School Nursing

The Relentless School Nurse: Wendy Lamparelli is Bridging the Divide Between Education & Neuroscience

For several years I was the Education Co-chair of New Jersey State School Nurses Association (NJSSNA), tasked with co-creating our annual spring conference. It was a formidable job, but one that I relished. Our overarching goal was to bring the quality of a national conference to our state. One of the many components was to have scholarly poster presentations in order for school nurses in NJ to share the excellent work they were doing with colleagues. 

Posters are tricky, not all school nurses feel comfortable or skilled in creating them to share publicly. One of the nurses who wanted to share her work but had never created a poster was Wendy Lamparelli. Her poster and the explanation of her work are included as attachments at the end of this blog post. You will see that Wendy did an exemplary job creating a scholarly poster that illustrated her journey to addressing a need that she identified in her school.

Like many of us, Wendy was seeing an abundance of mental health issues in her students. Her nursing curiosity led her to take a deep dive into behaviors that the students were exhibiting. The work that Wendy is doing in her district is innovative and impressive. I invited her to share her program with the readers of this blog.  I am delighted that she said “YES” to sharing her poster at the NJSSNA Spring Conference and also to guest blog as this week’s Relentless School Nurse.

Wendy Lamparelli, MEd, BSN, RN, CSN-NJ

 

EDUCATORS OR NEUROSCIENTISTS? Can we be both?

Every day children are placed into educational environments and expected to engage and activate their most valuable asset for learning: their brain. As a school nurse, I consider myself an educator and have experienced first-hand how educational environments demand a certain level of competence but do not always plant the seeds for growth and learning. The good news is that fixing what’s broken in education may in part, come down to neuroscience. I know what you’re thinking—neuroscience in itself is very complex and not completely understood. How can a complicated and seemingly unrelated discipline apply to an average day in the life of today’s school teacher?

 As school nurses with training based in human anatomy and physiology, we may have a leg up on our teaching peers when it comes to the basic knowledge of neuroscience. Neurogenesis is the process by which brain cells are grown and regenerated. We know that children who are in stable, nurturing home environments often have healthy and more optimal brain function. This is evident in the tasks of reading, executive function and memorization. The children sitting in our school classrooms however, more often than not, live in home and community environments where trauma, chronic stress, and or physiological neglect are commonplace. In these cases the key areas of the brain that are essential for learning have been deeply affected. Learning is slow and difficult for these children. In many cases they are shut down and way behind some of their peers in terms of their chances for academic success.

We as educators and support staff can be aware and actively involved in helping to repair and grow the structures in the brain that need attention. Growing a brain cell, believe it or not, does not require a neuroscience degree. Becoming aware and taking action in some of the ways listed below proves that we as educators can contribute to neurogenesis, and in doing so can drastically improve the chances of academic success for all children.  Consequently factors that contribute to neurogenesis will also benefit a child’s overall well-being.

Making brain cells grow; what can we do?

Many things contribute to a healthy brain but there are specific opportunities for schools to implement certain measures as part of their commitment to education and ensuring the success of their students. With consistent implementation of these strategies, students will learn better, retain more information, have better impulse control be more engaged in learning, and be fully optimized in other ways including socially and emotionally. The suggestions below have been discussed in the neuroscience research and have proven to be beneficial to process of neurogenesis and consequently to student learning.

Optimal nutrition. Children need healthy fats, lean protein, and a diet low in refined sugars and carbohydrates. This doesn’t sound like the average American diet and it certainly doesn’t sound like a school lunch. When was the last time we saw children getting a sliced avocado and a serving of lean protein as part of their breakfast after the bell, or a large salad with legumes and or healthy fats for lunch? In most cases breakfast after the bell consists of a cold cereal and a packaged item.  Try as I might, changing the school menu is a slow and steady uphill climb. Most of our school children get a carb-loaded, sugar-filled diet to start their day. Free school lunches rarely include any brain food like avocados, walnuts, and lean protein. It is also hard to find blueberries or a hot breakfast with steel cut oats.  This may be different in more affluent schools; however, usually it is our poorest children who receive free lunches and suffer most with receiving foods that are cheap, boxed, and easy for adults. These school foods somehow meet the “guidelines for school nutrition”, but do not support growing a healthy brain. One Item to note is that is typically, it’s these children who may need the most support for learning and a diet lacking in the nutrients needed to replenish and replace damaged brain cells puts them at more of a disadvantage.

Vigorous physical play. Recess is getting shorter and shorter in almost every school to allow for more packed curriculum and preparation for testing, in some cases recess is even being withheld as a disciplinary measure. Gone are the old days of 60 minute free play. Today’s school children are not getting that burst of needed blood and nutrients to the brain or eliminating toxins through healthy sweat. When they get home, they are inundated with homework or in front of screens scrolling and clicking and tweeting, missing out on the physical, social and emotional benefits of play. Children need 45 to 60 minutes of vigorous play daily for a healthy brain. The current schedules for recess and gym just don’t add up to the amount they need. This fact is only reinforced by the alarming statistics of obesity in children, the drastic rise in the sedentary lifestyles of children overall and a notable increase in the number of children with type two diabetes.  

Sufficient Time. In our fast-paced educational world, how often are children expected to quickly grasp concepts or come into the classroom already prepared with basic skills and knowledge? Little time is afforded to master a concept before quickly being pressured to move on to a new one.  We know that time for repetition is a luxury. Close your eyes and think about how fast our society moves. Somehow school can mirror that frenzied pace, seeming like the scene from “I Love Lucy,” where the conveyor belt which starts out slow at first begins to speed up, forcing her to hide the chocolates just about everywhere and anywhere she can. We need to give children more time, and more individualized learning. Children with compromised brain structures from trauma or neglect need a great teacher with an endless supply of patience and an apron pocket full of strategies. It’s certainly a tall order and near-impossible in the current system.

Social Support. In spite of the lack of knowledge surrounding mental health, we know that kids need connections with trusted adults early on. In many cases, the support just doesn’t exist at home or anywhere else. Social workers and guidance counselors have large caseloads with more and more children facing serious mental health issues. Occasionally all of us suffer with compassion fatigue. We need to collaborate and provide a team approach to ensure that each child who is at risk is supported by a caring adult. In addition building community in the classroom helps to foster an environment of respect and support among peers. Schools should always be a place where there is somewhere and someone for a child to turn to when they just don’t feel loved, cared for or supported as a human being.

Stress Management. Adults are stressed at all-time high levels. When children depend on a caregiver who is not skilled at dealing with stress, children are affected and often internalize their own. This becomes especially problematic when stress in children becomes chronic. High levels of the secreted hormone cortisol are toxic to brain cells and actually cause cell death. Teaching children to cope with stress and to balance the challenges of life cannot just be accomplished through “telling” kids how to do it. It must be modeled.  Literature proves time and again that adding social emotional practices to curriculum can impact student AND teacher stress levels and more importantly, contribute to better student outcomes. Techniques such as mindfulness can not only repair and regrow brain cells but it can also impact many other brain functions that are essential for learning and coping with the challenges of life in general.

Joyful and meaningful learning Often times we pop into classrooms and see children sitting in neat rows with serious expressions. Only occasionally we do encounter children with expressions of awe and wonder. In order to grow brain cells and provide deep and meaningful learning experiences, classroom learning must provide more than the drone of reading, writing, and test preparation.  When children experience a positive emotion, or a positive physical sensation along with content, the neural pathways are excited, (firing) and activated (wiring) creating a deeper and more lasting memory. Over time with more and more experiences such as this, brain structures essential for learning increase in size and capacity.   This is where teacher creativity and “thinking outside the box” is crucial.  For instance while memorizing, synchronizing a yoga pose or movement to each bite size piece of information would be extremely beneficial. Playing happy music in the classroom, having a class mascot or pet, can all contribute to positive emotion.  Using outdoor classrooms tends to make just about anyone more joyful. When children feel more joy they activate their brain structures necessary for learning and remembering.

I am hopeful that teachers are as passionate about growing a child’s brain (the organ of learning) and repairing the necessary structures of memory just as a heart surgeon becomes knowledgeable about the intricate function of the human heart, advocates for a healthy lifestyle and takes great care and precision when repairing a damaged heart while using stellar precision.

Educators need the support of principals, policy makers and parents.  We all play a role in ensuring the home and school environment supports optimizing every single child’s brain. Of course it won’t be easy or convenient. These needed improvements do lean towards rearranging and rethinking some of our priorities in setting up the schedule of an average school day. Growing brain cells and repairing damage to crucial structures from the inside out must be part of the work of education. Tending to the needs of the brain first can and will drastically improve learning outcomes for every child.

References for the article provided are included in the poster section – see below

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Know to Grow – The school nurse’s role in promoting neurogenesis

Wendy Lamparelli, MEd BSN RN CSN – NJ

Role of the School Nurse:

School Nurses assess their population needs. They are influencers in the educational setting and play a major role in improving the health of individuals, the environment, and the school culture. Below are some of the main methods which can be integrated into the school program and enhance the neurogenesis.                      

Joyful Education

The goal is to create novelty and engagement that allows for:

  • A stronger opportunity for new learning pathways in the brain (neural firing and wiring)
  • Opportunities for thinking and exuberant discovery
  • Coherent and challenging learning
  • Relevancy that promotes interest and motivation

The School Nurse Can:

  • Advocate for outdoor classrooms and stimulating school environment
  • Educate staff on how to incorporate these types of learning environments
  • Advocate for enrichment programs

 Optimal Nutrition

Foods that allow for optimal nutrition include:

  • Healthy fats, fatty acids, and Omega 3
  • Diets rich in antioxidants
  • Complex carbs that are needed for energy
  • Foods that supply B6, B12, tryptophan, phenylalanine, turmeric, and choline
  • Practice clean eating habits

The School Nurse Can:

  • Advocate for healthy school meals and gather change agents
  • Educate and involve parents/ guardians
  • Fight to limit refined sugars and processed foods

Stress Management

Ways to decrease stress include, but are not limited to, the following:

  • Play
  • Mindfulness
  • Yoga
  • Deep breathing
  • Fostering a friendship and kindness culture in school

The School Nurse Can:

  • Advocate for wellness programs for teachers and parents/guardians
  • Advocate for a peace corner or calm down space in classrooms or somewhere in the school itself
  • Teach deep breathing especially during points of contact
  • Advocate and support mindfulness programs in schools and/or consistent social, emotional curriculum

 Sufficient Time

Benefits of allowing for sufficient time include:

  • It takes three to six weeks for a neuron to mature, and neuron growth is approximately 700 per day in the adult brain
  • Repetition creates long term memories by eliciting strong chemicla intercactions at the synapse
  • Weeks to months of repeptitive and positive experiences cause myelination in key areas
  • Plasticity in the brain organizes and forms new connections

The School Nurse Can:

  • Educate staff on the importance of persistence, perseverance, and patience
  • Advocate for repetitive, quality experiences in learning
  • Educate parents/guardians, teachers, and staff how repeated mental states become mental traits

 Social Support

The goal of social support is to:

  • Extend the network of social support and the frequency of interactions
  • Create functional support that meets needs
  • Foster feeling of emotional support
  • Provide material support – goods and services – that help solve practical problems
  • Help students understand the crisis and adapt

The School Nurse Can:

  • Refer to counserlors when needed and follow up
  • Know ACES scores and assist teachers in knowing their students
  • Be familiar with community resources

Vigorous Play and Exercise

Vigorous Play and Exercise are crucial due to their ability to:

  • Increase production of BDNF
  • Increase baseline of neuron growth
  • Increase blood flow and oxygen in select areas of the brain
  • Indirectly improve mood, sleep, stress levels, anxiety, and reduce inflammation
  • Strengthen the basal ganglia cerebellum and corpus callosum
  • Improve the transfer of data encoding synaptic structure activity and the plasticity of neurons

The School Nurse Can:

  • Advocate for brain breaks frequently
  • Advocate for longer recess
  • Educate Staff/ administration on the importance of longer recess and the importance of play and exercise

Bio: Wendy Lamparelli, MEd, BSN, RN, CSN-NJ  is currently in her 16th school year with the Hackensack Public School District. She has served as the lead nurse since 2012.  In May of 2017 she was awarded the “School nurse who makes a Difference” for Bergen County.” In May of 2019 she was awarded the Educator of the year award.

 In addition to serving in a school nurse role she is a mindfulness facilitator and developed a curriculum for students in the after school program at Jackson avenue elementary school where she has been for the past 9 years. She can be reached at wlamparelli@hackensackschools.org

In the next section, Wendy shares the impressive poster that she created for the New Jersey State School Nurses Spring 2019 Conference. She had never created a poster before! What an outstanding job Wendy did! She shared her innovative work with school nurses from across New Jersey who visited her presentation.

Click the link below to see Wendy’s amazing poster!
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