Concussions and The School Nurse

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Hopefully Helpful School Nurse Tip: Each year thousands of student athletes are diagnosed with a concussion. These blog posts were written to help the school nurse help those students.

What is a concussion?

It won't take long before a student enters your school nurse office and notifies you they have been diagnosed with a concussion. It is important that your student understands what this diagnosis means and as a school nurse you have the opportunity to educate your student. A textbook definition from the Centers for Disease Control and Prevention is:

"A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells." (CDC, 2021)

However, that is a very technical and medical definition- will your student understand what that actual means? It is OK to give an actual medical definition, but then follow it up with easy to use words and terms that your student will understand. This will depend on the grade level, age, and compression level of your student.

What are common symptoms of a concussion?

Although school nurses are not allowed to diagnose a concussion, they should be able to recognize and refer for signs and symptoms of a potential concussion caused by a recent head injury. As a school nurse you'll want to know your school district's protocol when dealing with a student who has suffered a head injury at school or comes to school with a concussion diagnosis. Do you know what signs and symptoms to look for? For a review of signs and symptoms related to a concussion read this CDC article titled Concussion Signs and Symptoms.

Are concussions serious?

Although concussions might not be life threatening, the side effects can be serious. Many students recovery within a few weeks, but others might need a few months or even longer to make a complete recovery!

What classroom accommodations can be made to support a student with a concussion?

There are many appropriate and suggested classroom accommodations that can be made when a student is diagnosed with a concussion. Sometimes the physician or athletic trainer might even provide you or the classroom teachers with accommodations when they provide the diagnosis. Other times the school nurse will only receive the written diagnosis. When this happens, what are you accepted to do? Is the school nurse supposed to notify the student's classroom teacher/s or the student's school counselor? Each school or school district should have a written concussion protocol to follow in this situation.

A brief concussion protocol example might be something like this:

School Nurse receives documentation that student has been diagnosed with a concussion
School Nurse notifies classroom teachers and school counselor that the "concussion protocol" has been started
School Nurse asks for or receives updates from students, parents, classroom teachers, and/or school counselor as needed
School Nurse might need to inform athletic trainer or physician of received updates
School Nurse receives documentation the Return To Learn is complete
School Nurse notifies classroom teachers and school counselor that the "return to learn" has been completed
School Nurse asks for or receives updates from students, parents, classroom teachers, and/or school counselor as needed
School Nurse might need to inform athletic trainer or physician of received updates
School Nurse receives documentation the Return To Play is complete
School Nurse notifies classroom teachers and school counselor that the "return to play" has been completed
School Nurse asks for or receives updates from students, parents, classroom teachers, and/or school counselor as needed
School Nurse might need to inform athletic trainer or physician of received updates

The above are only brief suggestions ... as a school nurse you'll want to check on your school district's specific policies and procedures regarding concussion. If your district doesn't have one, then you might want to work on creating one to use at your school when needed.

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NEED HELP CREATING A CONCUSSION PROTOCOL / POLICY / PROCEDURE?

These Google Slides are Available For Purchase and 100% Editable

THREE CONCUSSION PROTOCOL / CLASSROOM SUGGESTION SLIDES

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3 fully editable slides for the following concussion situations:

Concussion Protocol Starting
Return To Learn
Return To Play

Edit to make each slide specific to your school / students
Save as PNG or JPG in order to insert into the body of an email

School Nurse Concussion Resources:

CDC HEADS UP to schools

CDC HEADS UP to schools for School Nurses

Trends in Emergency Department Visits for Contact Sports–Related Traumatic Brain Injuries Among Children — United States, 2001–2018
Weekly / July 10, 2020 / 69(27);870–874

Digital Health History Form for Students

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Digital Health History Form for Students

Keeping student health information up to date is an important part of school nursing practice. Knowing your students' current health conditions can help you plan for their needs, identify students who may need an Individualized Healthcare Plan (IHP) or Emergency Action Plan (EAP), and provide appropriate care throughout the school day.

A digital student health history form can provide an easy and organized way for parents and guardians to share updated health information with the school nurse.

Health History Purpose

The purpose of this digital student health history form is to provide an easier, yet formal way, for the school nurse to gather (collect data) on medical conditions for current students. Although this digital form is 100% editable, it currently offers parents a way to inform the nurse of the following:

Current health concerns

Explanation of the health concern

Description of how the health concerns impacts the student's school day

Requested accommodations the might benefit the student throughout the school day

Doctor contact information

As you can see, this digital health history form provides parents a chance to subjectively provide the school nurse with an overview of their child's current health conditions. The school nurse can then ask for needed / required follow up information from the student's parents and/or physician.

How To Collect A Student Health History

Have you ever had a parent call with an important health update—or had a student casually mention something you didn't previously know?

Those conversations can provide valuable information, but having updated health information documented in writing can make follow-up much easier.

A digital health history form can be shared with families at the beginning of the school year, during registration, when a student enrolls, or anytime a student's health status changes.

If you're using a Google Form, remember to review your notification and response settings so you have a reliable process for knowing when new information has been submitted.

After reviewing a response, follow up with the family as needed to:

Clarify health information
Request additional medical documentation or healthcare provider orders
Discuss school accommodations or supports
Determine whether an IHP, EAP, 504 Plan, or other documentation may be appropriate
Discuss how relevant health information will be communicated to appropriate school staff

Why a Health History Is Important

Accurate student health histories are important. Knowing what to do with that information is even more important.

Digital Health Records

Many schools use electronic student information systems to maintain student records. Determine how health information should be documented within your district's system and whether health conditions can be entered, tracked, and reported.

Taking the time to maintain accurate records throughout the year can make reviewing student needs—and preparing end-of-year reports—much easier.

Health Condition Lists

Many moons ago, I created Excel spreadsheets to track student health concerns because that was the best option I had!

Thankfully, today's student information systems often make this much easier. Depending on your system, you may be able to generate reports by health condition, grade level, graduation year, teacher, or other criteria.

These reports can help you understand the health needs within your school population and provide valuable data when preparing reports for administrators, supervisors, or your school board.

Individualized Healthcare Plans

Information gathered through a health history can help identify students who may need an Individualized Healthcare Plan (IHP).

Review each student's individual needs along with your district policies, state requirements, nursing standards, and professional nursing judgment when determining appropriate health planning and documentation.

Emergency Action Plans

Students with health conditions that have the potential to become a medical emergency during the school day may require an Emergency Action Plan (EAP).

The health history can help identify students who need additional follow-up with their parent/guardian and healthcare provider to ensure appropriate emergency plans, orders, medications, and supplies are available at school.

Medication Forms

Knowing which medications a student takes can help the school nurse understand the bigger picture of the student's health.

If medication needs to be administered during school hours, follow your state requirements and district policies regarding healthcare provider orders, parent/guardian authorization, medication documentation, and administration.

Nursing Procedures

Health history information may also identify students who require nursing procedures during the school day, such as tube feedings, catheterization, suctioning, dressing changes, or other skilled nursing care.

Follow applicable state requirements, district policies, provider orders, and nursing standards when developing an appropriate plan of care for these students.

One Form Can Be the Starting Point

A student health history form doesn't replace nursing assessment or individualized follow-up. Instead, it gives the school nurse a starting point.

The information families provide can help you identify students who need additional assessment, documentation, healthcare provider orders, emergency planning, accommodations, or other school health support.

And having a consistent system for collecting that information can make the process much more manageable—especially at the beginning of a busy school year.

Looking for an easier way to collect student health information?

My editable Digital Student Health History Form can be customized for your school and shared electronically with families.