Presentation Skills Presentation Skills for School Nursesfor School Nurses

Let People Know what you do!Let People Know what you do!

Kathleen A. Hassey BA RN BSN MEdKathleen A. Hassey BA RN BSN MEdDirector of the School Health InstituteDirector of the School Health Institute

Northeastern UniversityNortheastern UniversityJune 2006June 2006

Why do we need to Present?Why do we need to Present? To let administrators, faculty, parents, To let administrators, faculty, parents,

community and legislators know community and legislators know exactly what we do for school children.exactly what we do for school children.

To increase awareness of medical To increase awareness of medical acuity within the educational system.acuity within the educational system.

To justify staffing patterns.To justify staffing patterns.

To increase funding to Health Services To increase funding to Health Services in your district and across the state.in your district and across the state.

How do we begin?How do we begin?

Decide what group you need to Decide what group you need to educate.educate.

– Parents: Services available or support neededParents: Services available or support needed

– Administrators: Staffing needs and office dataAdministrators: Staffing needs and office data

– Educators: Impact of health on academicsEducators: Impact of health on academics

– Community: Inform about available programs Community: Inform about available programs and keep school health on the radar.and keep school health on the radar.

– Legislators: Need for funding for programsLegislators: Need for funding for programs

How to decide on a TopicHow to decide on a Topic

What is a “pressing” issue for you or What is a “pressing” issue for you or your school/district.your school/district.

– Policy (Policy (Is there a policy ex Dealing with Life threatening Is there a policy ex Dealing with Life threatening

allergies neededallergies needed)) Laws that may apply to equal education for childrenLaws that may apply to equal education for children Medical information regarding LTA (you ARE the Expert)Medical information regarding LTA (you ARE the Expert) How it will benefit children by keeping them in class.How it will benefit children by keeping them in class.

– Staffing (Staffing (one nurse or more needed for each schoolone nurse or more needed for each school)) Office visits Office visits

List of medical/chronic conditionsList of medical/chronic conditions Number and types of medications administeredNumber and types of medications administered Total mandated screeningsTotal mandated screenings

How do you get YOURSELF Ready?How do you get YOURSELF Ready?

BE PREPARED….BE PREPARED….have your data and your points to make have your data and your points to make succinct.succinct.

DON’T OVERWHELM… DON’T OVERWHELM… sometimes less is more…sometimes less is more… short, short, informational presentations allow them to ask questions.informational presentations allow them to ask questions.

DON’T USE ALLL MEDICAL LANGUAGE… DON’T USE ALLL MEDICAL LANGUAGE… take into take into consideration the “group” you are speaking to. Give them consideration the “group” you are speaking to. Give them what they NEED to know.what they NEED to know.

SPEAK SLOWLY… SPEAK SLOWLY… Pause when you are trying to make a Pause when you are trying to make a point.point.

ALWAYS INCLUDE EDUCATIONAL OUTCOMES… ALWAYS INCLUDE EDUCATIONAL OUTCOMES… make sure that the group can understand the value of the make sure that the group can understand the value of the issue in relationship to educational outcomes (ex decrease issue in relationship to educational outcomes (ex decrease in dismissal rate, decreased absentee rates for in dismissal rate, decreased absentee rates for asthmatics).asthmatics).

PRACTICE>>>PRACTICE>>>PRACTICE PRACTICE>>>PRACTICE>>>PRACTICE

Impress with Power Point!Impress with Power Point! Decide what you want to get across, have Decide what you want to get across, have

your data available, and OPEN the Power your data available, and OPEN the Power Point.Point.

You can play with the Power Point You can play with the Power Point program…it’s all there for you!program…it’s all there for you!

You can use… You can use…

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Waltham Public SchoolsHealth 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

253 328 344 421

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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 ProgramMelanoma Prevention ProgramHudson High SchoolHudson High School

Kathy Hassey BA RN BSN MEdKathy Hassey BA RN BSN MEdDirector of Health ServicesDirector of Health Services

20052005

Tanning Bed Controversy:Tanning Bed Controversy:Are They Safe?Are They Safe?

No, tanning beds are not safe and No, tanning beds are not safe and are actually more dangerous than are actually more dangerous than direct sun exposure.direct sun exposure.

UVB rays effect the skin layer and UVB rays effect the skin layer and cause sunburns (sun exposure)cause sunburns (sun exposure)

UVA rays penetrate to a deeper UVA rays penetrate to a deeper layer of skin and directly hit the layer of skin and directly hit the melanocytes (cells that produce melanocytes (cells that produce melanin).melanin).

UVA rays are 10-13 times greater UVA rays are 10-13 times greater than direct sun.than direct sun.

Using a tanning bed more than 10 Using a tanning bed more than 10 times a year increases the risk of times a year increases the risk of melanoma 7.7 times.melanoma 7.7 times.

SPF (sun protection factor in SPF (sun protection factor in sunscreen) only deals with UVB sunscreen) only deals with UVB rays and does nothing for UVA rays and does nothing for UVA (tanning beds).(tanning beds).

Mental Health Issues:

A School Nursing Perspective

Kathleen A. Hassey BA BSN MEdDirector of the School Health Institute, Northeastern

Universityk.hassey@neu.edu

781-238-8476March 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 Health Impact on EducationEducation2004-20052004-2005

Health Services DepartmentHealth Services DepartmentHudson Public SchoolsHudson Public Schools

August 2005August 2005

Children with Special Health Children with Special Health Care NeedsCare Needs

Special Health Care needs are defined as those that require health and Special Health Care needs are defined as those that require health and related services of a type or amount beyond those required by children related services of a type or amount beyond those required by children

generally. In Hudson Public Schools, we now havegenerally. In Hudson Public Schools, we now have

859 Special Health Care Needs students 859 Special Health Care Needs students (368 ongoing Health Care Plans)(368 ongoing Health Care Plans)

Life threatening allergiesLife threatening allergies ArthritisArthritis AsthmaAsthma Blood dyscrasiasBlood dyscrasias CancerCancer Cardiac conditionsCardiac conditions DiabetesDiabetes ADHDADHD Depression Depression Migraine headachesMigraine headaches Neurological conditionsNeurological conditions Eating disordersEating disorders Mental Health/Emotional issuesMental Health/Emotional issues

Health Office VolumeHealth Office VolumeMondayMonday TuesdayTuesday WednesdayWednesday ThursdayThursday FridayFriday

HubertHubert 15%15% 23%23% 8%8% 27%27% 27%27%

FarleyFarley 19%19% 20.5%20.5% 19%19% 21%21% 19.5%19.5%

ForestForest

Ave.Ave.21.4%21.4% 25.5%25.5% 17%17% 20%20% 16.5%16.5%

MulreadyMulready 18%18% 23%23% 24%24% 17%17% 18%18%

JFKJFK 23%23% 22%22% 17%17% 18%18% 16%16%

HHSHHS 23%23% 23%23% 16%16% 17%17% 19%19%

District Student Office Visit District Student Office Visit FrequencyFrequency

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526

409

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Number of Number of Children on Daily Children on Daily medications medications

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There was a total of There was a total of 43,11343,113 Health Health Office visits includingOffice visits including

– Office visits, mandated screenings Office visits, mandated screenings (vision, hearing, scoliosis), and (vision, hearing, scoliosis), and medication administrations.medication administrations.

– Staff visits totaled Staff visits totaled 1,707.1,707.

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, NCSNNurse 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 2005-2006 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 Alert @ 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 Get out there and educate the Community, Faculty, the Community, Faculty,

Administrators, Parents and Administrators, Parents and your School Committeeyour School Committee..

Thank you for your time…any Thank you for your time…any questions?questions?