As the role of the school nurse has expanded to include significant health care responsibilities, so has the need for plans to handle specific types of situations and, on occasion, specific students. Today’s school nurse handles the primary health care needs of a number of students, those whose parents cannot afford or do not have health insurance. Public school populations have been expanded to include special needs students who might formerly have been enrolled in a tutorial responsive to their disabilities.
Students with special needs include those with physical or mental disabilities and those with chronic illnesses (such as asthma) that require periodic treatment. It is likely that students in these categories will be periodic visitors to the school nurse’s office. If possible, school nurses should develop personal histories on these students by talking with the parents in order to thoroughly understand the nature of the disability or illness.
By acquiring a the health records the nurse can develop an individual health plan for each student. This may include communicating with school staff about the issues these students face and early warning signs for incident onset. Emergencies can be avoided through this type of planning. Since the most common emergencies school nurses face are respiratory in nature, early intervention can be critical and simple preventative steps should be explained to the teaching staff. This kind of planning avoids a full blown emergency.
Development of a plan after an emergency is also an important health care role for school nurses and personnel. A student who has suffered an injury or come down with an illness should leave the nurse’s care with instructions for ensuing treatment. Communication among the nurse, school staff and the parents can insure execution of this plan. It no longer makes sense to assume that an injured or ill student will be seeing a doctor after leaving the school grounds. It is vital that post emergency health care plans come from the school nurse.
Any school-based health care plan, whether individual or in the form of general guidelines must incorporate recognition that nearly all school health care is pediatric health care. When developing a plan for a special needs child, the school nurse should focus on the child’s abilities instead of disabilities. Working up a history with a child and the parents should give the child a sense of safety while at school rather than further focus on his or her functional shortcomings. Children that are required to report to the nurse for monitoring or medication should feel welcome in order for a health care plan to function properly.
Post trauma school health care plans should incorporate monitoring of the injury whether or not a physician has become involved. A student’s performance in school may be affected and, depending on the nature of the injury, an allowance for reduced performance should be part of the treatment plan. Many school nursing facilities have relatively sophisticated equipment to deal with emergencies. It is important that the health care plans developed for post-injury care recognize the academic and social consequences of the medical issue and prepare the child as well as school staff for both.