About 25% of children ages 2-8 in the United States are impacted by chronic health conditions. For many of those students, a school nurse plays an important daily role in their care.
School nurses ensure these students can thrive academically and socially while managing their health.
Chronic conditions such as asthma, diabetes, epilepsy, and food allergies are common among school-aged children, and these health issues require ongoing attention and care. School nurses provide a range of services that support students' physical well-being, promote their academic success, and foster a safe and inclusive school environment.
Common chronic conditions in schools
Chronic conditions are long-term health issues that often require ongoing management and care. In school settings, the most common chronic conditions that students may experience include asthma, diabetes, epilepsy, and food allergies. Each of these conditions presents unique challenges that can affect a student’s ability to participate fully in school activities. In many cases, a school nurse is part of a student’s care team.
Among the common conditions:
Asthma
One of the most prevalent chronic conditions among children, affecting approximately 1 in 12 children in the United States. Asthma is a respiratory condition characterized by inflammation and narrowing of the airways, leading to symptoms such as wheezing, coughing, shortness of breath, and chest tightness. Asthma attacks can be triggered by allergens, exercise, cold air, or stress, and they can be life-threatening if not managed properly.
Diabetes
Another significant chronic condition that affects school-aged children, particularly type 1 diabetes, requires careful management of blood glucose levels. According to the Centers for Disease Control and Prevention, approximately 325,000 children and adolescents under age 20 have been diagnosed with diabetes.
Students with diabetes must monitor their blood sugar regularly, administer insulin, and manage their diet and physical activity to prevent complications such as hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar). Diabetes management in a school setting can be challenging, as it requires coordination between the student, school nurse, teachers, and parents.
Epilepsy
This neurological disorder causes recurrent seizures, which are sudden bursts of electrical activity in the brain that can affect a person’s behavior, movements, feelings, or level of consciousness. Students with epilepsy may experience different types of seizures, ranging from brief staring spells to full-body convulsions. Seizure management is critical in a school setting to ensure the safety and well-being of the student.
The national Epilepsy Foundation offers training for school nurses to effectively care for students.
Food allergies
These are becoming increasingly common among children, with some of the most severe allergies involving peanuts, tree nuts, shellfish, and eggs. An allergic reaction can range from mild symptoms such as hives or itching to severe anaphylaxis, a life-threatening condition that requires immediate intervention with epinephrine. Managing food allergies in schools involves preventing exposure to allergens, educating staff and students, and preparing for potential allergic reactions.
How the school nurse assists students
School nurses have a wide range of responsibilities to support students with chronic conditions. Their role is multifaceted, involving direct patient care, health education, advocacy, and collaboration with other members of the school community.
One of the primary duties of school nurses is to develop and implement individualized health care plans (IHPs) for students with chronic conditions. These plans are tailored to each student’s specific needs and outline the necessary accommodations, interventions, and emergency procedures required to manage the condition effectively. For example, an IHP for a student with asthma may include guidelines for using inhalers, avoiding triggers, and responding to asthma attacks.
Medication management is another critical responsibility of school nurses. Students with chronic conditions often require medications during the school day, whether it’s insulin for diabetes, rescue inhalers for asthma, or anticonvulsants for epilepsy. School nurses are responsible for administering these medications, monitoring their effects, and ensuring they are taken safely and as prescribed. The school nurse must also maintain accurate records of medication administration and communicate with parents and healthcare providers as needed.
In addition to managing medications, school nurses are tasked with monitoring students’ health status throughout the day. This involves regularly checking vital signs, assessing symptoms, and responding to any health-related concerns that arise. For students with diabetes, this might include monitoring blood glucose levels before and after meals, as well as during physical activity. For students with epilepsy, it could involve observing for signs of an impending seizure and providing appropriate care during and after a seizure.
Emergency preparedness is a crucial aspect of the school nurse’s role, especially for students with conditions like epilepsy or severe allergies. School nurses must be prepared to respond to health emergencies, such as administering epinephrine during anaphylaxis or providing first aid during a seizure. They also train teachers and other school staff on recognizing the signs of an emergency and how to respond appropriately, ensuring the student receives prompt and effective care even if the nurse is not immediately available.
School nurses also provide health education and support to students, helping them understand and manage their chronic conditions. This includes teaching students how to recognize symptoms, use medical devices such as inhalers or insulin pumps, and make healthy lifestyle choices. For younger students, school nurses may use age-appropriate tools like games, visuals, and stories to help them learn about their condition in a way that is engaging and understandable.
The school nurse also plays an essential role in advocating for students with chronic conditions. They work closely with teachers, administrators, and parents to ensure the student’s health needs are met within the educational environment. This may involve advocating for accommodations such as extended time for exams, modified physical activities, or special dietary considerations in the cafeteria.
School nurses also help to create a supportive and inclusive environment where students with chronic conditions can participate fully in school activities without stigma or discrimination.
Types of support from school nurses
The support that school nurses provide to students with chronic conditions extends beyond clinical care and into emotional and psychological support. Chronic conditions can be a source of anxiety, stress, and social challenges for students, and school nurses are uniquely positioned to offer the guidance they need to navigate these difficulties.
Easing anxiety, particularly for students who may feel overwhelmed by the management of their chronic condition, is a key trait among school nurses. For example, a student with diabetes might feel anxious about checking their blood sugar in front of peers, or a student with asthma might worry about having an attack during physical education class. School nurses can help alleviate these anxieties by providing a safe space for students to discuss their concerns, offering coping strategies, and reassuring them that they are not alone in managing their health.
School nurses also provide emotional support by building trusting relationships with students. They listen to students’ fears, frustrations, and challenges, offering empathy and understanding. For many students, the school nurse is a trusted adult they can turn to when they need someone to talk to about their health or any other issues affecting their well-being. This emotional support is vital in helping students build resilience and confidence in managing their condition.
Managing medications is another key area where school nurses provide essential support. For students with chronic conditions, taking medication regularly and correctly is critical to maintaining their health and preventing complications. School nurses help students develop a routine for taking their medications, whether it’s before lunch, after recess, or at specific times throughout the day. They also educate students on the importance of adherence to their medication regimen and help them understand how their medications work.
School nurses also play a role in supporting students’ academic success. Chronic conditions can sometimes interfere with a student’s ability to focus, complete assignments, or participate in class. School nurses collaborate with teachers and special education staff to ensure students receive the accommodations they need to succeed academically. This might include providing extra time for assignments, allowing breaks during the school day, or offering a quiet space for students to rest if they are feeling unwell.
School nurses also help students develop self-management skills, which include teaching students how to monitor their symptoms, manage their medications, and make informed decisions about their health. For older students, school nurses might also discuss how to navigate social situations where their condition might come into play, such as eating out with friends or participating in sports.
Another vital aspect of the school nurse’s support role is family engagement. Managing a chronic condition often involves the entire family, and school nurses work closely with parents and caregivers to ensure the student’s health needs are met both at school and at home. This may involve regular communication with parents about the student’s health status, coordinating care with the student’s healthcare provider, and providing resources or referrals to community services that can support the family.
School nurses also play a critical role in promoting a healthy school environment that supports students with chronic conditions. This includes working with school administrators to implement policies and practices that reduce the risk of health emergencies, such as having emergency medical plans in place, ensuring that staff are trained in first aid and CPR, and promoting awareness about chronic conditions among the student body.
School nurses are invaluable members of the educational community, providing essential support to students with chronic conditions. Their role is multifaceted, encompassing clinical care, health education, emotional support, advocacy, and emergency preparedness.
As the prevalence of chronic conditions among school-aged children continues to rise, the role of the school nurse will become more critical.
