Nurse

healthy children

Michelle Huffaker, RN
325-537-2721
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Leindy Estes, LVN
325-537-2721
email


 

The ability to learn at school is directly related to the status of a student’s health.  Students must be healthy in order to be educated, and they must be educated in order to remain healthy.  Hawley ISD employs two full-time RN for all three campuses.  They are health advocates for all the school children and staff providing preventative health information, health assessments and referral services.  The principals on each campus have designated employees to render first aid in the absence of the nurses.

 

Asthma

All students diagnosed with asthma must have a current asthma action plan on file in the school nurse’s office.  This plan must be completed by the student’s primary asthma care provider and must be signed by both the physician and the parent. All asthma action plans must be updated yearly and/or anytime changes are made in the treatment of the asthma. Under certain conditions students may be allowed to carry and self-administer inhalers (see guidelines for Self-Administration); otherwise, inhalers will be kept in the nurse’s office or campus office.  Hawley ISD has handheld nebulizer machines available, but all other equipment and medications must be provided by the parent.  Asthma medication must follow the same requirements as all other medications (see medications at school).  Inhalers must be labeled with a current prescription label or must be kept in the original prescription box.

 

Automated External Defibrillators (AEDS)

Hawley ISD has Automated External Defibrillators available in various locations in the district including each campus, gym and at the field house.  AEDs are utilized and maintained as directed by the UIL and TEA as well as the recommendations of the American Heart Association.

An AED is a small, portable device that analyzes the heart’s rhythm and prompts the user to deliver a defibrillation shock if it determines one is needed.  Once turned on, the AED guides the user through each step of the defibrillation process by providing voice and/or visual prompts.  Defibrillation, the most critical factor in sudden cardiac arrest (SCA) survival, can be reduced if an AED is “on-site” and can be brought to the victim quickly.

AEDs are specially designed for easy use by “first responder”, who would be the first person to typically arrive on the scene of a medical emergency.  Hawley ISD will train all UIL sporting event coaches, cheerleader sponsors and band directors as well as “first responders” on each campus using an accredited first aid and CPR/AED course. 

Source:  http://www.aaedhelp.com/aeds/

 Chronic Health Issues

Because your child may have a medical condition that requires extra attention/care from the school personnel, it is important the parent/guardian visit with the school nurse.  She will then inform others of care as needed.  Up-to-date address and telephone numbers are imperative to the school as emergency care can arise at any time during school hours.  

 

Communicable Diseases/Conditions for Exclusion from School

Children should only be in school when they can fully participate in their educational program. Therefore, children with the following may need to be excluded from school or will be referred home by the nurse or other school personnel:

  1. Temperature of 100.4 degrees or above.  Temperature must be below 100.4 degrees for 24 hours without fever reducing medicines for readmission to school.
  2. Nausea and vomiting and/or diarrhea.
  3. Undetermined rash over any part of the body accompanied by fever.
  4. red, draining eyes with pus formation and crust
  5. Intense itching with signs and symptoms of secondary infection
  6. Open draining lesions
  7. Signs of jaundice
  8. A persistent cough and/or excessive (discolored: green, yellow) discharge from the nose or eyes
  9. Under state and local Health Department regulations, if your child has certain medical conditions, he/she must be excluded from school for a period of time.

 

By following the above guidelines, we hope to provide a healthy environment for everyone in the school community.

 

Diabetes Information of HB 984

The Texas Health Safety code provides for unlicensed diabetes care assistants to be trained to assist school children who need help with their diabetes management while at school or participating in a school activity.  If a school nurse is at a campus and is available, then the nurse shall assist the student with diabetes as directed in the student’s diabetic care plan.  If a nurse is not available, an unlicensed diabetes care assistant shall help with the student.  School children with diabetes are allowed to self-manage their own diabetes, if capable.  The law provides immunity from liability for school employees and school nurses.  This bill also requires schools to provide bus drivers and other persons supervising a student with diabetes during off-campus activity with a one page information sheet that: (1) identifies the student who has diabetes (2) identifies potential emergencies that may occur as a result of the student’s diabetes and the appropriate responses to such emergencies and (3) provide the telephone number of a contact person in case of an emergency involving the student with diabetes.  All involved staff will receive training yearly on signs and symptoms of hyper- and hypo-glycemia.

 

Emergency Medications

As a part of the district’s emergency response measures, each campus will be stocked with an Epi-pen when prescribed by a physician then provided by the parent. These medications will only be used in severe allergic or asthmatic crisis and under the direction of a physician. The Epi-pen will be administered by either by the individual student or a staff member, 911 and the child’s parent will be called.  Only personnel and students trained in proper usage of the Epipen will be allowed to administer.  Parents will be notified if their student requires these measures.

 

 

Epinephrine (Epipen)

Anaphylaxis is a life-threatening, severe allergic reaction to specific triggers such as foods, medications, insect venom or latex.  The most common signsthat an anaphylactic reaction is taking place are:

  • Swelling of the throat
  • Swelling of the tongue
  • Constricted breathing
  • Sudden outbreak of hives

 

Staff members and faculty on each campus are trained to recognize these signs and when needed to give an injection of epinephrine while rendering first aid and/or CPR.  In the case of such an emergency, 911 will be immediately called, then the parent/guardian.

 

Head Lice

It is the responsibility of the parent to check for head lice.  Repeated scratching of the head is a sign that a check is needed.  The grayish white nits or eggs are found close to the scalp, attached to the hair shaft.  These are found, most commonly, at the nap of the neck, and over the ears. A lice shampoo must be used to kill the lice and eggs.  The nits will not fall out; they must be pulled from the hair.  Treatment can be easily done in one day.  Please notify the school if you suspect that your child may have head lice.  For more information, go to this website:

                  www.dshs.state.tx.us/schoolhealht/pdf/headlice.pdf

 

Illness or Injury at School

We will promptly attempt to notify you or a person you have authorized us to notify if we have knowledge that your child has been injured or becomes ill at school and requires parent or other medical intervention.  One of the forms we ask you to complete at the beginning of each school year is a form authorizing designated school employees to consent to medical treatment in case your child is injured or becomes ill at school or school-related activities and requires emergency treatment in the event a parent can not be reached. We, of course, will attempt to call you in such a situation and will also call for emergency assistance if necessary, via EMS.  Parents must understand that the school is not responsible for the charges incurred for medical treatment or emergency transport.  If students need to be transported via private care for medical care, a school vehicle will be used if available.  

 

Immunizations

In accordance with the Department of State health Services immunization schedule, a child or student shall show acceptable evidence of vaccination prior to entry, attendance or transfer to a childcare facility or public or private elementary or secondary school, or institution of higher education.  You may obtain a copy of the required school immunizations from the school nurse or DSHS. You may also view: http://www.dshs.state.tx.us/immunize/school/  for detailed schedule of immunizations.

 

Exclusions from compliance are allowable on an individual basis for medical contraindications, reasons of conscience, including a religious belief and active duty with the armed forces of the United States.  Children and students in these categories must submit evidence for exclusion form compliance as specified in the health and Safety Code 161.004(d), Health and Safety Code 161.0041, Education Code, Chapter 38, Education Code, Chapter 51, and the Human Resources Code, Chapter 42.

  1. To claim an exclusion for medical reasons, the child or student must present a statement signed by the child’s physician, duly registered and licensed to practice medicine in the physicians’ opinion, the vaccine required is medically contraindicated or poses a significant risk to the health and well being of the child or any member of the child’s household. Unless it is written in the statement that a lifelong condition exists, the exemption statement is valid for only one year from the date signed by the physician. 
  2. To claim exclusion for reasons of conscience, including a religious belief, and affidavit MUST BE obtained by submitting a written request to the Texas Department of State Health Services, 110 West 49thStreet Austin, Texas 78756 (Rule 97.62 Title 25 of the Texas Administrative Code).  The affidavit will be valid for two years.

 

A student may be provisionally enrolled for 30 days, if transferring from a Texas school.  Once immunization records are received, the rules of compliance apply as stated by DSHS standards.  If at the end of the 30-day period, a current record is not on file, the student will be considered “not in compliance” and the school shall exclude the student from school attendance until the required dose is administered (Rule 97.66, Title 25 of the Texas Administrative Code).  Students enrolling from out of state must provide a current immunization record upon enrollment.  Failure to provide the current, up-to-date record will prevent immediate enrollment until Texas immunization guidelines are met.

Students must remain current on all immunizations or risk being withdrawn from school and being regarded as truant is proof of required immunizations are not received in a timely manner.  Proof of immunizations may be in the form of personal records from a licensed physician or health clinic with a signature or rubber stamp validation.

 

Medications at School

The school nurse or employees of the district as designated by each specific campus principal will be allowed to administer medications or render first aid treatment according to protocol and after appropriate training.  Hawley ISD will only have available preparations listed on the parent permission form provided to each parent; all other medications must be provided by the parent in accordance with the directions below.  All unused medications will be discarded at the end of the school year if not picked up by the parent.  Often, students have to take prescription medications and/or over-the-counter medications for a certain period of time as treatment for a medical condition.

  1. Prescribed medicationmust be brought to school by an adult, in the original pharmacy bottle with the label on it.  This includes inhalers.
  2. If medication is only given 1-3 times per day or time released, it can usually be given at home, unless specific times are ordered by the physician.
  3. Parents must sign a medication consent form before medication can be given at school.  The parent’s written request must not conflict with the label instructions.
  4. Any increase or decrease in dosage must be stated in writing by a physician until a new prescription bottle is provided. Otherwise, school personnel must administer medication as it is stated on the container label, or parents may choose to come to the school and dispense the medication to their student.
  5. Over-the-Counter medicationmust be purchased in the United States and it must be in its original container stating directions and dosage.  If school personnel reading the label directions find that the medicine is contraindicated for that student must come to school and administer the medication (ex: if a student is younger than the recommended age on the label directions, school personnel can not administer the medicine without a physician’s order).
  6. The following is a list but not limited to over the counter medications and/or first aid treatments that will be provided the district:  Saline eye wash, Sting Eze®, Triple antibiotic ointment, Hydrocortisone Cream, Hydrogen Peroxide and Saline. Any other over the counter medications are to be provided by the parent/guardian, and must be accompanied by a medication consent form, signed and dated by the parent/guardian.  Over-the-counter medications that must be given for more than 5 consecutive days must be accompanied by a physician’s order.
  7. Herbal or dietary supplements will not be administered unless the medication will benefit the student’s educational achievement as stated in the student’s individualized educational program (IEP) or Section 504 Plan and is prescribed by a physician.  Unless FDA approved, the school nurse standards will not permit the school nurse to administer these supplements
  8. All medication must be turned in to the office upon arrival on the campus.  We do not permit students to carry their own medications and self-administer (except asthma inhalers/epipens under guidelines outlined below) without prior approval from the physician and/or the school nurse.
  9. School personnel will not be allowed to administer sample medication unless it is accompanied by a physician’s note and appropriate packaging inserts to indicate- indications for use, contraindications, and possible side effects.
  10. If parents allow students to transport medications on their person to and from school, the school does not assume any responsibility in the mishandling of that medication.  If students are found to posses any medication on their person that has not been approved, they will be at risk of disciplinary action.

 

Guidelines for Self-Administration of Asthma Medicine or Anaphylaxis Medication

A student with asthma or severe allergic reaction (anaphylaxis) may be permitted to posses and use prescribed asthma or anaphylaxis medication at school-related events only if he or she has written authorization from his or her parent and a physician or other licensed health-care provider. The student must also demonstrate to his or her physician or health-care provider and to the school nurse the ability to use the prescribed medication, including any device required to administer the medication.

Also, if:

  1. The prescription asthma or anaphylaxis medicine has been prescribed for the student as indicated by the prescription label on the medicine;
  2. The self-administration is done in compliance with the prescription or written instructions from the student’s physician or other licensed health care provider;
  3. A parent of the student provides the school a written authorization, signed by the parent, for the student to self-administer prescription asthma or anaphylaxis medicine; and
  4. A parent of the student provides the school a written statement from the student’s physician signed by the physician that states:
    1. The student has asthma and/or anaphylaxis and is capable of self-administering the prescription asthma or anaphylaxis medication.
    2. The name and purpose of the medicine
    3. The prescribed dosage for the medicine
    4. The time at which or circumstances under which the medicine may be administered;

 

If the student has been prescribed asthma or anaphylaxis medication for use during the school day, the student and parents should discuss this with the school nurse or principal.  The physician’s statement must be kept on file in the office of the campus the student attends. A person standing in parental relation to a student or the student himself, if over the age of 18, may give permission to use an asthma inhaler under these guidelines.

 

Meningitis

What is Meningitis?  Meningitis is an inflammation of the covering of the brain and spinal cord.  It can be caused by viruses, parasites, fungi and bacteria.  Viral meningitis is the most common and the least serious.  Bacterial meningitis is the most common form of serious bacterial infection with the potential for serious, long term complications.  It is an uncommon disease, but it requires urgent treatment with antibiotics to prevent permanent damage or death.

Someone with meningitis will become very ill.  The illness may develop over one or two days but is can also rapidly progress in a matter of hours.  Not everyone with meningitis will have the same symptoms.  Children (over 1 year old) and adults with meningitis may have a severe headache, high temperature, vomiting, sensitivity to bright lights, neck stiffness or joint pain, and drowsiness or confusion.  In both children and adults, there may be a rash or tiny, red-purple spot.  These can occur anywhere on the body.  The diagnosis of bacterial meningitis is based on combination of symptoms and laboratory results.

If it is diagnosed early and treated promptly, the majority of people make a complete recovery. In some cases, it can be fatal or a person may be left with a permanent disability.

Fortunately, none of the bacteria that cause meningitis are as contagious as disease like the common cold or the flu and they are not spread by casual contact or by simply breathing the air where a person with meningitis has been.  The germs live naturally in the back of our noses and throats, but they do not live for long outside the body.  They are spread when people exchange saliva (such as kissing, sharing drink containers, utensils or cigarettes).  The germ does not cause meningitis in most people. Instead, most people become carriers of the germ for days, weeks, or even months.  The bacterial rarely overcome the body’s immune system and cause meningitis or another serious illness.

Bacterial Meningitis can be prevented by not sharing food, utensils, toothbrushes or cigarettes.  Limit the number of persons you kiss.  While there are vaccines for some other strains of bacterial meningitis, they are used only in special circumstances.  These include when there is a disease outbreak in a community or for people traveling to a country where there is a risk of getting the disease. Also, a vaccine is recommended by some groups for college students, particularly freshmen living in dorms or residence halls.  The vaccine is safe and effective (85-90%).  It can cause mild side effects, such as redness and pain at the injection site lasting up to two days.  Immunity develops within 7 to 10 days after the vaccine is given and lasts for up to 5 years.

More information may be found at the following websites:  Centers for Disease Control and Prevention – www.cdc.gov  and the Texas Department of health – www.dshs.state.tx.us  

 

School Health Advisory Council (SHAC)

A SHAC is a school board appointed advisory group or individuals who represent different segments of the community.  By law, a majority of the members must be persons who are parents of students enrolled in the district and who are not employed by the district.  The Hawley ISD SHAC is made up of parents, community members, and school staff working together to improve the health of all students and families through coordinated school health programs.  You may learn more about SHAC at www.dshs.state.tx.us/schoolhealth/

The components of a coordinated school health program include:

  • Family and Community Involvement
  • Nutrition Services
  • Physical Education
  • Counseling, Psychological and Social Services
  • Health Services
  • Healthy School Environment
  • Health Promotion for School Staff

 

State Mandated Screenings

Hawley ISD addresses state mandated screening procedures by conducting screens for vision, hearing, and spinal (Scoliosis and Kyphosis) according to the Health Screening Branch of the Department of State Health Services.

Parents may exclude their child from the screening by providing the school in advance with the results of the screening done by a medical doctor.  Parents may also exclude their child for religious reasons.  The religious affiliation of which the student attends is required to submit a notarized letter stating this screening is against their belief.

Hawley ISD is committed to providing each student with the opportunity to learn in a safe, healthy and pleasant environment. As part of the educational team, the school nurse, and those designated to provide health services to the students, will do their best to meet the health needs of each student and provide them with the optimum potential to reach their academic goals.