What School Nurses Need to Know About Concussions

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As school nurses, we know that head injuries happen—whether it’s on the playground, during sports, or just from an accidental fall. March is Brain Injury Awareness Month, making it the perfect time to refresh our knowledge on concussion protocols, return-to-learn and return-to-play plans, and how to support teachers in accommodating students post-concussion. Let’s dive in!

Recognizing the Signs of a Concussion

A concussion is a mild traumatic brain injury (TBI) that can occur after a blow to the head or a sudden jolt. While some symptoms appear immediately, others can take hours or even days to develop.

Common Signs & Symptoms:

Physical: Headache, dizziness, nausea, sensitivity to light or noise, balance problems
Cognitive: Confusion, trouble concentrating, memory issues, slowed thinking
Emotional: Irritability, mood swings, anxiety, depression
Sleep-Related: Sleeping more or less than usual, trouble falling asleep

As school nurses, we cannot diagnose concussions, but we play a key role in recognizing symptoms and making sure students receive proper care. If a student shows any of these signs after a head injury, it’s essential to remove them from activity immediately, contact their parents, and urge medical follow-up as soon as possible. When in doubt, always refer them for further evaluation.

Best Practices for Return-to-Learn & Return-to-Play Plans

Returning to normal activities too soon can make concussion symptoms worse. That’s why gradual reintegration is key. After an official diagnoses, many doctor's or athletic trainers will provide guidelines similar to the below-

Return-to-Learn:

Start with shortened school days or reduced workload
Minimize screen time (computers, tablets, smartboards)
Provide extra breaks as needed
Allow extra time for assignments and tests
Reduce bright lights and noise exposure in the classroom

Return-to-Play:

Students should be completely symptom-free before returning to sports
Follow a stepwise approach, increasing activity levels gradually
Always get medical clearance before full participation in sports
Monitor for any return of symptoms

Educating Teachers on Concussion Recovery

Teachers play a crucial role in helping students recover, but many don’t realize how much a concussion can impact learning. As a school nurse, you can help by:

Explaining common symptoms and how they affect students in the classroom
Providing classroom accommodation tips (e.g., reducing screen time, modifying workloads, allowing movement breaks)
Encouraging open communication between teachers, parents, and medical providers

Final Thoughts

As school nurses, we’re often the first line of defense in identifying concussions and guiding students through recovery. By recognizing symptoms early, ensuring gradual reintegration into learning and sports, and educating school staff, we can help students heal safely and effectively.

Have you implemented a great concussion protocol in your school? If so, please share your experiences in the comments below!