College Health Nursing

Eleven years ago when I accepted the position, Director of Health services at Wilkes University, I had my doubts if it would be exciting and challenging enough for me. Prior to accepting the position, I worked in a busy Emergency Room for fifteen years, where life-threatening situations came through the door continuously. I knew that I was ready for a change of pace but I wasn't sure this pace would be quick enough for me. After eleven years, I can honestly say that I grow everyday with my students, and have found college health nursing to be fun, challenging, and forever changing in it's demands.

College health services today take on many forms, depending on the size of the institution. The larger colleges are usually physician directed and have staff available 24 hours a day, with facilities to keep students over night for observation. Small colleges, like Wilkes, are usually nurse-directed and have a physician come on campus a few hours each week. At our university, the health service is open 5 days a week without weekend or late evening hours. If there is a medical problem after hours, the resident assistant will follow protocols to have the student seen by a physician or the emergency room.

On a typical day in our college health services, the nurse will assess the student, make a diagnosis and treat the student according to protocols written by the physician. If certain guidelines are met, we can dispense
antibiotics and other non-narcotic medications according to protocols. If there is a student with special concerns, we commonly call the physician and give them an assessment over the phone and they will decide if the student should be seen in their office, go to the emergency room or be treated at the health services. On an average day, we see 15 to 20 students with a variety of medical concerns from upper respiratory infection, urinary tract infection, sprains, strains, lacerations etc. When you are the health care provider for 2000 students, staff and faculty, anything can walk through the door. This is where emergency room experience has helped me a great deal. Other services that are provided include, health screenings, allergy shots, immunizations, urine pregnancy tests, laboratory services in conjunction with our local hospital, counseling and resident hall educational programming. All of the services provided by the health services are strictly confidential, which sometimes becomes an issue with parents of students and the staff. If there is a serious emergency, we provide treatment until the paramedics arrive, for example, IV insertion, nebulizer treatments for acute asthmatics and epinephrine for allergic reactions.

The college population is unique, in that they are usually a relatively healthy group of people with some very unhealthy behaviors. Increased alcohol consumption, smoking, drug use and sexual promiscuity makes them at particular risk for diseases like meningitis, STD's, and pregnancy, HIV disease, tuberculosis, and dependence on drugs and alcohol. Health promotion and health teaching is probably one of the most important pieces to college health. I try to incorporate some form of health promotion in each visit with a student.

In looking back over the years that I have spent in college health, I feel the most fulfilling part of my job is knowing I can make a difference in a student's life. You are not only here for the medical emergencies you are here for the emotional emergencies. Whether it involves a medical problem, trouble with relationships, sexuality issues, or family situations, providing advise and guidance enables students to get through some tough decision-making, at a vulnerable time in their life. College health nursing is rewarding not only because you address their diverse health needs but you also become the student's friend, confidant, parent and disciplinarian.

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