How School Nurses Advocate for Children and Youth with Special Health Care Needs

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M Sanchez
4 hours ago, at 8:56 PM
Review the priorities of the school nurse in coordinating the care for CYSHCN. How can the school nurse advocate for this student population?
As there is an advancement in medicine and technology, there is also an increase in the survival rate of individuals with medical conditions that previously had a shorter life span. As a result, there is an increase of students with chronic and medically complex conditions in the school setting (Selekman & Ness, 2019). School nurses play an integral role in coordinating and delivering medical care for these children. To start, school nurses are in a position of identifying students that may require educational and health-related services and accommodations (National Association of School Nurses [NASN], 2018). The school nurse would assess and evaluate for the child’s needs prior to recommending for a 504 Plan or IEP evaluation. Together with the parent/guardian, CST team, guidance, and administration, the school nurse will develop a plan to ensure the child has an equitable and appropriate plan for access to healthcare needs and an education (NASN, 2018). The school nurse would also ensure that appropriate staff training is provided yearly and as needed. Individualized training for delegates such as for epi-pen administration is also a step the school nurse is required to take to ensure student safety. Throughout the school year, the nurse with the appropriate team would evaluate the IEP or 504 plan to identify if revision of plan is warranted (NASN, 2018).
There are many steps a school nurse can take to advocate for CYSHCN. Recommending for accommodations via a 504 Plan or IEP is a valuable tool to ensure the student obtains proper services at school. It is also important for school nurses to familiarize themselves with the available resources in the community to make available to families of CYSHCN. Removing barriers that may exist in the classroom or other school settings also aids in providing patient safety.
In what ways can the school nurse provide a holistic school experience?
Holistic nursing care refers to the patient-centered approach in which their overall health is considered (Garmy et al., 2021). School nurses do not provide a cure, but instead provide the care and healing needed for the student to fully participate in the school setting. It is important to also take the student’s mental health into consideration when dealing with a chronic medical condition (Garmy et al., 2021). Students may have difficulty accepting the limitations and side effects of their medical condition or treatment. Taking the time to ask students of their emotional wellbeing goes a long way when providing care. There may be times in which a student presents with continuous headaches. Through further questioning, it may come to light that familial circumstances are negatively impacting the student. This approach will not only support a holistic school experience, but also allow the school nurse to advocate for the student’s needs outside of school.
Consider the challenges as discussed by Selekman and Ness (2019) and review the care map created by the mother of a child with medical complexity to pictorially represent the aspects of her child’s life. How can you, as a school nurse, intervene to ease some of the tensions experienced in the school setting?
Parents of children with disabilities may experience anxiety when the time comes for their child to attend school. The school nurse can aid parents to feel comfortable by listening to their concerns. Working with parents and involving them in the process of developing a plan for the child’s medical and education needs allows parents to feel heard and included. Constant communication regarding updates and care with parents is also beneficial in the student, family, nurse relationship.
Discuss best practices for family, health care provider, school staff and child study team member involvement in the plan of care? Include any relative New Jersey administrative codes and state/city/township services that are in place to provide additional support to the child and family to ensure success in the classroom. Use the literature provided in Module II and Promoting Health and Learning: School Nursing Practice in New Jersey’s Public Schools (2018) and the June 2020 Supplement, which can be located at https://www(dot)njssna(dot)org/njssna/resources/practice-guide to support your answer. Also include current practice, if applicable, with appropriate protection of student rights according to HIPAA and FERPA.
N.J.A.C. 6A:16-8.1 indicates that school districts should have policies in place regarding the establishment of intervention and referral services for students with learning, behavior, or health challenges (New Jersey Department of Education [NJDOE], n.d.). These services are to be coordinated by the Child Study Team (CST). The CST involves school social workers, school nurse, school psychologist, learning disabilities teacher, and any other appropriate specialist (NJDOE, n.d.). The CST works closely with the health care provider, school staff, and parent to develop the appropriate plan of care for the student’s health and educational needs. Once a plan is developed, the CST ensures that accommodations are in place and provided for the student. Evaluation of the IEP is to be reviewed at least annually to determine if modifications are warranted.
References
Garmy, P., Clausson, E. K., Janlöv, A. C. & Einberg, E. L. (2021). A philosophical review of school nursing framed by the holistic nursing theory of Barbara Dossey. Journal of Holistic Nursing, 39(3), 216-224. https://doi(dot)org/10.1177/08980101211006615
National Association of School Nurses. (2018). IDEIA and section 504 teams: The school nurse as an essential team member. https://www(dot)nasn(dot)org/nasn-resources/professional-practice-documents/position-statements/ps-ideia
New Jersey Department of Education (n.d.). Programs to support student development. https://www(dot)state(dot)nj(dot)us/education/code/current/title6a/chap16.pdf
Selekman, J. & Ness, M. (2019). Students with chronic conditions. In J. Selekman, R. A. Shannon, & C. F. Yonkaitis. (Eds). School nursing: A comprehensive text (3rd ed., pp. 480-499). F. A. Davis Company.
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