Safe and Appropriate Health Care Service for Oregon School-Aged Children
Position:
It is the position of the Oregon School Nurses Association that all
students are entitled to a safe and healthy school environment and that
management of special health care needs must be individualized and
directed by a registered nurse knowledgeable in the practice of school
nursing.
The Issue(s):
Oregon students bring to school many health conditions, e.g.
life-threatening allergies, asthma, diabetes and seizures as well as
conditions relating to normal growth and development, e.g. illnesses and
injuries. These conditions influence their well-being, growth and
development and potential for successful learning. An increasing
number of Oregon students depend upon medical assistive devices and
procedures during the school day, e.g. suctioning, oxygen
administration, gastrostomy tube feeding, clean intermittent
catheterization, postural drainage1. Federal
legislation2, Oregon Statutes3, and other case law4
determinations obligate schools to safely provide school health service
which is required for student's access to free and appropriate
education. Without professional nursing assessment, development of
individualized care plans and evaluation treatment outcomes, students'
health needs are not safely managed. Training assistive persons,
though well-intentioned, to respond to individual disease conditions are
an inadequate surrogate for a qualified registered nurse who has the
knowledge and skills to respond to all health conditions. Without
nursing delegation and supervision, assistive persons delivering nursing
services are practicing nursing without a license.
Rationale for Position:
The Individuals with Disabilities Education Act (IDEA)2,5
and Sections 5042 of the Rehabilitation Act provide the right to
students needing health services to remain in school and to have their
health needs met to enhance optimum learning. The Supreme Court,
in the Garret F Case4 supported school's financial responsibility for
providing required nursing services. The Oregon State Board of
Nursing ruled on the obligation in the school setting to adhere to
established standards of professional nursing practice6.
The Oregon Department of Justice determined the responsibility for
delegation of nursing tasks in schools rest solely with the registered
nurse7.
THEREFORE,
it is the position of the Oregon School Nurses Association that a
registered nurse knowledgeable in school nursing is essential to the
planning and delivery of health service in schools and especially for
students with special health needs and that minimally trained,
non-medical and non-supervised personnel in schools lower the standard
of care for students with special health needs and are not a safe or
appropriate management system for Oregon's students.