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School Nurses are Health Workers, Lie Detectors, and My Favorite People

School nurses have a job to tamp out sickness and patch skinned knees, but they also need to discover lies without calling kids liars.

School nurses have a ridiculously tough job. They are embedded in a petri-dish and surrounded by emotionally unstable liars. If they’re not slinging thermometers, they’re offering bandages or asking pointed questions. They have to be tough. They have to be kind. They have to be very, very clued in. Triage is way harder in an elementary school. Why? Because of kids like mine.

My 7-year-old does not like going to school, and even though he’s just in the first grade he is aware that the way out of class is through the school nurse. On a recent morning, in fact, he didn’t even make it to his classroom. He walked off the bus, directly to the nurse’s office, claiming that he was having trouble moving his legs. Naturally, the nurse called me.

“Hi, Mr. Coleman. I have your son here in my office and he says he isn’t feeling well,” she said with a voice as sweet as lunchroom Jell-O.

I could hear in her tone that my son was close by and she was talking to him as much as she was talking to me. The loudness and lilt of her words were designed to let him know that she was making this call in good faith, while simultaneously calling his bluff.

“Okay,” I said. “He was feeling fine this morning. He was in a bad mood, but other than that he was okay. Does he have a fever?”

“No. His temperature is normal but he says he is having trouble walking,” the nurse replied with an audible wink.

I had to give it to my boy. Of all the illness that could cause alarm, claiming that your legs were failing you was pretty up there on the scale of drama. It indicated something was seriously wrong but was also an ailment vague enough that it could not be precisely measured. I asked the nurse to put my young con on the phone.

“Hello, poppa,” he croaked pathetically. He’s not the worst actor.

We spoke for about a minute. I let him tell his story and responded empathetically, but let him know there was no way he was coming home. We worked out a deal: He would rest a bit and try to get back to class. If things were still bad, he could call back. Satisfied, he handed the phone back to the nurse and I told her our plan. I apologized for my little bullshitter.

“It happens all the time,” replied this saint of a woman, not a note of anger in her voice.

The fact that my son did not come home early is a testament to the nurse. But even more important is that she managed to walk a very fine line between nurturing and shaming. It would have been easy for her to dismiss my child out of hand for his obvious subterfuge and shame him for seeking an easy way out. But instead, the school nurse gave my kid comfort and a little space to find his footing before returning to class.

Honestly, I wish I had that kind of grace at home. I do not. My child’s made-up complaints are often met with a skepticism that borders on wholesale disdain for the inconvenience he’s created. Obviously, this is problematic. I want my kid to come to me with stuff and it’s possible that eyeing him with skepticism before compassion means I might be conditioning him to think I’m not the guy to go to.

I’m certain school nurses understand that they have a duty to make sure that kids feel comfortable to seek help when they need it. They are, after all, not only the front line in school illnesses, they also catch those kids who are struggling at home or experiencing psychological trauma. They have to be kind even when a child is trying to manipulate them. That’s hard. That’s the hardest.

Also critically important for my son is that in setting up a relationship of trust, the nurse is showing him that there is nothing wrong with seeking help as a boy, specifically. Instead of telling him to toughen up and get back out there like a big boy, she offers him some solace and an assurance that his needs will be taken seriously, despite the fact they’re bullshit.

The hope is that he carries this understanding with him as he grows. Particularly considering that men seek medical help at about half the rate that women do, which is probably one of the reasons we are more likely than women to die of every leading cause, except Alzheimer’s.

It takes a certain skill to get at the truth while making a person feel that their secret was never revealed. That’s something school nurses do every day. And it means they’re keeping kids like mine in class, while maintaining their bright, clean offices as a place of refuge, help, and peace.