The Things We Do

I hate to see budget cuts affect good people who make a clear contribution. At my school, some of these cuts are jeopardizing the school nurse and her ability to function optimally. For example, she needed an otoscope to examine the ears and had to buy one out of her own pocket. It shouldn’t have to be that way. The school should be able to afford to replace it. They questioned the need for it at all.

An otoscope is a medical device with which one can check the ears and they are regularly used by health care providers to help detect problems that are revealed in this area. A school nurse definitely needs such a diagnostic tool. She uses it all the time to view the ear canal and tympanic membrane or eardrum. This is important because the eardrum is the dividing border that separates the external ear canal from the middle ear and many conditions can be detected here. Plus, she would be able to spot excess ear wax, any pus, skin edema, a foreign object, or signs of disease. The school’s judgment was clearly wrong.

So what is this thing anyway? It is a handle and a head basically, the head being the light source and a low-power magnifying lens (about 3.00x Mag). The front end of the otoscope has an attachment for an ear specula, a disposable plastic piece. So after the nurse straightens the ear canal, she inserts the ear speculum into the external ear carefully to avoid injury. As she looks through the lens, she can spot problems. It is a basic aspect of her medical examination on students who complain of earaches. She can attach a device to remove earwax or use a pneumatic otoscope to push air into the canal to see the mobility of the eardrum. This adds to the cost of course. Because it was her own expense, she bought the portable and not wall-mounted model. It is a battery-operated instrument that is rechargeable. With a nasal speculum you can look at the patient’s inner nose and without it the upper throat.

Since we are getting into detail here, the type of gadget she bought suitable for a school medical room is monocular. You can a two-dimensional view of the contents of the ear canal and a glimpse of the eardrum and its status. You need more depth perception to do a proper job in a doctor’s office, for example, but this means a different type of device that requires more training and skill. The nurse will have to make do with this one-eyed construction. She says it is sufficient for her needs. She isn’t worried about misdiagnosis or she would come up with the money for a binocular microscope attachment.

As I understand it, she got a set that included an otoscope, a convertible rechargeable handle, a halogen lamp, and a set of reusable polypropylene pneumatic, operating, and consulting specula. The long-lasting lamp shows true tissue color and the fiber-optic light offers cool illumination. The open system makes the otoscope convenient to use during procedures, if the nurse were to perform any, while the rotatable lens and specula ensure ease of use. She clearly didn’t spare any expense on her choice of medical device.