School Nurse Feels the Pain of Looming Personnel Cutbacks : Coping: Tom Hecht, who may see five or six students at a time for a variety of maladies, faces an uncertain future with the district.

The morning recess had just ended at Pacoima Junior High School and for school nurse Tom Hecht, the headaches were just beginning.

In a Spartan waiting room outside Hecht’s small office, a boy signed his name to a list on a clipboard, then shyly walked into the office.

“When I was playing outside, I felt a real bad headache,” the boy said.

“When did it begin?”

“It started about 6 this morning,” the boy replied.

“Did you tell your mother?”

“No. She had to be at work at 6:30.”

As in so many of the headache cases he sees every day, Hecht surmised that maybe the boy hadn’t had enough to eat.

Many of the children at Pacoima Junior High, which serves a predominantly lower-income and minority population, go hungry each morning until government-subsidized snacks are served during the 10:30 a.m. nutrition break, Hecht said.

As a result, the nurse said, they show up at his office with signs of mild malnutrition: headaches, stomachaches and lightheadedness.

“Try to eat,” Hecht advised. “Maybe that’ll help.”

And with that, Hecht sent the boy back to class. There was little else he, as a nurse, could do. “I hope you feel better,” he said as the boy walked out.

The scene, with minor variations, would be repeated throughout the day as student after student checked in with headaches, stomachaches, bloody noses, bruised fingers and an assortment of other ailments.

Hecht’s main responsibility is to determine whether a child is too sick to attend class or should be sent home. In serious cases, he will refer them to a doctor and, in emergencies, administer first aid.

It’s not General Hospital, but the 10-foot by 15-foot office--and dozens like it throughout Los Angeles--is the closest thing to a doctor’s office many students have ever encountered, Hecht and nursing administrators in the Los Angeles Unified School District say.

But nearly 300 nursing positions could be eliminated--in addition to positions held by psychologists, counselors, physicians and other health-care workers--as the district tries to cope with a $341-million budget shortfall for the coming year.

Hecht, a soft-spoken man with a love for gardening, got a layoff notice in March after almost two years with the district. More than 2,100 district employees would be laid off or transferred under the budget cuts, which still must be approved by the school board. Final layoff notices must be sent by Wednesday.

There’s rarely a quiet moment in Hecht’s office, and he often finds himself tending to five or six children at a time. One day last week, Hecht examined a boy for stomach pains while two girls lay on cots in an adjacent room. One of the girls, Alma Villalobos, was on her second visit to the office that day because her stomachache wouldn’t go away.

“Does it hurt a little, medium or a lot?” Hecht asked Alma after her rest. “A lot,” she mumbled in a pained whisper.

“What do you want to do? Do you want to stay in school or not?”

“I want to go home,” Alma said. Hecht had someone call the girl’s mother, who promptly picked her up.

Hecht said he commonly sees students who should have been taken to a doctor or an emergency room but whose parents can’t afford medical care.

He recalled a boy who recently fell on his way to a school bus stop, seriously cutting his leg. But the boy’s parents put him on the bus anyway, Hecht said, and told him to see the school nurse.

“I called home and had him taken to the emergency room,” Hecht said. “He had to have six stitches.”

For now, Hecht, a Sierra Madre resident married to a school speech pathologist in Alhambra, is trying to cope with an emergency of his own.

“My future is a question mark,” he said. “I’m doing the best job I can. This is a very stressful way to live.”