Enhancing School Health Services

For schools, good health is the blessing from which all other accomplishments and successes flow. Protecting and managing your school community’s health is obviously essential, but it can be challenging as well, due to the wide variety of considerations that must be taken into account. A school health office is usually at the center of any healthy community, but running and managing one is no small feat.

Our guide below offers an outline to what a successful health office looks like, from the person managing it to the supplies and strategies needed to keep your school healthy. Navigate to the specific section you want through the list above or read along as we delve into how to make it happen! We promise it’s easier than it seems.

Who's Managing Your Health Needs?

In many independent schools, there is no designated individual on campus whose sole job is to care and look after the students. Many schools employ the science teacher, a head of operations, or a chief financial officer to take on the role of “school nurse” or School Health Office Technician. While this is the only option for many campuses, managing a school health program should be a full-time position because it requires complete attention in order to properly care for the students, faculty, and staff. An individual attempting to handle their position of CFO, head of operations, or any other staff position on campus while also adding on the role of School Health Office Technician is taking on a huge task. Sometimes, individuals with dual positions have background knowledge in medicine and and thus can treat signs and symptoms of illness or condition properly. However, in many cases these individuals do not have the broader knowledge base of a medical professional, making treating campus illnesses and injuries more challenging. Attempting to "double up" on responsibilities can lead to underwhelming output and performance in both positions, leaving a school worse off than before. 

Another source of strength on school campuses may come from the First Aid and CPR certification that most faculty and staff have. However, this is still an inadequate substitute for medical and emergency management experience. In order to ensure this expertise is present on your campus, hire a School Health Office Technician to focus on your community's needs.

Unique Factors in Healthcare

There are unique factors that distinguish each individual from one another. Pertinent on a school campus are the different medical conditions community members deal with and how to properly treat and care for them. Some common conditions on a campus are epilepsy, anaphylaxis, asthma, and diabetes. These conditions can be very serious and require background knowledge of the signs and symptoms in order to preemptively manage them or to treat them in case of a medical emergency. Students with life-threatening, serious conditions should have emergency medications kept in the health office. There will also be students on campus that require medication to be administered at a certain time of the day. Students with ADHD or ADD may take Ritalin or a generic form of this medication every day at a certain time.  A School Health Office Technician manages these medications and ensures they stay in a safe place. A medical professional will be comfortable in administering any medication, emergency or otherwise.

Do You Need a Professional?

As previously stated, having a medical professional on campus gives your school’s health program a boost. The extent of their medical credentials may vary depending on the needs and other factors specific to your school. For some campuses, like those with students who need a higher level of care or skill, such as injections of medications, a nurse is necessary. However, other schools find that an EMT is more than sufficient to care for not only students but faculty and staff as well. An EMT is trained in emergency situations and well-educated on medical knowledge. Before a higher level of care, such as an ambulance, arrives on the scene of an emergency, an EMT has the capacity to make immediate emergency decisions and treat and sustain patients.

Regardless of the technician's level, it is important to have a professional certified in medicine on campus at all times in order to properly care for and assess patients. This position ensures that all individuals on campus are receiving informed care. Knowing that there is a professional on site who will be able to properly care for the students and staff gives a sense of comfort and dependability to those within the school's walls.

A Day in the Life of a School Health Professional 

Depending on the specific needs of the school community, a School Health Office Technician performs different tasks throughout the day. Students may come into the health office for minor bumps and bruises simply requiring a quick clean-up and a band-aid. Other students will need to be sent home with fevers or other illnesses. Some students feel anxiety upon arriving at school and require assistance immediately in the morning. This does not mean immediate medical attention is required; instead, students sometimes need emotional support and someone to talk to.

The health office is not only a place for students to seek medical attention, but a place for them to feel safe and understood. It is not uncommon for students who are emotionally upset or under duress to display symptoms of illness. Sometimes students just need a friendly face and the space to understand that what they are feeling may be due to stress or anxiety. However, it is up to the School Health Office Technician to make that judgment call and to be able to decide on next steps depending on the situation.

The health office should be a quick stop that encourages the majority of students to go right back to class. There are no cots in an ideal health office, as this is not an area where students sleep. The health office is the place where students can seek solace in times of need and come get their bumps and bruises attended to. In many ways, the School Health Office Technician's goal is to promote perseverance and help students see that their current situation is not permanent and will pass.

Monthly Checklist and Reporting

Another important aspect of this role is the recording and reporting of every interaction a student has with the health office. Every visit is logged with the time a student came in, the reason for their visit, the diagnosis, the course of action, and the time they left. Over time, this reporting will allow the health office to assess “frequent flyers” and dig deeper into the core reasons a student visits. Trends will appear, like a student missing the same class over and over. All of this information, accumulating over the course of the year, allows a School Health Office Technician to facilitate a plan of action based on concrete data. This assessment makes the health office on your school campus much more efficient in delivering care and help to those who need it, when they need it.

 Common School Health Concerns

Any decently sized community of individuals will have a plethora of common health concerns over the course of a school year. A School Health Office Technician is tasked with anticipating and treating these typical campus issues and their effects, such as lice, puberty, pregnancy, cold/flu, concussions, chronic illness, mental illness, minor injuries, anorexia/bulimia, drugs and alcohol, and immunizations. Treating these health concerns, common as they are, requires a blend of skills. In talking about many of these concerns with students, a School Health Office Technician will use tact, research, and communication in order to effectively take action. Any member of a health office should utilize research and their own experience to become skilled at handling these common school conditions. Below are some useful resources in dealing with and learning about some of them.

• Eating Disorders
  https://www.nationaleatingdisorders.org/help-support/contact-helpline
• Immunization
  https://medlineplus.gov/immunization.html
• Concussions
  https://www.cdc.gov/headsup/pdfs/schools/tbi_returning_to_school-a.pdf
• Drug and Alcohol Abuse
  https://www.therecoveryvillage.com/teen-addiction/high-school-drug-use/#gref
• Mental Health
  http://teenmentalhealth.org/learn/mental-disorders/

Equipment for Your Health Office

In order to have a successful health office, it must be well-organized and properly equipped with materials and First Aid supplies. If the office has closet space, it should be filled substantially with common medical items like bandages, wraps, band-aids, antibiotic cream, and hydrocortisone cream. While these daily treatments will be the most commonly used supplies, a good health office also is prepared for a more serious medical emergency. Have a “go-bag” filled with all consumable supplies for basic First Aid, as well as a stethoscope, blood pressure cuff, OPAs (oropharyngeal airways), NPAs (nasopharyngeal airways), and all other items or equipment needed for basic life support during a more extreme emergency.

As previously mentioned, the office will store all sorts of student medications. These medications include but are not limited to emergency medications such as epipens, inhalers, glucagon pens, daily medication such as ADD/ADHD medication, over-the-counter medication such as Advil, antihistamines, and many more. The School Health Office Technician will ensure these medications are properly organized and labeled along with the proper forms and signatures.

What to Expect When You're Not Expecting

Inevitably, emergencies will occur on your campus. A School Health Office Technician will be called upon to be a key resource in that situation. For example, if a student experiences a seizure while in class, the technician is tasked not only with treating the medical emergency itself but also in managing the rest of the likely anxious students. Other adults in the room are a resource in managing the trauma and exposure of those witnessing the emergency. If at all possible, clear the room during the emergency. This allows the situation to be slightly less complex. For any seizure, diabetic emergency, anaphylactic reaction, asthma attack, broken bone, or other serious medical emergency, immediately call 911. Advanced medical care is needed. A School Health Office Technician may ride in the ambulance with an injured student along with their emergency medical card, which should include their medical insurance, emergency contacts, and any medical conditions or allergies. The technician will be able to inform the first responders in the ambulance of the emergency that occurred and provide insight as to the context of the incident. Once the patient is at the hospital with their emergency contact, the technician is relieved of their duties.

How to Manage Challenging (All?) Parents

It will come as no surprise to any administrators reading this that a school comes with a multitude of personalities to manage. Some parents will be understandably challenging to deal with when it comes to their children’s health needs. The medical instincts of a School Health Office Technician may occasionally be in conflict with a parent’s wishes. For example, a student cannot take any medications without signed consent for that specific medication from parents or guardians. Even ibuprofen, which can be dispensed for adults on campus from the health office, requires a signature. When speaking with parents, a School Health Office Technician will remain calm and find collaborative solutions whenever possible. Establishing these positive relationships is a less obvious but still important part of the job. One shortcut in immediately de-escalating any parent-health office conversation is to start with an introduction and a reminder that “this is not an emergency.” Start by putting parents at ease, and the situation can be managed much more calmly.

How (And When) to Call Home Without Panicking

A common part of the School Health Office Technician’s job is to send students home from school early. It will not be uncommon for you to send students home. Whether they are genuinely sick, need to go home for their mental health, or have already called their parents to pick them up, sending students home is just an inevitable part of the day. The real challenge comes from speaking to parents on the phone. In the absence of an emergency, the goal is to not panic the parents or guardian. You do not want to alarm home when there is not an emergency on campus. Below are a few sample guidelines for effective communication with the home front.

• A student, Jill, needs to go home because she is not feeling well. Before calling, take her temperature and note any symptoms she is displaying so you will be able to report this information back to her parent. Ultimately the parent and the student will decide what is the best for the student. A technician can exercise their opinion in a respectful manner that takes into account their knowledge, but should never push their opinion on a parent.
• When you call her parents or guardian, make sure to ask their name and confirm you have the right number. Then, introduce yourself and state the school you are calling from. Ask the parent how they are and continue along the lines of, “Not an emergency, however, I do have Jill here, and she is not feeling too well today. She is being a trooper and really trying to stick out the day, but it may be in her best interest to go home and really rest to get better. Is this something you think we can coordinate?”
• There will be instances where students visit the health office due to anxiety or feeling stress from the rigors of school. Some students will be so overwhelmed that they will request to go home. It is up to the technician’s discretion how to handle this type of situation, but ideally, students can learn to persevere through minor adversity. Sometimes, a School Health Office Technician can make a large impact with simple reassurance and encouragement to return to class.

READ MORE ABOUT SCHOOL HEALTH ON JOFFE'S RESOURCES PAGE

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