Day to Day Health

Primary care providers and nurses require parent permission to communicate. The consent form is an agreement that sets guidelines for what will be shared amongst the home, the school and the primary care provider. The purpose is to ensure that the school has the proper information to create an educational plan.

There are two different federal regulations regarding confidentiality of information. FERPA ( the Family Educational Rights and Privacy Act ) protects student educational information within the school environment. HIPAA (Health Insurance Portability and Accountability Act) protects health information within the larger community such as protected health information. However, when health information is accepted by a school, it becomes FERPA protected and not HIPAA protected and anyone with a right to know (i.e. those directly involved with a student’s educational program)can potentially review health information. To provide a more HIPAA like protection to a students health information, BPS has added additional confidentiality protections. The school nurse in conjunction with the principal and parent has a release of health information where the parent sets the parameters for what can be shared with the staff.

The physical exam provides the school nurse with important information to maintain health and safety in the school, especially for new enterers. Parents of new students should ensure the nurse receives a physical exam within 2 weeks of school entrance. When a child has chronic disease, such as diabetes or sickle cell disease, the nurse will need more detailed information. In order to work together with the student’s clinician, the parent or guardian must sign a consent to share the medical information. The Chronic Disease section discusses this in more detail.

In addition, the state requires that all high school sports participants have an updated physical every 13 months.

The purpose of a sports physical is to ensure safety of student and provide guidelines for those with health needs. The student’s primary care physician clears a student for participation and should indicate any accommodations the school should provide for safe play. The school nurse reviews all students participating in sports to ensure this clinician clearance has occurred. Monitoring for concussion is an important function of the athletics department and the school nurses. Parents should inform the school of any offsite concussions.

The state requires that all students be up to date on their immunizations. In order to ensure compliance with this regulation, BPS requires that all new students ensure that their immunizations are up to date at time of registration and provide the documentation of any additional immunizations throughout the school year.

The state requires students be screened for height, weight, hearing, vision and scoliosis (curvature of spine). School nurses and health paraprofessionals complete most of the screenings. Vision screening often discovers a vision deficit. BPS links with several community agencies that will do more detailed vision screening and assist with obtaining glasses.

Although parents can opt out of screening on the online or paper student family handbook along with the other permissions requested at the start of each new school year, we encourage that all children be screened. 

• A doctors order is required if a child is taking medicine in school. Massachusetts state regulations allow only a nurse to dispense medication, with the exception of field trips and Epi pens.
• The parent is responsible for delivering to the nurse medications in a pharmacy labeled container along with a physician’s order and permission for nurse to give the medication in school.
• Over the counter medications require a physician's order for them to be dispensed in a school. The BPS school physician provides a standing order that allows the school nurse to dispense medication with parental permission
• In some instances, such as with asthma inhalers, medications may be self administered. Self administration is determined by the nurse and the family and requires a process of monitoring student use.
• Parents should pick up any unused medications at the end of the school year. Any unused medication will be destroyed.
• School nurses are responsible for a students health during regular school hours. Before and after school programs are responsible for working with parents should there be a medical need such as medication outside of school hours.

• The nurse assesses the acuity of presenting symptoms and makes the determination of 911 transport. Therefore it is vitally important that parents maintain updated emergency contacts.
• Parents will be notified if a child is transported.
• Students must be accompanied by school staff; as EMS assumes the clinical role, the school nurse is more appropriate to remain with the school.

Disaster Planning

Each school has a disaster plan. The school nurse is the risk analyst in the event of a school disaster. Parents should familiarize themselves with the schools disaster plan, in particular the reunification plan, should there be a school evacuation. Parents of children with special needs involving medication, equipment or supplies, should discuss plans for shelter in place or lockdown.