Special healthcare needs
School Nursing
Special healthcare needs
- Caring or Your Child With A Gastrostomy (Primary Children's)
- Gastrostomy Tubes (Let’s Talk About… Pediatric Brochure)
Special diet
- Thickening Agents What You Need To Know (Let’s Talk About… Pediatric Brochure)
- Homemade Blenderized Diets For Tube Feeding (Let’s Talk About… Pediatric Brochure)
Forms
Videos
G-tube replacement
When a G-tube comes out, the priority is to keep the stoma (opening) from closing. The tract can start to shrink within 1–2 hours, even a short delay can make reinsertion more difficult and uncomfortable for the student.
Staff trained by the school nurse may:
- Replace the same G-tube and tape it in place
- Use a Foley catheter if the G-tube is broken, damaged, or dirty
If using a Foley, this should be for temporary emergency placement until the G-tube can be replaced by the nurse, family, or provider.
G-tube replacement resources:
Inclusive safety planning for students with health and support needs
School nurses play an important role in emergency planning for students with medical, mobility, communication, behavioral, and other access or functional needs.
The Especially Safe® Planning & Preparation Guide from Safe and Sound Schools provides a team-based framework to help schools plan for the safety of all students, staff, and visitors during emergencies. The guide focuses on inclusive safety planning and includes tools for developing Individual Safety Plans, also called ISPs.
This resource can help school teams identify students who may need extra support during evacuation, lockdown, shelter-in-place, reunification, field trips, or other emergency situations. It also includes planning considerations for medication, medical equipment, emergency go-kits, trained staff, backup staff, communication needs, mobility needs, and regular plan review.
School nurses can use this guide as a planning resource when working with administrators, special education staff, parents, emergency responders, transportation staff, and other school team members.
Key takeaways for school nurses
School nurses can help the school team think through:
- Which students may need an Individual Safety Plan
- What medical supplies, medication, or equipment must be available during an emergency
- Where emergency supplies or go-kits should be kept
- Who is trained to help the student
- Who the backup trained staff members are
- How the student will be supported during evacuation, lockdown, shelter-in-place, reunification, field trips, lunch, recess, and passing periods
- How the plan will be shared with staff who need to know
- When the plan should be reviewed or updated
Medical planning considerations
The guide includes several medical planning points that may be helpful for school nurses to review with the school safety team. For students with medical needs, consider:
- Are required medications easy for trained staff, or the student if appropriate, to access during shelter-in-place, evacuation, or other emergency situations?
- Is there a plan for an adequate supply of critical medication? Is there a backup supply location?
- If medication must stay at a certain temperature, how will it be transported safely? Is a lockbox, cooler, or other equipment needed?
- Do primary and backup locations have refrigeration or power access, such as a battery or generator, for medications or medical devices?
- Who is trained and authorized to administer medication? Who is cross-trained if the primary person is not available?
- Who is trained in first aid and CPR?
- Are staff trained on how to help transport students with different assistance needs, including students who use mobility devices or service animals?
- Have aides, teachers, substitutes, and other staff who work with the student been trained on the student’s needed medical equipment, supplies, and emergency procedures?
Individual emergency go-kits
For some students, the team may also consider an individual emergency go-kit. This may include items such as:
- Medication or emergency supplies
- Medical equipment or care items
- Communication tools
- Comfort or sensory items
- Copies of needed emergency information
- Supplies needed during evacuation, shelter-in-place, lockdown, or reunification
Go-kits should be easy to locate, portable, and reviewed regularly so items do not expire or become outdated.
Students served by special education will have an individualized education program (IEP). This is an academic learning plan that may include related services. Some related services may include school health services, and/or school nurse services that are designed to enable a child with a disability to receive a free appropriate public education (FAPE) as described in their IEP.
School nurse services are services provided by a qualified school nurse. School health services are services that may be provided by either a qualified school nurse or other qualified person
Students not served by special education may be served by the Section 504 of the Rehabilitation Act of 1973. Section 504 can provide accommodations for students who have a physical or mental impairment that substantially limits one or more major life activities.