Back to School (Health) Check List

One school nurse sounds off on getting your kids ready

The fall wardrobe is in. The pencils are sharpened and your kids are waiting with anticipation to see who their teacher will be. The back to school shopping lists might be crossed off, but are your children mentally and physically ready to be launched into a brand new school year? If you ask one woman who has worked in school nursing for close to a decade, run a checklist of your own to make sure your kids get off to a healthy start.


Just like that jolt between the weekend and getting back to business Monday morning, kids need a little structure to make sure the new school day is a little less jarring. Karen Graf, R.N. and RiverStone Health’s school nurse coordinator, says it's important to take steps in the weeks before school to get your child back on track. She suggests putting kids to bed 15 minutes earlier each night until you get to the right bedtime. And, it's not just bedtimes to be concerned about. Graf says, "Get kids up and eating breakfast at the time that they would be having to get out the door. Have some type of activity plan for the morning so that they have to get up and get dressed and into the routine."  Whatever you do, Graf says, don't let your kids skimp on sleep. "We get so involved with our kids and with after school activities that we put sleep on the back burner. Kids really do need eight hours of sleep."


Before that first school bell rings, make sure your refrigerator is stocked with good, healthy ways to start the day. "I encourage one good protein. Eggs are pretty quick, easy and inexpensive and some kind of carbohydrate that is going to maintain them over that period of time," Graf says. "If you add a glass of juice, then you get a fruit in there as well."


Before you pencil in a whole bunch of activity on your fall family calendar, Graf says take a step back and see if your child is up for all the structure. She says, "I am seeing the anxiety and the stress in children rise because the sports and other activities have become very competitive," she says. "Kids are not as able to sleep well at night. They are not able to rest and relax and wind down. And then, they have to be up and going again for school the next day. We see some of that played out through behaviors in the classroom." Graf says, before committing your child to more than one activity at a time, you might want to ask, "Are they really enjoying it?"


When the school bell rings and hundreds of children come together under one roof, Graf says, "You get back to school in an enclosed room and the germs and bugs start to fly!" That's a good reason to take a little time to have your children polish up on those good, old fashioned hand washing techniques. And, while we are on the topic, remind them to sneeze or cough into their arm. Graf says the average cough or sneeze travels at roughly 75 miles per hour, delivering all kinds of little germs in its wake.


While most school secretaries do a good job making sure they have the right emergency contact list for your child, Graf says double-check the information and even add to it. She says, "If you can have more than one or two people in addition to mom and dad, like a neighbor, a grandma or auntie, that's a good thing. If mom and dad both work and there is an emergency, we like to be able to get a hold of someone right away."


You know how you feel when you enter into a new situation. It can be unsettling. That's why it's a great idea to put yourself in your children's shoes and find a way to calm those before-school-year jitters. "Have a yearly tradition, whether it's having a lunch with all your kids' friends or having some sort of fun activity to look forward to." Graf says it will take those young minds off the anxiety a new school year brings. If your child is still a little anxious after school starts, try taking an evening family walk. Graf explains, "If you do some sort of physical activity in the evening, it does help the body wind down and sleep better."


When your child starts school, try to do a backpack check. Watching your child bring home every book from his locker night in and night out can do a number on his developing back. In fact, doctors recommend that a backpack weigh no more than 10% of your child's body weight. Graf says a cross-body backpack is another good idea. "That way they are not using just one strap on one shoulder. It helps to make sure your child has the center of gravity better evened out."


What's tiny, parasitic and irritating and can impact more than 12 million school-age children each year? That's right, it's lice.  "They definitely make the rounds!" Graf admits. These little insects don't hop or jump, she says. The only way to get head lice is from direct contact. "So, don't share hats and don't share combs!"


While schools require that your child's immunization records be up to date, most parents need a little help remembering what shots their children need and when. That information is just a click away at the American Academy of Pediatrics website by clicking on If you find that your child is in need of a booster or two, RiverStone Health will offer its Back-to-School Clinics starting two weeks before school starts. (See our sidebar story for more on clinic hours).


If your children need to bring some of their immunizations up to date, RiverStone Health's Back-to-School Clinic can help. The clinics will be held from 1 PM to 4:30 PM at RiverStone Health at 123 S. 27th Street in Billings on August 14, August 19, August 21, August 26 and August 28th. If you happen to miss out on those dates, RiverStone Health does offer a walk-in immunization clinic on Mondays and Fridays from 1 to 4:30 PM and on Wednesdays from 11 AM to 6:30 PM. If you are concerned about the cost, be sure to ask about the Vaccines for Children program, which provides vaccines to children from 0 to 18 who are uninsured or underinsured. Call 406-247-3382 for more information.



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