School Nursing

The Relentless School Nurse: Pockets Filled With Chicken & Other Social Determinants of Health

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There is a little 4-year-old preschool girl who gathers food for her family by putting her school lunch in her pants pockets. Chicken and french fries have been found, uneaten, in her pockets. The same little girl refuses to eat her afternoon snack because she told her teacher she was “saving her food for mommy.” Her compassionate teacher reassured the little girl that school has extra food to share with mommy. In fact, the school staff was so concerned about the family that they pooled resources and delivered a pantry full of food to the house.

The visual of this preschooler stuffing her pockets with chicken and french fries to bring home to her family hit me deep in my heart. Tears flowed as I heard the story of how the family escaped a very dangerous South American city and traveled for more than a year, mostly on foot, to arrive in the states. The adversity that our students face is sometimes overwhelming to process. The question I was asked was “how can we help this family?” A loaded question to say the least. How can we help a traumatized family assimilate into a foreign land with nothing but what they could carry on their backs?

How do we help these families? Families that are waiting for the other shoe to drop, to be picked up by Immigration and Customs Enforcement (ICE). Here is a letter, written by a father as part of his request for asylum, translated from his native language:

I am writing this to whom it may concern with the most respect possible. I would like to express my situation in this moment of anguish and sadness since I don’t know what will happen with my family and my life.

I am married to a wonderful woman and I have two biological children. I have a son who is 14 years old and a daughter who is 4 that I love with my all my heart. My wife has a 19 year old son that I love and care for as well. It has never crossed my mind to be separated from my kids, not even for one second. It would be very painful for everyone in the family.

We are used to working as a family unit. My wife and I share different responsibilities and household chores. We share cooking, taking care of the kids, cleaning the house, taking the kids to school and to doctors appointments. We take care of them when they are sick, especially our daughter who suffers from asthma. We need to take extra special care of her and give her medication treatments. We both work together through sickness and health to keep our family well.

I don’t even want to think what would happen if I was not here for my family. They would have severe hardships. They would have to move out of our comfortable home into an apartment. My wife alone would not be able to pay for the utilities, internet, the gymnasium that my children use for their health and well-being. My wife could not pay for the car insurance or buy my little daughter her daily ice cream treat that she loves. Every morning she asks if I will be picking her up from school.

I know what it is to grow up without a parent. My mother worked very hard to care for us and sacrificed for all of her children. This is why I care for my kids, my wife, and my mother. As long as God gives me life and strength, I will always care for them and will try to minimize any suffering they might encounter.

It will be with great sadness for me to go back to Mexico, a place that is strange to me. I have been in the USA for most of my life. I love my kids and my family. If you give me the opportunity, I will take full advantage of this since I have been here for so long with no legal documents. If you would let me, I will reach my goals and they will benefit my family. Long live the family.

This pleading voice of a parent, begging not to be separated from his beloved family, gives an inside view of what families are dealing with on a daily basis. I cannot help but wonder what the future of these children will be, knowing the impact that toxic stress has on long-term health outcomes. These are my students, and like many school nurses across the country, I struggle with how to help the families navigate the treacherous waters of a seemingly unwelcoming country.

Meet the real social determinants of health. I heard one colleague call them the social determinants of death. I strive to call them the social influencers of health. Whatever we call them, when a 4-year-old preschooler believes it is her job to fill her pants pockets with chicken and french fries to bring home for her family to eat, we have a crisis.

What I do know is that relationships are healing and can counterbalance adversity. Our schools can be beacons of light for families who are struggling with the social determinants shared in this post. Being trauma-responsive must become a “Universal Precaution” in our nation’s schools. We must have the resources available to us to care for the families that are walking through our doors, without judgment or adding to the shame that they must already feel.

Kindness, listening and observing, are tools that we all possess and they are freely available. This blog post illustrates the stark reality of what happens when theory meets practice. I challenge the readers to pause and imagine yourselves in the shoes of the families that are depicted in this post and I ask you to answer the question posed to me this week: “How can we help these families?” I look forward to your feedback.

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1 thought on “The Relentless School Nurse: Pockets Filled With Chicken & Other Social Determinants of Health”

  1. A foodbank at school makes allot of sense. We have students in need, volunteers (PTO, teachers) and all it takes are some administrative support (who can so no to this), phone calls and a few grocery stores to donate. I have seen this occur in many models throughout the US.

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