Educators and health care professionals alike recognize the importance of health care planning in the school environment. Our public schools are increasingly burdened with the task of attending to the health of its students. With both parents working in the majority of American households, more children with mild illness are being sent off to school. As school district budgets go through regular budget cuts, special programs are being dropped. This means that students with special needs who might have landed in a tutoring program or special education classroom are being integrated into the general school population.
These trends have resulted in a significant expansion of the school nurse’s duties. Today a school nurse may be charged with dispensing medicine and then monitoring reaction to the medication, with monitoring glucose levels for diabetic students, with dispensing medication and treatment for the onset of chronic conditions such as asthma or an allergy attack, and so on. Ninety plus percent of public school nurses report caring for students with seizures, with diabetes and with chronic and severe asthma.
It has become a generally accepted premise that for students with special needs or with chronic health problems, it is good policy for the school nurse and/or school staff to develop an individual health plan for each of them. The process should begin with an in-depth interview with the student and parents or caregivers. The school’s nursing office needs to assemble as comprehensive a health record as possible on the student who may experience ongoing problems in school. This interview may be conducted with the student as active participant and the result needs to be a careful review of the child’s medical history and what early symptoms may be for the onset of medical difficulty.
The next step in the individualized health care plan is inclusion of treatment recommendations for the most common occurrences. The most common chronic medical emergency in school is some sort of respiratory problem. School staff should know if there has been medication prescribed for such incidents and, if so, have some provided to them by the parent. This portion of the plan should also include a discussion of the early warning signs that might be given off by the student and that information should be distributed to the appropriate teachers and school staff.
Individualized school health plans should include contact numbers for the child’s regular physician along with a list of any medications that the child is currently using or has been prescribed in the past. Also included in the plan should be treatment suggestions based on accepted medical practice and on what has been successful for the child during past occurrences. For children with a history of emotional dysfunction, the treatment history is particularly important. Sometimes a soothing word in the right context will accomplish more than any pharmaceutical alternative.
The individualized plan should also provide specifics for follow up on an incident. This may include contact with the parents, the child’s physician if allowed, and the child himself. The most thorough school health plan will make it incumbent on the school staff to determine that the child has moved beyond the emergency and returned to normal in a reasonable period of time.