Blueprint for Health: Build It! by Sue Carson as told to Jim Schott

Sue Carson’s story demonstrates that it is not necessary to be a “designer” to have a positive and intelligent influence on the use and arrangement of clinic space. Sue is not an architect or a designer and denies having any artistic or creative experience; but Sue is a confident, well-trained and highly qualified school nurse practitioner who has created a contest-winning clinic.

There is no question that the primary mission of the public schools is the education of our children, nor is there any question that the health of school-age children is a primary factor influencing their ability to learn in school.

The number of “boiler room” clinics is rapidly declin- ing; but even in schools which have a nurse’s room, it is often poorly designed and inappropriately located in the midst of administrative or counseling areas.

The expanding health care role of the schools has resulted in the training of increasing numbers of school nurse practitioners who are able to accept more complex responsibilities. However, where this is a necessary condition for obtaining first-rate health care, it is not a sufficient conditon. To do the job right and serve the community adequately, the school nurse needs to have a physical facility that is appropriate to the tasks s/he is trained to perform. Unfortunately, the school clinic seldom reflects the influence of health care professionals.

If there is to be a change in these conditions, it needs to come from the “grassroots.” The individual school nurse is often the sole representative of the health care needs of the school. It is the nurse who is on hand when talk of school renovations or additions are discussed. Whatever oppor- tunities there are for influencing health care space decisions will likely fall at the feet of the local school nurse. Unfortunately, school nurses have felt unqualified to be the “expert” in clinic design.

Sue, who has been a school nurse in the Boulder Valley Schools for years, was enrolled in a course entitled “Creative Nurse Management.” Students were assigned the task of developing a clinic to meet the needs of the SNP’s job. As an added incentive, a panel of judges composed of an architect and health professionals was selected to identify the best design submitted.

Sue’s plan won the competition. The architect who evaluated the plans said that the design was “playful,” its use of space was “efficient and economical,” the sizes of the spaces were “comfortable” and would “foster social interaction either one to one or in group settings” and that there was a “nice flow of space.” He further observed that the sequences of the spaces and activities were logical and contained the necessary components of a health room for a fully functioning school nurse practitioner.

Sue’s method of planning was simple and to the point. She first listed all the tasks she felt should be performed in a fully functioning school-based clinic and then divided those tasks into categories representing the different groups of clients with whom she worked on a regular basis. She then created a separate space for each category of client and function and arranged them in a logical order.

Area I is the reception and initial treatment area into which most people using the clinic will enter. In this area students can be screened for vision and weight. Students may also participate in health education activities without disturbing those students who are ill. Space is provided for children t o come to the clinic without being sick.

Area I1 is designed to be a rest area for students who are ill and waiting for medical treatment or to be taken home or who just need a place to rest before returning to class.

Area I11 is the treatment room complete with an examination table and private dressing area. The room will be adequate for hearing testing and motor screening and is conveniently located adjacent to a full bath.

Area 1V is the nurse’s office and is accessible to the waiting room and examining room with a separate entrance to prevent students and others who visit the nurse from pass- ing through a public area. The nurse’s office is also furnished with conference table and chairs for consultation with parents, students and staffings with other professionals.

The design is simple, straightforward and functional. Most important, it was created by a school nurse. It would be a fine ending for this article to report that Sue’s design is now being constructed and that she will soon be at work in her own clinic. Such is not the case. Sue is still working in school health rooms that were designed without the informed influence of people like her. However, it can be reported that the influence of her design has prompted direction in the design of a health room that is being built in the district; and she has found that the thinking that went into the complete design has value in reorienting the spaces that she has available to her.

Sue Carson, SNP. 1335-A Bear Mountain Drive, Boulder, CO 80303. Jim Schott, Curator of Education, Historical S0ciet.v of Colorado, Colorado Heritage Center, 1300 Broadway, Denver. CO 80203.

Sue learned from this experience that there were several which come out of my head . . . although they are not functions that she was being asked to d o as a school nurse elaborate, have value.” Sue’s experience need not be that just didn’t mix in the same space. For example, if she is unique. The capacity to translate the health care needs of using her office for counseling, the door has been shut on your community into practical recommendations for an everyone else and they don’t return. I f her office is full of effective physical facility is within the skill of school nurses sick children, there is no way to have a confidential phone everywhere. To take the plunge and become the “expert” call or conference. Perhaps the greatest long-range value is will take initiative and courage. W expressed by Sue’s comment that, “1 learned that the ideas

574 THE JOURNAL OF SCHOOL HEALTH OCTOBER 1981