Nurse

HEALTH POLICIES

A nurse is in attendance at each school for the majority of the school day. If you have any questions concerning the following, please call the High School Nurse, Nancy Thorsen,RN at 781-275-1700 ext. 1113.

Massachusetts's law requires that all children have a physical examination and be fully immunized against childhood diseases before entering Bedford's school system. A physical is required upon entering grade 9 and transferring into the school system. It is desirable that your family physician performs the physical exam because he or she has a comprehensive knowledge of the health status of your child. The "Physician's Examination" form (found on the high school web site) or a similar doctor's form must be submitted to the nurse prior to school entrance. The physical form is very important and is included in your child's School Health Record. The immunization information included on the physical exam report is used to assure that your child is up-to-date and in compliance with Department of Public Health regulations.

ILLNESS

It is important for parents/guardians to fill out the Emergency Sheet for the nurse, which is sent home during the summer. A copy of the Emergency Sheet can be found on this web site. The completion of the form is critical in delivering appropriate and efficient care to your child.

A child will be sent home if he or she has a temperature of 100.4F or above.

When your child has a fever of 100.4 F or above, please keep the child home for 24 hours. If your child is diagnosed with strep throat , please keep your child home until the child has had 24 hours of antibiotics. If a child becomes ill or injured at school, parents will be contacted. Students are not sent home unless a parent is contacted. If your child calls you from their cell phone during the school day and wants to be dismissed because your child is ill, he/she must come to the nurse's office before they are dismissed. The nurse will not dismiss a student without evaluating the student.

COMMUNICABLE DISEASES

Communicable diseases that should be reported to the Health Office are:

• Fifth's Disease
• German Measles – exclude until rash disappears
• Hepatitis
• Impetigo – a child with questionable lesions should be referred to a physician
• Infectious Mononucleosis – refer to a physician
• Measles – exclude for 5 days from appearance of rash and afebrile for 48 hours
• Meningitis
• Mumps – exclude until one week after initial swelling or 24 hours after the swelling subsides
• Pertussis
• Ring Worm – refer suspicious lesions to a physician
• Scabies – exclude until a physician sees student
• Streptococcal Infection/Scarlet Fever – exclude until 24 hours after initiation of antibiotic therapy

MEDICATION POLICY

1. Administration of medications during school hours has to be verified by the school nurse to be absolutely necessary. The nurse will verify this information through communication with the parent and/or family physician.
2. All medications should be brought to the Health Office and will be administered by the school nurse. Self-administration of medication may be permitted if directed by the licensed prescriber and with parent/guardian consent, provided the school nurse determines it is safe and appropriate.
3. A signed and dated request form from the parent/guardian authorizes the school nurse to give medications in the dosage prescribed by the physician.
4. For short term prescription medications, i.e., those requiring administration for ten school days or fewer, the pharmacy labeled container may be used in lieu of a licensed prescriber's order. If the nurse has a question, she may request a licensed prescriber's order.
5. Medication provided to the school must be in a pharmaceutical container specifying the patient's name in full, the name of the medication, the dosage and frequency, the physician's name and the name of the dispensing pharmacy.
6. For long term prescription medications (more than ten school days) a signed statement by the child's physician authorizing the administration of the medication by the nurse. The medication form must clearly state the student's name, the name of the medication, the dosage, time of administration route of administration possible side effects, when the administration of medication is to begin, estimated duration of administration, name, signature and phone number of licensed prescriber and diagnosis.
7. All medications shall be kept secured and locked.
8. Acetaminophen may be given if it is determined that there is no known allergy to the medication and the student is taking no other medications which may contradict the administration of acetaminophen: Parental/guardian permission is on file in the health office; after each acetaminophen is administered, the following information will be recorded in the Log Book and student health record, time and date of administration, dosage and the reason for administration.
9. The use of emergency medication, e.g., epipen, shall be according to the School Physician.

• Each school Health Office will keep a daily record of medications that have been administered. Routinely, the nurse will check with the student and parents for an interval history relating to continued administration of a medication.
• Medication orders must be renewed annually. No more than a 30 day supply of medication should be kept at school. A parent/guardian may retrieve the medication from school at any time. Medication will be destroyed within one week of termination of order or one week beyond the close of school.

SCREENINGS

The Massachusetts Department of Public Health requires all public school systems in the Commonwealth to provide postural screening to all students in grades 5-9. These grades cover the years in which adolescents experience most rapid growth, and in which signs of curvature most often appear. If minor postural concerns are found, the student will be re-checked by the nurse practitioner every six months or as needed to detect changes. You will be notified to contact your physician if further evaluation is necessary.

Vision and Hearing Screening is conducted annually in grades K- 5.

Vision and hearing screenings are mandated by the state of Massachusetts to be done in one grade in middle school and one grade in high school. At JGMS, vision and hearing will done in the 7th grade beginning in the fall of 2012. At the high school, vision and hearing is done in the 10th grade. Parents will be notified of any deviations from normal that should be checked by a physician.

Updates to Annual Height and Weight Screening

Massachusetts schools have taken heights and weights of students each year since the 1950's. The Massachusetts Department of Public Health has made amendments to improve the annual height and weight screening protocols to include the calculation of a Body Mass Index (BMI) and percentile for grades 1,4,7, and 10, beginning in the fall of 2010.

Each child's height and weight will be used to calculate their BMI. The results will be kept confidential in each student's school health record and will be mailed directly or directly communicated in writing to the parents or guardians; not sent home with the student.

BMI is a "weight for height for age" index that can be a useful tool in early identification of possible health risk factors among children and youth. Please feel free to contact your school nurse with any questions you may have about the BMI screening. Additional information about children's wellness and fitness is available upon request or you may access the state's resources at www.mass.gov/massinmotion.

SPORTS PHYSICALS

Every student, who participates in interscholastic sports, including try-outs, is required by the Massachusetts Interscholastic Athletic Association (MIAA) to have a physical exam. Effective this fall, the MIAA states that all students must pass a physical exam within 13 months of the start of each sports season. Students must meet this criteria at the start of the season will remain eligible for that season. The best time to have the physical exam is between JUNE 15 th AND AUGUST 15 th to be valid for the entire school year. For your child's safety, form#1 and the medical questionnaire (Form #2) must be completed yearly prior to participating in a sport. The waiver form must be completed by parents for every sport each season. Forms #1, #2 and the waiver form are to be returned to the coach. You can obtain the forms on the high school web site, at the athletic director's office or student office. We strongly encourage you to have your family physician perform the sports physical. Please make sure the physical form specifies approval for sports activity.