School Nursing –Above the AverageAbove the Average.

October 16, 2008A i W ll RN BSNAnnie Wallace, RN, BSN

H NASND bHow NASND began….

f National Association of School Nurses for the Deaf was started in 1992 by Jody Daulton from Ohio 1992 by Jody Daulton from Ohio.

NASND id f h NASND provides a forum to share information, support and network with other nurses who understand with other nurses who understand the unique needs of our students.

M b hiMembership:

Regular membership is open to any nurse currently working with Deaf students in a school settingstudents in a school setting.

1 $25 2 $401 year = $25, 2 years =$40

Associate membership:1 year = $10, 2 years = $15

What does NASND do?

Biennial Conference Biennial Conference- provides workshops on topics relevant to the Deaf communityrelevant to the Deaf community.- opportunities for networking,

p omote p ofessional s ppo t- promote professional support,- reduce workplace isolation,- opportunity to observe design and procedure of other Schools for the Deaffor the Deaf.

WWW NASND NETWWW. NASND.NET

f f Provides contact info for Executive Board members.

f d h d Q & A forum used to share ideas, solutions and support.N l Newsletter

Links to Nursing websites, current h l h i f i d health information and resources.

C rrent OfficersCurrent Officers:

President: Linda Meier – Washington State President: Linda Meier Washington State School for the Deaf

Vice-President: Jill Kes – Minnesota State Academy for the Deaf

Secretary: Annie Wallace – Kansas State School for the DeafSchool for the Deaf

Treasurer: Virginia Muraoka-Myers – Central Institute for the Deaf

Past President: Deb Robarge – Indiana State School for the Deaf

Save the Date (and some budget money) for the 2009 Conferencefor the 2009 Conference Where: The Minnesota State Academy for

the Deaf the Deaf

When: July 29 – 31, 2009

Estimated Cost: $200 - 250 per person (includes room & board)

Anticipated topics include: bullying prevention, diabetes updates, computer p , p , pdocumentation, MRSA updates, obesity prevention and more.

The Goal of School Nursing:The Goal of School Nursing:Keep kids healthy so they can learn.

Challenges:

- students with complex medical needs

- changes in medical treatments/practices

- maintenance of medical conditions for residential students ( appointments, therapies, diagnostics).p , g )

Career Challengesg The difference between School Nursing and

being a Nurse at a School for the Deaf…..

Continuous care vs. occasional care

Meeting state requirements for day schools

Additional responsibilities for after school hours, athletics, field trips, travel & training for stafffor staff.

Opportunity to know our students well.Opportunity to know our students well.

Language ChallengesLanguage Challenges Schools for the Deaf need experienced p

nurses. How to encourage ASL fluency.

Provide classes on campus to improve ASL skills. Consider shift work when scheduling.g

May require individual tutoring for best resultsMay require individual tutoring for best results.

L Ch llLanguage Challenges

Encourage nurses to attend on campus events to increase ASL exposure. Especially important for 2nd & 3rd shifts.

Provide alternative communication adjuncts: Ubi-Duo, word wall/posters, j , p ,VP, email & tty.

E i bExperience base Look for Nurses who have a variety ofLook for Nurses who have a variety of

clinical experience. Need strong assessment skillsNeed strong assessment skillsCurrent patient experienceRelevant knowledge baseRelevant knowledge baseExcellent teaching skills

Consider job sharing option toConsider job-sharing option to encourage info sharing and increase continuing education optionscontinuing education options.

How many nurses do you need?y y Full campus coverage:Clinic care for the ill +/or injuredClinic care for the ill +/or injured

Scheduled medications includesScheduled medications- includes finding the student.

Attend various meetings: IEP, BIP, Deaf-Blind Committee, Wellness Committee, Crisis Management, etc.

Attend on-campus games/events.

Full campus coverage:p g

Local field trips with medically fragile studentsLocal field trips with medically fragile students

Scheduled appointments for chronicScheduled appointments for chronic conditions

Answer phone and door simultaneously

PRN nurses to supplement staffing

Providing nursing care to KSD t d tKSD students

Census: (ECC PostGrads): 138 students Census: (ECC – PostGrads): 138 students

# of students with chronic medical condition (asthma, seizures, diabetes, etc): 59

Scheduled daily medications:35 students for 62 scheduled visits/day

Providing nursing care to KSD t d tKSD studentsAugust 17 – September 30, 2008

# of med visits: 1302

Illness/Injury visits: 696

Vision screenings: 34

Management entries: 140

Field trip doses: > 275 doses

Providing nursing care to KSD t d tKSD students School Physician/ Medical Directory

Write care plans for every student who has a medical condition. Update with any changes during the school year.

Training staff to recognize signs & symptoms d d f t t tand need for treatment.

Delegation training for medications while Delegation training for medications while students are off campus.

Meeting State Healthcare i trequirements

Kansas State law mandates: Kansas State law mandates:

Track immunizations on all students Obtain physician medication orders on all students

who take medication. Vision screenings every 2 years and as needed.

Facilitate optometry exams and obtaining eyeglasseseyeglasses.

Dental screenings annually. Facilitate dental exams when possible.when possible.

Meeting State Healthcare i trequirements

Height/Weight Screenings with BMI calculations This leads to Nutrition counseling and assessment of

travel needs (car/booster seats)travel needs (car/booster seats)

Health Department guidelines must be followed for clinic and for exclusion due to illness.

Standing orders must be developed and maintained Standing orders must be developed and maintained for treatment of minor illness & injury.

In our spare time...pManage chronic conditions and collaborate

with parents and health care providerswith parents and health care providers

Manage medication supply (varying schoolManage medication supply (varying school schedule, field trips, refills, etc)

Contact parents for medication supply, funds, lab work, etc., ,

Prepare meds for field trips – athletics,Prepare meds for field trips athletics, academics, boy/girl scouts, etc.

N t St ffNurses as a resource to Staff

Provide support for Social worker, School Psychologist and counselor efforts with t d t & f ilistudents & families.

Annual staff training: Blood borne pathogens, CPR AEDCPR, AED.

First aid for work related injuriesBlood press re checks Blood pressure checks

Health education resource –for classroom and staffand staff

What do Nurses need to d?succeed?

Continuing Education – budget for these needs annually.

Technology: Computer Documentation:

Decreases workload* Meets documentation requirements Meets documentation requirements More time providing care, less time on paperwork

Equipment:q p Reinforces new skills learned in continuing education Gives nurses the tools they need to provide excellent

care

Fi l th htFinal thought

"Let whoever is in charge keep this simple question in her head - (not, how can I always do this right thing myself, but) how can I provide for the right thing to be always d ?"done?"

Florence Nightingale~Florence Nightingale