School nurses report rise in toileting issues and high clinic volume in annual health-services update
July 15, 2025 | Greenfield-Central Com Schools, School Boards, Indiana
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Greenfield-Central health services staff reported 22,609 clinic visits by students and 134 visits by staff during the 2024-25 school year, and flagged a new trend: an uptick in restroom-related visits and toileting challenges across multiple grade levels.
Dawn Hanson, who presented the annual health-services report, said 85% of students who visited school clinics returned to class after care. The district logged 20 EMS calls during the year; 15 students were transported to a hospital, and five cases involved parent-declined transport or self-transport. "We administered 14,692 medications and 6,865 medical-order treatments," Hanson said.
Top visit reasons, staffing and trends: Stomach aches remained the top complaint. Hanson told the board that restroom visits moved into the top three complaints districtwide, and characterized the rise as a strain on staff resources. "We're seeing more students enter the school setting who are not toilet trained, as well as a rise of students experiencing frequent bowel and bladder incontinence during the day," she said, adding that the trend has substantial operational and staffing impacts.
Hanson referenced clinical discussions she heard at a conference linking the trend to behavioral patterns and reduced regular toileting, noting an informal label she'd heard used by a specialist: "Fortnite constipation," describing preoccupation with other activities that delays regular bathroom habits.
Staffing and coverage challenges: Hanson told the board that filling nursing vacancies has been difficult; a most recent nursing vacancy took eight months to fill and required other nurses to cover duties. She said school health staff pivoted repeatedly to maintain services and that the presence of therapy dogs had been helpful in some clinical episodes.
Why it matters: The rise in toileting and complex medical needs increases workload for nurses and support staff and could affect classroom instruction if students require frequent clinic time. Hanson recommended continued attention to staffing, wellness resources and immunization clinic support; she also noted local partners' limited capacity for mass immunization events following state funding cuts to the Indiana Immunization Coalition.
Board response and next steps: Board members thanked Hanson and acknowledged the increased complexity of student health needs. Staff will continue to report back on staffing levels and student health trends as the district prepares for the school year.
Dawn Hanson, who presented the annual health-services report, said 85% of students who visited school clinics returned to class after care. The district logged 20 EMS calls during the year; 15 students were transported to a hospital, and five cases involved parent-declined transport or self-transport. "We administered 14,692 medications and 6,865 medical-order treatments," Hanson said.
Top visit reasons, staffing and trends: Stomach aches remained the top complaint. Hanson told the board that restroom visits moved into the top three complaints districtwide, and characterized the rise as a strain on staff resources. "We're seeing more students enter the school setting who are not toilet trained, as well as a rise of students experiencing frequent bowel and bladder incontinence during the day," she said, adding that the trend has substantial operational and staffing impacts.
Hanson referenced clinical discussions she heard at a conference linking the trend to behavioral patterns and reduced regular toileting, noting an informal label she'd heard used by a specialist: "Fortnite constipation," describing preoccupation with other activities that delays regular bathroom habits.
Staffing and coverage challenges: Hanson told the board that filling nursing vacancies has been difficult; a most recent nursing vacancy took eight months to fill and required other nurses to cover duties. She said school health staff pivoted repeatedly to maintain services and that the presence of therapy dogs had been helpful in some clinical episodes.
Why it matters: The rise in toileting and complex medical needs increases workload for nurses and support staff and could affect classroom instruction if students require frequent clinic time. Hanson recommended continued attention to staffing, wellness resources and immunization clinic support; she also noted local partners' limited capacity for mass immunization events following state funding cuts to the Indiana Immunization Coalition.
Board response and next steps: Board members thanked Hanson and acknowledged the increased complexity of student health needs. Staff will continue to report back on staffing levels and student health trends as the district prepares for the school year.
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