School Health Services are established at the school site, to promote the health of student – through disease prevention, early case finding, referral for intervention, and remediation of specific health problems. The school health services are vitally necessary, in order to provide first aid and triage for illness and injuries, to provide direct services for students with special needs, and to provide health counseling and education for students, staff, and parents. School nurses are available to enable the achievement of this goal.
These health services are not intended to supersede the parents’ health care responsibilities, or to supplant the role of the physician. Optimally, the services are a continuum of care, from the family to the community health care system.
Chronic Health Conditions
Chronic health conditions are defined as “any physical or mental conditions that require long-term (more than 6 months) monitoring and/or management to control symptoms and to shape the course of the disease” (Corbin, 2001, p.1). If you have a student who is in need of special interventions at school relative to diabetes, asthma, seizures, ADHD, or other chronic diseases, please contact your school nurse.
Communicable Diseases and Infections
Students are expected to be in compliance with the required immunization schedule that is put forth by the State of Nebraska to avoid many of the communicable diseases. Children who are obviously ill or who are known to have a communicable disease shall not attend class during the course of the illness. Any student with a temperature of 100° or higher will be excluded from school. That student should not return for 24 hours after they are fever free without the aid of medication. Following are some of the common communicable/infectious diseases for which students could be excluded from school, depending on medical recommendation:
One of the primary roles of the school nurse is to prevent disease from occurring through the monitoring of immunizations, promoting good hand hygiene, and enforcement of environmental controls for blood borne pathogens. Lexington Public Schools work in cooperation with the local medical community and Two Rivers Public Health Department for the prevention and containment of communicable disease in our schools.
Common Communicable Diseases
The Nebraska State School Law, in part, requires that each student have a physical examination and a vision examination within six months prior to entrance into school, or upon transfer into the school district from a district outside of the state. A physical exam is also required for seventh grade, without the vision exam requirement. The vision exam form is included on the physical exam form, and may be completed by a health care provider or an optometrist.
A complete dental check-up is strongly encouraged at this time also.
If you do not wish to provide evidence of a physical exam and/or a vision exam, a signed statement waiving this requirement must be submitted to the school.
Please note, if your child will be participating in competitive athletics, a physical examination by a licensed health provider is required and signing a waiver does not satisfy this requirement. This exam must be done after May 1st of each year, to carry through the following sports year.
Sports physical cards can be obtained from the High School and Middle School.
In Nebraska, children can’t attend classes in public or private school until the school has written proof of their immunization status (Neb. Rev. Stat. §§ 79-217 through 79-253).
To attend school, children in Nebraska are required to be immunized against the following diseases:
- Diphtheria, tetanus, and pertussis
- Measles, mumps, and rubella
- Hepatitis B
- Varicella (chicken pox)
Each school in Nebraska is required to keep the immunization history of the students enrolled on file. In addition, schools are required to report information on student’s immunization status annually to the Nebraska Immunization Program. School reporting is conducted on-line via survey, and the deadline is November 15 of each year.
Violation of these requirements is a Class V misdemeanor. Schools must report on students entering school for the first time (kindergarten or 1st grade); 7th graders; and all out-of-state transfer students (including foreign exchange students).
For complete information, please refer to Title 173 of the Nebraska Administrative Code, Chapter 3: Rules and Regulations Relating to School Health, Communicable Disease Control, and Physical Examination and Immunization Standards. Title 173 is available on the Internet.
While there are exemptions to the immunization requirements, parents need to be aware that unvaccinated children are not the only ones at risk for contracting disease. When parents choose not to immunize, their decision affects every other child in the school as well as their own child. Many immunizations require multiple doses before a child builds up full immunity, and some children are not able to be vaccinated. These vulnerable children depend upon “herd immunity” for protection.
What if You Don't Immunize Your Child?
Exemptions to the vaccination requirement include:
- A statement signed by a physician that the required immunization would be injurious to the student or members of the student’s family or household.
- An affidavit signed by a legally authorized representative stating that the immunization conflicts with the tenets and practices of a recognized religious denomination of which the student is a member.
Students with exemptions on file may need to be excluded from school if there is an outbreak of a vaccine-preventable disease.
A medical emergency is a situation that arises suddenly and threatens life or welfare of one or more persons. Protocols have been established to address these emergencies. Emergency Medical Services (911) are capable of responding within a few minutes to any of the school sites.
Mediations are provided at Lexington Public Schools, in accordance with the Medication Aide Act. The administration of medication at Lexington Public Schools is considered to be the responsibility of the professional school nurse, and can be delegated to an unlicensed person, if the Registered School Nurse deems the unlicensed person competent. Medications are to be provided to students at school only after written consent, from the parent or guardian, has been received in the school health office.
Medications are to be made available to the school, in the pharmacy or manufacturer’s packaging, with intact labeling. All medications are to be kept in the school health office, unless the school nurse approves alternate arrangements, and /or the procedure for self-carry of medications is in place for the student. Outdated medication products will not be accepted. Medications will not be administered during school hours, unless necessary for promoting a child’s learning experience, first aid or emergency purposes, or management of a medical condition. Parents/guardians should be encouraged to give medications that are not for these purposes, at home. The school nurse is responsible for observation and monitoring functions, conducts the competency training and assessment activities, and provides ongoing supervision of all personnel providing medications to students.
Students with asthma, anaphylaxis or diabetes will be permitted to self-administer their own medication with the development of a medical care plan and written authorization of parent/guardian, physician, nurse and student.
Students at the Lexington Public Schools are screened yearly according to the Nebraska State Regulations. This screening could include vision, hearing, height, weight, dental or scoliosis. Students are required by law, to participate in these screenings, unless they provide the school with a signed statement by a physician, PA or an APRN, stating that such child has undergone the required inspection within the past six months. If problems are detected during these screenings the school nurse will notify the parent/guardian with written notice or phone contact. The parent/guardian are requested to take the student to the physician, dentist or optometrist for further evaluation.