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Using Experience from the Past to Push School Telehealth Into the Future

When Georgia Partnership for Telehealth set up a telemedicine cart in Loren Nix’s Berrien Elementary School clinic in 2009, the South Georgia school nurse never anticipated that it would change the trajectory of her life.

At the time, Nix was the first school nurse to use telehealth in the state of Georgia. She now directs GPT’s school-based telehealth program. Her work as a tireless advocate for rural school systems, their nurses, and their students has yielded a tremendous payoff for rural Georgia’s schools and GPT alike. From one clinic in Berrien County, GPT’s network has grown to include more than 100 schools across over 20 systems in the State of Georgia alone—impressive numbers for our little South Georgia nonprofit, and a sure result of Nix’s leadership.

But Nix’s enthusiasm for telehealth was not immediate. She’s shared with me many times her initial reservations towards that first telemedicine cart.

“I hated that thing,” she once told me. “The technology itself was new and awkward, and the concept of telemedicine was foreign to everyone.” Nix’s story of those early days is one of immense frustration: “I had no clue how I was going to fit telehealth appointments into my already overfilled days. I felt decisions were being made about my clinic operations and that I had little to no input about these decisions. I was overwhelmed.” Remarkable as her role in the new program may have been, she felt nothing like a trailblazer.

There are plenty of reasons for school nurses to shut down in the face of a new telemedicine program. A day in a school clinic can go from slow to frenzied with the drop of an O2 stat or a spike in a blood sugar reading. The nurses preside over med distributions, sore throats, and even—in one of Nix’s favorite anecdotes—broken flip flops. Despite the good that telemedicine promises to bring, many nurses will admit that working consults into their already-hectic schedules seems impractical and counter-productive.

With nearly ten years of telehealth experience, however, Nix has become an expert in alleviating these anxieties, precisely because she’s experienced them herself. She’s also mastered them.

True to form, Nix honed her frustration with her circumstances into a stunning initiative that helped her take ownership of the Berrien Elementary program and turn it around. It’s a story she shares with every nurse she trains: “I requested a meeting with my telehealth team and requested a more pronounced role with the decision making of the telehealth program—my telehealth program.” Results were quick to follow. “Within just a few months, my telehealth appointments were the highlight of my day,” Nix said, “and I had finessed my clinic process into a well-oiled machine.”

Machine-like or not, however, Nix has let one very human motivation guide her throughout her career.

“Don’t forget you’re doing it for the kids,” I’ve heard her tell roomfuls of nurses countless times. “Your kids.”

And a telehealth consult program makes quite a difference in those kids’ lives. Illnesses get caught and treated sooner. Working parents no longer lose pay to ferry their children to the doctor. Healthcare becomes available to entire demographics who previously suffered in silence. This is what Nix reminds her nurses of when the endless influx of patients or the stubborn noncompliance of telemedicine technology overwhelms them: that this is their program, for their kids. And because of her zeal, they jump on board each time.

To be sure, Nix’s palpable passion for student health makes her a compelling figure. In the end, however, it’s not the fact that she fearlessly propels the landscape of school health into the future that is so impressive—it’s the fact that she effortlessly inspires countless nurses to do so with her. She’s become the trailblazer she never thought she could be.

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