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The Role of Your School Nurse

School nursing is a specialized practice of professional nursing that advances the well being, academic success, and lifelong achievement of students. To that end, school nurses facilitate positive student responses to normal development; promote health and safety; intervene with actual and potential health problems; provide case management services; and actively collaborate with others to build student and family capacity for adaptation, self-management, self advocacy and learning. The school nurse links the health service program within the school and the community.

In the school they:

Conduct health screenings: vision, hearing, growth and scoliosis.
Access health, and development.
Provide emergency first aid.
Track communicable disease.
Provide counseling for students and staff regarding health matters.
Serve as a resource for student health issues and in health education.
Assist in maintaining a safe school environment.
Monitor required daily medication administration.
Maintain safe environment for students with specific health concerns.
Collaborate With Special Education Services.  
Provide in-service education to staff in special health care procedures.
Meet with counselors and school psychologist to provide the best environment for students.
Serve as a member of Crisis Team.

Suzanne Thompson | RN | 781.871.0263.

Immunization Requirements  

All students must be completely immunized in order to attend school. Massachusetts immunization regulations specify minimum immunization requirements for enrollment in school (105CMR 220.00). Those students with documented medical contradictions or documented religious beliefs are the only ones exempt from the immunization regulation. However, any student who is not properly immunized will be excluded from school if there is a vaccine-preventable disease outbreak. The length of exclusion is determined by Department of Public Health guidelines and may vary according to disease.

Massachusetts School Immunization Requirements 2008*

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Physical Exam Requirements

The State of Massachusetts DPH regulation 200.100 requires a physical examination within one year prior to entrance school or to provide a current physical within 30 days after student transferred from another school system. A physical exam is required for all transfer students.

MIAA requires a physical examination prior to participation in any school sport. A physical is valid for 13 months.

Communicable and Infectious Diseases

The Massachusetts Department of Public Health has identified the following as being particular problems among the school population.

• Conjunctivitis (pink eye)
• Impetigo
• Streptococcal Infections (strep throat)
• Pediculosis (head lice)
• Scabies
• Chicken Pox
• Influenza

*This list is not all-inclusive. Please contact the school nurse if you have any questions.

If the school nurse suspects the presence of one of these, or any other contagious disease, the parent will be contacted and requested to seek the advice of his/her physician. In the case of a confirmed diagnosis of a communicable disease or infestation, the student will be required to stay out of school until the condition is treated and rendered non-communicable. Parents are asked to report all cases of communicable disease to the school nurse.

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Absence/Dismissals from School

Parents are advised to keep their child home if they have a temperature of 100.4 degrees or greater, have vomiting, diarrhea, persistent respiratory or flu symptoms. Students who are prescribed antibiotics for strep throat need to be taking the medication for a full 24 hours before returning to school.

• In the event that your student becomes ill during the school day, a parent or guardian will be contacted to pick up the student. With parent permission, the student may be dismissed to another family member or friend provided proper identification is shown. If the school is unable to reach the parent, the emergency contact (designated each September on the emergency card) will be called to pick up the student.
• In order for an absence to e medically excused – a doctors note must be received within 3 days of their return to school.

Student Medication Policy

The responsibility of giving medicine belongs to the parents. On occasion, medication is required during school hours. For the safety of all children, no child is allowed to transport his/her medication to school. This includes over the counter as well as prescription medication. If a child needs medication during school hours, the School Nurse can only administer medication if it is brought to school by a parent or designated adult in its original container accompanied by a doctor's order. When medication is delivered to the School Nurse by the parent, a letter stating the type of medication, prescribed dosage, and time to be given is required and kept on file.

Exclusions to students carrying their medications are on a case by case basis and are currently applicable to individuals with Asthma, Life Threatening Allergies and Diabetes.

First Aid

First aid is treatment given to protect the life and comfort of the student until authorized treatment is secured and is limited to first treatment ONLY; following first aid, the student is to be placed under the care of his/her parent or guardian, upon whom rests the legal responsibility for subsequent treatment. If a student becomes ill or injured at school, first aid will be administered in accordance with school policy. In the event a student becomes seriously ill or injured, every effort will be made to reach the parent. If a parent cannot be reached, the student will be transported via ambulance to the nearest hospital emergency room. Any illness or injury that occurs at home or after school hours should be evaluated by the student's own physician, urgent care or in a hospital emergency room.

Life Threatening Allergies

The number of students with life-threatening allergies has increased substantially over the last several years.  As with all children with special health care needs, it is important that students with life-threatening allergies are able to access all education and education related benefits. For these children, every allergic reaction has the possibility to develop into a life-threatening and potentially fatal anaphylactic reaction.  This can occur within minutes of exposure to the allergen. Some students who are very sensitive to their allergen may react to just touching or inhaling the allergen. For others, ingesting even the tiniest portion of their allergen or an insect sting can cause death.

The School Nurse is responsible for coordinating the management of students with life threatening allergies (LTA) in school. The management of LTA takes a multidisciplinary approach of collaboration between the family, student, principal/administrator, nurse, classroom teacher(s)/specialists, school psychologist/guidance counselor, food services/cafeteria staff, lunch/recess paraprofessionals, transportation department, and custodial staff.  Awareness, prevention and emergency preparedness are crucial elements in the management of a student with LTA.

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In accordance with M.G.L,.c. 71, s. 57, upon entering kindergarten or within thirty days after kindergarten entry, the parent or guardian of each child shall present certification that the student within the previous 12 months has passed a vision screening. For children who fail the screening and for children diagnosed with neurodevelopmental delay, evidence of a comprehensive eye examination meeting the requirements of c. 71, s. 57 shall be provided to the school. In accordance with the Massachusetts Department of Public Health Laws and Regulations 105 CMR 200.The vision screening is conducted in grade 10 at SSVT.

Hearing Screening

Hearing screening is given in grade 10.

Growth and Development Screening

Massachusetts DPH and DESE Laws and Regulations 200.500, April 8, 2009.  Each school committee or board of health shall adopt policies and procedures to ensure that the Body Mass Index (BMI) and corresponding percentile of each student in grade 10 (or, in the case of ungraded classrooms, by a student's 16th birthday) is calculated and reported directly and confidentially to a parent or legal guardian.

• A report of each student's BMI and percentile, along with easily understood informational and explanatory materials provided or approved by the Department of Public Health on BMI, healthy eating and physical activity shall be mailed or otherwise directly communicated in writing to the parent or legal guardian of the student, in accordance with guidelines of the Department. The materials shall indicate that questions about healthy weight should be discussed with the student's primary care provider.
• Measurement of weight and height shall be done by trained school personnel or others approved by the Department for this purpose, in accordance with guidelines of the Department. Prior notice of the screening and the benefits of the screening shall be provided to the parent or legal guardian by any reasonable means. Every effort shall be made to protect the privacy of the student during the screening process and in the communication of information about the student's BMI.

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