GUIDELINES FOR THE NURSE IN THE SCHOOL SETTING
Guidelines for the Nurse in the School
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the Nurse in the School Setting
The Illinois Emergency
Medical Services for Children (EMSC) program recognizes the unique field of school nursing
and the multiple roles that the nurse in the school environment is called upon to perform.
The intent of this manual is to provide nurses working in the school setting with a set of
emergency care guidelines that can be utilized during the delivery of care to the ill or
injured student. In addition, other resources are contained in this manual which school
nurses may find useful to reference or integrate into their current practice. The EMSC
School Nurse Task Force has worked to ensure that the information presented in this
document is accurate and in accordance with professional standards in effect at the time
of publication. It is hoped that this document becomes a valuable addition to the
resources already available within the arena of school nursing practice.
It is important to note that there exist variations in school settings, services and access to resources and
personnel. These differences can impact upon delivery of care. Therefore the protocols
contained in this manual should be regarded as guidelines and not as dictating an
exclusive course of treatment. In addition, these protocols should not serve as a
substitute for the professional advice of a physician and should not be construed as
excluding other acceptable methods of treatment. It is recommended that care must always
be based upon the students clinical presentation and on authorized policies.
Because schools provide services to
students throughout the childhood and adolescent years, it is important when utilizing
this resource manual to remain cognizant of pediatric developmental stages as well as
"age appropriate" services and information. A baseline understanding of
pediatric developmental characteristics and a general knowledge of appropriate approaches
in the assessment and management of the varied age groups will be beneficial. The
assessment and treatment approach when dealing with an injured or ill kindergartner is
quite different from that of a high-school student, especially when considering
participation of the child in the decision making process, provision of educational
information and level of parental involvement.
In addition, children with special needs
or chronic conditions are seen in increasing numbers in the school system. This population
can present with physical disabilities, mental disabilities and/or chronic illnesses that
may require technological support. Special needs children may require frequent emergency
care interventions. When caring for the special needs child, "age appropriate"
guidelines should be utilized as well as the following reminders:
Concentrate on the child's abilities, not disabilities. Focusing on what the child is
able to do promotes self-esteem and a positive self-image.
Communicate with the child in a manner appropriate to his or her ability. Presence of a
physical disability does not mean that the child is also cognitively impaired.
Meet with the care giver and obtain a careful history. Their assistance in interpreting
behaviors and responses can provide a better understanding of the child's needs.
Develop an individual health care plan for these students.
Become familiar with respiratory emergency adjuncts and interventions since the most
common emergency encountered with these children is respiratory related.
Development of a plan identifying
appropriate follow-up after emergency incidents is essential. Communication between the
school nurse, the teacher and the parent/care giver assists in maintaining awareness of
student progress, identifies any new or additional care needs and reinforces any
restrictions or limitations that may have been placed on their activities at school.
Many emergencies are avoided daily in the
schools because school nurses have established individual health care plans for students
with special health needs and have educated parents and staff members in prevention and early
intervention techniques. The school nurse has a key role not only in the provision of
emergency care to students but also in the development of prevention strategies. School
nurses can work collaboratively with administrators, staff, medical advisors, local EMS
and health care providers and parents to establish a comprehensive emergency care program
in schools that results in the reduction of morbidity and mortality in students. School
policies, protocols, individual health plans, communication, documentation, data
collection and follow-up are all part of a comprehensive prevention program.