Nursing Notes
The school nurse is a key player in ensuring a successful school experience for
a student with a chronic illness. The nurse is the “glue” that connects the student,
family, school and hospital. He or she is integral in creating a smooth transition
from hospital to school, alleviating the fears of parents and the student with a
chronic illness, addressing concerns of peers, siblings, teachers and other parents,
and being a support to all of these stakeholders. It is obvious, therefore, that
the role of the nurse is significant and should not be underestimated.
Ongoing comunication is essential
When a student is diagnosed or experiences an exacerbation of a chronic illness,
effective and ongoing communication among all personnel is essential. Once a diagnosis
is made or an exacerbation recognized, the nurse should meet with the parents to
understand the child's health issues. Set up times to meet with the child (if appropriate
and possible) and the parents.
Consider scheduling additional meetings to include all school personnel involved
with the child. These meeting should include the hospital educator, nurse clinician
or hospital social worker, the child’s teachers and other key persons who will interact
with the student at school. Preferably, this meeting should occur with all parties
in attendance. If that is not possible, a telephone conference is recommended.
Checklist
The following checklist may assist the school nurse in developing a plan for academic
reentry and reintegration of the student with a chronic illness.
- the child’s current medical status and prognosis (the hospital educator, nurse
clinician or social worker will present information about the diagnosis and treatment)
-
any physical restrictions that have been recommended
- information about permanent IV devices, surgical sites or other issues that may
need special attention/precautions
- the child’s psychological or emotional status – how is he/she feeling about the
diagnosis and the impact it has on his/her life
- concerns the child or parent may have re: school reentry
- the family’s desires re: sharing information with other students, parents, etc.
(a signed consent should be obtained for information sharing with these persons)
- the development of an Emergency Health Care Plan or Individualized Health Care
Plan for the child in school. Most districts have a form for this purpose. If your
district does not have such a form, you may print one here: (Individualized Health
Care Plan). This plan will enable you to prevent many crises, and to have a good
plan of action if there is an emergency at school.
- give the family ample time to present any additional concerns that they may be
experiencing.
It doesn't end here
Although this list seems to be fairly comprehensive, it is merely a beginning for
the dialogue between the school nurse, family, and health care representative(s).
A chronic illness is not a stagnant condition, so it is vital to maintain ongoing
communication to ensure that current issues are addressed. The child with cancer,
for example, will have weekly blood counts that may determine if platelets are high
enough for her to participate in physical education and recess and if the white
blood count is high enough to prevent potentially life-threatening infections.
The school nurse is also an essential link in providing the student’s teacher(s)
and other educational staff with pertinent information. As the person who addresses
health care issues when the child is at school, you release the educators to do
their job – teach students. In this way, the student is more likely to enjoy success
at school, and all who interact with them will relish the experience!
For more information, please contact:
Kathy Davis, MSEd, PhD
kdavis2@kumc.edu
(913) 588-6305