Healthful Living from Your Arlington School Nurses - Issue 003 • … · 2020. 6. 1. · 0 of COVID-19 is 2.2 to 2.5 A NURSE • QUESTION OF THE WEEK What is Herd Immunity? Herd

Issue 3 • Newsletter Contributors Susan Almquist • Susan Franchi • Carol Howard • Michele O’Toole • Arielle Petti • Amy Volante • Andy Winther

Definitions to help you navigate in a COVID-19 World By Susan Almquist RN, MS, NCSN You may have questioned the meaning of various terms that are being used frequently these days in regard to the coronavirus SARS-CoV-2 and the disease it causes, COVID-19, specifically:

Isolation versus Quarantine:

• Isolation: separates sick people with a contagious disease

from people who are not sick.

• Quarantine: separates and restricts the movement of

people who were exposed to a contagious disease to see if they become sick,

The Center for Disease Control and Prevention Requirements for when a person no longer requires isolation or quarantine is set by State and Local

guidelines.

Testing: Appropriately validated serology tests (antibodies specific to SARS-CoV-2), when used broadly as part of seroprevalence studies, can be useful in understanding how many people have been infected and how far the pandemic has progressed. These tests can also be useful to examine demographics and geographic patterns, to determine which communities may have had more cases, suggesting more ‘herd immunity’ which reflects the degree of resistance to infection in a population. Various tests, specific for the virus SARS-CoV-2 can identify if an ill or exposed person has been infected by the virus.

Basic reproductive number, R0 (Rnaught): Basic reproductive number (R0); defined as the expected number of additional cases (infections) that one case (infection) will generate, on average, over the course of its infectious period in an otherwise uninfected population. N Engl J Med 2020; 382:1199-1207 Basic reproductive number, depends on the biology of the virus and it's environment, for example the level of crowding R0 of COVID-19 is 2.2 to 2.5

ASK THE NURSE • QUESTION OF THE WEEK

What is Herd Immunity?

Herd Immunity (also called Herd Effect or Herd Protection): Individuals who are immune to a disease act as a barrier in the

spread of disease, slowing or preventing the transmission of

disease to others. An individual's immunity can be acquired via

a natural infection or through artificial means, such as

vaccination. When a critical proportion of the population

becomes immune, called the herd immunity threshold (HIT) or

herd immunity level (HIL), the disease may no longer persist in

the population, ceasing to be endemic. Merrill, R. M. (2013).

Introduction to Epidemiology. Jones & Bartlett Publishers. pp.

68–71. ISBN 978-1449645175. Retrieved 29 March 2015.

Please see the diagrams on page 2

Congratulations Class of

2020 2020


Diagram 1 - Left side of the diagram displays the situation

with established Herd Immunity, where susceptible individuals

are not infected and the virus dies out.

The Protection Given a Population Through Immunity.

_______________________________________________________

_ _ _ with social distancing ____ without social distancing

Diagram 2 - Right side of the diagram displays a situation

similar to COVID-19 where with an Ro of 2 and over half the

non-immune population still susceptible to infection.

_______________________________________________________

Flattening the Curve: Until Herd Immunity is established either by natural immunity acquired

by infection or by immunization, social distancing can slow down the

spread of infection, allowing time for establishing the best care

protocols to protect and support ill individuals to a return to health.

Time

Number ofInfected

Individuals

Area Under the Curve(number of infectedindividuals) is the sameon both curves.


Massachusetts Leads the Way in Contact Tracing By Michele O’Toole, MEd, BSN, RN

Governor Baker is making contact tracing and testing a priority

for the State of Massachusetts. The Contact Tracing Collaborative

(CTC) as it is called, will help us in the fight to contain the virus and

to get people back to work and back to a new normal. Countries

such as South Korea, China and Germany, had success with contact

tracing early in the spread of COVID-19. The MA contact tracing

program was piloted in April and now has a workforce that is

scalable to meet the need anywhere in the state. Partners in Health

(PIH), a non profit Massachusetts based company, with a wealth of

experience around the world protecting people from diseases such

as HIV/AIDS, Cholera and TB, has created, collaborated and

implemented this ambitious and exemplary initiative. PIH is

working with the Massachusetts Department of Public Health

(MDPH), 300 local MA Boards of Health (LBOH) and academic

health departments to reach out to those who test positive for

COVID19 and their contacts. The program can connect infected

individuals with testing, health providers and supports as needed.

Timely intervention is vital to the health and safety of everyone.

One thousand contact tracers have been hired to work on a

mission that is anticipated to last for at least a year, maybe longer.

The workforce is anticipated to reach 5-10 thousand people a day

by phone with initial calls lasting 30-40 minutes.

In addition to contact tracers, PIH has hired “case investigators”

who supervise a team of contact tracers. It is the case investigators

job to initiate the dialogue over the phone with the COVID positive

patients and ask them to recall when they first noticed symptoms,

who they were in close proximity with from two days before the

start of the symptoms through the time of their diagnosis. The

“contact tracers” are then assigned to follow up with the contacts

of the patient and in some cases may need to do detective work to

find them. “Care resource coordinators” will then help the most

vulnerable contacts. The care resource coordinators are nurses,

social workers and those knowledgeable about the community and

it’s resources.

The CTC model is being shared with other states around the

country. This program brings hope that we will be able to keep the

virus under some control. Of course the program is voluntary and

confidential. It is important that people believe in, understand and

trust CTC. People should know that information kept in

Massachusetts Virtual Epidemiologic Network (MAVEN) is private

and secure. People will see an identifier on their phone “MA COVID TEAM” when the phone rings. So pick up the phone if you see this identifier, the team is there to help. Social

distancing, contact tracing, testing, quarantine/isolation and

treatment are five elements that experts advise will make the

difference in reducing the spread of the virus. The human element

exemplified in this program, is an important reason why this

approach has proven to be so effective all over the world. People

need human connection and to know that other people have their

back. Contact tracing if done correctly provides that human touch.

Resources: - Mass.gov/covid19 -PIH COVID19 Webinar Series, April 28, 2020

- PIH.org, Partners in Health website

- ‘A way out’: Inside the ambitious Mass. coronavirus contact tracing

effort by Victoria McGrane, Globe Staff, Updated April 25, 2020

- An Army of Virus Tracers Take Massachusetts by Ellen Barry, The New

York Times, updated April 17th, 2020


Three Types of Support Dogs By Andy Winther R.N., B.S.N You may have seen a dog in your school and wondered what is

the dog doing in my school? It is very likely that the dog you

saw was a Therapy dog, but did you know that it could also

have been a Service Dog or Emotional Support Dog. There is

often some confusion about the different jobs that these

support dogs do so let’s try to clarify them. We won’t go into

details about the specific jobs they do, but we will cover the

basics. In separate articles we will cover each support dog’s job

in more detail, so look for it in this newsletter and future

newsletters.

What is a Therapy Dog? A Therapy Dog’s job is to

provide emotional support to a group of people in a situation,

not just one person. They have had formal training and they

need to pass a standard test for certification. The training they

experience is basic; they have to be able follow basic

commands, and have a good temperament. You may see a

Therapy Dog in schools, hospitals, nursing homes and other

places. Some of the schools in Arlington utilize Caring Canine

Visiting Therapy Dogs to come and socialize with the students.

You can pet a Therapy Dog, (that’s why they are there) but you

should always ask for permission first.

What is a Service Dog? A Service Dog is

specifically trained and

certified to assist the

needs of just one

person. They have been

individually trained to

perform specific tasks for individuals who have disabilities.

There are many different kinds of Service Dogs. Some can aid

in navigating people who are hearing or visually impaired,

some can assist people who are at risk of seizures by alerting a

person before the seizure happens, and some dogs are trained

to use their nose to help people with diabetes by alerting the

person if their blood sugar is high or low. Service dogs are

protected by the American with Disability Act and are allowed

in all public places. They can also go in the cabin of airplanes.

You are not allowed to pet a service dog because it could

distract the dog from doing its job.

What is an Emotional Support Dog? An

Emotional Support Dog

provides emotional support

to a person with a disability.

They are not trained or

certified for a specific skill,

their primary function is to provide emotional support, through

companionship. Emotional Support Dogs help people who

struggle with stress, anxiety or depression. They are allowed to

fly in the cabin with the owner with proper paperwork from a

medical professional. You may be allowed to pet the dog but

only with the owner’s permission.

As you can see, dog’s capabilities go way beyond “man’s best

friend”. Dogs can have many different and complex jobs. Isn’t

it amazing that we can utilize a dog’s intelligence, instincts and

natural senses. Hopefully, you have less confusion about the

roles of Support Dogs. Coming soon, more details about the

different kinds of Support Dogs and what their jobs entail in

this newsletter and future newsletters. They are amazing!


The Superheroes of The Dog world: Diabetic Service Dogs By Andy Winther R.N., B.S.N Service Dogs are specifically trained to help and support

humans in times of need. There are many different kinds of

service dogs. Just a few of them are: guide dogs for a blind

people, seizure response dogs, mobility assistance dogs, and

dogs who are trained to use their nose to help humans. We are

going to learn more about a Diabetic Service Dogs that has

super hero skills.

The Bode family of Arlington has a very special family member,

a Diabetic Service Dog named Atlas. Atlas’ family are his big

human mom and dad Crista and Jim, and little humans Anna,

Luke, and Matthew. Anna has Type 1 Diabetes, so Atlas’ job is

to help Anna. Anna is 6 years old and is a student at Stratton

Elementary School. Anna and her mom Crista have been so

kind to help us all learn what a Diabetic Service Dog can do

and what it is like living with a superhero working dog. Before

the Bode family got Atlas they did not have any animals, so

having a dog with superhero powers has changed their lives.

Now, they could not imagine a life without their dog Atlas.

Talking with Anna’s mom Crista it was clear that the whole

family is absolutely in love with Atlas Bode. Join us for a few

minutes to learn all about diabetic service dogs from Atlas’ big

human mom; Crista Bode.

What is the dog's name, breed and age? “Atlas Bode. Atlas’ Breed is a Golden Doodle; Age, 1 years

old”.

People may not appreciate the extent of the training a

specialized service dog must engage in prior to matching

with its owner. Can you briefly describe the training

involved to become a diabetic service dog?

“We worked with a Diabetic Alert Dog organization that

services people of all ages affected by diabetes. Atlas was

selected at four months old, very carefully, based on Anna’s

age, her typical daily activities, personality, and our family

lifestyle. The questionnaires and in depth discussion with the

organization director helped determine which dog would have

the right temperament and energy level for Anna.

Atlas lived with an experienced certified dog trainer for 6

months and was put through advanced training that included

three levels: Obedience, Public Access and Scent Training.

We froze numerous samples of Anna’s saliva on cotton balls.

Anna’s saliva samples were used to train Atlas before he was

delivered to us. He was trained to alert us in advance of low

(hypoglycemia) or high (hyperglycemia) blood sugar events and

more specifically when Anna’s blood sugar levels were out of

range, which for her, is below 80 and above 150. Dogs are able

to do this through smell. Dogs have a naturally heightened

sense of smell. There are distinct odors that accompany blood

sugar levels.

Do you know how sensitive a dogs nose is?

Here are some fun facts.

• A dog has 300 million olfactory receptors in their nose, compared to about 6 millions in humans.

• The part of a dog’s brain that is devoted to analyzing smells is 40 times bigger than humans;

Think about that for a second;

• A dog can smell something that is a mile away.

• A dog can smell an item buried 40 feet under the ground, and 80 feet under the water.


Atlas was trained to Anna’s specific scent which allowed for a

much shorter transition period after he arrived here. Ten

minutes after walking into our home, Altas alerted us to Anna’s

high, out of range blood sugar level.“

When the service dog needs to signal Anna, what is the process? “When Anna is out of range or is heading either up or down

quickly, Atlas will start sniffing the air and pacing around one of

us. He will then start smelling Anna and will place his paw onto

Anna’s lap to alert her that she is not in range or heading out of

range quickly. Then he will alert again by placing his paw on

any of the other family members nearby, either Anna’s parents

or siblings. Altas will not stop alerting us until he is given a

special treat and told, “Good alert, Altas, Good boy” over and

over again. This is the only time Atlas receives treats which

keeps him motivated. The treat also signifies to him that he can

stop alerting in that moment and that we have it under control

(we will give Anna what she needs to address the high or low

blood sugar event). Altas alerts us ahead of the Continuous

Glucose Monitor almost 99% of the time.”

Does the dog need to maintain the training? If so, how do you refresh its skills?

“Atlas came to live with us when

he was 10 months old. Even

though Atlas graduated from a

vigorous training program and

was ready to work immediately

upon his arrival to our home, we

continue to reinforce his training

and skills on a daily basis. We

followed along with

videos/demonstrations during

Atlas’ training and then we were

trained by his trainer upon

delivery to us. It has

become part of our daily routine to use basic commands with

him (sit, down, come, stay, etc.) as well as play scent games

to keep him motivated to respond to treats for smelling out of

range blood sugar levels. Consistency is necessary with service

dogs so they continue to alert and we have made the

commitment to keep up with his training.”

We hear that people should not pet a service dog; if so, why is that and are there times when it's ok? “When we are out in public and Atlas is with Anna, he is

“working.” If others pet him and try to engage him, it is highly

likely he will get distracted and not catch the scent of Anna’s

blood sugar changing. If he has recently alerted and/or we

know Anna is in range, then we make a decision to let

someone pet him. 99.9% of the time, individuals that we do

not know, will ask us permission to pet him or will inquire about

his job. We love having the opportunity to educate the public

and bring awareness for this invisible disease.”

What is the relationship between Anna and Atlas? “Atlas provides a tremendous amount of love and emotional

support for Anna. He intuitively goes to her when she has to

have her insulin pump and glucose monitor injections. He

provides comfort and a wonderful distraction during these

times. It is evident each day that he knows that he is her

companion. Atlas responds to Anna’s guidance and

commands wonderfully. He listens to her, follows her around

and clearly adores her.”


What is special about him? Does he do anything funny? “Atlas wants to be

in the middle of

everything we are

doing. His tail is

always wagging.

We giggle

because

sometimes he

thinks he is a “small, lap” dog and he lays his 65lb. body on us

and snuggles in tight. He nudges us to rub his belly and scratch

his back. He communicates with his big, brown eyes, exactly

what he needs whether it is to go potty or that he needs more

water or food.”

When not "in service"; does he like to play? “Absolutely!!! Atlas loves to play ball and run around outside

with us. He figured out the game of fetch very quickly. The

moment he gets outside, he looks for his ball and brings it to

us. He is super playful. “

Is there anything else you think that is important to know or misconceptions to clarify? “Some people suggested that a service dog would inhibit

Anna’s ability to live independently and that she would not

learn how to “feel” her lows and highs on her own and that a

dog wearing a vest would impact her sense of self. We were

also cautioned that siblings would feel left out and not bond

with the dog and that “a service dog could be robotic and not

provide the emotional love and support that other dogs

provide.” Thankfully we have not had difficulties with any of

these potential situations. In fact, we have experienced the

exact opposite with Atlas. He is incredibly affectionate and

playful and fun with each family member. He loves to be

snuggled and prefers to be close to one of us at all times.

When Anna was diagnosed and

before she got the CGM, we

checked her blood sugar levels

every hour of the day. It was

extremely overwhelming. Caring

for a child with T1D is a 24 hour a

day job with no break. Our

decision to get Atlas was made

after weeks of research, learning

about how a service dog could

help us manage the life changing

diagnosis and connecting with

families that were already living the experience. Having a

diabetic service dog is not a replacement for checking blood

sugar levels. Anna is fortunate to have a CGM, an insulin pump,

a blood glucose meter and a great exercise and nutrition

management plan. For us, it’s extra peace of mind, being able

to have Atlas around to alert us before things get to a

dangerous level.”

Thank you to the Bode family for sharing your incredible

story about living with Atlas.


Adapting to Change When an unexpected curve in the road throws you off course, there are ways to get back on track By Amy Volante RN, BSN

Change is constant but when a worldwide pandemic is the

source of change, it can send us reeling. Life is especially

unpredictable and scary right now. What can we do to cope

with the fallout from the Covid-19 crisis? Let’s start by looking

at stress.

There are two types of stress--eustress and distress. Eustress is positive stress. It feels exciting and it is

perceived as something within our ability to cope. Examples of

eustress include earning an award, graduating from high

school, getting a job, going on a trip, etc. Eustress brings with

it good feelings and makes good memories. Distress is

negative stress. It causes anxiety and feels unpleasant.

Examples of distress include failing a test, getting sick, financial

problems, being abused or neglected, or loss of a loved one.

Face it head on. Not everyone reacts to change the same

way. Some people accept and address it as soon as it occurs.

Others take more time. If you actively participate in the

process, you will adjust faster. Define the challenges you face.

Give yourself permission to feel. Avoiding your

feelings hinders healing. It is okay to be sad. It is okay to feel

angry. Expressing your feelings is the next step. Whether you

write down your feelings in a journal or share them with a

trusted confidante, expressing them is essential.

Surround yourself with supportive people. Stay

connected with friends. Include others like a teacher, sibling,

grandparent, or a mental health care professional. When we

are in the presence of people we trust, with whom we feel safe

and able to share, we feel better about ourselves. We are

better able to cope.

Maintain a daily routine that stimulates your mind and body. Having a set time to do activities provides

structure and predictability. Eat healthy and exercise. Exercise

wards off depression and improves sleep. Reward yourself with

some creative and fun activities like reading, yoga, a calming

bath or video game.

Put your plan in writing. Goals can range from taking the

dog for a walk to making a new resume. Be realistic. Small and

steady progress is still progress. Periodically evaluate your plan

and adjust as needed.

Do things for others. Some activities take very little time

and have big rewards. Clean the aquarium or donate blood.

Load an app on your Grandma Ipad and teach her to play a

game. Babysit your sibling. Making a difference in your family

or community brings good feelings to all involved.

continued on next page


Reach out. If you see someone struggling, talk to them. it is

okay to grieve the loss of different things. For example, my son

is sad because his construction safety internship is cancelled.

His friend is sad because his dad is sick with Covid-19 induced

pneumonia. Their circumstances are different. However, the

need to talk is universal. Talking about our experiences is

mutually beneficial because it helps us to feel heard, validated,

supported and loved.

Give yourself permission to be happy. Negative

feelings associated with change will gradually be replaced with

positive ones. Joy will come in pieces. It is okay and important

to find humor even during the hardest times.

Trust the process. Although we cannot control all aspects

of change, it presents us with opportunities to grow. You are in

the driver’s seat. With planning, perseverance, and time, the

road will become clear. Navigate with purpose and caution

when necessary. No doubt, you will soon be traveling at full

speed in your pursuit of a happy future.

_______________________________________________________

Three Fruit Smoothie Refreshing and delicious, fun and nutritious: strawberries, banana and orange juice make

this smoothie a favorite!

Yogurt is another key ingredient.

It is made by fermenting milk with a yogurt culture. Some

yogurts contain living bacteria called probiotics. Probiotics

promote digestion. Some yogurts have more health benefits

than others. The most nutritious yogurts are low in fat, and high

in protein, calcium, vitamins and probiotics. Avoid over

processed yogurt with added sugar, artificial dyes and

flavors.

Fresh or frozen fruits provide sweetness and color

to smoothies. Strawberries contain fiber and are rich in

Vitamin C. They contain manganese, folate and

potassium. Bananas are a good source of potassium and

magnesium. They are high in fiber and low in fat.

Orange juice is a good source of Vitamin C, potassium

and folate.

Look forward to more smoothie recipes in this

newsletter. We invite you to send in a recipe if

you would like to share!

Three Fruit Smoothie Recipe

½ cup plain yogurt

¾ cup strawberry yogurt

¾ cup orange juice

1 ½ cups fresh or frozen strawberries

1 sliced frozen banana

1. Pour plain and strawberry yogurts into a blender or food processor and gently blend.

2. Add orange juice and blend for 10 seconds.

3. Place strawberries and banana into the mixture and process until smooth.

Pour into glass and enjoy!


Poison Ivy/Oak/Sumac By Arielle Petti, R.N., B.S.N.

Spring has sprung! The warmer weather is upon us and that means more adventures outdoors! Outdoor activity is an excellent way to decompress and get exercise but poses additional health considerations. Our current circumstances can make it challenging to see or speak with a healthcare provider regarding basic health concerns. This issue

will discuss a common seasonal-specific health concern and give tips for how to manage it at home • Poison ivy vines usually have solid green and pointed leaves that hang from the stem in groups of three. Remember: "leaves of three, let them be". Poison ivy most often grows as a vine, but can also be a shrub. As the seasons change, the poison ivy vine often produces yellow-green flowers and white berries in the spring and early fall, and the leaves can change to yellow and red in the Autumn. Poison oak and sumac leaves are very similar but are usually shrubs. • All three plants can cause a rash when they come in contact with skin, whether the leaves are fresh or dried up. The reaction is caused by Urushiol, an oily sap in the stems and leaves. You should avoid touching these plants and never use them as a fire-starter or in a bonfire, as the Urushiol is released in the atmosphere and can cause severe breathing problems, if inhaled, requiring immediate medical attention.

What are the symptoms of a poison ivy/oak/sumac reaction?

• Rash (redness and usually weeping blisters) in streaks or lines • Extreme itchiness • Onset 1-2 days after exposure to a wooded area or field

Home Care • Wash hands and affected area immediately with soap and warm water to remove the oil and prevent its spread to other parts of the body and other people.

• Remove and wash clothing to remove any residual oil. • Soak affected area in cool water for 20 minutes or massage with an ice cube to reduce itching and oozing. Cool or lukewarm showers and baths can also be effective, especially with oatmeal bath products. (Warm or hot bathing can exacerbate the itching and discomfort.) • Apply 1% Hydrocortisone Cream 4 times per day.

• Take oral antihistamine, such as Benadryl/Diphenhydramine, every 6 hours, if the itching persists.

• Avoid scratching the rash, which can cause infection and increase the spread of the plant oil via your hands and nails, if the area has not been washed. • Do not touch or disrupt blisters, if present, as they are the body’s way of protecting itself from infection. (If the blisters break, cleanse with warm soapy water and cover the area.)

When should I seek medical attention? Call 911 for difficulty breathing or severe cough following exposure to any burning plants or weeds, regardless of whether they were known poison ivy/oak/sumac.

Be seen by a healthcare provider today for severe swelling, (e.g. eyes are swollen shut); for affected area covering ¼ or more of the body; for a history of severe poison ivy reactions; or if the rash looks infected: increased pain, spreading redness, increased swelling, purulent drainage, or the area feels warm or hot to the touch.

Be seen by a healthcare provider by tomorrow for affected areas involving the face, eyes, lips, or genitals; for severe itching that will not subside, despite home care interventions; for very large blisters or oozing sores; if you have already been on oral prednisone for >24 hours and symptoms worsen.

Other helpful hints… • The reaction usually lasts about 2 weeks. Treatment reduces the severity of the symptoms but not their duration.

• Poison ivy/oak/sumac oil can remain on pet fur and hair, which can promote spread of the oil to others.

• If new blisters develop several days after the initial lesions, you are likely being repeatedly exposed to the oil. Ensure all clothing, shoes, linens, pets, and surface areas that may have come in contact with the oil are washed.

• Fluid from the blisters or rash is not contagious and cannot cause a poison ivy/oak/sumac rash.


Welcome Back to Meet the Nurse By Amy Volante RN, BSN

Susan Almquist is the

school nurse at Peirce

Elementary School.

Let’s get to know her a

little better!

Susan, please tell us a little bit about yourself.

Q. Did you live and grow up in Arlington?

A. No. You could say I’ve

been around. I was born in

Colorado and lived there through middle school, so I’m

comforted whenever I see a mountain top. I then moved with

my family to Kansas where I remained through undergraduate

school. After my husband's graduate school stint in Minnesota

we moved to the San Francisco Bay area where I got my

Master’s degree in Medical Microbiology at Stanford, and

started my career in research in the pharmaceutical industry.

That continued when we moved to Lexington MA, where I still

live, right across the border from Arlington.

Q. How long have you worked at Peirce as a school nurse?

A. I’m finishing up my 5th year at Peirce.

Q. Where did you work before then?

A. As I said I had a career in research in the pharmaceutical

industry, first in California then at Vertex Pharmaceuticals in

Cambridge MA. What I loved about that career was gaining a

deep understanding of the diseases we were working to treat

and also, noticing that I most enjoyed working directly with my

colleagues, I realized I was a real people person. My daughter,

who I’d encouraged to become a nurse practitioner urged me

to combine those interests with nursing so I went back, got my

RN and happily ended up first as a one on one nurse at Hardy

then the nurse at Peirce.

Q. Susan, you and the other school nurses were sent home on March 13 just like the students and teachers. What have you been doing to support students and families from home?

A. I’ve done a little checking in and reading to students in

virtual classrooms, and I’ve delivered school based medications

to families both to their homes and from the school. This

helped overcome, just a little, my sadness at not getting to see

the kids regularly. I’ve also had the pleasure of working with

some amazingly creative nurses on the Healthful Living

Newsletter. I act as an editor, get a chance to use my science

background and occasionally get to contribute to the articles.

Q. What do you do when you are not taking care of students?

A. Until the social distancing requirements my husband and I

sang in our church choir and in a hospice choir called Sounds of Grace. Because I love to cook, and doing it more with social distancing, frequent bike rides have become essential. I’ve even had the occasional chance to wave at Peirce students from the bike path.


Q. Can you tell us about your family? A. I come from a family of 7 kids. We are still having fun with

family Zooms. Now, besides my husband, I have 2 daughters,

one is working on a farm in the Asheville North Carolina area.

The other, the Nurse Practitioner, is on the Emerson College

Health Care staff. She and her husband and his high school age

daughter are all taking care of the newest addition to our

family, 5 month old Addison. They are in Northborough MA

and we see them (at 6 feet) as much as we can and look

forward to babysitting regularly soon.

Q. What can you tell us about yourself that might surprise us?

A. As a younger woman I completed nine 26 mile marathons

and 2 triathlons, the last (and shortest) in 2015.

Q. What have you learned about yourself through your work as an Arlington school nurse?

A. That as long as I can get one smile a day from a Peirce

student, for me it was a day worth living.


Computer Break Exercises; Ease Tension in Your Face and Jaw By Michele O’Toole, MEd, BSN, RN

Without even being aware of it, we hold tension in our faces.

Often the tension causes creases between our eyes and on our

forehead. The tension in our jaw may cause us to grind our

teeth at night. You can try the exercises below at any point

during the day, when you feel stressed or need a break. Before

you begin, wash your hands well! You will be touching your

face. It might be best to do these exercises in a quiet place

without distraction.

1. Take a deep breath in while reaching your arms above your head. Exhale and bring your arms behind you, clasp hands if you can, lift your chin, squeeze your scapula/wing bones firmly together. Release your clasp on exhale. Roll your shoulder backward and forward a few times, then sit still.

2. Close your eyes and imagine tension streaming off your face, especially your forehead and jaw. Take your time.

3. With clean hands, place several fingers on your jaw joint

or TMJ /temporomandibular joint, and press down gently moving slowly in a circular motion around the TMJ and down the jaw bone.

4. Continue these small circles slowly up to your temples and forehead.

5. Find your hairline or top of forehead, pick a spot for each fingertip and massage in small circles with gentle pressure. Continue this movement through your scalp, top of head, back of the head and back of the neck. Give both your shoulders a squeeze or two.

6. Rub your palms vigorously together creating a feeling of warmth between them. Gently place your clean warm palms over your closed eyelids. Feel the muscles of your eyes relax as you cover them. Release your hands and shake them out.

7. Jut your bottom jaw out. Imagine a figure eight in your mind, and draw the figure slowly with your jaw. Try and make your figure eight as smooth and relaxed as possible. Change directions a few times.

8. Open your mouth wide, stick your tongue out as far as you can. Make a “ahhh” sound on the exhale. Exhale completely. Inhale, through your nose, drawing the breath into the back of the throat. Make a whisper sound or wind in the trees sound with your breath. Try a few more times.

Notice how you feel after these exercises; repeat as necessary and have fun.

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Healthful Living from Your Arlington School Nurses - Issue 003 • … · 2020. 6. 1. · 0 of COVID-19 is 2.2 to 2.5 A NURSE • QUESTION OF THE WEEK What is Herd Immunity? Herd