School nursing is a specialty for RNs that carries a number of unique characteristics. As the primary healthcare professional on site, the school nurse plays multiple roles that include providing treatment, health counseling, and developing plans to handle students with special needs.
In most cases, a school nurse’s first encounter with a student involves the onset of illness or an injury suffered on campus. In either case, the school nurse provides the initial medical treatment. Once the student is stabilized, it is up to the school nurse to provide the student with a plan for dealing with the injury or illness. A thorough school nurse may ask the parents of the ill student to report back on the student’s progress or on the findings of the physician, if a visit to the doctor is deemed necessary.
A plan for an injured student may also involve further medical attention, or it may just require a plan for treatment of the wound: wash it twice daily, treat it with heat or with ice, use disinfectant and so forth. The school nurse can write down this treatment plan, hand it to the injured student and ask for a return visit in a few days.
That is the end-to-end approach that school nurses must take. Many students (or their parents) will not follow up a visit to the school infirmary with a doctor’s appointment. So many families have no health insurance today that it might be a sensible assumption for a school nurse to make in all cases, especially in schools with a less affluent population. In those instances, it is of great importance that the school nurse develop and suggest a treatment plan, as that may be the only medical treatment that the student receives.
School nurses are also going to be faced with a small percentage of the student population that has special needs. Students with allergies, asthma and other chronic conditions or who are on a medication program, students with physical handicaps even as basic as migraine headaches are going to be the school nurse’s responsibility during school hours. The nursing office must be aware of students with these sorts of medical issues and have plans to deal with them when they develop health problems. Students with chronic difficulties or disabilities are going to have emergencies at school and the school nurse needs to be prepared for them.
Once the emergency is dealt with, the school nurse develops a plan for further treatment and presents it to the student. This task must be performed in an age-appropriate manner and in many instances is going to involve the child’s parents. As a hedge against parental indifference, the school nurse may wish to present the treatment plan to the child as an agreement between them, and ask for a return visit. The plan has been put in the child’s hands in a non-threatening manner and will make the return visit seem like a caring request rather than an authoritarian edict.