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Communicating Health Messages
A. COMMUNICATING WITH SCHOOLS AND SCHOOL BOARDS
1. The School Nurse
The school nurse is often the most natural link with the school the pediatrician can make. School nurses occupy unique roles because they are often the only health care professionals at the school site, and they can provide pediatricians with valuable information on many issues. The school nurse can communicate with the pediatrician as a colleague in the health professions and help translate important medical information from the pediatrician to the school. As a school employee, the school nurse has information and expertise that the pediatrician may lack.
Pediatricians should communicate with school nurses on the following critical issues:
The scope and organization of health services offered within the school.
One school nurse may serve several schools over a wide geographic area. When the school nurse is not present, duties may be delegated to anyone from a school principal or secretary to a health assistant who may not have any formal health care training. Pediatricians can learn from school nurses how and when it is best to interact with the school on health issues.
The health of the general student population.
School nurses have a unique vantage point. They are able to observe the student population on a day-to-day basis and help identify public health concerns and other trends that may affect health or behavior.
The health of specific patients and their behaviors while in the school setting.
Students with health
or family problems are often able to approach school nurses at their convenience.
While these students' visits with the pediatrician may seem routine, their
interactions with the school nurse can be significantly different and
quite revealing. In addition, the school nurse interacts with teachers
and other personnel who can help gather additional information on the
health and behaviors of individual students.
The need for school health programs and services in general.
The school nurse appreciates the importance of providing children and adolescents with appropriate medical care and can help the pediatrician advocate for services and policies within the school.
The school health education curricula.
The school nurse may be familiar with the health education curricula-may even be teaching them-and can help the pediatrician reinforce health messages during office visits.
Issues of concern to school administrators.
The school nurse may be able to explain to the pediatrician various concerns the school may have about fulfilling the pediatrician's orders. In addition, the school nurse may have information on staffing arrangements or school budgets that can help the pediatrician determine the most appropriate orders. The school nurse can give insight into the concerns of the school administrator or the school boards and help all parties arrive at a reasonable solution to potential dilemmas.
What areas of the school health program or services need improvement, and which issues most require pediatrician involvement?
Inclusion, delegation of care, substance abuse, sexually transmitted diseases, do-not-resuscitate orders, eating disorders, depression and suicide, technology-dependent students, diabetes, asthma, epilepsy, environmental conditions, immunizations . . . school nurses face all these issues, often alone and often with thousands of students in their care. Pediatricians and other health care professionals in the community should work with the school nurse to make sure the nurse has support.
2. The School Administrator
School administrators include school principals and assistant principals, as well as district superintendents and assistant superintendents. Administrators set the tone for the school community and are key in communicating with parents and the greater community. Without their participation and commitment, sustained implementation of any program rarely occurs.
Administrators are ultimately responsible for the physical, emotional, social, and educational environment in a school building and throughout the district, but they often delegate responsibilities to individual staff members or committees. The school principal is an opinion leader who can support programs within a school through direct words and actions. The principal is the direct link between the school and the district office and can often help secure needed fiscal and human resources, as well as administrative support.
The pediatrician should
always communicate with appropriate administrators before solidifying
plans. If working with just one school, start with the principal. If working
with multiple schools, start with the district administrator.
Decide specifically how you want to become involved.
- Health advisor or /consultant
- Sports team physician
- Recipient of referrals
- Communication link for parents on health issues
- Promoting wellness programs and health education
Determine what the administrator wants from you.
- Consulting with the school nurse
- Encouraging collaboration among community physicians
- Establishing more contacts with the school
- Writing health alerts or bulletins
- Donating time for physical examinations for sports and other purposes.
If appropriate, draw up a contract and agree on payment for services.
Establish specific times for ongoing communication.
- With whom?
- How often?
- How? By meeting, phone, letter, e-mail?
3. The School Board Member
School boards and school board members are as diverse as the communities they represent. All, however, have one thing in common - wanting the best education possible for the children. The pediatrician should help them understand that this includes a healthy mind and a healthy body.
Pediatricians should be familiar with some basic facts about school boards and their members.
- School board members are primarily volunteers or unpaid public servants.
- The school board operates as one unit, and its members have no individual power outside the boardroom.
- The school board is a policy-making body and, as such, is influenced strongly by state and federal laws. Its operations are also strongly affected by local mores, customs, and attitudes, however.
Pediatricians can make the following efforts to develop productive relationships with school boards and to impress on them the importance of student health and safety:
- Holding meetings with the local school board or speaking with individual members to identify local health issues that affect school children.
- Asking to present a session to the school board on critical health issues affecting the district's school children.
- Offering to work with the school board to find solutions for key local health problems such as obesity, violence, tobacco use, and teen pregnancy.
4. The Parent and the PTA
The National Parent/Teachers Association (PTA) works to support and speak on behalf of children and youth inthe schools, communities, and government. The PTA supports reforms that partner school staff, community members, and parents in implementing educational improvements that meet local needs. The pediatrician can work with the PTA by effectively educating parents, schools, and communities about child health, safety concerns, and prevention activities. The pediatrician can also work with the PTA and the school by taking the following actions:
- Staying current on the local issues within the community and the local schools.
- Learning about national PTA programs and initiatives that can be successfully implemented within the school or the community.
- Encouraging parents to become instruments of change within the school as members of the local PTA.
- Encouraging parents to learn about and influence school policies that may affect their children's health and education.
- By holding workshops or training programs, assisting parents in developing the skills they need to raise and protect their children
- Supporting funding for public schools, after-school programs, and educational programs that will improve the health, safety, and education of children.
- Encouraging parents, community members, and schools to work together for the education of children.
