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Caring for a Child through a Mental Health Crisis

By Egypt Middleton, a Children's National Hospital school nurse
Egypt M

As a school nurse in one of Washington, D.C.’s neediest areas, Monday mornings are often the hardest. Some kids arrive having felt unwell all weekend, waiting until they get to school and see me for nursing care.

Some come from homes where there is neglect or abuse. They may not have eaten or have clean clothes. They carry heavy emotional burdens that get in the way of learning.

Not long ago, a student tore things up in the classroom, called the teacher names and hit other kids. This baby was so young. His parents were both in jail. I worked with the school social worker and psychologist to deescalate the situation.

On another day, when this child broke glass and became violent — it took all of us — me, the school principal and vice principal, the social worker, the behavior tech, the security guard and the psychologist — to contain him. He was suffering. But our crisis intervention wasn’t enough. He went by ambulance to the psychiatry and behavioral sciences unit at Children’s National Hospital. Hospital staff cared for him and helped family members understand the cause of his mental crisis: a family member he'd been living with had been sexually assaulting him. Care providers diagnosed him with PTSD, ADHD and separation anxiety. They created a recovery plan for home and school.

Every school day I assess, triage and treat kids. Resources are limited. We don’t have a rapid response team — I am it. Being on the school nurse team at Children’s National, I know I’m part of something great: care that makes a difference every day for children.

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