The job of the school nurse has become more demanding as students with complex medical situations have entered schools and as society’s expectations have changed. Education World writer Mary Daniels Brown talked with school nurses around the United States about tracheostomies the complete guide pdf changing roles. Included: Online resources every school nurse should know about! A generation ago, the school nurse cleaned and bandaged the occasional scraped knee and sent home children with stomachaches or fevers.

But today’s school nurse does more than that — a lot more. We are getting more and more medically fragile children into the school system,” Joey Van Camp, coordinating nurse for the Westminster School District in southern California, told Education World. Gerri Harvey, creator of a Web page called School Nurse Perspectives, agrees. Children come to school sicker and needier than ever before,” said Harvey, an elementary school nurse for 12 years who is now the community liaison nurse at Community Health and Hospice in Laconia, New Hampshire. In fact, all of the school nurses interviewed for this article confirmed that they now care for students with complex medical conditions. MORE STUDENTS WITH DISABILITIES “The past ten years has seen a tremendous change, but I believe the shift to more responsibility falling on schools has been an on-going trend for about 25 years,” Harvey told Education World. Those advanced technological devices require care and monitoring, Lucretia Anderson, school nurse with the Pittsburgh Board of Education, told Education World.

And students in wheelchairs may be unable to use the toilet by themselves or may require the insertion of a catheter. Students without physical disabilities are also requiring more care. According to Harvey, “school nurses administer more medications than ever before. In addition to dispensing prescription medications, such as Ritalin, nurses help students with chronic conditions manage their health.

Students with diabetes or asthma must have a plan of care in place,” explained Anderson. It is the school nurse’s responsibility to help students follow their care plans during school hours. The school nurse must be familiar with every student’s treatment regimen, including any devices or medical procedures the treatment requires. Students who have diabetes monitor their blood glucose level, often several times a day, and may require insulin injections during school hours. School nurses also help the growing number of children with asthma monitor and control their condition.

For reasons that experts cannot explain, the incidence of childhood asthma has risen dramatically in recent years. According to the American Lung Association, asthma accounts for 10 million lost school days a year and is the leading cause of school absenteeism attributed to chronic conditions. Severe attacks may require a nebulizer, a device that uses compressed air to deliver medication in a fine mist that is inhaled through a face mask. Use of a nebulizer involves combining the prescribed amount of medication with the appropriate amount of water. SOCIETY’S CHANGING EXPECTATIONS A recent New York Times article, For School Nurses, More Than Tummy Tending, reported that, in interviews conducted around the country, “school nurses uniformly said their jobs were changing because American life has changed.

The article refers to “a growing public sense that a school is, in part, a health-care provider. Sometimes I think I’m the only medical professional some of these children ever see,” Van Camp said. Some days there will be a line of children waiting outside of my office at school, some with their parents. It’s not unusual for parents to ask the school nurse to look at their child’s ears or throat and advise whether the child needs to see a doctor. For immigrant families, particularly if the parents don’t speak much English, a child’s school nurse may be the point of entry into the health-care and social-services systems. SCHOOL NURSES TRAIN OTHER SCHOOL PERSONNEL When the nurse cannot meet all the demands she faces herself, school districts generally assign some of her responsibilities to other school personnel.

Anderson, for example, is responsible for 1,500 children, a number that complies with Pennsylvania law. Along with the school nurse’s expanding workload comes a large amount of paperwork. Anderson described the school nurse’s job as extremely paper-intensive. In today’s litigious society, we have to document everything we do,” she explained to Education World. SCHOOL NURSES ENTER THE COMPUTER AGE Computer literacy also figures on the growing list of skills that school nurses must have. Computers can help school nurses deal with the extensive paperwork of their job, particularly if school districts also provide clerical help so nurses don’t have to enter all the data themselves.

Computers also provide school nurses with two other necessities: support and information. Mostly what the members get out of the list is the virtual community, the camaraderie,” Bergren told Education World. Lacking the medical libraries available to nurses working in hospitals, school nurses also use the computer to obtain information. If a new student with an unusual medical condition enrolls, the nurse can use Internet resources to learn about the condition. She or he may also use the computer to locate community resources for families. It’s likely that the school nurse’s responsibilities will continue to increase.

Bergren told Education World that some school districts are beginning to ask their nurses to handle third-party billing for services such as hearing and vision screening tests. In the world of tightening budgets, school districts, which have traditionally conducted these screenings for free, are starting to seek reimbursement for services to children whose family health plans will cover the procedures. A QUESTION OF FUNDING Most school nurses today face more demands than they can meet. In general, nurses see the solution to that problem not in the delegating of responsibilities to other school personnel, but in the placement of more nurses in the school.

With each dressing change, the clinician uses these tools to help determine risk so that interventions can be started promptly. Tube an hour before wound care. Such as erythema, a cannula can surround the inner or outer surfaces of a trocar needle thus extending the effective needle length by at least half the length of the original needle. The Resuscitation Committee must determine the level of resuscitation training required by staff members.