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School Nurses and Teachers: Educating Educators about Students’ Health Needs.

School Nurses & Teachers

Increasing chronic illnesses and behavioral stresses have changed today’s schools and classrooms. The demands to keep students healthy and safe require school nurses to employ new and evolving strategies. Developing and expanding the school health team is crucial to meet these ever increasing needs. With the school nurse as the lead, the school health team, in some areas, has traditionally included the front office secretaries, school counselor, and school psychologist. A recently recognized and integral member of the school health team is the classroom teacher. When included in the health team process, the teacher is often the first person to recognize signs of illness or imbalance. Early intervention and referral to the school nurse is what will help keep students healthy, safe and ready to learn.

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Upcoming webinar from the CHHS!

Upcoming webinar from the Center for Health and Health Care in Schools!

This is a reminder to register for the Center’s January 26th webinar, “Sustaining School-Community Approaches”, featuring a recently launched online tool called Partner Build Grow. The Center promotes child wellness and school success by partnering with communities to create collaborative solutions that bridge health and education so that kids are happy, healthy, and motivated to learn. Partner Build Grow uses a four-pronged approach based on promising practices to assist community coalitions in advancing and sustaining school-based child development and behavioral health objectives.

The 90-minute webinar will feature several communities that have successfully implemented cross-sector, school-connected, child health initiatives. Olga Acosta Price, Ph.D., director of CHHCS at the George Washington University Milken Institute School of Public Health and associate professor in the Department of Prevention and Community Health, will be moderating.  

Panelists will include: Liz Warner & Patricia Heindel, Ph.D. from the School Culture and Climate Initiative in Northern New Jersey, and Luann Kida, MA, LMSW, Director of Community Schools in Broome County, New York. Additional information about these initiatives can be found through the webinar registration link below. 

Date: January 26, 2016

Time: 12-1:30 PM EST


Participants must have a working microphone & speaker on their computers in order to hear audio during the presentation (webinar will be in VoIP format).

We encourage registrants to preview the Partner Build Grow tool prior to the webinar on 1/26, share with your networks and colleagues, and also to register as a user in our database. Questions and comments can be sent to [email protected].


Do You Know the Healthy Youth Act?

Comprehensive Sexual Health Education

Washington law on sexual health education states that “the decision as to whether or not a program about sexual health education is to be introduced into the common schools is a matter for determination at the district level by the local school board.” Any district that chooses to provide sexual health education must follow the requirements outlined in the Healthy Youth Act.

All sexual health education offered in Washington public schools must meet the following criteria:

All instruction and materials used must be:

Abstinence may not be taught to the exclusion of instruction and materials on FDA approved contraceptives and other disease prevention methods. In other words, the instruction must be comprehensive.

More information is available on our Frequently Asked Questions page.

Resource: OSPI


Take Care of Your Heart From the Start

Teen Take Heart™ is an evidence-based cardiovascular health promotion and disease prevention program for high-school students. The program aims to promote wellness and mitigate risk factors for cardiovascular disease (CVD) through a series of in-class instructional, and hands-on web- and kit-based lessons organized into four learning modules.

Teen Take Heart

The program incorporates the sciences of anatomy, physiology, and disease pathology, into engaging learning sessions to promote heart-healthy lifestyle choices, based on current best practice standards.

Students have opportunities to ask questions, plan and conduct an investigation, test a design, record and analyze data, apply scientific reasoning, develop, revise, and/or use a model to predict relationships, apply algebra, critically read scientific literature, and write explanatory narrations, throughout the integrative curriculum.

Students will discuss and implement lifestyle changes/personal behaviors that support heart health. Students learn to apply concepts with parents & community by creating and implementing culturally relevant community outreach.

Healthy Heart Ambassador

The program is targeted toward underserved/under resourced communities at high risk for cardiovascular disease. High school students are coached to serve as Healthy Heart Ambassadors to their community; organize and lead outreach events; and connect individuals, families, and communities to health-related resources.

Additionally, exposure to health career options are embedded in the program and discussed throughout the students’ interactions with Teen Take Heart.

Each of the four Teen Take Heart modules have a dedicated “kit” of materials for that module. The four modules can be paced according to the needs of the class and are intended to be delivered over a 4-6 week period. Each module and corresponding kit was designed using the latest evidence-based information. 

Click Here for Information on How to Order This Lesson & Kit for Your School

Source: Teen Take Heart

WaKIDS Helps With Transition

The Washington Kindergarten Inventory of Developing Skills (WaKIDS) is a transition process that helps to ensure a successful start to the K-12 experience and connect the key adults in a child’s life.


Three Components of WaKIDS

    1. Family connection welcomes families into the Washington K-12 system as partners in their child’s education.
    2. Whole-child assessment helps kindergarten teachers learn about the skills and strengths of the children in their classrooms so they can meet the needs of each child.
    3. Early learning collaboration aligns practices of early learning professionals and kindergarten teachers to support smooth transitions for children.

Whole-Child Assessment

WaKIDS isn’t a “test.” Kindergarten teachers observe children during everyday classroom activities. This helps teachers find out what each child knows and can do at the beginning of the school year. Knowing more about children’s entering skills and strengths helps teachers and parents work together to support student growth in the kindergarten year.

Before October 31, teachers take an inventory of each child’s developing skills in six areas:

  1. Social-emotional
  2. Physical
  3. Cognitive
  4. Language
  5. Literacy
  6. Mathematics

They use an observational tool called GOLD™ by Teaching Strategies® .

Parents who wish to excuse their children from participating in this inventory should notify their building principal in writing during the first week of school, or as soon as possible thereafter.

The state is phasing in WaKIDS in all state-funded, full-day kindergarten classrooms. Public schools that have not yet received state funding for full-day kindergarten may volunteer to participate, as well.


  • What is WaKIDS? (PDF) English | Spanish – a one-page document that provides an overview of this program.
  • Family Brochure (PDF) is an invitation for families of students who are participating in WaKIDS this year to get involved in the program and find out what to expect.

SOURCE: Office of Superintendent of Public Instruction

School Nurses are Vital

Five Ways a School Nurse Benefits the School

1) Attendance
School nurses improve attendance through health promotion, disease prevention and disease management. Students with a full-time school nurse have about half the student illness- or injury-related early releases from school where no school nurse is present.

2) Academics
Improved attendance means the healthy student is in the classroom and ready to learn. School Nurses enable better performance, which also contributes to reducing drop-out rates.

3) Time
School nurses save time for principals, teachers and staff. A school nurse in the building saves principals, teachers, and clerical staff a considerable amount of time that they would have spent addressing health concerns of students.

A school nurse in the building saves:

  • Principals almost an hour a day
  • Teachers almost 20 minutes a day
  • Clerical staff over 45 minutes a day

4) Staff Wellness
School nurses improve the general health of staff. According to school reports, principals, teachers, and clerical staff are VERY satisfied with having school nurses in their schools for several reasons:

  • Teachers can focus on teaching
  • Office staff spend less time calling parents and sending students home
  • Healthy staff means increased attendance and productivity

5) Accountability
School nurses help schools stay accountable.

  • Promoting compliance with federal and state law mitigates lawsuits
  • Advocating for adequate staffing aligns with Healthy People 2020 recommendations of the ratio of one school nurse per 750 well students (1:750)
  • Preparing for emergencies saves lives and property
  • Addressing student mental health links to academic achievement

School nurses are instrumental in the identification and referral to community resources for health risks and are often the only health professional who see students on a regular basis. School nurses are responsible for:

  • Significantly decreasing the amount of days missed due to asthma, the leading cause of school absenteeism, accounting for more than 14 million missed days annually
  • Managing students with chronic conditions such as diabetes and seizures to allow them to stay in class
  • Identifying and treating accidents and injuries
  • Counseling students about physical and emotional issues

SOURCE: National Association of School Nurses

One family member’s story…

Tracy Grant shares the tragic story of how her niece, Mercedes Mears, died of anaphylactic attack due to severe asthma because the school nurse was at one of the other two schools she was assigned to and an untrained school staff member under-responded.

She is now an advocate for having a school nurse in every school and has joined WISH to work toward health equity for all children.

Immunizations Saves Lives

Immunizations are one of the greatest medical success stories in human history because they have saved millions of lives and prevented illness and lifelong disability in millions more.

We can prevent many serious childhood disease by using vaccines routinely recommended for children. Since the introduction of these vaccines, rates of diseases, such as menigits, polio, rubella, and diphtheria have declined by 95 to 100 percent.

Before we had vaccines, hundreds of thousands of children got infected and thousands died in the U.S. each year from these diseases. Without immunization or low rates of immunization, serious outbreaks can recur.

Vaccine Safety

All parents want to do what’s best for their kids and vaccine safety is a concern for many. Parents get a lot of conflicing information online, in the press, and in books and magazines. The Washington State Department of Health developed a guide, Plain Talk About Childhood Immunization, which gives you the facts and answers the most common questions parents have about vaccines.


Recommended Immunization Schedule

We know you want to protect yourself and your child from disease. But it’s hard to keep straight all the different diseases and the vaccines that can prevent them. Vaccines do such a great job of preventing dangerous diseases that it’s easy to forget what diseases look like, how easy they can spread, and the real-life effects of getting them. Learn more about diseases and the vaccines that can prevent them.

You can print off and follow this easy to read chart from the Centers for Disease Control and Prevention (also available in Spanish).

Adolescent Immunizations

Adolescence is the right time to check on immunization status.   Among the most important vaccines are those recommended for the first time at age 11-12—Tdap, which protects against whooping cough; meningococcal, which protects against meningitis; and HPV, which protects against a cancer-causing virus. It is also a great time to catch-up on other important vaccines like MMR, hepatitis B, and chickenpox.

The National Association of School Nurses has partnered with the National Foundation for Infectious Diseases (NFID) and other leading organizations to improve immunization rates among adolescents.

SOURCE: Washington State Department of Health and National Association of School Nurses

Essentials for Childhood

All children need healthy and supportive relationships and environments to help them learn and grow.

These relationships and environments are essential for lifelong health and success. When children experience trauma, violence, maltreatment, or adversity, it can cause toxic stress that can have a lifelong impact on their learning ability, brain development and health.

Fortunately, there are ways to enhance the natural strengths and resilience of children, families, and communities to prevent trauma and limit its impact. System-wide changes can create a healthy context for parents and caregivers, promote relationship health, and foster the development of positive, healthy outcomes for all children.

Essentials for Childhood Framework

Safe, stable, and nurturing relationships and environments are essential to prevent child maltreatment and to assure children reach their full potential. The Essentials for Childhood Framework[PDF 5.5MB] proposes evidence-based strategies communities can consider to promote relationships and environments that help children grow up to be healthy and productive citizens so that they, in turn, can build stronger and safer families and communities for their children.



The Essentials for Childhood Framework is intended for communities committed to the positive development of children and families, and specifically to the prevention of child abuse and neglect. While child maltreatment is a significant public health problem, it is also a preventable one. The steps suggested in the Essentials for Childhood Framework — along with your commitment to preventing child maltreatment—can help create neighborhoods, communities, and a world in which every child can thrive.

State Level Implementation of the Framework

The Centers for Disease Control and Prevention’s (CDC) Division of Violence Prevention is funding five state health departments in California, Colorado, Massachusetts, North Carolina, and Washington to implement the five strategies in Essentials for Childhood Framework. Specifically, state health departments will

  • Coordinate and manage existing and new partnerships with other child maltreatment prevention organizations and non-traditional partners;
  • Work with partners to identify strategies across sectors;
  • Identify, coordinate, monitor and report on the strategies implemented by multi-sector partners;
  • Coordinate improvement processes (e.g., continuous quality improvement) for multi-sector partners to refine strategies; and
  • Document state-level impact of these efforts.

Who is Involved
A wide variety of partners are working to carry out the EfC vision. These include a Steering Committee, staff at the Departments of Health and Early Learning, four workgroups, and partners across the state. This work is funded by the Centers for Disease Control and Prevention, private funders, and partners.

Stay Involved in EfC
The success of EfC depends on the collaboration of partners, communities, families, and individuals. If you are interested in receiving updates and learning how you can be more involved, email essentials4[email protected].

Source: Washington State Department of Health and the Centers for Disease Control and Prevention

School Nursing is a Professional Specialization

School Nurses are often the only health professional in a school building. There are no doctors down the hall to help in an emergency. There are often no other nurses in the building with whom to confer.

There is no one else on the education team who can interpret the impact of health conditions on learning except the School Nurse. In this setting, with the broad diversity of children and their medical needs, it is critically important that School Nurses be adequately prepared.

The additional education enables the School Nurse to evaluate the impact of health conditions upon the student’s ability to learn. The certification program for School Nurses provides professional training in the management of school age populations:

A baccalaureate degree in nursing (BSN) is a minimum requirement for becoming a Certified School Nurse. (Not all RNs hold baccalaureates; some RNs hold associate degrees or go through nondegree programs.) Washington State School Nurses also hold Educational Staff Associate certification.

In order to become a Certified School Nurse, the nurse must have training in:

  • child development
  • child abuse
  • educational psychology
  • school organization
  • working with special education students and English language learners
  • writing 504 plans and participating in the IEP process
  • advocating for students with special needs to access their education while attracting as little attention as possible to that student
  • managing school age populations
  • application of the distinct law governing students’ privacy rights in schools, the Family Educational Rights and Privacy Act (FERPA)
  • the Individuals with Disabilities Act (IDEA)
  • the Washington State Public School Code.

School Nurse candidates must complete a practicum in a School Nurse’s office, much as teachers must complete student teaching and doctors complete residencies.

School Nurse Certification provides for standardization of care among Washington’s school districts. Certification ensures that your child’s School Nurse is prepared to work with the school age population. If your child becomes sick at school, or is medically fragile, would you not desperately want your child’s School Nurse to be adequately prepared?

Source: PSEA

School nurses manage medically fragile children…

See testimony to the Washington State House Education Committee by Lori Miller, Mount Vernon School District, on the importance of school nurses in managing medically fragile children.

Strengthening Educational Outcomes

The Office of the Superintendent of Public Instruction (OSPI) just released a technical report on reducing distruptive behaviors.

Legislation required OSPI to work with a panel of experts to identify and develop a menu of best practices and strategies for reducing disruptive behavior.

The table below shows a quick summary of the practices that are proven to be effective in strengthening student educational outcomes, as determined by the expert panel.


See the full report for more detail on each practice.

Not all behavior intervention strategies work all of the time with all students. The expert panel, in their deliberations, strongly voiced the importance of ensuring that each of the intervention strategies and best practices described in the menu be designed to meet the diverse needs of students and be implemented with fidelity.

Educators must engage in a process of observation, analysis, action, and reflection in their classrooms regardless of the interventions chosen. This approach helps solve problems as they arise, and can ensure that the interventions chosen by the teacher or district have a greater chance of succeeding. 

Source: OSPI, July 2015