites you about the future of healthcare?
Rob Oliver: What excites you about the future of healthcare?
Tina Mahoney: For me, and I can speak again for the school setting, that the thing that excites me is we had been for a long time reaching out to our providers in the community and saying, can you send us your resources? Can you tell us what we can do to assist our families and our children in identifying where they can go for whatever their needs might be? Clothing, food, eyeglasses, healthcare. immunizations, those things. We try and absorb and get as many resources as we can. And what I’m seeing now is that we are being contacted and it’s being identified that the school setting is one of those key places that children are seen throughout the day. whether you have a medical issue or you don’t. It could be something as simple as, you know, the child that comes in every day and their sneakers are falling apart and you’ve identified that student as needing something. So community caregivers are now contacting us and saying, you know, what can you do? What do you have at the school? How can we help you? And that to me is an exciting thing. I’ve had Phoenix Care Network contact me recently. We’ve done some… wrap around care services with Phoenix Children’s Hospital, where we’ve gone out to the community and spoken to community members about how can we organize things so that we have all of these resources available that can assist these families so they don’t feel like it’s a disjointed process. So that excites me because people are still understanding that school is band-aids and crackers, but it is also the place where you may be the initial identifier of a need for a family or a student because we do care for not only our students that come to our schools But their families and what their needs are and sometimes we’re the first to identify those things.
What is one thing medical professionals can start doing today to improve healthcare quality for their patients?
Rob Oliver: Excellent. All right last question for you What is one thing medical professionals can start doing today to improve the quality of health care?
Tina Mahoney: Ask the questions What can you do for our kids or what can you do for our families in your setting? Many people, like you said very early on in the broadcast, the view of what school health is or what nursing in the school setting is might be band-aids and crackers, but what else do we do? How else do we care for our students and what kind of services do we have? what can we do in the school setting? So asking those questions to gain that knowledge so that moving forward, everything can get worked through as we talked about earlier, like in a seamless fashion.
Rob Oliver: Wonderful, listen, Tina Mahoney, thank you so much for joining me today. I appreciate you coming on and educating me about healthcare in the educational system. I appreciate your perspective on healthcare.
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Disclaimer: All opinions expressed by guests on the Perspectives on Healthcare Podcast are solely the opinion of the guest. They are not to be misconstrued as medical diagnoses or medical advice. Please consult with a licensed medical professional before attempting any of the treatments suggested.