Wednesday, October 13, 2021

School Nurse Boo Boo Crew


Trick or Treat?

+ this post mainly contains affiliate links - have fun looking & exploring +
- there is a free school nurse BOO BOO CREW printable too -

Helpful School Nurse Tip: I prefer treats, but I'm not opposed to a few friendly tricks too. How about you? Does your school do anything special for Halloween? If so, do you participate? Here are a few simple ideas and ways you can get involved at your school.

Four Ways For The School Nurse To Get Involved This October....


Wearing school appropriate attire is probably one of the easiest ways to get involved and the students really like it too. Consider wearing a fun headband, t-shirt, leggings, and/or socks. If you are feeling daring then you can go all out with a full costume. Not sure what to do?  Here are a few school nurse options I found for you on Amazon:



In my experience, students of all ages enjoy a festive clinic. Some schools allow Halloween office decor while other schools allow seasonal office decor. Either way, here are a few options I found for you on Oriental Trading:

FREE 5x7 Printable! right click, save, share / print


Does your school provide a fun Trunk or Treat parking lot event? If so, consider decorating your car or van. There are so many Trunk or Treat DIY decorating options available and here are a few fun ones I found on Oriental Trading:


Instead of candy, consider some fun non food items. There are many alternative options available on Oriental Trading!


Friday, October 1, 2021

IEP : Health Domain

Completing an IEP Health Domain

+ this post contains affiliate links +

Helpful School Nurse Tip: Being involved in the special education / special services process can seem overwhelming and confusing for many school nurses. Having a better understanding of the process and the role of the school nurse throughout the process will give you confidence to complete each of your areas.  Let's start with the health domain.

What is a Health Domain?

To understand what a health domain is, you must have an understanding of the special education Individualized Education Program (IEP) process.  First, an IEP is a formal document that describes a specific education plan with goals and intended outcomes for a specific student. Before the specific goals and outcomes are written or any assessment or evaluation can start, a review of the "domains" must take place. 

Special Education Domain Meeting

A  domain meeting is an official special education meeting where each member of the special education team reviews the findings specific to their domain. Depending on the findings, the school nurse or other member, may request "additional evaluations" needed. 

There are eight domain sections: 

  1. Academic Achievement
  2. Functional Performance
  3. Cognitive Function
  4. Communication Status
  5. Health
  6. Vision and Hearing
  7. Motor Ability
  8. Social/Emotional Conditions 

Typically, additional evaluations and assessments are needed to determine if an identified concern might negatively impact the student's educational learning process. Parents need to consent and team members need time to gather more information. The follow up information would then be presented at another meeting (Eligibility Determination Meeting) scheduled in the future. 


Who can Complete a Health Domain?

There are different guidelines depending on the state you live in. For example, in Illinois, a School Nurse holding a Professional Education License (PEL) should be the one to complete all Individualized Education Program (IEP) paperwork, including health domains. 

However, if school districts do not have a PEL School Nurse, they may hire a Registered Nurse who takes & successfully passes a six week RN with IEP designation course through the Illinois State Board of Education (ISBE) to complete the IEP paperwork. Do you know the requirements in your state?


How & Why is a Health Domain completed?

Most school nurses complete health domains by performing a school health chart review.  Think of this as your information gathering phase.  During this review, school nurses are looking for any current or previous health diagnoses, medication treatments, health concerns, school health action plans, Individual Healthcare Plans, etc. School Nurses are using this time to gather a health history in order to present at the upcoming Domain Meeting. They will also determine whether or not additional information is needed by gathering more specific and detailed information in the future.

How The School Nurse Completes Health Domains

  1. Print my calendar invitation to attend the meeting
  2. Pull the school health chart for the student listed on the calendar invitation. I keep the invitation upright so I can see the date of the meeting and know that is my deadline to complete the domain paperwork by
  3. Print this Health Domain Document- I'm old school & like to complete with paper and pen, but you could easily complete this electronically and just "make a copy" for each new meeting, ditch the lines & just type the information
  4. Fill in the information listed on the Health Domain Document by completing a school health chart review
  5. Enter my findings into my school district's web based special education system
  6. Print a copy of the electronic report and file that along with my paper Health Domain Document into the student's school health chart


Teachers Pay Teachers Resources

Original IHP form-
Updated IHP form-
FREE IEP Google Tracking Sheet -

free resources

Students with Disabilities Receiving Special Services-
IDHS IEP Overview-
Six Tips for Successful IEP Meetings-
School Nurse / Special Education & Reference Books-

Sunday, September 19, 2021

School Nurse Promotion

Healthy Children Learn Better,

School Nurses Make It Happen!

~ this post contains affiliate links ~

Helpful School Nurse Tip: Nurses have been working in schools for over a century! And although there have been many changes since then, the goal remains the same. The goal is to keep children in school through health promotion, education, and disease prevention. Remember- Students must be healthy to be educated and educated to be healthy. 

What is school nursing?

School nursing as defined by the National Association of School Nurses (NASN) is “a specialized practice of nursing, protects and promotes student health, facilitates optimal development, and advances academic success. School nurses, grounded in ethical and evidence-based practice, are the leaders who bridge health care and education, provide care coordination, advocate for quality student-centered care, and collaborate to design systems that allow individuals and communities to develop their full potential.” (Adopted by the NASN Board of Directors February 2017) The vision is that “all students are healthy, safe, and ready to learn” and their mission is to “optimize student health and learning”. It is a big undertaking, but with adequate staff and a team collaboration it is possible. Keeping this definition, mission, and vision it is clear to see why school nurses are needed in schools!

Why are school nurses needed?

Healthy Children Learn Better, School Nurses Make It Happen

Most school nurses have heard the above phrase before and I'm not 100% certain who said it first, so it is difficult to give credit. However, it seems true, right? Healthy children learn better and school nurses make it happen. I bet you're not surprised that over 98% of US children attend school (National Center for Education Statistics, 2019). However, you might be surprised to know that 40% of those children have been diagnosed with a chronic health condition (CDC, 2019).  Having a school nurse on campus can help those children attend school safely while remaining in the least restrictive school environment.

Compilation of Some Common Physician Verified Student Health Diagnoses

This chart is just a partial list- Add diagnoses you have dealt with in the school setting in the comment section below. The severity of each health condition is specific to each child. So, the responsibilities and duties of school nurses changes from one semester to the next and one school year to another school year. Regardless, school nurses must be prepared to care for students with mild health conditions to severe, life threatening health conditions (not to mention health emergencies in the school setting too).

Attention Deficit Disorder




Bleeding Disorders

Brain Defects

Celiac Disease

Cerebral Palsy with Partial Limb Paralysis

Diabetes- Type 1

Gastrointestinal Issues

Gilbert’s Syndrome

Hurler Syndrome


Autoimmune Hepatitis


Heart Conditions

Rheumatoid Arthritis

Ehlers-Danlos Syndrome


Seizure Disorders

Vision Impairments-

partial and total blindness

How many nurses are employed by your school district?

How many students are at your school?  How many schools do you cover? 

These are very common questions among school nurses and the answers seem to vary greatly! Using the recommended ratio provided by NASN- is your school overstaffed, understaffed, or perfectly staffed?  Please use the comment section to leave your answer and let us know if you're surprised by your answer?  If you feel as though your school and/or school district is understaffed then come up with a plan of action on how you can promote school nursing positions and advocate for more nursing staff within the schools of your school district.  Keep in mind that the number of nurses needed could change from school year to school year depending on the required health needs of your students.

Having a full-time nurse in every school building is a recommendation by the National Association of School Nurses AND the American Academy of Pediatrics (link in the resource section below). School nurses are capable of caring for student health needs while at school. In addition, (when time allows) school nurses can: 
  • Become certified to screen vision and hearing 
  • Conduct drug testing for your high school athletic department
  • Teach coaches & other staff/students basic first aid and CPR skills
  • Support the monthly AED checks
  • Provide health education lessons and demonstrations in classrooms
  • Complete health reviews as part of the Special Education IEP team
  • Collaborate with community professionals to host school wide immunization clinics, physical exams, and dental exams and restorative dental treatment

Benefits of Hiring a Full Time School Nurse

There are countless benefits to hiring a school nurse for every school. Let's list 5 here that were pointed out by the CDC in their School Nurses Help Keep Students Healthy article:
  1. School Nurses can actually save a school district money!
  2. School Nurses may be the first health provider to identify a chronic health condition in a student.
  3. School Nurses can help students manage their chronic health conditions.
  4. School Nurses help protect the health and safety of both students and staff.
  5. School Nurses play an important role during public health crises.
Some people might find it hard to believe that hiring a school nurse could actually save their community money, but it's true. Wang et al (2014) utilized standard cost-benefit analysis methods to estimate the costs and benefits of an essential health services program compared with a scenario involving no school nursing services. They found for every dollar invested in full-time registered nurses, there was a gain of $2.20 for the society. This gain occurred because school nurses and the services they are able to provide offer a "benefit to schools, families, the health care system, and the community at large through increased student attendance, improved teacher and worker productivity, and reduced health care costs." Wang et al (2014)

PS- As you can see, the Wang et al study was completed in 2014- it would be very interested for someone to replicate this study for 2022 and compare the results! Who is looking for a research project?

PSS- Not touched on in this post is Medicaid Reimbursement for schools when nurses perform medication administration and other required and/or prescribed nursing services for students with IEPs who qualify for billing and reimbursement. I will save that detailed topic for it's very own blog post!


School Nurse Resources

CDC, 2020
CDC Healthy Schools, 2021
Illinois State Board of Education, 2014
NASN, 2015
National Center for Education Statistics, 2019
Wang et al (2014)


The School Nurse