At the 2013 Voices for Children Spring conference, Marilyn E. Crumpton, MD, MPH Medical Director Division of School & Adolescent Health City of Cincinnati Health Department and Kate King, RN, MS, President of the Ohio Association of School Nurses presented a session on Adolescent Health in Schools. The presentation was about what we really see-including problems with sexuality, adult responsibility, drugs and alcohol, mental illness, violence, teen needs of medically fragile and special needs students and chronic disease- such as asthma and diabetes.
The latter two -asthma and diabetes- have increased significantly in the past 10 years: asthma 40% in school aged children and diabetes 50%. School nurses must deal with more complex medical needs like catheterizations, tube feedings, tracheostomies, and ventilators. There are pregnant teens and teen moms. Prenatal care is important. According to the 2011 YRBS (Youth Behavior Survey) 42% of teens had sex during the past three months and 77% didn’t use birth control pills.
Educating about and dealing with the effects of alcohol and drug use is important. King presented statistics that 38% drank alcohol during the last month; 24% binge drank during the past month; 24% used marijuana during the past month; 7% ever used cocaine; 24% offered, sold or gave an illegal drug on school property and 19% used drugs or alcohol before having sex. Aside from illegal underage aspect of use, and criminality of purchase/sale of substances, binge drinking is a huge problem with ‘shot time’ a popular activity. Alcohol poisoning is a concern. Another reason binge drinking is an issue is because 21% of teens rode with a drinking driver, and 9% were forced to have sexual intercourse. Other substances King outlined include tobacco: 21% smoked cigarettes, and 52% tried smoking.
Other risky behaviors include violence: 16% carried a weapon and 31% were in a physical fight. The reasons behind some violence include 23% having been bullied at school and 15% electronically bullied. This is one cause for some teens to suffer suicidal ideation; 9% attempted suicide. Then, there are homeless teens; 40% of homeless youth are LGBT and the primary cause is family rejection.
‘We don’t have that type of teen here. These are good kids. Can’t remember that I’ve seen any kids here in crisis,’ a silver haired volunteer at the desk of an Ohio hospital said, shaking her head. The ER Department team had a quite different take. Far too often it takes a headline news story to shake a community up and realize how real these issues are and what teens face day in and day out. Adolescents have always experimented and pushed the boundaries. The difference now is that bullying is front and center with social media, substance abuse has escalated dramatically with opiates, and energy drinks coupled with mega-caffeine and alcohol have introduced bigger dangers. There will always be a frontier of exploration. “There’s a difference between a frontier with a horizon, and one with a cliff. Adolescent health is an important topic,” adds Pomegranate Nursing Director, Rosetta Cowan. [Nursing care is provided 24-7-365 at Pomegranate Health Systems, a secure facility.]
[Photo credit: Isolated girl from bullying group; Dreamstime 6214438]