504 index - School Nurse

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504 index - Suggestions

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An NASN Tool Kit
http://www.nasn.org/ToolsResources/FoodAllergyandAnaphylaxis

http://www.nasn.org/PolicyAdvocacy/PositionPapersandReports/NASNPositionStatements

NASN new 2013 document as to Anaphylaxis

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Food Allergies & Elementary School: Tips for Parents from a Couple of Veterans!

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"Students With Food Allergies on the Rise: How Prepared Are You?"
http://www.jackstreet.com/jackstreet/WNASN.TannerSchoessler.cfm

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Tweeted by @AllergyEducator

"FOOD ALLERGY AND ANAPHYLAXIS NEWS"
August/September 2014
SEASONAL RESOURCES FOR HEALTHCARE PROFESSIONALS
By Anne F. Russell, BSN, RN, AE-C
http://www.asthmaeducators.org/food-allergy-and-anaphylaxis-news-aug-sept-2014

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MASN (Michigan Association of School Nurses)
"Anaphylaxis & Administration of Stock Epinephrine Tool Kit"
https://mischoolnurses.nursingnetwork.com/page/20671-anaphylaxis-administration-of-stock-epinephrine-tool-kit

&

http://www.allergyhome.org/michigan/


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"What every school nurse needs to know about Section 504 eligibility."
NASN Sch Nurse. 2012 Mar;27(2):88-93.
http://www.ncbi.nlm.nih.gov/pubmed/22567783

The Americans With Disabilities Amendment Act of 2008 (ADAA), effective January 1, 2009, expanded the definition ofdisability. These changes in turn impact which students qualify for Section 504 plans in the school setting and will no doubt strain school resources as implementation of the law progresses.

"History and expansion of section 504 student eligibility: implications for school nurses."
J Sch Nurs. 2009 Aug;25(4):256-60. Epub 2009 Jun 4.
Zirkel PA.

The explanation shows the evolving application of Section 504 to students in terms of three phases: awareness, constriction, and expansion. The latest phase, expansion, started with the January 1, 2009, effective date of the ADA Amendments (ADAA), which dramatically reversed the previous phase of judicial constriction of the eligibility criteria. The changes affect two of the three criteria in the definition of disability under Section 504 and the ADA: (a) an expanded list of illustrations of "major life activities" and (b) much less restrictive standards for interpreting "substantially limits."

"Use of 504 plans for children and youth with disabilities: nursing application."
Pediatr Nurs. 2001 Jul-Aug;27(4):347-52.
http://www.ncbi.nlm.nih.gov/pubmed/12025272

This article provides information about the history of 504 plans; requirements for primary, secondary, and post-secondary settings; and how nurses can be involved. Nurses can have an important role in schools and clinical settings in developing 504 plans.

School Nurse Liability Issues

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School-nurses group opposes proposal to change EpiPen rules

When the nurse refuses to admin EPI?!

the new nurse

Love our School Nurse

The SCHOOL NURSE: Role in LTFA mgmnt in school

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A lot of schools don't even have a nurse. 

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Article tweeted by @AllergyEducator

"Cost-Benefit Study of School Nursing Services"
http://archpedi.jamanetwork.com/article.aspx?articleid=1872779

Conclusions and Relevance  The results of this study demonstrated that school nursing services provided in the Massachusetts ESHS schools were a cost-beneficial investment of public money,

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"Another Philadelphia student dies at a public school with no nurse"
http://www.msnbc.com/msnbc/another-student-dies-school-no-nurse

A 7-year-old Philadelphia public school student died Wednesday after falling ill at a school where no nurse was on duty. Yet the absence of a trained healthcare practitioner was not unusual for a school district crumbling under budget cuts that have stripped vital resources from schools serving some of the city's most vulnerable children.

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"School Nurse Advocacy Success!"
http://www.allergyhome.org/blogger/school-nurse-advocacy-success/

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2013 Food Allergy Bloggers Conference - School Video

Let me start off by saying that I love our school nurse ... she's great and has been so helpful ... and I know she has worked so hard to keep my dd safe.  Also, I wish every school did have a nurse as I feel this protects the kids and can save lives.

At the same time, coming from a pure patient/caregiver perspective, I have heard of situations where school nurses were not good advocates for FA families, where they sided with school admins in denying accommodations that seemed necessary.

I guess I view the situation as being complex.  There is cooperation, but also often a kind of push & pull between the different interests of those involved:  FA parents, non-FA parents, nurses, teachers, admins, docs, etc.  The more cooperation & agreement - generally the better, but I look at it as a formal situation, kind of a negotiation.

Also, individual parent/student input is very important in addressing the specific needs of the specific child.  Guidelines/policies are very important, but "necessary & appropriate" must be tailored to the individual.

School nurses can often be our (FA families) best advocates ... but at the same time, they work at the school and that is sometimes going to be a factor.

My opinion is that there is no group in the 504 process that should be put on a pedestal & that includes food allergy parents (ex - we can go overboard asking for things that aren't necessary, we do not always approach things in the best way, etc.)

No doubt that there are so many nurses that deserve      , but not all.

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NASN new position statement

NASN has consistently ticked me off over the past ten years, and this document is a shining (glaring?) example of why.  In the one instance, they make statements of OPINION (as in the first quote above) with zero evidence to support those statements, and then later on make stinkers like this gem:

Entering school or changes in the school environment are stressful events, and many parents view these events as opportunities that increase their child's chance of exposure to allergens (Roy & Roberts, 2011).

Uhhhh... NO.  We don't "view" them that way-- they are that way.  Evidence backs that up.  Disruptions in routine and a lack of clear expectations and communication = disaster.  Period.  Several studies have said so.

Think they'd listen to us?

http://www.nasn.org/AboutNASN/ContactUs

No.  I don't.

The reason is that there is language in this statement that is (deliberately, I should think) indicative that parents are, by definition, rather 'emotionally invested' to a degree that prevents any FA parent from objectively evaluating risk.

In other words, that parents are not "experts" in management (by definition) because they are parents.  The reason that planning needs to include them is to make them FEEL more comfortable, and to make sure that the school gains their cooperation. 



Until NASN begins to understand that its members would be well-advised to LEARN about management quirks from the parents, because those parents are quite often experts in that particular child's medical management by the time schools see those children...


well, I don't think that anything that a group of parents says to them is going to get through this kind of hubris, honestly.  I hate to sound bitter, but there it is.

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Let's talk about anxiety

"VOLUNTARY GUIDELINES FOR MANAGING FOOD ALLERGIES IN SCHOOLS AND EARLY CARE AND EDUCATION PROGRAMS
WHAT THE PEDIATRICIAN NEEDS TO KNOW"

http://tinyurl.com/qeorwjs

Page 11 - Starting School with a Food Allergy

Her mother is terrified.

Sigh.  For sure, this is sometimes true ... but how about other examples of a mother who understands allergies & risk, is a partner with the doc, & is a strong advocate for her child?  Do docs understand how this "anxious mom" thing has perhaps gone too far?

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504 index - 504 Plan Basics



How much weight does letter from allergist hold in 504 planning?

Think of a good 504 plan as being a STOOL.  There are basically three legs (sometimes four) to a solid 504 plan.  By 'legs' here I mean input streams of expertise.

a) MEDICAL-- this is where your physician comes into things(and to a lesser extent, a school nurse... and yes, I DO mean 'lesser' extent, because this is about medical diagnosis and practicing within one's professional scope of expertise.  Nurses are not allergists.)  The medical stream is the one offering advice on how much exposure is "okay" or not, what kind of responose is appropriate under which conditions (ie-- for a non-specific symptom of asthma, does this child get epinephrine?  Or an inhaler?) 

b) DAILY REAL-WORLD MANAGEMENT AND RISK ASSESSMENT/RESEARCH-- this is us.  Allergists are medical experts, but they are NOT the experts at navigating the world with a particular child and keeping him/her out of anaphylaxis.  WE ARE.

c) SCHOOL OPERATIONS-- this is school staff.  They know layout, they know logistics of first-response, they know their staffers, they know the culture of the school community. 

d) (possible) Special Education needs-- can be GT/SpEd needs, but this will have to dance with the other three.

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As parents, are we seen as true partners in the 504 process?

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FA school nurse webinar

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Please don't post in this thread 

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504 index - Suggestions