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Welcome to the School Nurse Office

As school nurse, my goal is to help our students maintain optimal health so they can fully take advantage of the educational opportunities offered to them.  

The school nurse provides the following services:

  • Vision and hearing screenings at various grade levels. Parents will be contacted if their child does not pass any screening.
  • Dental screenings performed by a local dentist.   Parents will be notified of results of dental screenings.
  • Management of prescription medications and over-the-counter medications administered during school activities
  • Maintain individual health record for each student, including immunization records.
  • Notification of required immunizations for each school year.  Parents will be notified each spring of required immunizations for students. 
  • Injury and illness assessment.
  • Basic first aid measures for injuries..
  • Identification of health concerns and individualized health care plans as needed.
  • Baseline cognitive computerized testing for athletes prior to each sport season.
  • Health information resource for students, parents, and faculty
  • Health promotion activities.
  • Chronic disease monitoring.

Parents are encouraged to contact me with any health concerns that may affect your child during the school day.  I appreciate the opportunity to work with students and parents to provide a safe, healthy environment for learning. 

Jami Kuchar, RN

From Nurse Jami, School Nurse



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Wellness - It is Important to All of Us!


It’s the time of year where cold and flu symptoms begin, and It is important to know the difference between cold and flu symptoms. The common cold is milder respiratory illness than the flu. While cold symptoms can make you feel bad for a few days, flu symptoms can make you ill for days to weeks. The flu can also result in secondary health problems leading to hospitalizations.


Common Cold Symptoms:

Cold symptoms usually begin with a sore throat that may last a day or two. By the fourth and fifth day, nasal symptoms, runny nose, cough, and congestion follow. Fever is not common in adults. Children are more likely to have a fever with a cold. In the first few days the nasal secretions are watery, but become thicker and darker later. Mucus may become dark and does not mean you have developed a bacterial or sinus infection.


Symptoms usually last for about a week. You are most contagious in the first three days that you have symptoms. You should stay at home and rest at this time to prevent the spread of the infection to others. If cold symptoms do not improve after a week, you may have a bacterial infection, which will may need antibiotics.


It is easy to confuse cold symptoms with allergies or a sinus infection. If symptoms come on quickly and resolve after a week, then it is a cold and not allergies.


Flu Symptoms:

Flu symptoms differ in that they are more severe than cold symptoms and come on quickly. Symptoms include sore throat, fever, headache, muscle aches with soreness, congestion, and cough. Most flu symptoms gradually improve over the course of two to five days. You may feel weaker than usual for a week or more following the flu. Pneumonia is a common complication of the flu in the young, elderly, and those with additional health concerns. Shortness of breath is an indication of pneumonia and you should notify your doctor. The flu virus is spread just like the common cold. Stay home to rest when symptoms begin and maintain good hand washing practices.


So how do you know? Start by taking your temperature. The common cold rarely has symptoms of fever above 101 degrees. With flu symptoms, you probably have a fever initially with the flu virus. Body and muscle aches are more common with the flu and can make you feel miserable.


As with any virus it will have to run it’s course and antibiotics will not be effective. If you already have flu or cold symptoms, notify your doctor if you experience any of the following:


  • Persistent fever: Last 3 or more days.

  • Painful swallowing: Severe pain could mean strep throat.

  • Persistent coughing: Coughing that doesn’t resolve after 2-3 weeks.

  • Persistent congestion and headaches.


Signs and symptoms of crisis in adults:

  • Severe chest pain

  • Severe headache

  • Shortness of breath

  • Dizziness

  • Confusion

  • Persistent vomiting


Signs and symptoms of crisis in children:

  • Difficulty breathing or rapid breathing

  • Bluish skin color

  • Not drinking enough fluids

  • Lethargy and failure to interact normally

  • Extreme irritability or distress

  • Symptoms that were improving and the suddenly worsens

  • Fever with rash

(Crisis symptom list from WebMD)


The most important prevention measure with the cold and flu is handwashing. The flu vaccine is available to prevent seasonal influenza. Most drug stores in the US offer the flu vaccine as well as local health departments and doctors offices. Flu season in the US usually peaks between late December and early March.  



 Allergies are always a major health concern in September.  Doctor’s offices have a huge increase in patients every September due to allergies.  Allergies can result not only in mild symptoms such as head congestion, runny nose, and itchy eyes but also lead to sinus infections and asthma attacks so it is important to provide treatment.  If your child is experiencing head congestion, itchy eyes, mild sore throat day after day, it is very likely that he/she is suffering from allergy symptoms.  Fall allergy triggers are different, but they can cause just as many symptoms as in spring and summer.


What Causes Fall Allergies?

Weed pollen grains that fill the air from August through October (up to the first frost). Ragweed is the biggest allergy trigger in the fall. Though it usually starts to release pollen with cool nights and warm days in August, it can last into September and October. About 75% of people allergic to spring plants also have reactions to ragweed. Even if it doesn't grow where you live, ragweed  pollen can travel for hundreds of miles on the wind..

In someone with hay fever (allergic rhinitis), inhaling these tiny particles triggers a cascade of biochemical reactions, resulting in the release of histamine, a protein that causes the all-too-familiar symptoms. In addition to sneezing, runny nose, congestion, and fatigue, histamine can cause coughing; post-nasal drip resulting in sore throat; itchy or watery eyes, dark circles under the eyes; and asthma attacks.

Mold is another fall trigger. You may think of mold growing in your basement or bathroom -- damp areas in the house -- but mold spores also love wet spots outside. Piles of damp leaves are ideal breeding grounds for mold.

Going back to school can also bring allergies in kids because mold and dust mites are common in schools.


Since it’s not realistic to stay totally inside to avoid allergens, here are some tips to help your child if he/she suffers from moderate to severe allergy symptoms listed above.

  • Whenever you come in from outside, wash your face and hands. If you’ve been exposed to outdoor air for quite a while, shower and change into fresh clothes.
  • sinuses -- can be very effective at curbing hay fever symptoms---it needs to be more than just a quick spritz.
  • Medical therapy may be in order. Nonprescription antihistamines, such Claritin,Zyrtec and Allegra are generally the first choice for mild to moderate symptoms (no need to pay extra for brand names, as generics cost less and work just as well).
  • If you’re bothered by congestion as well as sneezing and a runny, itchy nose, adding a decongestant such as Sudafed or Mucinex should help. There are also antihistamine-decongestant combinations available. These products generally include a “D” in the name, as in Claritin D or Allegra D. (If you havehigh blood pressure, ask your doctor if taking a decongestant is OK. Some cause a potentially dangerous rise in blood pressure.) These are usually only available behind the counter of pharmacies in stores like Walmart or Dillons.
  • For severe or persistent symptoms, asteroid nasal spray (FlonaseNasonex, and so on) may be helpful. 

Experts say the best approach may be to start treatment early and combine various therapies.   Whichever prevention strategies and medications you decide upon, don’t wait until the last minute to start using them.  If you know your child has seasonal allergy problems, start giving the allergy medicine as soon as you are aware of symptoms or high pollen counts.  Helping your child feel as healthy as possible will help him or her to do his best at school and minimize school absences.


Pertussis Information

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vision screening clipart for website.JPG


One of the most important tasks of the school nurse is vision screening.  By Kansas state law, schools are required to provide vision screening to all enrolled students every 2 years, as a minimum interval.   Vision screening guidelines for school nurses also emphasize the importance of doing such screening annually for all children 8 years and younger.  After the vision screening is done,  the person doing the screening is required to encourage  the parents of students who failed screening to have their child receive an eye examination by an optometrist or ophthalmologist---this is known as a vision referral.  The school nurse is also required to follow-up on referrals made.

An initial vision screening for a student 4 years and older at our school includes: 

  • Distance acuity (far vision)---each eye is tested separately and then with both eyes together
  • Near acuity (near vision))---each eye is tested separately and then with both eyes together 
  • Depth perception--using stereoptic glasses
  • Color vision
  • Fusion testing (only up to age 8)

* For preschoolers and kindergarteners new to the school, the screening also includes fixation, tracking, pupil response, corneal light reflection and near point of convergence.  

* Near acuity is not tested for preschoolers under the age of 4.

Each year, all students in preschool, kindergarten, 1st grade, 2nd grade, 3rd grade, 5th grade, 7th grade, 9th grade and 11th grade receive vision screening.  In addition, each student new to the school that year and all students receiving special services through special ed and the gifted program receive vision screening.   Vision screening is usually done in the fall before Christmas break to ensure that any child who has undetected vision problem will receive the necessary treatment to help him/her in his academic performance through the rest of the school year.   Although children's near acuity remains pretty much the same after the age of 8, distance acuity can begin to change for the worse around the age of 9--sometimes sooner.  

Criteria for referring to an optometrist or opthalmologist are as follows for children 4 years and older: 

  • Distance acuity (far vision) and/or near acuity  of 20/40 or worse (higher numbers indicate a worse condition such as 20/50, etc.) in one or both eyes.
  • Two or more lines difference between the 2 eyes in either distance or near acuity.  An example would be a child having 20/20  distance or near acuity in the right eye and 20/30 in the left eye.   The lines checked are 20/20, 20/25, 20/30, 20/40, 20/50, etc. going as high as needed to find where a child's vision is at.
  • With the Worth 4 dot test for fusion, the child counts an incorrect number of dots
  • Inability to track properly with eyes, inability to fixate on an object or fixation with one eye only----such as in 'crossed eyes'
  • With corneal light reflection, the reflection of a penlight does not appear in the same position in each pupil.
  • With the near point of convergence, there is poor fixation of eyes to object beyond 3 inches of nose or asymmetrical response between the eyes.
  • For depth perception, inability to detect butterfly in stereoptic book
  • For children 3 years old, the criteria for referring for distance vision is 20/50 in one or both eyes.

Vision screening at school should not replace having regular eye examinations for children.  There are eye conditions which can only be detected with the more sophisticated equipment and knowledge of an optometrist or opthalmologist.   At times, a child may pass the vision screening done at school but still have a vision problem.  Some examples of such vision problem areas are teaming of the eyes, ability of the eyes to remain focused,  and visual perceptive processing disorder.  In that situation, the eyes can see but the brain and eyes are not working properly together to process what the child is seeing. 

It is recommended that children begin having eye examinations at the age of 3 and in Kansas, all children age are eligible for free eye examinations under a program called See to Learn.  There are a large number of optometrists who participate in this program, including optometrists in Wellington and Arkansas City as well as other local communities.   Vision is crucial to all areas of academic learning so the sooner children have an eye examination, the better!  

For anyone who has questions about the See to Learn program or vision screening at school, you are welcome to contact our school nurse,  Jami Kuchar, R.N. at 620-892-5215 Monday through Friday between 9 AM and 3 PM.


Immunization Requirements for 2017-18


For Preschoolers 4 years and under:

4 doses DTaP (diphtheria, tetanus and pertussis)

3 doses IPV (polio)

2 doses MMR (measles, mumps, rubella)

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