Day Care R.N. Health Department’s Role Largely Unseen Fort Myers – "Public health activity, at its best, is invisible," states Lee County Health Department Director Dr. Judith Hartner. A good example of this ‘active invisibility’ occurs in the realm of child day care centers. According to Child Care of Southwest Florida, nearly eleven thousand children, ranging in age from a few weeks up to 12 years old, attend day care in our county. When a parent drops a child off at any one of approximately 130 large or small state licensed centers countywide, they should be able to rest assured that their child’s health is of primary concern. County health department Environmental Health specialists perform sanitation inspections twice yearly throughout the state’s day care facilities (when food is prepared onsite, the department inspects four times annually). Still, Florida has no law mandating medical day care inspections. But Lee County can count itself as fortunate. Although the Department of Children and Families does an outstanding job of policing the overall activity and administrative end of the day care business, some Florida counties have no direct link between day cares and nurses from the local county health department. But in Lee, Mary Margaret Koontz, RN, spends her days traveling from center to center.
"I attempt to inspect each and every day care at least twice a year," says the eighteen year veteran of public health. Koontz looks at accident and incident reports, checks for the proper administering of medicines, diaper changing equipment and hygiene, verifies up-to-date, properly administered immunizations and shot records, gives expert advice and more. "Children and Families does a great job, but they’re not medical people. A child’s record may have the right number of immunizations stamped, but were they given in the correct order and at the right times?" Adds Doctor Hartner, "A few years ago, do to budgetary constraints, the department eliminated the day care nurse position. The following year we saw a large increase in Shigella (dysentery) infections in day care children and a decrease in immunization rates. We learned our lesson – the day care nurse is an essential part of our public health services." Maryanita Kennedy, owner and operator of Carousel Kiddy Kingdom in Cape Coral with seventy-five day care attendees, applauds the health department’s presence in her program. "I’m so glad they restored her (Mary Margaret Koontz’) services. When she does something, I know it’s done right – totally professional and extremely helpful." On a practical note, Kennedy adds that "As a business person, she saves both time and money for me and the children’s parents." Because day care administrators and staff know that health department expertise and advice are never more than a phone call away, the parents’ view of public health in their child’s day care truly can remain "invisible" – an assumed presence, and rightly so. |