Presentation Skills for School Nurses Let People Know what you do! Kathleen A. Hassey BA RN BSN MEd Director of the School Health Institute Northeastern University June 2006

Why do we need to Present? To let administrators, faculty, parents, community and legislators know exactly what we do for school children. To let administrators, faculty, parents, community and legislators know exactly what we do for school children. To increase awareness of medical acuity within the educational system. To increase awareness of medical acuity within the educational system. To justify staffing patterns. To justify staffing patterns. To increase funding to Health Services in your district and across the state. To increase funding to Health Services in your district and across the state.

How do we begin? Decide what group you need to educate. Decide what group you need to educate. –Parents: Services available or support needed –Administrators: Staffing needs and office data –Educators: Impact of health on academics –Community: Inform about available programs and keep school health on the radar. –Legislators: Need for funding for programs

How to decide on a Topic What is a “pressing” issue for you or your school/district. What is a “pressing” issue for you or your school/district. –Policy ( Is there a policy ex Dealing with Life threatening allergies needed )  Laws that may apply to equal education for children  Medical information regarding LTA (you ARE the Expert)  How it will benefit children by keeping them in class. –Staffing ( one nurse or more needed for each school )  Office visits  List of medical/chronic conditions  Number and types of medications administered  Total mandated screenings

How do you get YOURSELF Ready? BE PREPARED…. have your data and your points to make succinct. BE PREPARED…. have your data and your points to make succinct. DON’T OVERWHELM… sometimes less is more… short, informational presentations allow them to ask questions. DON’T OVERWHELM… sometimes less is more… short, informational presentations allow them to ask questions. DON’T USE ALLL MEDICAL LANGUAGE… take into consideration the “group” you are speaking to. Give them what they NEED to know. DON’T USE ALLL MEDICAL LANGUAGE… take into consideration the “group” you are speaking to. Give them what they NEED to know. SPEAK SLOWLY… Pause when you are trying to make a point. SPEAK SLOWLY… Pause when you are trying to make a point. ALWAYS INCLUDE EDUCATIONAL OUTCOMES… make sure that the group can understand the value of the issue in relationship to educational outcomes (ex decrease in dismissal rate, decreased absentee rates for asthmatics). ALWAYS INCLUDE EDUCATIONAL OUTCOMES… make sure that the group can understand the value of the issue in relationship to educational outcomes (ex decrease in dismissal rate, decreased absentee rates for asthmatics). PRACTICE>>>PRACTICE>>>PRACTICE PRACTICE>>>PRACTICE>>>PRACTICE

Impress with Power Point! Decide what you want to get across, have your data available, and OPEN the Power Point. Decide what you want to get across, have your data available, and OPEN the Power Point. You can play with the Power Point program…it’s all there for you! You can play with the Power Point program…it’s all there for you! You can use… You can use…

Click to Add Title Click to add text Click to add text

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Some examples

Waltham Public Schools Health Services Program Report November 2005 Marie DeSisto, RN, MSN Director of Nurses

Health Office Visits 96% of the students were seen by a nurse 1 or more times during the school year 45% of the students were seen 6 or more times This is in addition to mandated health screenings

Disposition of Visits 91.5% of the students seen by the nurse are treated and return to class 8% are dismissed for illness Only.5% dismissed due to injury

Classroom Presentations by the Nurse

Health Conditions 20% of the Students have Health Conditions that require nursing intervention 5.9% Asthma 118 students with Life Threatening Allergies requiring an EpiPen 12 students with Diabetes 41 student with Seizure Disorders

Melanoma Prevention Program Hudson High School Kathy Hassey BA RN BSN MEd Director of Health Services 2005

Tanning Bed Controversy: Are They Safe?  No, tanning beds are not safe and are actually more dangerous than direct sun exposure.  UVB rays effect the skin layer and cause sunburns (sun exposure)  UVA rays penetrate to a deeper layer of skin and directly hit the melanocytes (cells that produce melanin).  UVA rays are times greater than direct sun.  Using a tanning bed more than 10 times a year increases the risk of melanoma 7.7 times.  SPF (sun protection factor in sunscreen) only deals with UVB rays and does nothing for UVA (tanning beds).

Mental Health Issues: A School Nursing Perspective Kathleen A. Hassey BA BSN MEd Director of the School Health Institute, Northeastern University March 10, 2006

School Nursing in the Educational Setting The School Nurse role is to assess, and alleviate or minimize the medical/health barriers to learning. Our goal is to keep “children in school, in class and ready to learn”. We strive to enhance/improve academic performance by evaluating the “whole” child and alleviate/minimize any medical/health interference to a child’s school/academic success. The Health Office is often seen as a “safe haven” for students with mental health issues…it is a place to re-group. The School Nurse is one more trained professional available to assist.

Example of Dismissal rate decrease with a School Nurse in every school

Health Impact on Education Health Services Department Hudson Public Schools August 2005

Children with Special Health Care Needs  Special Health Care needs are defined as those that require health and related services of a type or amount beyond those required by children generally. In Hudson Public Schools, we now have  859 Special Health Care Needs students (368 ongoing Health Care Plans) (368 ongoing Health Care Plans)  Life threatening allergies  Arthritis  Asthma  Blood dyscrasias  Cancer  Cardiac conditions  Diabetes  ADHD  Depression  Migraine headaches  Neurological conditions  Eating disorders  Mental Health/Emotional issues

Health Office Volume MondayTuesdayWednesdayThursdayFriday Hubert15%23%8%27%27% Farley19%20.5%19%21%19.5% ForestAve.21.4%25.5%17%20%16.5% Mulready18%23%24%17%18% JFK23%22%17%18%16% HHS23%23%16%17%19%

District Student Office Visit Frequency

Final District Numbers 2004  Number of Children on Daily medications 238

Health Office Visits 03/04  There was a total of 43,113 Health Office visits including – Office visits, mandated screenings (vision, hearing, scoliosis), and medication administrations. –Staff visits totaled 1,707.

Life Threatening Allergies Accidents are never planned. Plan ahead for handling them, and hope never to use your plan Marjorie McEttrick-Maloney, RN, BSN, MPA/H, NCSN Nurse Leader, Plymouth Public Schools August 2005

Why Think of Life Threatening Allergic Reactions in the Plymouth Public Schools? The number of students nation-wide with life-threatening allergies (LTA) has increased substantially in the past five years In the school year, 190 students and staff enrolled/teaching in the Plymouth Public Schools had a diagnosed life-threatening allergy. They may have allergies to foods such as peanuts, tree nuts, eggs, milk, shellfish, chemical and drug allergies as well as allergies to bees and insects. In some individuals, a life-threatening allergic reaction may occur as a result of exercise. Approximately 25% of all life-threatening allergic reactions occur to persons that do not know they have life-threatening allergies

What Do We Do to Protect Our Students and Staff? Plymouth Public Schools Policy (6/03) requires that all school personnel be educated annually regarding the recognition of life- threatening allergic symptoms and the building’s emergency medical response procedures (Staff Crisis Manual - Medical Emergency Protocol) School Nurses develop Individualized Health Care Plans and Emergency Care Plans for students with known LTA. These “Care Plans” are shared with appropriate staff members to ensure communication of the students medical needs. (Medical symbol)

What Else Do We Do to Protect Our Students and Staff? Provide an environment that is as safe as possible for persons with known allergies Encourage early identification of a person experiencing an allergic reaction Encourage prompt notification of available emergency personnel (school nurse, 911) to respond immediately

What Else Do We Do to Protect Our Students and Staff? Administration of Epinephrine (Epi-Pen) and Benadryl – In the Plymouth Schools, only a registered nurse can administer epinephrine (Epi-Pen) and Benadryl to anyone displaying symptoms of a life threatening allergic reaction. – In the Plymouth Schools, the registered nurse can delegate this responsibility to selected individuals (health aides, teachers, administrators) for a specific person/student, only after formal training and documentation. Call 911

Symptoms of a Life-threatening Allergic Reaction Mouth – itching and swelling of the lips. Tongue or mouth Throat – itching and/or sense of tightness in the throat, hoarseness and hacking cough Skin – hives, itchy rash, and/or swelling about the face or extremities

Symptoms of a Life Threatening Allergic Reaction (Continued) Stomach – nausea, abdominal cramps, vomiting and/or diarrhea Heart – “thready” pulse, “passing out” Lungs – Shortness of breath, repetitive coughing and /or wheezing The severity of these bolded symptoms change quickly. All above symptoms can potentially progress to a life-threatening situation !

Take Away Thoughts Be aware persons around you while at school, home, or with friends If they are bitten by an insect, encourage them to bled the bite and wash the area. Watch for a possible reaction If they accidentally or unknowingly eat something they are allergic to - get help. Ask them if they have an Epi-Pen - get it for them. If they develop any symptoms, don’t hesitate to seek emergency assistance (911) Don’t delay – better safe than sorry!

Primary References Plymouth Public Schools Policy for the Management of Life Threatening Allergies Plymouth Public Schools, School Nurses Protocol for the Management of Life Threatening Allergies The Food Allergy Network National Association of School Nurses MA Dept. of Public Health School Health Unit Prepared by Marjorie McEttrick-Maloney, RN, BSN, MPA/H, NCSN Nurse Leader, Plymouth Public Schools 8/05.

You are ready to begin! You are ready to begin! Get out there and educate the Community, Faculty, Administrators, Parents and your School Committee. Get out there and educate the Community, Faculty, Administrators, Parents and your School Committee. Thank you for your time…any questions? Thank you for your time…any questions?