By Abby Spegman

The Bulletin

Margo McDonald spent part of the day Tuesday caring for a middle school boy newly diagnosed with diabetes who will need to take insulin. Karen Hecker helped a parent navigate immunization requirements, and Connie Hoffstetter checked on high schoolers recovering from concussions.

On this, National School Nurse Day, these nurses want you to know: They are more than Band-Aids and ice packs.

“It’s a lot more demanding than what I expected and more stressful than what I expected,” said Maria Buagas, who is in her third year as nurse at Ponderosa Elementary School in Bend. “Now that I have a Fitbit, I can tell you I can log 10,000 steps at my job. There’s a lot of hustle, there’s no sitting around.”

They see broken bones and asthma flare-ups. They administer medication and train teachers on CPR and how to use an EpiPen for allergic reactions. They coordinate with public health officials on communicable disease control.

Perhaps most important: Under the federal Individuals with Disabilities Education Act, which says schools must provide services for students with special needs, these nurses are helping to care for children with a variety of chronic and complex conditions.

Oregon law requires districts maintain nursing staff based on the medical needs of students. Last year lawmakers created a task force to make recommendations on funding with the goal of having one registered nurse for every 750 students by 2020.

Right now the ratio is one nurse for every 4,664 students, according to Oregon Department of Education.

Bend-La Pine has 18 nurses who are assigned up to five schools. McDonald, for instance, splits time between Juniper Elementary and Pilot Butte Middle School.

Buagas is at Ponderosa all day, five days a week as the lead nurse for a special program for students with intense medical needs. Her workday starts on the school bus, making sure students get to school safely.

“We’re constantly juggling what the kids needs, what the parents demand, what the district can afford and get behind. I often feel like I’m triaging,” said Buagas, who also treats other students at Ponderosa.

Hecker spent more than 20 years as a pediatric acute care nurse. Today she is the nurse at High Desert Middle School and Elk Meadow and Silver Rail elementary schools, and is working toward a master’s degree in public health.

Hecker said she sees her role as an advocate for children and a bridge for families to other health care providers. They might not know the child is eligible for Oregon’s Medicaid program, for instance, or how to sign up.

“We might be the only medical (professional) some kids may interact with on a regular basis … It fills a lot of gaps in health care delivery,” she said.

After she did a training for teachers on subtle signs of seizures, one came to her about a first-grader who was making strange-looking movements in class. Hecker suggested the family ask her pediatrician: Could it be seizures?

It was, and the girl is on medication.

Then there is the nonmedical care these nurses can provide.

Hoffstetter, the nurse at Bend and Marshall high schools, was recently named nurse of the year by the Oregon School Nurses Association. A few years ago she counted up her students with Postural Orthostatic Tachycardia Syndrome, or POTS. These students experience fatigue, headaches, dizziness, heart palpitations and trouble concentrating. When they stand up, their blood pressure may drop and they could pass out.

Hoffstetter invited them to have lunch together. Now they meet every month or so, continuing over the summer.

“It’s a great way for these kids to come together and feel like they’re not so alone,” she said.

— Reporter: 541-617-7837,