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Working with the nurse’s office at your kid’s school

Whether your child has been recently diagnosed with a chronic health issue or has lived with a specific diagnosis for a while, it can be scary sending him or her off to school each fall. On average, kids will spend six hours a day away from their primary caregivers—which is when a school nurse can help. 

If your child has asthma, life-threatening allergies, seizures, mental health issues, or another chronic condition, he or she will likely need to visit the school nurse at some point during the school day. It could be to take medication or attend to medical procedures, like testing blood glucose levels. How that visit is set up depends on your relationship with the school nurse and the school’s specific policies. Here’s where to start.

Inform the school about your child’s diagnosis.

It’s important for you to know the specifics of your child’s diagnosis and what can be done to help. Meaning, start with an idea of how nurses can help your child manage diabetes or ADHD during the school day. Then, communicate that to the school.

Learn your school’s medication administration policies. 

There’s no blanket statement when it comes to medication administration in school. “States have policies about school health, but schools and school districts can also develop their own policies,” says Laurie Combe, RN, president of the National Association of School Nurses. “One school district might only accept prescription medication while another might allow over-the-counter preparations like Tylenol or ibuprofen. There is no national mandate for a school nurse in every building.”

The best way to learn what your school nurse needs to administer medication is by referencing the school’s handbook or finding a district policy. Some schools require that all medications must be in the original packaging with current prescription labels. There is likely a specific nurse’s office form that may (or may not, depending on the school) require a pediatrician’s or prescribing doctor’s signature.

Determine what the school nurse can (and cannot) do.

Find out exactly who is working in the school nurse’s office—is the employee a licensed nurse or an unlicensed assistive personnel (UAP)? “A registered school nurse has education and training that focuses on assessment of student health and has received training in pharmacology and the science of medication,” Combe explains. “They have an understanding of legal responsibility of what a drug’s intended use is and what actions the medication can be expected to have, and what untoward side effects would be a cause for concern.”

Ask what the nurse’s office coverage is during the school day or week. “Some schools have a school nurse all day, every day, while other schools have a registered nurse managing four to five schools and are maybe at each one day a week,” Combe says. Other schools decide to staff clinics with licensed practical or vocational nurses, who need to be supervised by a registered nurse, medical doctor, doctor of osteopathic medicine or dentist, while other school nursing offices are staffed by a UAP (may also be referred to as a health clerk), who is not a licensed nurse. 

“It’s important for parents to know and understand who is providing the care so that parents know what preparations to make,” Combe advises in order to ensure medication is given safely and effectively.

Get to know your school nurse.

It’s important to check in with the school nurse at least once a year to ensure your child is receiving proper medical attention. “Parents should definitely seek out the school nurse,” says Linda L. Mendonca, MSN, the president elect of the National Association of School Nurses who has been a school nurse for the past 24 years. “They should begin that line of communication and building that trust to develop a good rapport.”

Establishing a relationship with the nursing staff can help parents when obstacles occur, notes Mendonca. “Sometimes there are obstacles to go through, such as when some physicians’ offices will charge for a copy of an annual physical [that may need to accompany medication information] and that can be a hardship on a parent,” she says. “Maybe the nurse can make a phone call to the physician’s office and figure out if there’s a way to work around it.”

Keep communication open.

Ideally, if a nurse is administering medication to a child, he or she will be in regular contact with the parents, and doing so can help make the process easier. “If the parent knows the child has a side effect to the drug that is well tolerated, it’s good for the nurse’s office to know that,” Combe says. Doing so can help contribute to what “can be an ongoing, collaborative relationship.”

That collaboration goes both ways, Mendonca says: “A school nurse can let a parent know when a prescription is getting low, so the parent can be responsible for filling it. Communication is key.”