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Role of a School Nurse

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Kenneth Wagan

on 26 April 2014

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Transcript of Role of a School Nurse

Role of a School Nurse
Benedictine University
Kenneth Wagan
Judy Thompson
Romy Mendoza

History of School Nurses
• School Nursing was introduced to the United States in 1902. The first school nurse was Linda Rogers and she was hired in the New York school system. Her job was to educate and counsel families and school staff on the management of communicable diseases. Mrs. Rogers was very successful in her interventions and opened the door for the expansion of the school nurse role (Allender & Warner, 2014).
Network of System of a School Nurse
• There is a recognizable triad that exists within the healthcare network of a child with an illness.

• When there is poor communication between triad members, the school nurse must complete the often difficult task of gathering information to ensure the health and advancement of the child.
• Pediatricians and other physicians and healthcare specialists should collaborate with the school nurse to provide optimal health for the child……
• School nurses and the rest of the healthcare team should collaborate with guardians and caregivers for the child……
Nasn.org, 2014
• In today’s school systems there are many children (number is growing) that require “one on one” monitoring and assistance at school.
• School nurses play a very important role in the healthcare of children with chronic ailments within the school setting.
• The National Association of School Nurses states
seven core roles
for the school nurse:
1) Provide direct care
2) Is the head of healthcare in school setting(leader)
3) Screens and makes referrals
4) Promotes student health at school(emotional and physical support)
5) Provides health education to promote well-being
6) Leads in the application of health policies and programs
7) Acts as liaison

(Nasn.org, 2014)
Current School Nurses
• CPR Certified
• Vision & Hearing Screening Technician Certified
• Experience with children, youth, teens
• Most School Nurses In Illinois have a BSN
• New requirement effective
July 2013 by the Illinois State Board of Education
will require increase the number of
Certified School Nurse
School District
• You can be certified Nationally or by State:
o Must be a BSN and taken additional courses – A graduate school for Certified School Nurse Program
o Illinois type 73 certification
o National Board Certification of School Nurses

Education: Special Training & Siills
• The National Association of School Nurses (NASN) defines school nursing as: “A specialized practice of professional nursing that advances the well-being, academic success, and lifelong achievement of students. To that end, school nurses facilitate positive student responses to normal development; promote health and safety; intervene with actual and potential health problems; provide case management services; and actively collaborate with others to build student and family capacity for adaptation, self-management, self-advocacy, and learning" (NASN.org, 2014.
Definition of School Nurse
Top Chronic Conditions in school age children
School Nurse Team
1. Certified School Nurse
Manager of Non-certified school nurse, health aides and health volunteers, One nurse to multiple schools in a district, Data Collecting, Care Plan and Teaching Role
to coordinate a school health program
including the delivery of services to students and staff in order to enhance health and wellness in the school community

2. Non-Certified School Nurse (Registered Nurse)
Mostly a RN and works under the Certified School Nurse and is the main nurse of the school
To provide direct nursing services to student and staff
to maximize health and wellness of school community

3. School Nurse Aide or Health office clerica
At least HS graduate and is a Certified Nursing Assistance (CNA), knows CPR
To provide reception services, clerical assistance and technology support to the School Nurse in order to
optimize the delivery of health services
Assist in maintenance of health records, vision and screen assistance, ADL’s of special need students, encourage communicable disease prevention i.e. handwashing cover cough/sneezes, clerical assistance

School nurse
One in five children and adolescents have a diagnosable mental health disorder in the course of a year
School Nurses spend 32% of their time providing mental health services .
Academic achievement can be improved through:
– Early detection
– Timely referral
– Access to appropriate services

Statistics show that 15 to 18% of children and youth have some sort of chronic health condition and nearly half of these students could be considered medically disabled.
That translates to
18 out of every 100
students in every school – in a classroom of
25 students, 4 – 5
of the children present will have a health condition that impacts their ability to be successful in the classroom.
Top Chronic Conditions in School-age Children
1. Asthma
Affects over 10 million children in the US
Many State (88%) allow students to carry quick-acting inhalers
2. Diabetes
Rise in new cases each year
Estimated 13,600 under 20 y.o. youth are newly diagnosed with DM-II every year
3. Seizure Disorders
45,000 children under the age of 15 develop it each year
Requires medication (often given rectally) within minutes of onset although controversial caught between rights of student and parents and state’s own nursing practice act
4. Food Allergies
Increased 18% in children under 18
Many States (66%) allow students to carry and EpiPen
5. Obesity
Incidence of obesity has tripled among 6 – 11 year olds and more than tripled among 12 – 19 year olds
33% of students are overweight or obese affecting their physical and mental health

Mental Health Support
Emergency Care

School Nurses develop Emergency Care Plans to guide the response to life-threatening health issues:
A student with an allergy (bees, food or latex) who needs injectable epinephrine immediately
The Illinois Emergency Epinephrine Act: Allow Free Epi-Pen® to schools who have physician orders for stock epinephrine
Students with seizures need their medication within minutes – often given rectally
Students with diabetes may need injectable glucagon to treat a life-threatening low blood sugar episode
–A student with asthma who is struggling to breathe may need a nebulizer treatment

• Immunization rates are higher in schools with school nurses
• Unlicensed personnel in schools make more medication errors than nurses
• School nurses can identify environmental hazards at school based on injury patterns
A School Nurse first identified H1N1 Flu based on the increase in illness in her school!

Prevention and Care
School nurses reduce absenteeism. A higher nurse to student ratio is related to better attendance rates
– Less likely to dismiss students early than unlicensed personnel
– More time in the classroom provides more time for learning
– Increases a student’s chances for success!

School Nurse Visit Reflection
• Our nurse’s name is Mrs. Jovie Caccavale RN, BSN. We visited her and conducted our interview at Eisenhower junior high school in Darien.
Past experience:
Worked in pediatrics for 6 months then 1 year at the burn unit at Loyola, then 12 years at the cardiac unit at Hinsdale Hospital
Name of agency/institution:
LADSE – LaGrange Area Dept. of Special Education
• Average salary of her current position is $46,000
• Position requirements to be a school nurse at this school: BSN, 2 years of experience in an acute care setting. (NACSN exam optional).
• Our impressions of the role were diverse. We felt that the position appeared less stressful than traditional nursing in hospital setting.
The law in Illinois states that schools have to make special personalized education plans that accommodate students with special needs. Mrs. Caccavale helps to create these special plans and performs many of the interventions.
Caring for the special needs children at the school
-children with chewing and swallowing difficulties (choking incident)
-monitoring tube feedings (keeping log)
-monitoring epileptics (emergency plans)
-handling acute illness and emergency situations (allergies),
School Nurse Reflection continue
Briefly describe how the nurse’s role connects with and effects the health of the community
- There is regular communiation wit PT, OT, and speech therapist to collaborate the best plan of care.
- Frequent communication with parents and doctors

Salary – “Get’s paid hourly to somewhat goes into salary payment?”
Requirements to position: BSN, CPR, experience with children

Works under a Certified School Nurse, The CertifiedSchool Nurse covers 3 school of the district.
Has another health aide as another assistant at the school. The Health aide works with the entire school.
Special needs class currently has a total of 7 kids that is held inside Junior High School

Job Duties
- Assist In ADLs, to the gym, music class
- Tube feed log
- Does not pass any meds this year
- Does a medical log – Including incident report

LADSE – OT comes once a week, PT comes through out the week ,
Not all teachers are CPR certified, Just the Health department and Gym teachers

Once a Year there are Care Plan meetings , and meetings before visual and hearing screenings.

Most challenge: Having a child with Seizure Precautions. Child had multiple seizures and the school nurse had to monitor frequently

Seizure Precautions : No administration of medications. Have to wait 5 minutes until calling 911

LaGrange Area Dept. of Special Education (LADSE)
Lagrange Area Department of Special Education (LADSE)
• Established in 1957-Sheri Wernsing is executive director
• Services 15 school districts in Cook and DuPage counties
• Employs many professionals including nurses, psychologists, speech language pathologists, occupational therapists and physical therapists

Special Programs at LADSE include:
-Communication development classes
-District autism supports
Deaf and Hard of Hearing
-Regional deaf and hard of hearing program (birth-21yrs)
Early Childhood Education
-Special education preschool (ages 3-5)
Emotional Disability
-3 Prong team support system
1) Private Classroom: Instruction in therapeutic classroom setting.
2) General Classroom: Provide support in “regular” classrooms.
3) Primary Interventions: Preemptive strike at developing problems.
Intervention before an identified problem gets out of hand.
Extended School Year
-Recommended by treatment team to prevent regression
-Part of a child’s Individual Education Program (IEP)
-LADSE school district building over summer months
-Chooses their own staff, provides transportation for children
Multi Needs
-Support for children with physical, mental and sensory impairments.

-Children 3-6 years of age with speech disorders
-Not physically deformed or cognitively delayed (just cannot understand them)


Allender, J. A., & Warner, K. D. (2014). Community and public health nursing: promoting the public's

health (8th ed.). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health.

Illinois Association of School Nurses [IASN]. (2012, March 14). IASN. Retrieved April 23, 2014, from


Education, L. A. (2013). From LADSE: http://www.ladse.org

Nurses, N. A. (n.d.). NASN.org. From The National Association of School Nurses: http://


Pediatrics, J. O. (2008). Role of the School Nurse in Providing School Health Services. American

Academy of pediatrics , 1052-1056.

Sonnenberg, M. (2013, October 24). School nurses' duties expand with changing times. <i>USA Today</

i>. Retrieved April 9, 2014, from http://www.usatoday.com/story/news/nation/2013/10/24/


School Nurse Reflection

1. Educate about the general role of school nurse.
2. Share the reflection of our experience with a shoool nurse

Illinois Association of School Nurses [IASN], 2012
Illinois Association of School Nurses [IASN], 2012
Full transcript