According to information received from parents at Beltsville academy, Prince George’s County Public Schools (PGCPS) needs a full time nurse at Beltsville Academy. “A school with close to 2,000 kids and adults and no nurse on grounds is a disaster in waiting,” stated one parent who wanted to remain anonymous.
PGCPS Beltsville academy is pre k to 8th. Some students have health issues and whenever a problem develops a teacher calls parents who have to pick their child up. Some have varying issues such as an upset tummy or other issues such as a cut. Others needs medication. If the school had somewhere to lay down a student for 10 minutes or so for minor health issues, one parent who did not want to be identified said, “they would have been fine.” But instead students are missing half a day at school and parents have missed work to attend to their loved ones. It would be helpful if there was a nurse at Beltsville academy to assist the school community there as some of the students need medication regularly. It’s possible other schools with a large population of students in PGCPS and elsewhere need a full time nurse as well.
The school nurse has a crucial role in the seamless provision of comprehensive health services to children and youth. Increasing numbers of students enter schools with chronic health conditions that require management during the school day. This policy statement describes for pediatricians the role of the school nurse in serving as a team member in providing preventive services, early identification of problems, interventions, and referrals to foster health and educational success. To optimally care for children, preparation, ongoing education, and appropriate staffing levels of school nurses are important factors for success. Recommendations are offered to facilitate the working relationship between the school nurse and the child’s medical home.
SCHOOL NURSE ROLE
The National Association of School Nurses identifies 7 core roles that the school nurse fulfills to foster child and adolescent health and educational success. The roles are overarching and are applicable to school nurses at all levels of practice, in all geographic settings, and with all clients.
The school nurse provides direct care to students. The school nurse provides care for injuries and acute illness for all students and long-term management of students with special health care needs. Responsibilities include assessment and treatment within the scope of professional nursing practice, communication with parents, referral to physicians, and provision or supervision of prescribed nursing care. An individualized health care plan is developed for students with chronic conditions, and when appropriate, an emergency plan is developed to manage potential emergent events in the school setting (eg, diabetes, asthma). Ideally, this health plan is aligned with the management plan directed by the child’s pediatrician and regularly updated through close communication. The school nurse is responsible for management of this plan and communication about the plan to all appropriate school personnel. The school nurse has a unique role in provision of school health services for children with special health needs, including children with chronic illnesses and disabilities of various degrees of severity. Children with special health needs are included in the regular school classroom setting as authorized by federal and state laws. As a leader of the school health team, the school nurse must assess the student’s health status, identify health problems that may create a barrier to educational progress, and develop a health care plan for management of the problems in the school setting. The school nurse ensures that the student’s individualized health care plan is part of the individualized education plan (IEP), when appropriate, and that both plans are developed and implemented with full team participation, which includes the student, family, and pediatrician.
The school nurse provides leadership for the provision of health services As the health care expert within the school, the school nurse assesses the overall system of care and develops a plan for ensuring that health needs are met. Responsibilities include development of plans for responding to emergencies and disasters and confidential communication and documentation of student health information.
The school nurse provides screening and referral for health conditions. Health screenings can decrease the negative effects of health problems on education by identifying students with potential underlying medical problems early and referring them for treatment as appropriate. Early identification, referral to the medical home, and use of appropriate community resources promote optimal outcomes. Screening includes but is not limited to vision, hearing, and BMI assessments (as determined by local policy).
The school nurse promotes a healthy school environment. The school nurse provides for the physical and emotional safety of the school community by monitoring immunizations, ensuring appropriate exclusion for infectious illnesses, and reporting communicable diseases as required by law. In addition, the school nurse provides for the safety of the environment by participating in environmental safety monitoring (playgrounds, indoor air quality, and potential hazards). The school nurse also participates in implementation of a plan for prevention and management of school violence, bullying, disasters, and terrorism events. The school nurse may also coordinate with school counselors in developing suicide prevention plans. In addition, if a school determines that drug testing is a part of its program, school nurses should be included in school district and community planning, implementation, and ongoing evaluation of this testing program.
The school nurse promotes health. The school nurse provides health education by providing health information to individual students and groups of students through health education, science, and other classes. The school nurse assists on health education curriculum development teams and may also provide programs for staff, families, and the community. Health education topics may include nutrition, exercise, smoking prevention and cessation, oral health, prevention of sexually transmitted infections and other infectious diseases, substance use and abuse, immunizations, adolescent pregnancy prevention, parenting, and others. School nurses also promote health in local school health councils.
The school nurse serves in a leadership role for health policies and programs. As a health care expert within the school system, the school nurse is a leader in the development and evaluation of school health policies. These policies include health promotion and protection, chronic disease management, coordinated school health programs, school wellness policies, crisis/disaster management, emergency medical condition management, mental health protection and intervention, acute illness management, and infectious disease prevention and management.
- The school nurse is a liaison between school personnel, family, health care professionals, and the community. The school nurse participates as the health expert on the IEP and 504 teams. IEP teams identify the special education needs of students; 504 teams plan for reasonable accommodations for students’ special needs that impact their educational programs. As the case manager for students with health problems, the school nurse ensures that there is adequate communication and collaboration among the family, physicians, and providers of community resources. This is a crucial interface for the pediatrician and the school nurse to ensure consistent, coordinated care. The school nurse also works with community organizations and primary care physicians to make the community a healthy place for all children and families.