Student Health Office Visits

Health office visits play a vital role in supporting the health and well-being of students, promoting a safe and nurturing school environment, and addressing the diverse healthcare needs of students within the school community.

While most health office visits are minor or routine, all school health staff must always be prepared for an emergency.  This includes readily available communication to 911 (medical emergency), 988 (mental health crisis) or MN Poison Control 1-800-222-1222.  

It is important to consider how to utilize the space in the health office to separate ill and healthy students. This helps to streamline health services and minimize wait times for both groups of students. It minimizes the spread of illness, allows for efficient triage and prioritization of care, ensuring that those with urgent medical needs receive prompt attention, and that appropriate care is provided in a safe and supportive environment. School health services should follow Infection Control and Prevention recommendations and guidelines to prevent the transmission of communicable illness in the health office, classroom, and school as appropriate.

Types of Health Office Visits

Routine Health Office Visits

Routine health office visits typically involve students visiting the school nurse or health office for various reasons related to their health and well-being. Students with chronic or complex health conditions may have “scheduled” cares provided by the school nurse and health services staff. Examples of routine health office visits may include medication administration, health assessments, screenings, and specialized care or support.  

Minor Injury Visit

School health services should develop or adopt general guidelines for first aid care, parent notification, and referral for a higher-level care, such as primary care provider, urgent care, or emergency room care.  The American Red Cross is one organization that offers general first aid training both virtual and in-person.  The “level” of first aid care provide will vary greatly pending staff role, unlicensed assistive personnel, and nurse (RN or LPN).  It is important that the health services communicate to school staff and parents about the type of care provided to students to set expectations and avoid misunderstandings which could impact student health.

Classroom First Aid

Teachers and other school staff can perform first aid in the classroom. School health services staff should collaborate and communicate with teachers and other staff about what minor injuries are appropriate to treat in the classroom. Teacher should know the appropriate steps for providing first aid and how to respond to other classroom medical emergencies.  This collaboration and communication will help the school to have a coordinated response to medical emergencies and it facilitates follow-up care for students.

Ill Student Visit

School districts should have written guidelines for when students are well enough to attend school and when they are considered ill and need to stay home. These guidelines or protocols should be posted and communicated to parents/guardians so they can be referenced when determining if a student needs to stay home or be sent home. These are typically the same guidelines that help school health services staff determine whether a student needs to be sent home and excluded from school because of illness. The CDC provides:  Fact Sheet: Help Your Child’s School Prevent the Spread of Infections. Parents/guardians should be promptly notified about their child’s illness and request to pick up from school. When a student is sent home sick, clear communication needs to be provided about timeline in which the student needs to be picked up, how long the student needs to stay home, and any expected follow-up, as needed.

The Minnesota Department of Health has partnered with the Hennepin County Medical Center to develop the Infectious Diseases in Childcare Settings and Schools Manual. This manual has clear guidance for most infectious diseases that are seen in schools. The manual includes fact sheets about the condition, incubation period, and symptoms, how long students are typically contagious and how long they should stay out of school. This tool has been developed using the most up to do date best practices and it is highly recommended that schools follow utilize this resource. The manual also provides general guidelines for the care of the student, who presents to the office with symptoms but not a diagnosis to help decision making as to whether the student could remain in school or does need to go home.

The Centers for Disease Control and Prevention released updated information (May 2024) about when to keep students' home for illness, returning to school, and use of personal protective equipment.  The guidance can be found at CDC: When Students Staff are Sick.  Key elements from the CDC guidance are:

Schools, parents, and caregivers often do not know what specific illness a child may have; rather, children present with symptoms. If someone has the following symptoms, they should stay home because their illness could affect their ability to participate in school and there is concern that they might spread an infection to staff and students.

• Fever, including a fever with a new rash
• Vomiting more than twice in the preceding 24 hours
• Diarrhea that causes ‘accidents’, is bloody, or results in greater than two bowel movements above what the child normally experiences in a 24-hour period
• Skin sores that are draining fluid on an uncovered part of the body and are unable to be covered with a bandage
• Respiratory virus symptoms that are worsening or not improving and not better explained by another cause such as seasonal allergies 

Documentation

The documentation of a student’s health office visit is essential for maintaining accurate student health records, ensuring continuity of care, and promoting the well-being of students. Documentation and Record Keeping is the professional responsibility of all health services personnel with expectations based on licensure and job description.   Timely documentation ensures the student health visit, and the health outcome are recorded accurately and thoroughly. It is important for those working in the health office to allow time to document promptly, especially in a busy health office. It is not recommended that health offices record health office visits in list format with multiple student names, because of data privacy.  A parent has the right to request and review all records, in which their student is named.  Providing a parent this list of student names would then violate the privacy of the other students.

Student and Staff Expectations

School Nurse and Health Office Staff Expectations

• Appropriate Use: Health Services staff expect teachers and staff to utilize and send students to the health office when appropriate after they have attempted to first problem solve or manage a minor complaint or deliver minor first aid for an injury in the classroom. This decreases the number of health office visits and increases student time in the classroom.  
• Respectful Behavior: Health Services staff expect students to behave respectfully within the health office, treating the nurse and other staff members with courtesy and consideration, including following instructions and guidelines provided by the nurse.  
• Communication: Health Services staff expect students to communicate their health concerns or reasons for visiting the health office clearly and honestly.

Student Expectations

• Accessibility: Students expect the health office to be easily accessible during school hours, with clear guidelines on when and how to visit.  
• Professionalism: Students expect the school nurse and other health office staff to demonstrate professionalism and empathy when providing care. They should feel comfortable discussing health concerns and receiving cares and procedures.  
• Confidentiality: Students expect their privacy to be respected during health office visits. They should feel confident that their medical information will be kept confidential and only shared when appropriate.  
• Resourcefulness: Students expect the health office to serve as a trusted resource for health information, guidance on managing chronic conditions, and referrals to outside healthcare providers if necessary.  

Family Expectations

• Safety and Well-being: Families expect the school health office to prioritize safety and well-being of their children. This includes providing timely and appropriate medical care for injuries or illnesses that occur during school hours, follow care plans for students with chronic health conditions, and promote and provide resources for maintaining good health.
• Communication: Families appreciate clear and effective communication from the school health office regarding any health concerns or incidents involving their children.  
• Confidentiality: Families expect that any health information shared with the school health office will be kept confidential and only shared with appropriate personnel on a need-to-know basis.  
• Collaboration: Families appreciate when the school health office works collaboratively with them, healthcare providers, and other school personnel involved in their child’s care to ensure continuity and coordination of services.
• Cultural Sensitivity: Families expect the school health office to be sensitive to cultural differences. This includes being willing to understand and respect different cultural perspectives, avoiding making assumptions based on stereotypes, communicating with families in a way that respects their cultural norms and preferences, provide educational materials and resources that reflect the cultural diversity of the student population, and to provide care that is respectful of their beliefs and practices.  
• Advocacy: Families expect the school health office to advocate for the health and well-being of all students, including promoting policies and practices that support a healthy school environment.  

Staff Expectations

• Assistance for Students: Staff expect the health office to provide prompt and effective assistance to students who become ill or injured during the school day.  
• Emergency Response: Staff expect the health office to play a key role in emergency response planning, coordination, and response to an event.  
• Communication and Collaboration: Staff expect communication and collaboration with the health office regarding student health issues they need to know about, including support or necessary classroom accommodations to support students with special health needs or medical conditions and any follow-up care staff needs to be aware of such as monitoring for signs and symptoms of a worsening injury or condition.