 It's a scene many health care professionals are familiar with. A student who has been bullied goes to the school nurse. This nurse and a student show us what the conversation often sounds like. How does that make you feel? Worry. Worry. Little afraid. I'm scared that everybody had been worse the next time. Okay. The nurse asks about adult intervention. Was there a teacher on the playground? Yeah, but there was on the other side of the playground. Okay, now if you begin to see this happen in the future, because we want you to feel safe at school, okay? And what you can do is just go right to that teacher and let her know immediately, okay? So you won't get hurt. According to experts, bullying consists of repeated aggressive behaviors directed by one or more children against another. Bullying occurs when there is an imbalance of power or strength. A recent research article in the Journal of the American Medical Association found that 30% of students in sixth through tenth grade have been bullied, bullied others, or both with some frequency within a school term. This represents more than 5.5 million young people. The nurse in this situation takes an important next step. She talks to the student who is bullying. John, I'm going to be calling your parents so we can talk and see what we can do to help you not to become angry and to find other ways that you can use other than hitting or fighting or getting in trouble. And let's get Mom and Dad involved and see what we can do to work this out, because it's... If it's the victim, they have a tendency to be a little fearful. They also will come to the health suite often with signs such as stomach aches, headaches, things that they say hurt, imaginary, not imaginary. And I notice that as they're sitting there and I'm assessing them, they seem to get better as we're talking. And then I investigate even further about what's going on in the class and they end up saying that someone's bothering them. Another classic sign is they don't want to go to class. They'll find ways to get out of class. Or if it's recess time, most children love to go out for recess, but kids that are being bullied have a tendency not to want to go outside and play. Dr. Howard Spivak is a professor of pediatrics and adolescent medicine at Tufts University School of Medicine. He says bullying, especially among girls, can take the form of social isolation. He says boys are typically more intimidated by the threat or use of verbal or physical force than girls are. Spivak also points to research that shows kids who are bullied may suffer from low self-esteem and depression, both in the short and long term. He says health and safety professionals have important roles to play in bullying prevention. I do think that bullying should be one of the questions asked about in a medical exam or for that matter in any assessment that's being done of a child, in a medical setting or an educational setting or a mental health setting. It's such a common experience that to not ask it, risks really missing something that's likely to be there. Again, especially with kids who are acting or looking depressed or who are showing some decline in their ability to function. The school setting is particularly important because it's a place where therapeutic interventions can be done. It's a place where the social dynamics can be sometimes even slightly modified to reduce the likelihood of kids being put in situations where they might be bullied. It's an opportunity to respond to the bully or the kids who are bullying as well, not punitively but again therapeutically. And it is the setting where bullying prevention appears to be most effective and where the most comprehensive kinds of strategies can be applied and implemented. SPIVAC says we all have an obligation to advocate for schools that teach the importance of health and safety. One of the basic elements of both dealing with bullying and implementing bullying prevention is the involvement of parents. We can't do this without parents. The home setting is often a place where some of the underlying issues are taking place that lead to kids either bullying or being bullied. Parents are extremely important role models for their kids and often model the behaviors that either teach pro-social interaction and negotiating or in fact model a coercive or coercion or intimidating behaviors. Judith Vessie is a member of the National Association of School Nurses who researches bullying issues. She says young people don't always report bullying incidents. Because of that health and safety professionals need to look for important warning signs of this behavior in medical screenings and in the treatment of injuries. Another place where teasing and bullying really need to be assessed is in the emergency department because a lot of times children will present at the emergency department with injuries that seem to have an okay explanation. But if you push a little harder you'll find out that the cause of the injury wasn't what was really initially described. I mean the child may have a broken arm because he did fall running but he was running away from someone. A really important role for health professionals when they're working with parents of kids in doing health education is to talk about teasing and bullying and talk about what places their child at risk for either being a victim or being a bully. And to give strategies, proactive strategies along with other child rearing advice to help parents deal with this early on. That includes recommending books, videos, TV shows and other things that they can use as a starting point for discussion. When it comes to bullying prevention experts agree everyone has a role to play. Many health and safety professionals and other adults who work with children often have had their own experiences with bullying that now open their eyes to the problems young people might be facing. I'm very passionate about bullying because I too was a victim of bullying. I can remember running home from school afraid to death. I remember telling my mom I'm sick, I can't go to school and I even developed a stuttering problem because I was just so afraid. And back then I'm a little older now but when I was a child one of the things that the teacher would do their technique was to keep the bully in school and give me time to get home but yet the problem was never really solved.