Working with Your School Nurse: What General Education Teachers Should Do To Promote Educational Success for Students with Health Needs
In this module you learned three important facts about school nurses:
They have multiple roles in the school environment.
Their participation in the IEP process is essential.
They collaborate with family, school personnel, and community professionals.
Because the roles of the school nurse and other educational professionals sometimes overlap, it is important that the school nurse, the general education teacher, and other school personnel collaborate and communicate about the healthcare needs of their students, including educating students about healthy lifestyles. This collaboration and communication has a ripple effect: When the general education teacher shows an active interest in the healthcare needs of his or her students, it enables the school nurse to better assist those students. In turn, students whose healthcare needs are met are better able to focus on learning.
My daughter Erin and I like to spend rainy afternoons in the kitchen. I used to work in a restaurant, and it is fun to show Erin all of the creative things one can make with just a handful of fresh ingredients. No matter what I’m making, our senses are treated to a variety of sights, sounds, and smells. Sometimes I’m sautéing onions–Erin loves to hear them sizzle in the skillet–and sometimes I’m baking shortbread. The smell is wonderful and Erin likes to feel the soft, cool dough before it is transformed into firm, warm cookies. I tell Erin that the trick to running a good kitchen is working as a team. To get every customer’s meal ready, it takes many cooks; and in addition to their individual responsibilities, the cooks have to collaborate to ensure that each complete meal will turn out well. Teamwork is also key when Erin goes to school. You see, Erin has a rare disease that was diagnosed at birth. The results of the condition appear like characteristics of cerebral palsy (which affects muscular control), and they keep Erin in a wheelchair much of the time. She is now in the seventh grade, and although Erin requires many special services while at school, she has a great team of people to take care of her there. Just like cooks in a kitchen, Erin’s school nurse, her general education teachers, her special education teachers, and all school personnel share the responsibility for creating a successful school experience for Erin. Each person has to contribute to the plan, and they have to collaborate to make sure they can offer the best possible services to help Erin excel at and enjoy school. In addition to the usual symptoms of her condition, Erin recently started having seizures, which can be dangerous to her health and are disruptive to her class time and that of her classmates. The first few times that Erin had a seizure in class, her teachers were surprised and didn’t know how to react, so they called 911. Fire trucks came to the school, and Erin had to go to the hospital in an ambulance for treatment. Like a domino effect, the reaction to panic caused one problem after another. These episodes have been scary and physically difficult for Erin, and they also have resulted in hospitalization and, consequently, missed school time.
To guarantee Erin’s safety and the quality of class time, the school nurse has been reviewing an emergency care plan with all of the special service providers and me. It explains everyone’s role in the case of an emergency. For instance, the plan tells teachers the warning signs for Erin’s seizures and explains that the signs should give them time to take Erin to the school nurse to receive prescribed medication to lessen the severity of the seizure. The school nurse has notified all school personnel-even the custodians and lunch staff-about the plan because Erin could have a seizure at any time of the day, in any part of the school. Because of the plan and the staff’s collaborative efforts, I think our visits to the emergency room and Erin’s time away from her friends and schoolwork are really going to be reduced!
The school nurse has helped Erin in other important ways, too. For example, a while back, we thought Erin was having a hard time seeing. So we got glasses for her. Once we did that, though, she began exhibiting problems such as running into other students with her wheelchair, taking longer than normal to get from one location to another, and not keeping track of her glasses. I didn’t know what to make of it, and neither did Erin’s teachers.
Fortunately, by communicating with each member of Erin’s team, the school nurse worked through the clues and finally discovered that Erin doesn’t have poor vision but is actually missing a portion of her visual field (meaning she can’t see things to her left). The glasses just made the problem worse, and so Erin was accidentally running into students in the hall because she couldn’t see them. None of us could have figured that out on our own–it took the school nurse to coordinate input from everyone who interacts with Erin to really understand what was going on. So, on the nurse’s referral, Erin went to visit a specialist. Now that we are aware of the problem, Erin’s teachers and friends at school can help her navigate the hallways.
Things can easily go wrong in any kitchen. If cooks don’t communicate, customers’ meals can be ruined, and people can even get hurt. Likewise, it is so important for school staff to communicate so that they may be proactive instead of reactive in caring for students with special needs. When it comes to monitoring Erin’s healthcare while at school-whether that involves eye glasses or something as serious as seizures-Erin’s school nurse is like the head chef in a restaurant who must manage a team of cooks (Erin’s teachers and all school staff) to get the job done. The chef distributes roles, teaches technique, and encourages efficiency, but each cook must then take responsibility to understand how the cumulative effort comes together. When everyone does contribute to the organized plan, it can be very rewarding to present that meal to a customer and to watch his or her satisfaction. It is great to see that when our team works together to spot problems and solve them quickly, Erin’s school experience is enhanced because she does better in her classes and gets along well with others. And that’s a recipe for success!
The IRIS Center would like to acknowledge Melinda and Erin Conroy for their contribution to Recipe for Success. Their input and cooperation with all aspects of the story’s creation-including content development, audio recordings, and photography-were essential to its completion and to its value as an educational tool. We would like to note that while details from Melinda Conroy’s transcript provided the practical information found in the story, the premise of cooking that framed the storybook’s plot was entirely fictional.
Revisiting Initial Thoughts
Think back to your responses to the Initial Thoughts questions at the beginning of this module. After working through the Perspectives & Resources, do you still agree with those responses? If not, what aspects about them would you change?
Do you think Ms. Worley’s and Ms. Valens’s reasons for being upset were valid?
What is Ms. Valens’s role as a school nurse?
With whom should Ms. Valens collaborate?
When you are ready, proceed to the Assessment section.