Here's how the academic year started for one school nurse: calling an ambulance for a high school girl who passed out; following up with sixth-graders who failed to get a new required immunization; and assessing an injured football player who waited all weekend to see her on Monday morning rather than get medical care for a fractured bone in his hand.

Many students use the school nurse for triage. Parents often send their child to the nurse to see if they need medical care, rather than seek treatment.

This has increased, said New Hartford school nurse Barbara Hammond, because more people are struggling with lesser levels of medical coverage and rising co-pays. Others have no insurance at all.

While students were finding classrooms and dialing locker combinations, Hammond checked that new students had immunizations, verified emergency contact paperwork and taught many students how to use inhalers.

Logging in medications for students needing daily treatment - for seizure disorders, diabetes or asthma, for example - is a major task in September.

Recording allergies has also become more of a job than ever.

"When I first started this job I had no EpiPens," said Hammond, a member of the New Hartford Teachers Association in Oneida County and the NYSUT Health Care Professionals Council. "This year I have 27."

EpiPens are auto-injectors used to prevent anaphylactic shock for people with severe allergies to bee stings, latex, seafood and peanuts, an allergy that has seen a significant increase, she said.

Hammond began the school year meeting with parents, bus drivers, playground monitors, teachers and cafeteria workers to relay medical information and assign responsibility. Cafeteria workers, for example, need to set up a peanut-free table; bus drivers cannot allow eating on the bus.

Although Hammond wrote parents of sixth-graders three letters and announced new immunization requirements for tetanus, diphtheria and acellular pertussis in monthly school newsletters, she still had to call when 16 students showed up without the T-DAP.

Elementary school nurse Ann O'Hara, a member of the Syracuse TA, is tracking immunizations at the start of her year - along with ambulances. A student was jumped and injured while riding his bike outside her building the first week of school.

O'Hara, also on NYSUT's Health Care Professionals Council, works in a district with a large refugee population that she says is under-immunized. Following up with parents who move often and have limited English is a challenge.

Next year, state law will add a requirement that school nurses make sure that students required to have a physical exam also have their Body Mass Index checked by a physician in order to track obesity.

Hammond finds it ironic that "the state keeps telling us there's new things to do every year, even though we're not mandated to be there. How is all this work supposed to be done if you don't need a school nurse?"

Because so many parents are working, Hammond said, some send their children to school with fevers or rashes. School nurses then call parents and have the children sent home.

Hammond is the only nurse for 1,100 students in grades K-6 and grades 10-12. Her reward is getting a child with a health challenge through the day.

"There's no shortage of students with unique medical needs," said James McNair, president of the 257-member New Hartford TA. "Every year there are far more."

Now in his eighth year teaching science, McNair said Hammond has "always been really great at making sure that whatever a classroom teacher needs is communicated." Knowing about latex allergies, for example, is key in a science lab.

When McNair runs field trips, it's important to be informed by the school nurse about the range of medicines today's students take.

"If we had a nurse in every building it would be so much more efficient," said NYSUT Vice President Kathleen Donahue, echoing NYSUT's quest to get legislation passed that would require such a mandate.

- Liza Frenette