Not Your Typical Doctor's Office by Emily Beamer

“Can I have _________ in the nurse’s office, please?” I call the student’s classroom, crossing my fingers they are not in the middle of a test. Not your typical doctor’s office waiting room setting, school-based health centers do things a little bit differently, working to address the needs of under-resourced students in true public health fashion.

Education Plus Health (EPH) operates school-based health centers in some of the most high-need public charter schools in the city of Philadelphia. While typical school-based health centers (SBHCs) operate as a full primary care office within a school, EPH SBHCs run the nurse’s office with a higher level of care by integrating a Nurse Practitioner. Working at the intersection of health and education, EPH strives to improve the wellness of communities by increasing academic performance through access to quality healthcare. School-based health centers around the country see decreased absenteeism and emergency room visits among their students, and EPH is following suit with similar outcomes. The model focuses on four key areas of health: sexual health, asthma, obesity/nutrition and mental health. As the school-nurse, issues are caught sooner than they otherwise would be, as school nurses are often the “problem solvers” for a host of student issues. Through this model, Nurse Practitioners can facilitate sick visits without students having to be sent out, and can serve them in a way typical doctor’s offices cannot, spending more time on education, medication management, healthy behaviors, etc.

The education piece is where I come in. I deliver classroom based sexual-health education to middle and high-school aged students, work one-on-one with asthmatic students whose asthma is not well controlled, and am newly working on a garden and nutrition project to be delivered in classrooms in the new year. Despite challenges with meeting state education guidelines and being in constant competition for funding, schools welcome this non-contemporary health education with open arms, because they see how their students benefit. Having the opportunity to facilitate classroom learning as well as work in on-one-one settings has given me a greater awareness of the challenges students face in both staying healthy and doing well in school. If a student does not understand the importance of proper medication management for their asthma (i.e. the need to take their inhaler every day), and is having frequent asthma attacks, or longer term flares where they’re missing school, it’s hard to expect that they will achieve high academic outcomes. Similarly, if students aren’t met with comprehensive sexual health education and tools to help them prevent unintended pregnancy and STDs, and space to discuss healthy relationships, consent and inclusivity, how can we expect them to thrive both academically and in life outside of the four walls of school?

School-based health centers, and the care and education they provide, fill a void in both the health and education fields. So often we focus on one without the other, but I’m learning that to truly address health disparities, we have to get a little messy and think outside of the box. Education Plus Health School Based Health Centers provide a hub of opportunity for increased health and education outcomes, community collaboration, and overall success for students and I can’t say enough how thankful I am to be a part of this innovative public health solution.