Michael Alexander - Confessions of a School Nurse

Skylar, the blonde in the front row, interrupted. ‘What do they want? What exactly is “it” you mean?’ She was enjoying every minute of this.

I suddenly felt shy saying the word ‘sex’ in front of them. It was irrational, but I feared my voice would crack, my face turn even more beetroot, or even giggle.

‘You know, they’ll say anything to get you to play …’ I was about to say ‘play around’ but that was too ambiguous. There was a long pause as I thought of a harmless way to say sex.

‘They’ll say anything to get you to play hide the sausage,’ I blurted.

Sarah’s mouth dropped, along with everyone else’s in the room, but I ploughed on.

‘Perhaps that was a sexist thing to say,’ I said, my tone apologetic. ‘I hear women these days are just as aggressive at pursuing men.’

‘He didn’t just say that.’ I overheard Sarah as she whispered in Michaela’s ear, but it was too late now.

‘Maybe I should tell the boys that you’ll say anything to get what you want. Perhaps I should be warning the boys to stay away from you lot,’ I said, deliberately making eye contact with Skylar. By this stage Michaela and Sarah were in an agony of laughter, along with the rest of the room. I wanted to hide, but I couldn’t stop.

While many of these girls were already sexually active, they weren’t adults. Just because they’d had oral sex or regular intercourse, they still had a lot to learn. Being able to physically do something has nothing to do with being mentally prepared, and especially nothing to do with being safe.

It doesn’t help that the school doesn’t want to deal with sex education, although that could be a good thing. When Michaela had suggested that we stock some condoms in the health centre, the headmaster had initially said ‘Why? They’re not having sex.’ This may sound unbelievable, but sometimes it’s easier to deny there is an issue, because then they don’t have to deal with it.

Other than what students learn in biology class, there is no plan, no policy or goal when it comes to educating them about the birds and the bees. It’s easier to leave it to the nurses, because – apparently – we know best!

‘Who’s had herpes before?’ I asked the girls. No one was really sure. I asked if any of them had had a cold sore, and most of them raised their hand. ‘Well don’t kiss your boyfriend down there if you’ve got one, he won’t forgive you. He’ll have it for life.’ There were gasps of disbelief. ‘You’re telling me you didn’t know that? It works both ways, except it’s usually worse for the women if they get it down there. So watch out.’

Due to the previous Hepatitis C scare, most the senior students knew about that, as well as Hepatitis A and B.

I asked them about syphilis, warts, HIV, gonorrhoea; they knew nothing, and they began to realise that they knew nothing. When I told them that we were down to the last antibiotic to treat gonorrhoea, and that pretty soon we’d have nothing to treat it, they were ready to listen. Even Skylar managed to keep her mouth shut.

I told them about my experiences working at a London STD clinic. The biggest lesson I learned from that place was not to judge anyone by appearances. In the waiting room you’d see the most sophisticated, beautifully dressed men and women, sitting next to someone more used to sleeping on the street, and they usually had something in common – an STD.

I was surprised when one young teen said that we didn’t need to worry about STDs so much in our village, because we lived in the Alps. She seemed to think that our location was some protection from STDs. I soon explained how wrong she was; ski resorts have a disproportionate number of STD cases. ‘And besides, I see cases from school every year with STDs.’ There were horrified gasps alongside demands to know who they were.

Another girl thought that oral and anal sex were safe alternatives to regular sex.

‘Hands up if you think you can catch a disease from oral sex.’ Only half the girls raised their hands.

‘A friend told me …’ began another. It’s always a friend, or a friend of a friend, but it doesn’t matter. I listened. This particular friend thought that anal sex meant the person was still a virgin. I’d never thought about it before, but I guess technically you could say that. ‘But bugs can spread particularly easily through anal sex,’ I explained. ‘It’s why we often give people their medicine that way.’

With my credentials established, the girls wanted to know more. They asked a whole range of questions:

• How do you know when it’s right?

• My friend has a boyfriend who is going to dump her if she doesn’t ‘do it’. Should she?

• Do condoms always stop disease?

• Can you cure genital warts?

• Can you get cancer?

• Is it always painful?

• What’s a normal size? (Penis size, that is.)

• Is anal sex safe?

• What is dogging?

• What is chariot racing? (I had to look this up on Google, although I advise you not to.)

Their appetite was insatiable, but finally we were finished, and we let the girls go, free to pursue or be pursued. Sarah came over and thanked us. She said that in her time as a dorm parent she’d never seen such an ‘enthusiastic’ response to a sex talk. I just hoped that I still had a job come Monday morning.

When Monday finally came around, instead of angry phone calls or vicious emails, I was approached by a group of senior boys. They asked when their sex talk was. They said they’d heard from the girls that it was the best sex education talk ever. I think they felt left out of all the fun.

As politically incorrect and potentially offensive as my tactics may sound, over the years that I’ve been a school nurse, I’ve discovered humour nearly always helps.

A lot of students come to me now, especially after I give a group lesson, to speak privately. It’s during these talks that I realise how little they truly know and how important it is that we continue to communicate.

We needed some guidance. After my first two sexual education talks, I had many unanswered questions:

• What is appropriate for a ten-year-old versus someone sixteen years or older?

• Should we even be offering sex education to everyone?

• Do we talk about homosexuality? And how do we handle such a sensitive subject given the backgrounds of some of our kids?

• Do we need parental consent?

• Could we get into trouble?

• What should you expect ten-to sixteen-year-olds to know? Is there a baseline of understanding, a bare minimum they should know?

• And how much is an average teenager exposed to, compared to when I was at school? Do they learn it all on the internet?

To help us in our quest to provide relevant, age appropriate, unbiased information, we went on a research trip to London. Britain has had boarding schools for hundreds of years, and, I like to think, pretty much have them sorted. These institutions have heaps of resources for matrons, nurses, dorm parents and teachers. Our brief was three-fold. Michaela, Justine and I went to a conference all about sexual education; we invited a sexual education specialist to come to our school and educate us about how to teach; and we invested in pamphlets, booklets, questionnaires, DVDs and online resources to make our lessons more interesting and, as far as possible, more ‘hands on’.

With all this new material, I now felt better prepared, but it wasn’t until my second year that I got to do another sex talk, and it happened to include some of the boys from my first: William, Chen and João. They had made the transition from junior school to high school, and the powers that be felt it a good idea to follow up from the previous year’s talk. They set aside the boys’ common room one evening for me to do my thing.