RT involvement helps a community of kids breathe a little easier

It takes a dedicated professional to remember green slime fondly.

“They had that stuff everywhere,” laughs Jackie Richards, BS, RRT, who helped establish the first asthma camp for children in southern Indiana as part of her role with St Mary’s Outreach Services, Evansville.

The slime was just one of dozens of activities enjoyed by the 30 campers, comprising students from the first to fifth grade who assembled on the campus of a local school during spring break. The crew at “Camp Nota-Gona-Wheeze” met every day for a week to have some fun while learning more about their asthma and how to control and treat it.

“By the end of the week, they all knew about their spacers, and they knew the peak flow—what was their green zone, what was their yellow zone, what was their red zone,” says Richards. “It was just a really good week working with the kids and seeing them grow into the education on their own disease process.”

Building a Local Resource
The camp evolved from the goal of providing low- and moderate-income children with the opportunity to educate themselves about asthma without traveling significant distances to attend existing programs hosted in a different part of the state.

In her role with Outreach Services, Richards works extensively with the asthma health team, and, along with two other teams focused on fitness and nutrition and mental health, coordinates with a group of about 70 different agencies to create a better environment for kids in the area. This team of schools and organizations, known collectively as the Evansville School Community Council, has been active since its creation in 1998.

During the year of planning and preparation, the asthma health team created brochures promoting the camp and distributed them to school nurses in the Evansville Vanderburgh School Corporation, one of the school systems that work in collaboration with the School Community Council.

The inaugural Camp Nota-Gona-Wheeze schedule kept the students busy, but provided ample time for both fun and learning. Each child was assessed in the morning and then received age-appropriate training and information designed to give them the tools necessary for living a full, healthy life.

“We took them to educational sessions about the medicines, peak flow meters, and spacers and gave them some information about why they wheeze, along with a little anatomy information,” says Richards. “We also had a dietitian come in and talk with them about healthy eating and how to keep their bodies healthy.”

Students were also given lessons on triggers and warning signs, along with relaxation exercises for coping with asthma and techniques for dealing with their feelings about the disease.

Class time was followed by breaks allowing students to participate in hands-on activities, making a variety of projects. In addition to green slime, campers went home with sun visors, T-shirts, picture frames, and playdough sculptures. One afternoon involved a carnival replete with asthma-themed games such as the Musical Mucus Walk (musical chairs), Lung Toss (toss bean bags at a “lung” target), and Pulmonary Putt Putt (putt a golf ball through a tube).

On the last day, members of the local 4-H accompanied the children to a local university campus and taught one group how to make water rockets while other campers swam. The 4-H volunteers are just one example of the active participation from members of the Evansville community.

It Takes a Community
“The School Community Council has about 70 agencies involved. When agencies that are not involved see the good things that we are doing with the children, they want to  participate,” explains Richards. “You can see we have a very good collaboration here in our community.”

In addition to Richards, St Mary’s Medical Center provided the dietician and complete funding for the week’s activities. The Vanderburgh County Health Department committed one of its pediatric nurse practitioners to provide ongoing medical assessment and care throughout the entire week, and the University of Southern Indiana sponsored a nursing instructor, five nursing students, and five RT students to lead and teach camp participants.

The only downside to the 2006 camp was that some children had to be turned away because of space limitations. Efforts are currently under way to make more room available at future gatherings of Camp Nota-Gona-Wheeze. Not only will Richards and her team host the camp again, but the goal is to make next year’s endeavor even bigger and better.

“We’re hoping it’s going to happen every year, and we want to have more kids,” she says. “We’ve already received an approval from St Mary’s hospital to fund it next year,  so we’re really very happy about that.”

Laying the Foundation
Richards began participating with the School Community Council in 1998—a year after its inception. At that time, she was working as an RT for one of the hospital’s mobile medical clinics that went into the community and provided care for people in housing developments.

“They put a respiratory therapist in that position because they knew we were already well trained to do just about anything,” says Richards. A significant part of her responsibilities included community education. “When it was created, the School Community Council contacted our facility because they knew we were already involved heavily with the community and in the schools, so they asked us to join them.”

In November 2004, St Mary’s Medical Center decided to reorganize the Outreach Services, maintaining their mobile dental clinic service to the community and continuing the educational outreach in collaboration with the School Community Council. To meet their needs, the hospital agreed to fund one respiratory therapist, Richards, as well as one registered dietitian as dedicated resources for the schools and community.

Since that time, Richards has developed a close rapport with the administration, teachers, and nurses throughout the local district. She takes time to meet with every school to give presentations, discuss concerns with principals, and help develop respiratory-related policies, such as those regulating student possession of inhalers and the use of automatic external defibrillators installed on campuses.

She is a trained facilitator with the district’s Tobacco Awareness Program (TAP), a comprehensive, 8-week tobacco cessation curriculum geared toward grades 7 through 12 that addresses both smoking and chewing tobacco. Richards also works closely with the Tobacco Education Group (TEG), another 2-month program designed to provide alternatives to suspension for youths who are caught using tobacco products.

“Before this program, if they were
caught smoking, they would get tickets and have to go to court, so it becomes a legal issue,” Richards says. “We arranged it so that instead of the punishment being an out-of-school suspension, smokers would have in-school suspensions with these programs as part of them. We had to write that policy before it could be implemented.”

She also encourages each school to make the most of the resources available to it.

“Part of the project is working with the American Cancer Society, the Centers for Disease Control and Prevention, and both the US and Michigan Departments of Education in an area known as Michiana (northern Indiana and southwest lower Michigan) to promote coordinated school health in each one of the schools,” says Richards.

The team attends training annually to learn techniques for helping guide each individual school through a process of self-evaluation.

“Each school is a little different, so after they assess their own needs, we help connect them with the most appropriate agencies in the area, so there’s no overlap of services, but they can still get the assistance they need,” explains Richards.

A Wealth of Information
As one of the RTs assigned to the School Community Council, Richards continues the tradition of respiratory techs well versed in just about anything. She is a vital resource for school nurses who are able to tap into the more than 3 decades of experience Richards has in the field.

“Part of my job is to work with the schools as a resource for them and help them whenever I can,” say Richards. For example, a nurse recently called asking for some information about an asthma inhaler a student was carrying at school. “She didn’t think it was the right kind, so she told me what it was and we determined that in fact he didn’t really have the right one.”

Her unique situation of improving the lives of students through respiratory education—either by interacting directly in a one-on-one environment or by creating proactive policies—is a privilege not lost on Richards, who finds satisfaction in helping kids breathe a little easier.

“This job has kind of evolved. I started out working purely respiratory, then helping the nurse practitioners at the clinic, then some community education, and it’s just continued to develop into really a nice career.”

Dana Hinesly is a contributing writer for RT